CARE HOME ADULTS 18-65
24/26 St Johns Road 24/26 St Johns Road Redhill Surrey RH1 6HX Lead Inspector
Cathy Clarke Announced 08 September 2005 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 24/26 St Johns Road H58 S52048 24-26 St Johns Road V241882 080905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service 24/26 St Johns Road Address 24/26 St Johns Road Redhill Surrey RH1 6HX 020 7388 1266 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) RNIB, 105 Judd Street, London, WC1 9NE To be confirmed Care Home (CRH) 6 6 6 6 Category(ies) of Learning disability (LD) registration, with number Sensory impairment (SI) of places Physical disability (PD) 24/26 St Johns Road H58 S52048 24-26 St Johns Road V241882 080905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1 The requirements made at the Fire Officers visit on 9th February 2004 will be actioned within the agreed timescale. 2 The recommendations required in the planning officers report will be actioned within the agreed timescale. 3 The requirements made after the pharmacy inspectors visit will be actioned within the agreed timescale. Date of last inspection 05 May 2005 Brief Description of the Service: 24/26 St Johns Road is a home for people with Sensory Impairment and Learning Disabilities owned by the Royal National Institute for the Blind. The home is in a residential area of Redhill. All of the Service Users attend the RNIB College. Each service user has their own bedroom. The property is close to all local amenities and transport. There is a small garden to the rear of the premises.. 24/26 St Johns Road H58 S52048 24-26 St Johns Road V241882 080905 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection took place over 4 hours and was the second inspection to be undertaken in the Commission for Social Care Inspection year April 2005 to March 2006. Cathy Clarke, Lead Inspector for the service, carried out this inspection Mr. Mark Eckersley was present as the representative for the establishment. A full tour of the premises took place and documents inspected included care plans, menu plans, staff records policies and procedures. Six service users were spoken to during the inspection. Comments received from residents, general practitioners, district nurses, relatives and representatives have been included in the report. This was a positive inspection. The inspector would like to thank the staff and service users for their time, assistance and hospitality during this What the service does well: What has improved since the last inspection?
The statement of purpose and service user guide have been updated and contain details of the proposed registered manager. The proposed registered manager is awaiting confirmation of registration from the Commission for Social Care Inspection. Residents have a greater sense of ownership and staff believe in the ethos of the home, which is to provide residents with the skills, knowledge and independence to live their lives, as they would choose given the opportunity. Pipes on the rear kitchen wall next to the back door have been boxed in since the last inspection. Work has begun to clear the garden, however this will be a
24/26 St Johns Road H58 S52048 24-26 St Johns Road V241882 080905 Stage 4.doc Version 1.40 Page 6 long-term project involving residents and staff. The registered manager has indicated that it would be nice to plan different sections including a sensory garden. Decorating has started and this has lifted the spirits of the residents and staff. The dining room is in the process of being changed into an activities room and each of the residents has given ideas for the colour and design of each of the walls, reflecting their personalities and tastes. Residents very much enjoyed a holiday to a complex within a wild animal safari park in England. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 24/26 St Johns Road H58 S52048 24-26 St Johns Road V241882 080905 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 24/26 St Johns Road H58 S52048 24-26 St Johns Road V241882 080905 Stage 4.doc Version 1.40 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,4 Prospective residents have the opportunity to visit the home prior to moving in and a comprehensive assessment is undertaken. EVIDENCE: A new resident had been admitted to the home three days prior to inspection. He was in the living room with other residents playing a quiz game. The other residents made sure that he was included. Records sampled for this new resident showed that he had previously lived on the RNIB campus. Staff have begun a comprehensive assessment of his needs including a risk assessment, which is being continually updated during the assessment period. A key worker is working alongside the new resident to ascertain his abilities. 24/26 St Johns Road H58 S52048 24-26 St Johns Road V241882 080905 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 9 Service users are encouraged to take risks and make decisions, which affect their lives. EVIDENCE: The registered manager and staff are keen to encourage residents to undertake activities, which will stretch their ability and increase their independence. Risk assessments are in place and their key workers monitor residents achievements. The residents themselves are very settled and happy within the home and keen to be part of the inspection process. One of the residents likes to answer the office phone and be fully involved. Another resident ensured that the inspector spoke with the new resident in his room and called in to him to let him know that the inspector was coming. 24/26 St Johns Road H58 S52048 24-26 St Johns Road V241882 080905 Stage 4.doc Version 1.40 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,15,17 Families are encouraged to take a full part in the care of their relatives however communication could be improved. A varied diet is offered to residents. EVIDENCE: One of the residents has a girlfriend and another occasionally likes to go out with one of the residents from one of the other RNIB homes in the area. The residents have an active social life and go home to family on a regular basis. Residents have enjoyed a holiday to a wild animal safari park holiday centre in the summer. Two family members arrived during inspection to take their son home for a long weekend. Relatives would like to be more informed regarding activities and events involving the residents. One relative has commented that opportunities for parents to meet up twice per year should be encouraged. Discussion was held with the registered manager regarding the possibility of a newsletter.
24/26 St Johns Road H58 S52048 24-26 St Johns Road V241882 080905 Stage 4.doc Version 1.40 Page 11 In some instances it may be that residents do not themselves feel it is necessary to inform family of events that they are taking part in and the balance between maintaining contact and their independence, confidentiality and privacy needs to be discussed and agreed with residents. Meals are varied and the menu is planned on a Thursday evening. A vegetarian option is available. Each learner assists one to one with meal preparation. At lunchtime the residents will choose what sandwich fillings they want. Most residents will get up and make their breakfasts independently. 24/26 St Johns Road H58 S52048 24-26 St Johns Road V241882 080905 Stage 4.doc Version 1.40 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Staff support residents with personal care ensuring their independence and privacy is observed. EVIDENCE: During the inspection the manager assisted one of the residents with personal care and the necessary infection control measures were taken. Personal care was provided in the bathroom in private. The new resident to the home is being assessed to monitor his level of achievement with personal care tasks. One other resident requires assistance with shaving and at times needs prompting to rinse his hair thoroughly. A referral has been made to East Surrey Dental hospital for one of the residents who requires dental hygiene treatment. Staff assist him with dental hygiene in the home when necessary. Each resident has a key worker and during the inspection one of the key workers was assisting a resident to and from a GPs appointment. A General Practitioner and district nurse for the home have commented that staff work in partnership and communicate clearly and that there is always a senior member of staff to confer with. 24/26 St Johns Road H58 S52048 24-26 St Johns Road V241882 080905 Stage 4.doc Version 1.40 Page 13 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Policies and procedures are in place for dealing with complaints and the protection of service users from abuse, neglect or self-harm. EVIDENCE: The manager confirmed that there have been no complaints or vulnerable adult investigations since the last inspection. 24/26 St Johns Road H58 S52048 24-26 St Johns Road V241882 080905 Stage 4.doc Version 1.40 Page 14 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28,30 The home is clean and tidy and much of the premises have been redecorated. Residents have been fully included in any changes made to the home. Plans are in place to change the garden area to the rear of the property. EVIDENCE: The office has been decorated since the last inspection and the dining room is in the process of being changed into an activities room for residents. The residents have chosen a theme for each of the walls in this room. One of the residents has commented that he is looking forward to having the activities room. The home has new curtains throughout and much has been done this year to improve the décor making the home brighter. Pipes in the kitchen have been boxed in. It is recommended that where carpets are to be replaced that they are in keeping with a domestic setting and not of the carpet tile type. The carpet in room 3 is threadbare in places and must be replaced. One of the bedrooms has a tongue and groove covering to one of the walls and this stops short of the ceiling in this room leaving a gap.
24/26 St Johns Road H58 S52048 24-26 St Johns Road V241882 080905 Stage 4.doc Version 1.40 Page 15 There is a large crack in the dining room wall where plaster was falling off at a low level. This was discussed with the manager during the inspection and he informed the inspector that this has been reported to a surveyor and the maintenance team. Plans are in place to improve the garden to the rear of the premises and during the inspection the inspector discussed the ideas for a sensory part to the garden with the manager of the home. There is a loose paving stone in the garden and this must be secured. A full tour of the premises took place as part of the inspection and the home was clean and tidy throughout with no mal odours. Please see requirements and recommendations section of this report. 24/26 St Johns Road H58 S52048 24-26 St Johns Road V241882 080905 Stage 4.doc Version 1.40 Page 16 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35 All interactions observed between staff and service users evidenced a high degree of respect and skill in working with the individual service users at the home. Staffing has been reviewed and the number of staff employed increased. EVIDENCE: The staffing levels within the home have been improved since the last inspection. A peripatetic care worker has been working at the home at the weekends. One of the relatives has commented that staffing is better now. A new training manager has been appointed to the RNIB College Redhill and is responsible for the annual training programme. A training needs analysis has been carried out and each member of staff has a staff development profile, which lists the individual training programmes undertaken. The RNIB College holds the “Investor in People” Award. Refresher courses in manual handling and fire safety awareness training are required for some staff. Appraisal training has been delivered internally for both the manager and deputy manager. Training on recruitment and selection and first aid refreshers
24/26 St Johns Road H58 S52048 24-26 St Johns Road V241882 080905 Stage 4.doc Version 1.40 Page 17 are planned for November 2005. Both the manager and deputy manager are to complete their level 4 NVQ by December 2005. Please see requirements section of this report. 24/26 St Johns Road H58 S52048 24-26 St Johns Road V241882 080905 Stage 4.doc Version 1.40 Page 18 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38,42 The ethos of the home is to provide opportunities for residents to take measured risks, which enhance the level of their independence in a safe and secure environment. EVIDENCE: The manager has recently attended an interview with the Commission for Social Care Inspection and is awaiting the outcome of the registration process. Meetings are regularly held with the maintenance manager. The service is using the probationary service to decorate the home. The probationary service is responsible for ensuring that probationers are vetted prior to working in the home. There were no specific problems identified in the Environmental health officer’s report of March 2004. Pat testing of electrical equipment was carried out in January 2005. 24/26 St Johns Road H58 S52048 24-26 St Johns Road V241882 080905 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score x x x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score x x x x 2 x 3 Standard No 11 12 13 14 15 16 17 x x x x 2 x 3 Standard No 31 32 33 34 35 36 Score x x 3 x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
24/26 St Johns Road Score 3 x x x Standard No 37 38 39 40 41 42 43 Score x 3 x x x 3 x H58 S52048 24-26 St Johns Road V241882 080905 Stage 4.doc Version 1.40 Page 20 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 28 28 Regulation 16 (2) (c) 23 (2) (b) Requirement The carpet in room 3 must be replaced. The gap between the tongue and groove wall panelling and ceiling in the upstairs bedroom must be filled. The wall in the dining room that is cracked with plaster coming off must be maintained. The garden to the rear of the property must be maintained to give access to service users with a visual impairment. This was a previous requirement that has not been met. Some intermediate work has taken place and an extended timescale has been given for the completion of the outstanding works. The loose paving stone in the garden must be secured. Refresher training must be provided for those staff who require manual handling and fire safety updates.. Timescale for action 31/12/05 28/02/06 3. 4. 28 28 23 (2) (b) 23 (2) (b)(o) 31/12/05 30/04/06 5. 6. 28 35 23 (2) (b)(o) 18 (c) (i) 30/11/05 31/01/06 24/26 St Johns Road H58 S52048 24-26 St Johns Road V241882 080905 Stage 4.doc Version 1.40 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 28 Good Practice Recommendations It is recommended where carpets are to be replaced that they are of a domestic type more in keeping and not of the carpet tile type. 24/26 St Johns Road H58 S52048 24-26 St Johns Road V241882 080905 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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