Inspection on 28/09/05 for 25 Raynton Close

This inspection was carried out on 28th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

25 Raynton Close 08/11/06

25 Raynton Close 25/01/06

25 Raynton Close 25/02/05

25 Raynton Close 28/07/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 25 Raynton Close 25 Raynton Close Rayners Lane Middlesex HA2 9TD Lead Inspector Clive Heidrich Unannounced Inspection 28th September 2005 08:10 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 Page 1 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 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 Page 2 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 Stationery 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. 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 25 Raynton Close Address 25 Raynton Close Rayners Lane Middlesex HA2 9TD 0208 868 3174 01895 638 974 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ms Santa Bapoo Ms Santa Bapoo Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25/2/05 Brief Description of the Service: 25 Raynton Close is a registered care home providing personal care and accommodation for a maximum of 4 adults who have learning disabilities. All service users at the time of the inspection were male. There were no vacancies at the time of the inspection. The Registered Provider/Manager is Ms Santa Bapoo who is similarly registered in respect of the two other care homes in her organization. She is referred to as “the owner” in this report. The home is located in a quiet residential cul-de-sac in Rayners Lane, close to shops, pubs and other community amenities. Parking is available on the road outside the home. All the home’s bedrooms are single, and none have en-suite facilities. Two are upstairs along with the sleep-over room for staff, whilst two are downstairs. Access upstairs is by stairs only. The home also has a spacious lounge, a dining room, and toilet & bathing facilities. The home has a garden to the rear that is reasonably maintained. It is accessible via some steps from the house. 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place across a cool morning in September. It lasted until 11am. The inspector met with all the service users and two staff members including a senior staff member who was able to answer most questions in the absence of the manager/owner. Additionally, some records were checked, care practices were observed, and most of the home’s environment was inspected. The four service users went out to their day service at around 9:30am. The manager/owner provided some paperwork in support of the inspection in the few days after the visit. The inspector thanks all at the home for their patience and helpfulness throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: There are not many requirements in this report. There are a few that relate to maintenance issues that must be addressed regardless of the outcome of redevelopment plans to the structure of the building. A tumble-drier is required, to enable service users’ clothing to be more easily dried. There are also minor improvements needed to the home’s overall medication systems. Please contact the provider for advice of actions taken in response to this 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 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 the following standard(s): None of these standards were assessed on this occasion, as there has been no new service users move into the home since the last inspection. EVIDENCE: 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 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 the following standard(s): 6, 8, 9, and 10. Service users’ needs and goals are reflected in their review meetings and care plans. These include broad risk assessments. Service users are enabled to take considered risks within their lives. Service users are involved in all aspects of the home life relative to their abilities and needs. Personal information about them is kept confidential. EVIDENCE: Service users spoke positively overall about the care and services that they receive. Checks of two of their files showed that each service user has a sufficiently broad care plan about their main needs and how these will be addressed. They have benefited from formal review meetings that are also attended by family and day centre representatives as applicable. Care plans include risk assessments that are usefully broad in their outlook. Feedback, particularly from one service user and the senior staff member, showed that service users are enabled to take considered and individual risks in such areas as going out alone, smoking, and handling money. 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 Page 10 Service users’ records were stored securely during this visit. Service users benefit from weekly meetings at which their influence on how the home operates, especially in terms of menus, activities, and complaints, is gained. Staff also gave examples of how individual service users assert themselves within the home. 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 12, 13, 14, 16 and 17. The service users in this home take part in many appropriate activities relevant to their age, culture and needs, both within the community and in the home. Service users confirmed that they receive suitable meals in the home. Their rights are respected and responsibilities recognised within how the home operates. EVIDENCE: Discussions with the service users found that they continue to attend a local day centre throughout the week. The service users spoke of the individual pursuits that they follow through the day centre, such as playing football and college attendance, and that they are happy to continue attending. They also individually spoke of attending recreational clubs on some evenings, going shopping locally, and of going to church. Feedback from the senior staff member established that there have been slight improvements overall to the support of service users in the community, such as with one service user now going out regularly to play pool in a local pub. It is also recognised that this and other activities are not liked by all service users in the home and hence 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 Page 12 there is often a second staff member present to stay at home with other service users whilst the community activity takes place. Holidays were discussed with the service users and staff. A date has been fixed for the service users to go on holiday this year, following some complications over the summer, but there were varying opinions amongst the service users, recognised by the staff, as to where to go. A compromise is being sought. It is recommended that ways of enabling two separate holidays, based on service users’ differing requests, be enabled. Feedback from service users about the food in the home was positive. Most were having breakfast of jam on toast at the start of the visit. There was a reasonable amount of food available in the home, including healthier foods such as fruit and vegetable items. Service users confirmed that they choose the menus that are set for the week ahead. Records from the service users’ meeting minutes confirmed this. Observations showed that service users are able to treat the home as their home. They were able to come and go throughout the home as they pleased and without undue staff attention. One service user in particular undertook most of the washing-up after breakfast. Service user meetings make plans to ensure that all service users have their say in how the home operates and in being responsible for domestic tasks. 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 18, 19 and 20. Service users receive personal support based on their individual needs. Their health needs are generally supported to be met. Some improvements are needed to the medication systems, but there are no concerns about service users receiving sufficient support with their prescribed medications. EVIDENCE: Those service users asked reported that they have sufficient clothing. Their appearances were individual and reasonable. They made clear decisions about what they wore. One service user made a point of showing the inspector his new glasses. Care files showed that individual service users are generally supported to attend standard health check-ups as needed. One exception was highlighted to the senior staff member for appropriate action. The files also showed that particular health needs are addressed through specialist support, and that appropriate staff support for such appointments is considered in advance. Service users are supported by staff to take prescribed medications. These medications are supplied within individual pre-packed dosette boxes from a local pharmacist. Administration checks found no concerns, and that staff are able to support with more complicated prescriptions such as every-other-day medications. Some periphery medication issues are listed within the 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 Page 14 requirements, to ensure that all aspects of the medication system are sufficiently robust. 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 22 The systems in place in the home enable service users to raise concerns and complaints and have them addressed. EVIDENCE: The home has an established complaints systems. The complaints book had no entries. Service users’ concerns are asked for and discussed within the weekly service users’ meeting, according to feedback and records. The service users themselves had no complaints to raise during this visit. 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 Page 16 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 the following standard(s): 24, 27, 28 and 30 The service users’ home is generally a comfortable and homely environment. Plans are in place to redevelop parts of the home. There are a few maintenance issues that must be addressed. Service users are provided with sufficient toilets and bathrooms, and communal areas. The home is kept clean and hygienic, but needs a replacement tumble-drier. EVIDENCE: Following a small fire in the home during late February, the local council’s environmental health department visited the home on a couple of occasions during March and April. The letter of the April visit shows that their concerns have been mainly addressed through the actions of the manager. Since the fire, there has been no tumble drier used in the home. Whilst this may have been manageable during the warmer months of the year, a new tumble drier will be needed to manage laundry during the winter months. The senior staff member said that this was being planned for. There was little evidence of the effects of the fire, in the affected areas of the laundry room and the adjacent toilet, during this visit. The exception is the 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 Page 17 broken and malfunctioning extractor fan in the toilet, which is recommended for immediate replacement. The senior staff member noted that there are however plans to redevelop parts of the house, the plans for which will depend on a final application to the local borough’s planning department. Once decisions are made, poor quality maintenance issues such as the worn carpet on the stairs will also be addressed one way or the other. The service users reported no concerns with the warmth of the home. It was suitably warm during this visit. The service users also pointed out that they have had a new, large television in the lounge since the last inspection. The toilet and bathroom upstairs now have override devices that allow staff access in cases of emergency. The inspector noted that the light bulb in the darkened walkway between the dining room and the laundry area was missing. As there are items stored in this area, and both service users and staff use it, it must to be kept permanently lit. On entry into the home, the inspector found that the inner front door’s handle was not secure and liable to partially fall off. This was pointed out the senior staff member for addressing. She noted that it had previously been fixed. The glass-door side exit into the garden from the back hallway needs to be able to open smoothly. It needed a lot of force to open it, and is hence not an exit for service users. 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 Page 18 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35 and 36. Service users are supported by a competent and qualified staff team. There are sufficient staff working in the home to meet service users’ identified needs. Staff benefit from appropriate management support. EVIDENCE: Service users spoke positively about the staff in general terms. The morning staff member was helpful to service users, and spent a lot of time cleaning. It was clear when the senior staff member arrived that some service users have a positive relationship with her. The rosters for recent weeks were seen. One staff member works at all times of the week except for when the service users are at the day centre. A second staff member works on Wednesday and Friday evenings, as well as at various times across the weekend. Staffing levels are therefore upheld. The home uses only those staff employed by the organisation, not agency. There were four people working on the roster, in addition to the manager. These minimal numbers of staff enable service users to become familiar with the staff, as was observed to be the case during the visit. Feedback and records showed that two of the four staff that work in the home have achieved NVQ qualifications in care, both above the minimum level-2 standard. Most staff have undertaken structured induction that include LDAF components. The senior staff member confirmed that the two newer staff 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 Page 19 members are working through an approved and recorded induction programme. The senior staff member provided written evidence of supervision sessions being in place for staff on a regular basis. Records also showed that staff meetings are held regularly. 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 Page 20 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 and 42 Service users’, and their representatives’, views are audited as part of the home’s development programme. The health and safety of service users and staff is protected through a number of professional and internal checks, with the exception of one identified issue. EVIDENCE: There was written evidence of a quality audit survey having been undertaken during the early summer of 2005. This involved service users, their representatives, and staff being asked a set of written questions. Feedback within these was almost entirely positive. A quality audit check of the home was also recorded about for Spring 2005. It checked on essential house and work systems and provided a plan for the direction of the home across the next year. It is recommended that both audits are summarised into one brief report that is made available to service users and their representatives, so as to provide summary and consistent feedback to all people involved in the home. 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 Page 21 Professional health and safety checks were evident in almost all the areas requested during this visit. This includes for the gas, portable electrical appliances, and fire equipment. Only a copy of the electrical wiring certificate is needed, to show that a suitable professional has judged this wiring as safe. Monthly fire safety, maintenance, and general health and safety, checklists are being used by staff in the home. The checks help to identify and address necessary actions. Staff checks of the fire systems and the water temperatures from hot taps were seen to be in place and suitable. These latter checks should be expanded to include the bath, not just sinks. The fire notice in the hall should explain where the fire assembly point is. 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 Page 22 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 X X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X 3 3 X 2 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 X 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 25 Raynton Close Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score X X 3 X X 2 x DS0000017556.V249886.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? Yes 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. Standard Regulation Requirement Medications received from the pharmacist must be checked and signed-in (quantity, date, and signature for each medication) on the medication administration form. To compile a list of signatures and initials of staff trained to administer medicines safely. (Previous timescale of 1/4/05 not met) The manager must ensure that light bulbs are promptly replaced where needed in the home, including in the dining room and the hallway outside the downstairs toilet on this visit. The stairway carpet was seen to be worn in a number of areas during this visit, as at the previous inspection. It must be replaced. The inner front door handle was loose and liable to fall off. It must be suitably repaired. The side exit to the garden, from two service users’ bedrooms, was seen not to work. This must be addressed. DS0000017556.V249886.R01.S.doc Timescale for action 1 20 13(2) 01/11/05 2 20 13(2) 01/12/05 3 24 23(2)(p) 10/10/05 4 24 23(2)(b) 01/12/05 5 24 23(2)(c) 15/10/05 6 24 23(2)(c) 01/11/05 25 Raynton Close Version 5.0 Page 24 5 30 16(2)(e) (Previous timescale of 14/4/05 partially met) A new tumble-drier must be promptly installed in the home for use. The owner must ensure that a professional re-test of the electrical wiring in the home takes place. A copy of the certificate for this must be sent to the CSCI. (Previous timescale of 1/6/05 not met) 01/11/05 6 42 13(4), 23(2)(c) 01/11/05 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 14 Good Practice Recommendations It is recommended that ways of enabling two separate holidays for this year, based on service users’ differing requests, be enabled. The broken and malfunctioning extractor fan in the downstairs toilet is recommended for immediate replacement. The location of the laundry area remains poor in terms of laundry having to be taken through the kitchen and dining areas to reach it. This should be considered as part of any extension work undertaken. It is recommended that the quality audit work undertaken earlier this year be summarised into one brief report that is made available to service users and their representatives, so as to provide summary and consistent feedback to all people involved in the home. Hot tap water temperature checks should be expanded to include the bath, not just the sinks. 2 24 3 30 4 39 5 42 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 Page 25 6 42 The fire notice in the hall should explain where the fire assembly point is. 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 25 Raynton Close DS0000017556.V249886.R01.S.doc Version 5.0 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!