Inspection on 08/11/06 for 25 Raynton Close

This inspection was carried out on 8th November 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

25 Raynton Close 25/01/06

25 Raynton Close 28/09/05

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 Andreas Schwarz Key Unannounced Inspection 8 & 9th November 2006 08:15 th 25 Raynton Close DS0000017556.V318142.R01.S.doc Version 5.2 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.V318142.R01.S.doc Version 5.2 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.V318142.R01.S.doc Version 5.2 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) Santa Bapoo Santa Bapoo Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 25 Raynton Close DS0000017556.V318142.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th January 2006 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 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 sleepover 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. Fees and charges can be obtained from the registered manager. 25 Raynton Close DS0000017556.V318142.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector visited the home twice for this unannounced key inspection, which lasted five hours. The inspector spoke to all service users, Deputy Manager and the registered manager visited the inspector at the Commission for Social Care Inspection office on Monday 13/11/06. The inspector sampled two care plans, three staffing files, policies and procedures and other records relating to the home. The inspector would like to take this opportunity thanking service user, the deputy manager and the registered manager for all their help and transparency during this key inspection. What the service does well: What has improved since the last inspection? What they could do better: 25 Raynton Close DS0000017556.V318142.R01.S.doc Version 5.2 Page 6 The inspector made five requirements during this visit four of the five requirements are relating to the environment, the home must be refurbished and redecorated, carpets have to be replaced, etc. The home is consulting service users and families about the care, but there is a need to produce an annual development plan for 2006. 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. The summary of this inspection report can be made available in other formats on request. 25 Raynton Close DS0000017556.V318142.R01.S.doc Version 5.2 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.V318142.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prior to being assessed appropriately, to establish if the home is able to meet the needs of new prospective residents. New prospective service users receive detailed information about the home, EVIDENCE: The home did not receive any new referrals and the current service users group has been living in the home since it was registered. The home does not have any vacancies. Original assessment documents have been archived. The registered manager informed the inspector that she has undertaken the needs assessment of the residents living at the home. 25 Raynton Close DS0000017556.V318142.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are of good quality and service users involvement is evident throughout all care plans. Residents can choose where to go, what to eat and evidence of this was observed during this inspection. The home has detailed risk assessments in place and service users are involved in the review process. EVIDENCE: The inspector case tracked two residents during this inspection and two care plans have been assessed. Care plans have been reviewed and service users have been involved in this process. The inspector was pleased to see that care plan objectives where carried out and activities chosen by the service users have been recorded in daily records. Service users informed the inspector of being aware of their care plan and having attended meetings in the past. Both care plan files viewed have been of very good standard and records have been up dated regularly. 25 Raynton Close DS0000017556.V318142.R01.S.doc Version 5.2 Page 10 The inspector observed breakfast time and has seen residents choosing their own breakfast and service users explained that they have chosen their own clothes to go to the day centre. Staff interacted with residents professionally and with respect. The home is managing service users finances and records were of good standard and correct. The inspector had difficulties understanding why large amounts have been paid for board and lodging, this was however clarified. Service users are now paying this by monthly direct debit, this is good practice and transparent. Residents are vocal and able to express their wishes, all residents informed the inspector of being happy and satisfied with living at Raynton Close. The inspector viewed two very detailed risk assessments, which have been assessed recently and have been updated to meet changing needs of the residents. The registered manager and deputy manager informed the inspector of having received planning permission for the new kitchen and some major redecoration work. While this is seen as very good for the home it is paramount that the registered manager ensures to risk assess all areas regarding the proposed building work. 25 Raynton Close DS0000017556.V318142.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is supporting residents to live a full, culturally appropriate and stimulating life. Residents can choose where to go, what to do and what to eat and are involved in the planning of activities. EVIDENCE: All residents living at the home attend local day services during the week. Service users informed the inspector that they are happy to go to the day centre and enjoy the activities offered. The inspector sampled two-day service timetables, which demonstrated suitable activities such as gardening, literacy, relaxation, etc. Care plans assessed included a written feed back from the day centre and the day centre is undertaking annual reviews, which can be attended by the home. 25 Raynton Close DS0000017556.V318142.R01.S.doc Version 5.2 Page 12 Raynton Close is close to Rayners Lane and residents informed the inspector that they regularly go shopping, to cafés, restaurants, etc. Daily records confirmed this. Staff informed the inspector of having no problems with neighbours. The home has a min bus, which is shared with another home owned by the organisation. Service users take part in culturally appropriate activities such as St Patrick’s Day, Christmas, Easter, etc. Residents informed the inspector of their holiday to the Lake District this year, which was very good and the weather was much better than the year before. Previously it was recommended to go on holidays separately, but residents told the inspector that they choose this holiday. Residents can invite friends if they wish to and service users raised no concerns of being able to contact families and friends. Records demonstrated that some families attend care plan reviews and visit the home occasionally. Residents go to evening social clubs on a weekly basis, where they can maintain and make new friendships and relationships. Residents informed the inspector of enjoying these evenings and talked to the inspector about their friends. The inspector observed the service user accessing all areas in the home and residents informed the inspector of staff knock before they enter service users rooms. One member of staff informed the inspector that one resident did not like his name shortened. The inspector observed residents sitting in the lounge together while other residents spend time in their bedroom on their own. Residents informed the inspector that they are responsible for the up keep of their rooms and laundry; daily records confirmed this. The inspector observed service users making their own breakfast, clearing the table and drying up dishes. The home has clear rules about smoking in place. The home is providing a healthy diet; service users have a cooked meal at the day centre and a light dinner in the home. Menus are discussed in weekly house meeting and service users choices are taken into account, on weekends residents have cooked breakfast, roast dinner and go to restaurants and café’s. The home is providing appropriate cultural meals for religious festivals such as Diwali, Christmas, etc. Fridge and freezer temperature is taken daily and was within the legal limits. 25 Raynton Close DS0000017556.V318142.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users health is managed appropriately and residents are encouraged to be as self-managing as possible. Residents are protected by appropriate medication procedures. EVIDENCE: The inspector viewed personal guidelines in service users files. Service users informed the inspector that the are happy how staff is supporting them around personal; care. All residents have been dressed gender appropriate and clothes were suitable for the time of the year. The home is using no technical aids. All residents have a designated key worker and clinical support can be obtained from the Harrow Learning Disabilities Team. Residents visit their GP regularly, for example on the first day of this key inspection all residents went to the GP for their annual flu jab. Records demonstrated that their dentist, chiropodist, optician and other health care professionals, has seen residents regularly. The home is monitoring service 25 Raynton Close DS0000017556.V318142.R01.S.doc Version 5.2 Page 14 users weight, which has been stable. Residents informed the inspector that they are able to see visitors such as friends, doctors, etc. in their room. The inspector observed staff administering medication, which was judged as appropriate and procedures and guidelines have been followed. Staff is using the non-touch method for medication administration. The MAR sheet had no gaps. The home is recording medication received and disposed of. The inspector recommended using the MAR sheet for this. Staff has attended medication training and certificates have been viewed. 25 Raynton Close DS0000017556.V318142.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are encouraged to raise their satisfaction and dissatisfaction of services and support received at the home and are protected from abuse neglect and self-harm. EVIDENCE: The home did not receive any complaints since the last inspection; complaints are addressed during the weekly house meeting and resolved immediately if possible. The complaints procedure is compliant with National Minimum Standards. The inspector viewed a form, which is used to record complaints, the form is judged as being appropriate. The home has a Protection of Vulnerable Adults policy in place; staff has attended Protection of Vulnerable Adults training and demonstrated good knowledge of what should be done if abuse is witnessed. The inspector noted that the home does not have the funding/ hosting borough Protection of Vulnerable Adults procedure, which should be obtained. There was no adult protection referral since the last inspection. Previous inspections raised concern regarding behaviour guidelines, guidelines viewed by the inspector have been judged as appropriate. 25 Raynton Close DS0000017556.V318142.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents live in a dated environment, which is clean and free of any offensive odours. Service users are encouraged to bring their personal possessions. EVIDENCE: The inspector had a tour of the whole premise. The registered manager informed the inspector that she has received planning permission for the building work in the kitchen. The inspector informed the registered manager that prior to work starting, she must forward a detailed action plan and risk assessment to the Commission for Social Care Inspection. The deputy manager told the inspector that the home would be redecorated when the work in the kitchen is starting. The following issues have been raised during this inspection. One of the service users room on the ground floor had a damp patch and flaky paint, which must be repaired. The carpet on the stairs is very worn and must be replaced. 25 Raynton Close DS0000017556.V318142.R01.S.doc Version 5.2 Page 17 Service users rooms have been decorated nicely and service users brought their own possessions to the home. The laundry room was clean and the home is providing a washing machine and dryer for residents to use. The home was clean and free of any offensive odours. The deputy manager cleaned the kitchen during this visit and informed service users to be careful on the wet floor, which demonstrate good understanding of health and safety procedures. 25 Raynton Close DS0000017556.V318142.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from a diverse, experienced and skilled staff team. Appropriate recruitment policies and procedures protect residents from unsuitable staff. EVIDENCE: The inspector assessed three files during this inspection, all staff assessed have their National Vocational Qualification in Care Qualifications or are in the process of working towards achieving their qualification. Staff attended a range of training such as sight loss, challenging behaviour, autism, etc. specific to the needs of service users living at the home. The home does not employ staff under the age of 18. All files viewed contained the necessary documents such as two references, Criminal Records Bureau checks, contract, application form, etc as required in National Minimum Standards. No new staff have been employed since the last inspection. 25 Raynton Close DS0000017556.V318142.R01.S.doc Version 5.2 Page 19 Staff has received a wide range of training and the deputy manager has her National Vocational Qualification in Care Level 4 and is currently doing her Registered Managers Award. Staff informed the inspector of being happy with training and development opportunities at the home. Training and development is addressed in staff appraisals and detailed training records are on file. 25 Raynton Close DS0000017556.V318142.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager is skilled and qualified to manage the home. Residents are regularly involved and consulted in the running of the home. Residents Health and Safety is not compromised and safe working practices are in place. EVIDENCE: The registered manager/ provider has not changed since the last inspection. Mrs Bapoo is experienced and qualified to manage a registered care home. Mrs Bapoo achieved her Registered Managers Award and informed the inspector that she attended different training sessions with staff since the last inspection. Staff spoke very positive about the registered manager. 25 Raynton Close DS0000017556.V318142.R01.S.doc Version 5.2 Page 21 The home has undertaken service users and family surveys, which were very positive and complimentary about the home. The inspector viewed an annual development plan done in 2005, the inspector informed the deputy manager that the home must produce an annual development plan for 2006 and forward a copy to the Commission for Social Care Inspection. Residents have regular residents meetings to discuss issues relating to the home and the care received. The London Fire and Emergency Planning Authority visited the home in March 2006 and the homes fire procedures and equipment was judged as satisfactory. The home is undertaking monthly fire drills, the fire system is checked weekly and a detailed fire risk assessment is in place. The home is undertaken monthly health and safety checks, water temperature is tested weekly and all certificates such as Portable Appliances Test Certificate, Landlords Gas Safety Certificate, and Electrical Installation Certificate are up to date. 25 Raynton Close DS0000017556.V318142.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 3 X 2 X X 3 X 25 Raynton Close DS0000017556.V318142.R01.S.doc Version 5.2 Page 23 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. Standard YA24 Regulation 23(2)(b) Requirement 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. (Previous timescales of 1/12/05 & 01/05/06 not met.) 2. YA24 23(2)(b) Mixer taps on the wash-hand basin in the bathroom were not firmly attached to the basin at their base and could hence be leant backwards significantly. This must be fixed before permanent damage is caused. 31/12/06 Timescale for action 31/03/07 3. 4. 5. YA24 YA24 YA39 23(2)(b) 23(2) 24 (Previous Timescale of 01/03/06 not met.) The damp patch and flaky paint 31/12/06 in one of the service users rooms must be repaired. The home must be redecorated 31/03/07 and repainted The home must forward an up to 31/12/06 date annual development plan to the Commission for Social Care Inspection. 25 Raynton Close DS0000017556.V318142.R01.S.doc Version 5.2 Page 24 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. 2. Refer to Standard YA9 YA14 Good Practice Recommendations It is recommended to fully risk assess any issues which may arise from the planned building work. Consideration should be given to both providing holidays to service users during the summer months and splitting the service users’ holiday locations up based on needs and wishes. The inspector recommends using the MAR sheet to record if the home receives and disposes of medication. The home should obtain Protection of Vulnerable Adults guidelines from the hosting/funding borough. Consideration should be given to installing wash-hand basins within service users’ rooms, during the impending redevelopment process, in line with recommendations under standard 26. A shower curtain should be installed on the shower curtain rail. 3. 4. 5. YA20 YA23 YA24 6. YA24 25 Raynton Close DS0000017556.V318142.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V318142.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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