Inspection on 11/08/05 for 8-10 Richmond Road

This inspection was carried out on 11th August 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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

8-10 Richmond Road 19/12/08

8-10 Richmond Road 27/12/07

8-10 Richmond Road 03/07/07

8-10 Richmond Road 09/01/07

8-10 Richmond Road 01/12/05

Similar services:

Trevayler Residential Care Home

Thornham Grove

Thistle Hill Hall

Conifer Lodge

Westwood Lodge

Egerton Lodge Care Home

Alfred Minto House Care Home

St Matthews Unit

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

CARE HOME ADULTS 18-65 8-10 Richmond Road Lincoln Lincolnshire LN1 1LQ Lead Inspector Julie Western Unannounced 11 August 2005 09.30 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. 8-10 Richmond Road C53 C04 S62565 Richmond Road V243307 110805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 8-10 Richmond Road Address 8-10 Richmond Road Lincoln LN1 1LQ 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) 01522 887123 Mrs Jill Ross Mrs Hayley Stephens Sheila Conlon Care Home 12 Category(ies) of Mental Disorder (MD) - 12 registration, with number of places 8-10 Richmond Road C53 C04 S62565 Richmond Road V243307 110805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered to provide care for service users of both sexes whose primary needs fall within the following categories:Mental Disorder, excluding learning disability or dementia (MD) - 12 Date of last inspection 7/10/04 Brief Description of the Service: 8-10 Richmond Road is a care home providing personal care and accommodation for 12 younger adults with Mental Health needs. On the day of the inspection the home was fully occupied. The home was opened in 1993 and is owned by Mrs Stephens and managed by the registered manager Mrs Mary Conlon. It is located in a residential area of Lincoln city centre and is within easy walking distance to the city centre and all the amenities the city has to offer. The building consists of a pair of two-storey late Victorian terraced houses connected via an internal corridor. An extension has been added to number 10 to afford more communal space on the ground floor. Accommodation is in 10 single bedrooms and one double room; number 8 accommodating five residents and number ten accommodating seven. Each house has its own kitchen and laundry, but facilities are shared freely between the residents. The home has small frontage gardens and small, steep interconnected rear gardens; these are maintained by the service users. There is no designated car parking area. 8-10 Richmond Road C53 C04 S62565 Richmond Road V243307 110805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 4 hours. A partial tour of the building took place and care records were inspected. The main method of inspection used was called ‘case-tracking’; this involved selecting three residents and tracking the care they received through the checking of their records, discussion with the residents and care staff and observation of practices. Some policies and procedures were examined and records concerning the safety of the home were also seen. Three of the twelve residents and two of the care staff were spoken with. The Assistant Manager Denise Foster, was present throughout the inspection. What the service does well: What has improved since the last inspection? The ongoing maintenance programme has recently included redecoration of the hallway and the redecoration of the bathroom and toilet in number 10, and new flooring to the kitchen and a new lounge carpet in number 8. All bedroom doors now have locks. Care plans now contain clear risk assessments. Staff are now supervised on a three-monthly basis. 8-10 Richmond Road C53 C04 S62565 Richmond Road V243307 110805 Stage 4.doc Version 1.40 Page 6 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. 8-10 Richmond Road C53 C04 S62565 Richmond Road V243307 110805 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 8-10 Richmond Road C53 C04 S62565 Richmond Road V243307 110805 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) 1,2,4,5 The home clearly sets out what it intends to do for its residents and this information is freely available. The statement of purpose needs to be updated and assessments would benefit from being more in depth. EVIDENCE: There is a comprehensive statement of purpose, which tells the resident and their relatives what they can expect from the service and that there will be an assessment process to undertake prior to a service being provided. This needs to be updated in general. The service user guide is very comprehensive and contains much information for residents, especially on the availability of various support groups for mental illnesses in the area. Assessments prior to admission are in each resident’s care records and showed that residents, their relatives and other professionals were involved and contributed to the care plans. The home demonstrates its capacity to meet identified needs by way of staff training and the conduct and management of the home. The most recent resident confirmed that she had stayed in the home for a weekend before making the decision to move permanently. 8-10 Richmond Road C53 C04 S62565 Richmond Road V243307 110805 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) 6,7,9,10 Service users benefit from a person centred approach to care and support, which enables them to develop their independence in a safe and supported manner. Risk assessments are detailed and clear. EVIDENCE: Care plans seen contained details about how residents expressed their needs and showed that they were encouraged to make decisions for themselves wherever they were able. Assessments would benefit from being in more detail to include information about meaningful education, training and/or occupation, family/social contact and compatibility with others living in the home. Staff members demonstrated that service users were encouraged to make decisions as part of the everyday support offered; for example residents were asked what they wanted to do and what they wished to eat. Risk assessments were contained in care plans and were comprehensive. All records were kept in a lockable cupboard and staff demonstrated their understanding of confidentiality issues throughout the inspection. 8-10 Richmond Road C53 C04 S62565 Richmond Road V243307 110805 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) 11,12,14-17 Service users enjoy a full and appropriate range of activities both in the home and in the local community. They benefit from the promotion of self-help skills; and clear care records underpin the care and support provided. Meals reflect the choice of residents and provide a balanced diet. EVIDENCE: On the day of the inspection three residents were going to Horncastle with the Contact Group, part of the registered charity The Volunteer and Contact Association, four were going to the De Wint centre, one was going out for a walk, one was visiting parents and three were staying in the home. Two residents spoke of the holidays in Caister-on-Sea near Yarmouth they had all recently enjoyed, when they stayed in three static caravans. There was evidence in care notes of leisure activity such as coffee mornings, meals out and visits to pubs. Service users were encouraged by staff to undertake activities such as shopping, cleaning their rooms, cooking and ironing. Most residents had complete freedom to come and go as they pleased as long as they informed carers. Records demonstrated that menus are based on residents’ needs and preferences; two residents were diabetics and one was on 8-10 Richmond Road C53 C04 S62565 Richmond Road V243307 110805 Stage 4.doc Version 1.40 Page 11 a low fat diet and there was always a salad alternative to the main meal, which was held at 5pm. Those residents who went out all day usually had a pack-up meal of their choice. Residents said they enjoyed the food provided and some assisted with preparing the evening meal. The atmosphere at breakfast was relaxed and informal, with most residents preparing their own food and drinks in the two kitchens. Recent events included a sponsored walk for the Tsunami in July and a barbeque last week. Residents are currently saving to go out for a meal, a regular occurrence. Care plans showed that some residents had regular contact with relatives, including trips home at weekends. Relatives were encouraged to take part in events such as the barbecues. A daily log gave details of residents’ daily activities. 8-10 Richmond Road C53 C04 S62565 Richmond Road V243307 110805 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) 18-21 The home’s records give a clear picture of the personal and health care needs of residents and enable staff to meet their needs with sensitivity and regard for their privacy and dignity. EVIDENCE: All residents in the home were fully mobile; however personal care was given in the form of assistance with showering for one resident. The Assistant Manager confirmed that a good working relationship was in place with the local surgery, which some residents visited regularly for DEPOT injections. Accident records showed that there had been no serious injuries to resident in the last twelve months. The most recent visit from the pharmacist was 22/6/05 and there were no issues from this. Several residents were self-medicating and these were recorded clearly on MAR sheets. The home used a blister pack or dosette box system to administer medication and only senior carers were able to carry out this duty. The home was supported by assistance from CPN’s and other health care professionals where necessary. 8-10 Richmond Road C53 C04 S62565 Richmond Road V243307 110805 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 The home’s complaints procedure is clear and gives residents and their relatives the confidence that comments and concerns will be listened to; there is a robust adult protection procedure. EVIDENCE: The compliments concerns and complaints book showed that there had been no complaints over the last twelve months. The home had an up to date copy of the Local Authority Adult Protection. Residents spoken with were aware of the complaints procedure in the home and where to access it. Care staff were knowledgeable on adult protection procedures and all had signed to say they had seen and understood the adult protection procedures. 8-10 Richmond Road C53 C04 S62565 Richmond Road V243307 110805 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) 24, 26-29 The residents live in a comfortable, pleasant and safe environment with both x private and communal space being generally suitable for their needs. EVIDENCE: A tour of the premises showed that the building was on the whole well maintained internally and the small back yard areas and gardens had chairs and tables for residents to sit out in good weather. The two steep steps leading to the upper garden at number 8 steps require a rail to be attached The Assistant Manager said that a regular health and safety check was carried out and this included a risk assessment of the building. The two houses are linked by an interconnecting area, with residents free to move between the houses. The ongoing maintenance programme has recently included redecoration of the hallway and the redecoration of the bathroom and toilet in number 10, and new flooring to the kitchen and a new lounge carpet in number 8. All bedroom doors now have locks. Residents’ rooms were well cheerfully decorated and clean. The home had two laundry areas, the larger one in number 8 was used for soiled laundry, but the Assistant Manager said that this rarely occurred within the present resident group. 8-10 Richmond Road C53 C04 S62565 Richmond Road V243307 110805 Stage 4.doc Version 1.40 Page 15 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) 31-34,36 There is an appropriately trained and supervised staff team who are able to meet service user’s needs. The home maintains appropriate staffing levels and the service users benefit from a stable and consistent team. EVIDENCE: The home benefits from having a stable staff group. Staff files contained up to date photographs and relevant information. The Assistant Manager said that supervision for staff was undertaken on a three-monthly basis. Staff members had a clear understanding of their roles and responsibilities. The residents were very positive about the care they received from the staff. One said ‘I like all the staff and they’re very helpful’. A trainee Mental Health Nurse was completing a placement at the home and said she had thoroughly enjoyed the experience and had learnt much from the staff. She thought that the residents in this home received excellent care and her tutor also thought this. Two staff members had recently completed the National Vocational Qualification at Level 2. Minutes of the recent staff meeting were available for all staff. The staff rota showed that there were enough staff numbers according to the staffing matrix and shifts were staggered to accommodate the needs of residents. All staff carried out cooking duties and a cleaner visited twice weekly to clean all bathrooms and toilets. There were no staff vacancies currently. Residents spoken with thought there were enough staff and staff confirmed this. 8-10 Richmond Road C53 C04 S62565 Richmond Road V243307 110805 Stage 4.doc Version 1.40 Page 16 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) 37-42 Residents and staff benefit from an open and supportive management approach. The home is well managed, ensuring that service user’s health and safety is maintained whilst promoting their independence. Records are well maintained. EVIDENCE: The home has a range of policies and procedures and a selection of these were sampled including infection control, health and safety, moving and handling, fire safety and Legionella controls. Risk assessments for the environment were seen and individual service user risk assessments were contained in personal files. Fire records were satisfactory; the most recent visit from the Fire Officer on 22/6/05 elicited some issues, which have since been satisfactorily addressed. Materials included in Control Of Substances Hazardous to Health regulations were stored appropriately. Questionnaires were completed by all residents and from these staff and residents’ meetings were held to address any issues. Residents’ monies were not inspected. 8-10 Richmond Road C53 C04 S62565 Richmond Road V243307 110805 Stage 4.doc Version 1.40 Page 17 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 2 3 x 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 3 3 3 3 x Standard No 11 12 13 14 15 16 17 3 3 x 3 3 4 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 8-10 Richmond Road Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 x C53 C04 S62565 Richmond Road V243307 110805 Stage 4.doc Version 1.40 Page 18 None 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 YA1 Regulation 4,16,Sche dule 1, Schedule 4[1] 13[4] Requirement The registered person must ensure that the statement of purpose in up to date The registered person must attach a rail to the side of the two steep garden steps at number 8 to prevent risk of falls to residents and staff. Timescale for action 10th October 2005 10th October 2005 2. YA24 3. 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 YA6 Good Practice Recommendations It is a recommendation that care plan assessments include information about meaningful education, training and/or occupation, family/social contact and compatibility with others living in the home. This would assist new staff and professionals from other agencies to find out about the needs of the residents. 8-10 Richmond Road C53 C04 S62565 Richmond Road V243307 110805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Unity House, The Point Weaver Road Lincoln LN6 3QN 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 8-10 Richmond Road C53 C04 S62565 Richmond Road V243307 110805 Stage 4.doc Version 1.40 Page 20 - 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!