Inspection on 13/10/08 for Kadimah

This inspection was carried out on 13th October 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Kadimah 18/10/06

Kadimah 08/12/05

Kadimah 04/08/05

Kadimah 17/02/05

Kadimah 21/12/04

Kadimah 10/03/04

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Pinta

Kestrel House, St Anne`s Opportunity Centre,

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Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Kadimah Ravenswood Village Nine Mile Ride Crowthorne Berkshire RG45 6BQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sally Newman     Date: 1 3 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: Kadimah Ravenswood Village Nine Mile Ride Crowthorne Berkshire RG45 6BQ 01344755573 Telephone number: Fax number: Email address: Provider web address: kadimah@norwood.org.uk Name of registered provider(s): Name of registered manager (if applicable) Mr Darren Young Type of registration: Number of places registered: Norwood Ravenswood Ltd T/A Norwood care home 11 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Kadimah is part of the Norwood organisation based at Ravenswood village. The home is registered to provide accommodation and care for up to ten service users, aged between eighteen and sixty five years and one service user over the age of sixty five, those main needs arise from learning disability. The home currently provides care to eleven male service users with learning disabilities and some who have physical disabilities also. 10 Over 65 1 Care Homes for Adults (18-65 years) Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection conducted over the course of three days and included a visit to the service of five hours duration. Time was spent observing practise in the service, talking to service users, staff and the manager. A range of documentation was seen and a tour of the premises was undertaken. Information held about the service by the Commission and information provided by the home prior to the inspection was used in the formulation of this report. All outcome areas were good with two areas being judged as excellent. The last inspection of this service was carried out on 18/10/2006. No requirement or recommendations were made as a result of this inspection. Care Homes for Adults (18-65 years) Page 5 of 25 The provider has a range of policies and procedures relating to equality and diversity. From the evidence seen the inspector considers that this service would be able to provide a service that meets the needs of individuals of various religious, racial or cultural needs. No complaints have been received about this service by the Commission since the last inspection. Fees range from 43,910 to 93,898 pounds per year and does not include the cost of toiletries, hairdressing and chiropody. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective service users are provided with appropriate information, have their needs assessed and are introduced to the the service according to their needs. Evidence: The service has had one service user admitted from another home on the village since the last inspection. The documentation relating to this move was seen and provided sound evidence that a full and comprehensive assessment of this individuals needs was undertaken. The service under the direction of the manager only agreed to accommodate this service user after satisfying itself that the service could meet the needs of this individual. It was reported that this service user had settled well into the home and was gaining in confidence. It was noted that the service user guide was being developed into a more user friendly format with the use of symbols and pictures. Care Homes for Adults (18-65 years) Page 9 of 25 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users assessed and changing needs are appropriately reflected in their individual plan of care. Service users are encouraged and supported to make decisions about their lives and to take risks where appropriate. Evidence: Three plans of care were seen. All followed a uniform format and included two files. One for historical information and the other called a working file contained detailed information about the individual and included up to date support plans and risk assessments. A key worker system ensures that all paperwork relating to individual service users is kept up to date and reflects their changing needs. Documentation seen was clear, concise and detailed and provided staff with clear information about how to support the individual service user. The service is actively promoting the principles of person centred planning but all staff spoken to acknowledged that this was a lengthy process if it is to be implemented in a meaningful way. Care Homes for Adults (18-65 years) Page 10 of 25 Evidence: Reviews of plans of care are carried out internally every 3 months and formal reviews involving all significant people important to the individual are held annually. The service working on the principles of person centred planning have introduced highly individual methods of carrying out annual reviews which have the service user at the centre of the process. Examples were provided where a service user had presented his own review using pictorial records of what he had been doing and what he had achieved. This had resulted in his staying throughout the duration of the review something that he had never been able to do previously. Another example included an individual who used a similar method of presenting himself but he had decided to hold his review in the pub. His brother who attended had indicated how satisfying it was to see his relative fully participating in the process. It is the intention of the service to develop individually tailored review formats for each service user following extensive assessment of the most appropriate methods for each individual. This is seen as excellent practise. There was considerable evidence from documentation, from talking to the manager and staff and from observations of interactions with service users that decision-making is actively encouraged in this home. It was acknowledged that this is a skill that some service users needed support in developing but numerous examples were provided throughout the inspection where individual service users had been supported to try new things in line with their own aspirations and wishes. Risk assessments were detailed and individually focused. They were readily available to support staff and there was evidence from documentation seen that they are reviewed on a regular basis. Any changes are recorded with the date when those changes are made. Care Homes for Adults (18-65 years) Page 11 of 25 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users take part in valued occupational and leisure activities with their peer group and within the local community. They are supported with appropriate relationships and to maintain links with family and friends. Service users are enabled to choose from a healthy diet. Evidence: Using the principles of person centred planning the service has undertaken considerable work over the last year to ascertain the preferences and wishes of service users and to identify appropriate opportunities for them to fulfil their aspirations. Each service user has an activities programme for the week that has been developed together with them. The home accommodates individuals with a wide range of needs but is clearly flexible enough to respond to specific needs using an imaginative range of support. Examples included an individual who needed regular one to one support. Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: The manager had secured additional funding for this individual and used the services of an external agency to provide support staff for specific pieces of work. Another service user did not cope with group situations very well and so was provided with opportunities to follow pursuits more appropriate to his needs and aspirations. All service users have the opportunity to have an annual holiday according to their needs and preferences. Recent trips have included New York, Holland, Butlins and where appropriate some day trips. One service user told the inspector that he was looking forward to an upcoming holiday staying in a hotel in Devon. In discussion with the manager it was apparent that service users are supported to maintain contact with family and friends external to the home and the village. Records are kept of family contacts and significant dates such as family members birthdays. Some service users are supported to visit relatives where travel has become difficult for family members. Regular telephone contacts is supported and encouraged for those relatives living large distances from the home. It was apparent from discussion with the manager and staff that the rights and responsibilities of individual service users is acknowledged and promoted. A senior member of staff advised that she had recently held a meeting with service users where they chose different household tasks to undertaken in the home. She is developing pictorial cards to indicate each task and these will be used to communicate with and by service users when these tasks need to be undertaken. All service users have the opportunity to go out shopping and to have lunch outside the home on a regular basis. The food preferences and dislikes of individual service users was recorded within plans of care. The home caters for a number of soft diets and aims to provide a healthy and varied range of foods. It was evident from within service user meeting minutes that food is a regular topic of discussion. A pictorial menu was being introduced to enable service users to become more actively involved in menu planning. The home is awaiting an inspection of the their food safety processes by the local Environmental Health Dept and in the meantime have completed a self assessment of their food safety provision. Care Homes for Adults (18-65 years) Page 13 of 25 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users receive personal support in the way they prefer and their physical and emotional health care needs are well met. Service users are protected by the homes policies and procedures on dealing with medicines. Evidence: Of the 3 plans of care seen all contained detailed information about how individual service users were to be supported with their personal care. They gave clear and concise guidance for staff on the preferences of service users and how to ensure a calm and positive experience for those individuals likely to challenge the service. Staff spoken to demonstrated a clear understanding of individual preferences with regard to personal support. Daily routines such as bed times and meal times are flexible according to individual needs and preferences. One service user likes to get up midmorning and needs this time to rest for health reasons. Therefore this individual has his breakfast and lunch later than the majority of other service users. All service users have regular health checks and any changes in health care needs are acted upon by staff without delay. It was evident from discussions held and from Care Homes for Adults (18-65 years) Page 14 of 25 Evidence: documentation seen that a range of health care professionals have been consulted to meet the needs of service users and to enhance their lifestyle and well being. These have included Occupational Therapy, Physiotherapy, Psychology and General Practise. The arrangements for medication are supported by robust policies and procedures. All staff designated with the responsibility of administering medication have received appropriate training. The arrangements within the home were inspected by the local Primary Care Trust on 6.2.08 where they concluded that all the relevant standards were met. It was noted that support plans contained detailed information about the medication requirements for each service user including how the administration was to be performed. Care Homes for Adults (18-65 years) Page 15 of 25 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users have their views listened to and are protected from abuse, neglect and self-harm. Evidence: The organisation has a robust complaints policy and procedure. The manager is compiling a more user friendly complaints procedure in order to enable service users to indicate their dissatisfaction or to raise a concern. The manager produced a draft of this procedure that he intends to implement once he is satisfied with the content. The complaints log was seen and contained no entries. There is an expectation that all staff attend Protection of Vulnerable Adults training to ensure their understanding of the potential for abuse and the procedure to be followed if abuse is suspected. One staff member spoken to was waiting to attend a formal course. However, he had covered Protection of Vulnerable Adults issues as part of his induction training and he demonstrated a sound understanding of the principles and the procedure. Care Homes for Adults (18-65 years) Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from a homely, safe and very comfortable environment that is maintained in a clean and hygienic condition. Evidence: A tour of the premises was undertaken. The home throughout is appropriately decorated and well maintained. Bedrooms were seen and had been decorated and furnished according to individual needs and preferences. The communal space consists of a large lounge a separate quiet multi-purpose room and a dining room. The kitchen had been refitted this year and one assisted bathroom had new non slip flooring fitted. The inspector was informed that finance had been secured for a large downstairs toilet to be converted into a wet shower room. This would be particularly beneficial to the current wheel chair users in the home. The garden is spacious and staff confirmed that it is well used be service users. There is a designated laundry area and a large locked cupboard acts as storage for all the cleaning materials. The COSHH file was seen and contained relevant information sheets relating to all the produces used in the home. Throughout the home was clean, tidy and fresh smelling. Care Homes for Adults (18-65 years) Page 17 of 25 Care Homes for Adults (18-65 years) Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are supported by competent, well-trained and qualified staff and are protected by the homes recruitment policies and practises. Evidence: The organisation provides a comprehensive and far ranging training programme that includes National Vocational Qualification training, specialist learning disability awards and core training such as moving and handling, fire awareness, medication, first aid and protection of vulnerable adults. More specialist training is also provided including epilepsy, dementia and end of life care. There is a designated member of staff whose responsibility it is to oversee the staff training arrangements for the home. The training department is highly regarded and provides regular up to date information about individuals who may be due for refresher training in particular subject areas. The training record was seen but was not audited. Each member of staff has an individual training record that contains their certificates. It was noted that of the 16 permanently employed staff 11 have achieved NVQ 2 and a further 4 are working towards this award. Observations undertaken throughout the course of the inspection confirmed that positive relationships exist between staff and service users. Service users were seen to Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: be supported appropriately and staff were clear about their roles and the expectations of them. Staff spoken to indicated that they felt well supported and that communication between the three teams operating in the home were good. Team meetings are well attended and minutes confirmed that a wide range of topics are discussed. The Organisation has a robust recruitment system that is administered centrally. Evidence was accepted from information provided by the service and from knowledge of the Organisation that no staff member commences employment within the home without having provided all the necessary documentation as dictated by the regulations. One current service user from the home is involved in the recruitment of staff for the village. The manager has developed a wish list for the home using the individual wish lists of service users to demonstrate the requirements of the home to ensure that prospective staff are clear about the homes expectations. Care Homes for Adults (18-65 years) Page 20 of 25 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home is well run and in a manner that reflects the views of service users. The health, safety and welfare of service users are promoted and protected. Evidence: The manager is qualified having achieved an NVQ 4 and the Registered Managers Award. Staff spoken to highly regarded their manager and he was described as approachable, service user orientated and fair. The manager has been working on a formal system of obtaining service user views and has implemented a questionnaire containing a range of questions about the experience of living in the home. The inspector was shown the results so far and was informed that the manager intends to repeat the exercise so as to ensure and accurate picture is obtained. He had also been working on surveys for the relatives of service users but considered that they required further work before sending them to relatives. It was the intention of the manager to incorporate these results into their annual development plan for appropriate action. The service is monitored through the monthly proprietor Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: visits and obtains feedback from annual reviews and from regular service user meetings. The health and safety records were seen. A wide range of checks is undertaken and includes hot water outlets, fridge and freezer temperatures, fire alarm tests and fire fighting equipment, portable appliance tests, mains electrical testing, gas safety and legionella tests, and servicing of the lift and lifting equipment such as assisted baths and hoists. The accident record was seen and included falls and slips relating to the increasing age of the current residents of the home. Care Homes for Adults (18-65 years) Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 25 of 25 - 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!