Inspection on 10/04/07 for Radfords

This inspection was carried out on 10th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 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

Radfords 05/10/05

Radfords 11/05/05

Radfords 14/10/04

Radfords 11/05/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Honeybourne House

32 Beaumont Way

Stallcombe House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Radfords Main Street Broadhempston Totnes Devon TQ9 6BD Lead Inspector Peter J Wood Unannounced Inspection 10 April 2007 4:00 Radfords DS0000003785.V330295.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 Radfords DS0000003785.V330295.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. Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Radfords Address Main Street Broadhempston Totnes Devon TQ9 6BD 01803 813622 01803 813622 radfords@roc-uk.org 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) Robert Owen Communities Gary Grieve Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th October 2005 Brief Description of the Service: Radfords is a detached property situated in the centre of the village of Broadhempston, near Totnes in Devon. The residents’ accommodation is provided in three separate units - The Cottage, Hayloft (and The Flat), and the Farmhouse. There is a main office and communal rooms, converted from previous farm and barn accommodation, sited around a courtyard. Radfords is part of the Robert Owen Communities, a charity to help learning disabled people achieve their aspirations. The Robert Owen Communities has other residential facilities locally. Fees are £750.13 per week. Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over an afternoon and evening on a weekday in April 2007. The focus of this inspection was to inspect all key standards and to seek the views of residents, staff, relatives and professional visitors to the home, the latter mainly using comment cards and survey forms. At the time of writing this report three care managers, eight relatives, and all twelve residents returned the “Have your say about Radfords” survey forms. Although the manager was not on duty at the time of the inspection visit considerable time was spent with the senior member of staff on duty. This was to examine documentation, particularly that relating to client assessment, care planning and staffing. Most of the evening visit, however, was spent having tea with the four residents and three staff supporting them, washing up afterwards and later attending a house meeting of all residents and staff. Only four of the twelve residents were at Radfords as most had not yet returned from the Easter holiday with their own families. All residents present were consulted as to their experience of living at this care home. A partial tour of the building was undertaken. Most of the public areas were seen, while residents proudly showed off their bedrooms. As the manager was not on duty at the time of the inspection visit, a telephone conversation was later held with him. The Pre-Inspection Questionnaire was also examined. What the service does well: Quality in six of the eight outcome areas is excellent, quality in two of the eight outcome areas is good. This judgement has been made using available evidence including a visit to this service. The individual needs and aspirations of prospective residents are assessed in great depth prior to admission. This ensures that the home can meet resident’s needs and help them achieve their aspirations as much as possible. Residents are thoroughly assessed, from which a comprehensive care plan is generated and regularly reviewed. Residents are then encouraged, enabled, supported and empowered to make their own decisions in as many areas as possible. Residents are able to enjoy a range of activities including leisure activities as part of the local community, are enabled to have personal relationships, and are treated with respect. Meals are largely chosen by residents, with appropriate staff guidance, which allows residents to maintain control over their own lives as healthily as possible. Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 6 Residents receive personal support and assistance with their physical, health, social and emotional needs in the way they prefer and need, and are protected by the home’s medication policies. Complaints and suggestions from residents, relatives or other visitors to the home are listened to and issues resolved before becoming complaints. Residents are protected from all forms of abuse. Radfords is comfortable, clean, and mostly well maintained. However the residents’ living environment could be yet further improved upon by implementing the identified upgrading programme contained within the home’s annual report. Residents are cared for by well-trained and motivated staff in sufficient numbers to meet the needs of those currently living in the home. Recruitment processes protect vulnerable residents. This is an excellent, well-managed home for people with mild to moderate learning disabilities. Residents’ views, wishes and needs underpin all that happens here. Residents’ health, safety and welfare are well looked after. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 7 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. Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 8 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 Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 9 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): 2 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The individual needs and aspirations of prospective residents are assessed in great depth prior to admission. This ensures that the home can meet resident’s needs and help them achieve their aspirations as much as possible. EVIDENCE: Two new residents have been admitted in the past twelve months, and two have been discharged. Examination of documentation revealed that very detailed assessments are undertaken to identify prospective residents’ needs, wishes, interests and aspirations prior to admission. Trial visits are absolutely essential in this process. Residents confirmed that they had been able to visit the home, initially with their parents, and later spending an increasing length of time at the home before the decision to move in is made. Care managers are also able to check out what the home has to offer first hand before a placement is considered. A major consideration prior to accepting any new placement is the likely impact on incumbent residents. Current residents are properly consulted about any Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 10 new residents prior to their sharing their house with a new person. A couple of current residents are planning to move into a supported living arrangement together shortly, creating two vacancies. The continuing trial visits of a prospective resident was discussed at the house meeting attended during the inspection. A new arrival told about her gradual introduction into Radfords. She also was able to confirm that she was very happy at the home, had made many friends and had been given lots of new opportunities since coming to live at the home. Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 11 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): 6,7,8,9,10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are thoroughly assessed, from which a comprehensive care plan is generated and regularly reviewed. Residents are then encouraged, enabled, supported and empowered to make their own decisions in as many areas as possible. EVIDENCE: Service User (Care) Plans are comprehensive and detailed and include all stakeholders: manager, keyworker, care manager but particularly the resident him or herself. Indeed, the major planning record is called “My Life My Plan” to emphasise that the document is not only about the individual client, but is owned by the individual client. Parents are invited to some Care Plan meetings if the resident agrees. Residents are enabled to take part using the principles Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 12 of Total Communication and tools such as photos, symbols, drawings, and sign language are used as appropriate within the document, review meetings, and indeed throughout daily life at Radfords. Residents confirmed the documentary evidence seen that they take full part in their assessments and care plans, which they recognise are truly “theirs”, written in formats which each resident is most likely to understand. They are consulted on all aspects of life in the home, from menus, including special diets, to individual risks and the degree of support necessary. Residents are also able to choose, with degrees of assistance, what day opportunities they wish to undertake. Residents may be supported by a member of staff accompanying them, or by being transported, or by enabling independence by encouraging residents to use the bus, as appropriate to the individual and the situation. Residents are given lots of information, much encouragement and a great deal of practice to enable them to make their own decisions, and to link decisionmaking with consequences. Residents benefit from the home’s philosophy to balance the rights of residents to self-determination with the “duty of care” principle. The manager has a sophisticated understanding of “risk taking” which empowers residents yet ensures that risks associated with hot water, manual handling etc are appropriately managed. The home uses a range of risk assessment tools to enable residents to be individuals - to grow, develop, mature, experience life, engage in personal relationships etc in an appropriately safe environment. Parents recognise and value the support given to their grown up children: “Radfords provides a home which is secure and comfortable. My daughter is treated as an individual, provided with lots of choices and supported when she finds life difficult. She leads a life which is varied and interesting”. “They create a very warm, caring, supporting environment. A consistent bank of staff who care and get to know my son and his needs. They encourage the residents to experience as much as possible in life. The “home” plus the day services provide much more that my son could experience in our local area”. Residents trust that the management and staff act in their (i.e. residents’) best interests, including maintaining confidentiality within the professional community, including the learning disability teams. Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 13 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): 11,12,13,14,15,16,17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents are able to enjoy a range of activities including leisure activities as part of the local community, are enabled to have personal relationships, and are treated with respect. Meals are largely chosen by residents, with appropriate staff guidance, which allows residents to maintain control over their own lives as healthily as possible. EVIDENCE: To enable residents to develop is one of the main aims of Radfords. Residents have opportunities to learn and practice personal life skills such as assertion and confidence building. Personal development, equality and opportunity, community links and social inclusion are the raison d’etre of the Robert Owen Communities at Radfords. Residents vote if they wish to. Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 14 Some residents work at Aspects in Paignton or the farm nearby, both operated by the Robert Owen Communities. Residents have very full and rich opportunities evidenced by speaking to residents and staff, viewing the activity list and reading from their care files what residents have been doing. Residents are part of the local community and use local facilities such as shop, church and pubs. Broadhempston is a small village and Radfords is one of the larger employers within it. The community at Radfords is now well established and part of the wider community. Some residents and staff shop locally, and attend the local pub. Residents use local health, sports and other leisure facilities. Villagers sometimes hire the upstairs meeting room at Radfords known as Rafters. All residents pursue individual lifestyles including interests and hobbies. Radfords deliberately does not bring in a great deal of entertainment, as most residents go out to such facilities, including Enigma (previously named Rafters) nightclub in Newton Abbot which is hired by the Robert Owen Communities on the last Tuesday of each month. Residents also enjoy the disco held at Oldway in Paignton. Residents are encouraged to learn and practice music: one resident plays the cello and some others the piano, whilst others enjoy drums or violin. Residents use whatever facilities are available, designed both for people with learning disability and those for the general population, within a reasonable distance, including bowls to horse riding. The Pre-Inspection Questionnaire lists twenty-six recreational and educational facilities / activities. Residents have a holiday for which they save from their Personal Allowance, together with a contribution from the Robert Owen Communities. Staff support residents to maintain family links and friendships inside and outside the home. The families of residents are encouraged to maintain links. While some families are reasonably local, many come from far away. Every year there is a parents’ weekend when they collectively as well as individually express their views. It is apparent that parents are involved throughout the year also. Parents value the support given to their grown up children: “Our daughter’s key worker rings us regularly about her welfare and medical needs.” “Radfords caters especially well to the individual needs of the residents. It is extremely understanding and helpful about personal relationships”. “Radfords provides a secure and friendly environment. Overall we are extremely pleased”. Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 15 “Needs are different for every person and the staff work very hard to meet those needs which may change as time goes on. The constant training they receive helps this. Respects and cares well for the individual supports individual needs. Listens to individual choices. Communicates well within the care home and with relatives. Values each person and their individual skills. Builds up each individual’s confidence and helps them to improve both their strengths and weaknesses. Values healthy organic food where possible. Believes in exercise and healthy living”. “Radfords is a very individual place which works brilliantly for the residents who are happy, secure and fulfilled yet always working towards a more independent future and greater choice. Radfords helps to build up confidence and security in vulnerable people who find communication difficult and general life daunting. The residents are respected and valued and engaged in building their own future”. “Our son has thrived at Radfords. He enjoys community living and the sense of belonging that comes with it. He benefits from having a circle of friends among whom are members of staff as well as fellow residents. We would like him to have the final decision as to whether her stays at Radfords or moves”. “One of the things which attracted us to Radfords for our son was their objective at obtaining the highest level of independence practicable for people in their care. As a result, our son’s confidence in his abilities has increased. We also very much value the happy family atmosphere which prevails and the welcome we always receive”. Residents can develop and maintain intimate personal relationships and information and specialist guidance are provided to help them make appropriate decisions. Two residents who have formed a relationship whilst at Radfords are planning their move to greater independence into a Supported Living arrangement shortly. The daily routines and house rules promote independence, individual choice and freedom of movement. Staff teach and practice respect for individuals, including residents, each other, visitors etc. Staff and residents from another house use the front door bell prior to entering. All residents have a key to their own room and those who wish to and are able to have a key to the front door have one. Meals in each house are taken with staff and residents together on the same basis. All residents are encouraged to assist with domestic tasks, including look after their own room and cleaning communal areas. Cooking, washing up cleaning etc are all undertaken on a rota basis. Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 16 Radfords is a community of residents and staff. Each house prepares, serves and eats all meals in their own house. These are taken usually at table. Menus are decided by consensus, whilst residents are encouraged towards fresh, organic, healthy options. Shopping for ingredients and cooking is by staff and residents jointly under the supervision of staff. Meals can be early or late according to circumstances such as activities undertaken. On the evening of the inspection all residents and staff had their meal together, (outside to enjoy the spring sunshine) as only four residents had so far returned from their Easter holidays with their own families. Joining the community at this meal and the house meeting that followed proved an excellent and informal way to ascertain resident’s views of living at the home. It was also a good opportunity to ascertain staff’s views of working at the home. Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 17 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): 18,19,20 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents receive personal support and assistance with their physical, health, social and emotional needs in the way they prefer and need, and are protected by the home’s medication policies. EVIDENCE: The home ensures that the healthcare needs of residents are assessed and recognised and that procedures are in place to address them. All residents are registered with local GP’s, and a dentist in Torquay. Staff showed sensitive and flexible personal support to maximise residents’ privacy, dignity, independence and control over their lives. Residents told of the different ways in which they want to be and are assisted. Residents appeared to feel, and reported that they did feel, safe and well supported living here. They feel respected and are encouraged and enabled to have as much Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 18 control over their lives as possible. Observation of the interaction between staff and residents evidences mutual respect and fondness. Some residents have required particular assistance from external professionals and agencies to meet their disability and / or health needs, which the home is eager to source and utilise. The home has good policies and procedures for the storage, administration, recording and disposal of medications, though there is minimal use of medication at Radfords. The home uses the Boots Monitored Dosage System for pills and capsules and proper systems regarding liquid and other medications. Witnessing the practice of medication administration confirmed that these policies and procedures are correctly followed. One resident has a range of homeopathic remedies. Residents who wish and are able to manage their own medication are enabled to do so following a risk assessment. The management and staff of this home sees the home very much as part of the local circle of support for people with learning disability, alongside (other) professionals such as GPs and particularly the team of various professionals in the learning disability teams. Care managers commented that: “I am very impressed with the support and guidance given to the person I work with”. “Staff always very assertive and communicative with any problems / queries that may arise” “Support is on an individual level. Encourage self-sufficiency and independence. The home offers a broad range of choices in food, activities, accommodation.” “ I feel Radfords is an excellent service. I have no concerns about the person I work with. I feel they are very well supported and cared for and has a wide range of activities / things to do at their disposal. I feel that Radfords’ staff are very professional and approachable. An excellent service provider.” “Plan person-centred outcomes. Assist individuals to reach their potential. Liaise with relatives”. Care provided continues to be tailored to each individual resident’s needs. To this end some residents have support with personal hygiene, whilst others with socialisation skills. Residents’ written records continue to contain full details of all care provided and these are presented in such a format as to ensure that residents can understand all that is recorded. A parent commented: “I believe that Radfords is an exceptional home. Generally the care my daughter receives is of a very high standards and Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 19 Radfords has a lovely atmosphere. The support our daughter receives with emotional and personal issues has been very helpful”. Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 20 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): 22,23 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Complaints and suggestions from residents, relatives or other visitors to the home are listened to and issues resolved before becoming complaints. Residents are protected from all forms of abuse. EVIDENCE: The complaints procedure is written in various formats, including a pictorial format, so that all residents can clearly understand it. Additionally, as with other important documents, residents are taken through the procedure by staff to ensure they understand it. The complaints procedure is displayed within the home’s main office/meeting room where residents regularly visit. There have been no complaints reported either to Radfords or to the Commission within the past twelve months. Residents are safeguarded from physical, financial or material, psychological or sexual abuse, neglect, discriminatory abuse or self harm, or inhuman or degrading treatment, through deliberate intent, negligence, or ignorance, in accordance with the home’s written policy. Radfords offers not only care but also a degree of education and training, including encouraging and enabling their residents to stand up for themselves. Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 21 The views of residents are constantly sought. Residents are confident through experience that their views are welcomed, encouraged, listened to and acted on. Residents said that they would speak to their keyworker, or other staff, or their parents if they were unhappy about anything at Radfords. Issues are resolved before becoming complaints. The home’s complaints procedure, does not therefore become activated. The Home has appropriate policies and procedures in place to ensure the protection of residents. Staff have attended Adult Protection training, and have a good understanding of the residents and their communication methods. Staff were observed to be patient and skilled in communicating with residents who have particular communication difficulties. A parent commented that Radfords: “Fully communicates well with residents, staff and parents. Understands and empathises with all residents. Listens to them and allows them to be as independent yet safe as possible. From the manager downwards staff are always respectful of the people they care for.” Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 22 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): 24,30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Radfords is comfortable, clean, and mostly well maintained. However the residents’ living environment could be yet further improved upon by implementing the identified upgrading programme contained within the home’s annual report. EVIDENCE: The home is a tastefully restored rustic courtyard with three self-contained accommodation units – The Cottage, Hayloft (with The Flat) and The Farmhouse – together with a general office, manager’s office and large upstairs activities / meeting room. The home’s premises are suitable for its stated purpose; reasonably accessible, safe and maintained. The building meets residents’ needs in a comfortable and homely way. Radfords is not Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 23 designed as a specialist home for people with physical disabilities. The environment and culture of the home is one which best suits relatively young, able and active residents. Few environmental adaptations and disability equipment are currently necessary to meet the assessed needs of the residents. Since the last inspection some considerable upgrading has taken place including the installation of new kitchens in the Hayloft and the Cottage. These have rounded corners, chunky handles and stainless steel tops to be as userfriendly as possible to all residents. Some carpets have been renewed. Such improvements add to the resident’s experience of living at Radfords. Other building upgrading works have been identified in the manager’s annual development plan. The exterior of the building needs repainting and the kitchen in the Farmhouse is to be totally refurbished as the other two units at Radfords. These improvements will allow for the home’s physical environment to be totally brought up to a better standard. The home is clean and hygienic. All residents clean their own room and a portion of the communal facilities, as part of daily living in a community. There are no domestic staff. All residents do their own laundry. Each house is a domestic house. All but one house has separate laundry facilities. These are suitable for the purpose. Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 24 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): 32,34,35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are cared for by well-trained and motivated staff in sufficient numbers to meet the needs of those currently living in the home. Recruitment processes protect vulnerable residents. EVIDENCE: Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 25 The home has a robust recruitment policy and procedure including Criminal Record Bureau checks. It also involves an element of resident choice following the candidates’ spending a day working in the home. Staff were seen to be approachable, dedicated and enthusiastic. Residents described the staff as very kind and caring and confirmed they supported them well. The staffing rota and observation on the day of inspection evidences that there are sufficient numbers on duty to properly care for the residents. Three staff, one in each of the three houses, is on duty during mealtimes and weekends when the residents are at home. One or two staff are on duty at other times such as during the day when most residents will be enjoying day opportunities. However, a residents commented that: Sometimes I would like not to go shopping, but I have to because there is not enough staff to stay back.” Subsequent clarification with the manager assured that sufficient staff are always on duty, though it is not always possible to provide staff to undertake separate activities for every individual client. Two residents currently benefit from additional funding to allow for one-to-one time extra hours each week. There are fourteen care staff and one ancillary staff who work at Radfords. Eight care staff (57 ) currently have National Vocational Qualification in Care at Level 2 or above. The home therefore exceeds the current target of having 50 qualified staff. All fourteen staff have first aid certificates. All training is now within the Learning Disability Award Framework (LDAF). All staff have a training and development and supervision programme, which was included in the Pre-Inspection documentation. This training, and the beneficial outcomes for residents, is recognised by parents: “We are very satisfied and have every confidence in the organisation and staff. Kept informed. The staff are always on training programmes to improve skills and keep up to date with current legislation”. “Needs are different for every person and the staff work very hard to meet those needs which may change as time goes on. The constant training they receive helps this. Respects and cares well for the individual supports individual needs. Listens to individual choices. Communicates well within the care home and with relatives. Values each person and their individual skills. Builds up each individual’s confidence and helps them to improve both their strengths and weaknesses. Values healthy organic food where possible. Believes in exercise and healthy living”. Residents reported in their own way that they had confidence in the professionalism of the effective staff team. This was supported by the documentation examined which indicates that staff are properly recruited, well trained and supported. Staff files include evidence of two references being obtained as well as CRB checks, terms and conditions, job description and photographic identification. Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 26 A care manager commented that: “Staff are approachable, professional and know the people they work with very well. Good relationships between staff and people living at Radfords.” Staff reported that Radfords was a good place to work. Comments taken from returned survey forms include: “The staff are really friendly. As I was new a few months ago it was lovely to be welcomed so warmly”. “Radfords provides a very homely atmosphere for residents and are respectful of individual need”. “Special, warm, loving and happy place to work. Warm, inclusive community”. “Team meetings monthly to pool observations, draw up care plans, solve problems, enabling us to all have a common knowledge of residents’ needs and current practice to solve difficulties and communicate with each other. Total communication”. Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 27 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): 37,39,42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. This is an excellent, well-managed home for people with mild to moderate learning disabilities. Residents’ views, wishes and needs underpin all that happens here. Residents’ health, safety and welfare are well looked after. EVIDENCE: The registered manager is well qualified, competent and experienced to run the home and meet its stated purpose, aims and objectives. He was previously a lecturer in care and has relevant qualifications including a masters degree, together with considerable care experience. The manager and his staff team Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 28 strive to provide a stimulating, safe environment that combines professionalism with care. The manager is supported by a competent and motivated staff team, which is becoming increasingly professional by training. Residents’ views and wishes are welcomed and sought, and underpin the service. Residents appeared to be and said they are happy living here. They have confidence in the Robert Owen Communities and Radfords’ staff that their health, safety and welfare will be looked after, and enjoy living with their fellow residents. Residents appear to be and say that they are happy living at this home. They like their bedrooms, activities, friends they live with and staff who support them. Comments from residents include: “I like living here”, “the staff are nice” “I like to work and listen to music”. “I like swimming.” “staff help me when I need it.” Care files evidence that residents’ health, safety and welfare is protected and promoted. Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 29 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 4 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 4 32 X 33 X 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 4 3 LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 X 4 X 4 X X 4 X Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 30 Are there any outstanding requirements from the last inspection? NO 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 Timescale for action 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 YA24 Good Practice Recommendations The registered provider should ensure that the identified, required upgrading of the premises continues to be undertaken. Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Radfords DS0000003785.V330295.R01.S.doc Version 5.2 Page 32 - 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. 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