CARE HOME ADULTS 18-65
Radfords Main Street Broadhempston Totnes Devon TQ9 6BD Lead Inspector
Judy Cooper Unannounced Inspection 5th October 2005 03:00 Radfords DS0000003785.V251444.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Radfords DS0000003785.V251444.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Radfords DS0000003785.V251444.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Radfords Address Main Street Broadhempston Totnes Devon TQ9 6BD 01803 813622 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) radfords@roc-uk.org Robert Owen Communities Gary Grieve Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Radfords DS0000003785.V251444.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 11/05/05 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 and 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 Communities has other residential and facilities locally. Radfords DS0000003785.V251444.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place on Wednesday afternoon. Opportunity was taken to tour the premises, examine some records and policies and talk with the manager, deputy manager, some residents and staff present (five residents were not at home, due to being away on holiday). Staff on duty were also observed, whilst in the course of undertaking their normal duties. All required core standards were inspected at the last inspection in May 2005 and were concluded as met at that time. Those inspected on this occasion concentrated on resident welfare on a day to day basis. What the service does well: What has improved since the last inspection?
The organisation has provided designated handyman/maintenance hours, which has resulted in several areas of the home having been able to be upgraded since the last inspection.
Radfords DS0000003785.V251444.R01.S.doc Version 5.0 Page 6 Redecoration has also taken place throughout different areas of the home, as has the provision of some new carpets and soft furnishings. The deputy manager, and staff at the home, have taken some considerable time to present all information in a pictorial manner. This has ensured that all information, that residents may need to know to allow them to be able to fully participate in the homes’ activities, is presented in such a way as to be easily understood by the residents. It is a credit to the staff that this work has been undertaken with enthusiasm and attention to detail. 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. Radfords DS0000003785.V251444.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Radfords DS0000003785.V251444.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The individual needs and aspirations of any prospective resident continue to be assessed in great depth and are well known by both the manager and staff prior to any resident’s admission. EVIDENCE: Radfords historically has had a very stable resident group. Consequently the one vacancy that the home currently recently had, was the first for a number of years. It had only occurred because another resident moved into a supported living scheme. The Robert Owen Communities manage vacancies in such a way as to ensure that all current members of the home are able to have a say in who comes to live at the home. Consequently the manager invited five prospective residents (who were all on a waiting list) to trial the home for a two week period on an individual basis. On completion of this all current residents at Radfords, along with the staff and the prospective residents themselves, made a joint agreed decision as to who would be most suited to living at the home. (All prospective residents were made aware of this admission process). The resident thought to be best able to benefit from the environment and lifestyle at Radfords, has now been living at the home for a few months. During the inspection the resident was able to confirm that they were very happy at the home and that they had made many friends and had been given lots of new opportunities since coming to live at the home. The manger had very detailed information regarding the resident, which had been obtained prior to their admission.
Radfords DS0000003785.V251444.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 Staff remain very skilled at ensuring that residents are involved in planning for all aspects of their overall needs and personal goals. EVIDENCE: During this inspection the documentation appertaining to the new resident was looked at. It was noted, that as with all other residents, a document entitled “My life My plan” which is an in depth assessment regarding all aspects of a resident’s life was in place. This is a portable document, which residents can take with them to any review or meeting and which, again, is in a format that each resident can understand and be able to easily refer to. Each resident has two appointed key workers who both work specifically with each resident. During the inspection it was noted that one staff member was taking the time to spend time with “their” resident to further expand and update the resident’s care plan. Radfords DS0000003785.V251444.R01.S.doc Version 5.0 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 the following standard(s): 11,14,17 Residents’ lives continue to be enhanced by being supported to participate in many varied activities and make full use of the local, nearby community facilities as well as to maintain, personal relationships as desired. The staff remain committed to ensuring that meal planning, along with all aspects of daily living within Radfords, is determined by resident choice which allows residents to maintain control over their own lives. EVIDENCE: Radfords DS0000003785.V251444.R01.S.doc Version 5.0 Page 11 Some residents remain engaged in work placements on a farm and a craft centre, both operated by the Robert Owen Communities and further work placement opportunities are also made available. On the evening of the inspection several residents returned to the home from the farm, and the craft centre. All had had a good day and were enthusiastic about how they had spent their time. Five residents were away on their annual holiday, whilst the others at the home had enjoyed a holiday earlier in the year in Spain. One other resident had chosen not to go away, preferring to stay at home. On the evening of the inspection a residents’ meeting was to take place followed by a music session. The residents’ activity programme was also provided in a pictorial format. Residents continue to have very full and rich recreational opportunities as was evidenced by speaking to the residents and staff, with music being considered to be an important opportunity within the home (one resident plays the cello and some others the piano, whilst another recently commenced learning the drums). Radfords is considered part of the local community and residents use all local facilities such as the shop, church and pubs. Visitors are welcomed to the home. Recently the manager hosted a parents’ day when the residents’ parents are invited to the home and have the opportunity to ask questions and be made aware of any new plans for the home as well as enjoy a social gathering. Meals continue to planned by the residents at the weekly residents’ meeting with each of the three houses having a different, personally tailored menu, which are now displayed in a pictorial form within each house. Recipes are also provided in pictorial form, which allows all residents the ability to prepare a meal relatively independently. Fresh, organic produce is provided where possible and a delivery of the same arrived at the home during the afternoon of the inspection. Radfords DS0000003785.V251444.R01.S.doc Version 5.0 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 the following standard(s): 18 Radfords continues to provide sensitive and flexible personal support and care to maximise a residents’ privacy, dignity, independence and choice over their own lives, within the framework of a community. EVIDENCE: 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. During the inspection it was noted that staff work sensitively and strive to be supportive and enable residents to take responsibility for their own decisions and choices. Radfords DS0000003785.V251444.R01.S.doc Version 5.0 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 the following standard(s): 23 Residents understand and are aware of the complaints procedure within the home and would feel able to approach the manager or staff with any concerns they may have. EVIDENCE: The complaints procedure is written in various formats, including a pictorial format, so that all residents can clearly understand it. It 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 CSCI within the past twelve months. Radfords DS0000003785.V251444.R01.S.doc Version 5.0 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 the following standard(s): 24 Radfords is very 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 (2006). EVIDENCE: Since the last inspection some considerable upgrading has already taken place including the repainting of one of the houses and some resident bedrooms, and the installation of a new kitchen in one of the houses, (which was designed to be able to be used confidently by the residents with such things as rounded corners being put in place and easy to hold handles). New carpet has been provided for the stairs and hallway and new bathroom flooring has also been supplied. Another house has again benefited from some new carpeting and the remaining carpets are due to be cleaned in the near future. Some new soft furnishings have been provided including a new settee and the use of “throws” on the others. Other building upgrading works have been identified in the manager’s annual development plan (2006) for the home.
Radfords DS0000003785.V251444.R01.S.doc Version 5.0 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected EVIDENCE: Although none were inspected on this occasion, it was noted that there has not been any staff changes since the last inspection, other than the appointment of a new administration assistant. Radfords DS0000003785.V251444.R01.S.doc Version 5.0 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected on this occasion. EVIDENCE: Radfords DS0000003785.V251444.R01.S.doc Version 5.0 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 x 4 x x x Standard No 22 23 Score 3 x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 x x x x Standard No 24 25 26 27 28 29 30
STAFFING Score 2 x x x x x x LIFESTYLES Standard No Score 11 4 12 x 13 x 14 4 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Radfords Score 4 x x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x DS0000003785.V251444.R01.S.doc Version 5.0 Page 18 NO 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. 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 24 Good Practice Recommendations The registered provider should ensure that the identified, required upgrading of the premises continues to be undertaken. Radfords DS0000003785.V251444.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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