Inspection on 05/07/06 for Radiant Home

This inspection was carried out on 5th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Radiant Home 11/12/07

Radiant Home 05/07/07

Radiant Home 17/11/05

Radiant Home 03/02/05

Radiant Home 26/08/04

Radiant Home 07/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Radiant Home 30 Sextant Road Leicester Leicestershire LE5 2JA Lead Inspector Mr Keith Charlton Unannounced Inspection 5th July 2006 09:30 X10015.doc Version 1.40 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 Radiant Home DS0000006382.V302814.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 Older People. 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. Radiant Home DS0000006382.V302814.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Radiant Home Address 30 Sextant Road Leicester Leicestershire LE5 2JA 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) 0116 241 9898 0116 241 0354 Mrs L Hopewell Mr Derrol Paul Hopewell Mr Derrol Paul Hopewell Care Home 6 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (6) of places Radiant Home DS0000006382.V302814.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No person who falls within category DE(E) may be admitted to the home when 3 persons who fall within category DE(E) are already accommodated 17/11/05 Date of last inspection Brief Description of the Service: Radiant House is a small home registered to accommodate up to 6 service users within the category of older people and up to 3 service users within the category of dementia. The home is situated in a residential area with parking available on the street. There are four single en-suite bedrooms on the ground floor and one double en-suite bedroom located on the first floor, which can be accessed by the stair lift. Radiant House has a large lounge with dining area and a sky lounge, known as the sky lounge because it has sky television programmes. There are two fresh water fish tanks and two cats at the home. Both lounges look onto the garden at the rear, which has a lawn and is surrounded by mature plants and shrubs. There is seating for service users, which can be accessed by a ramp or steps. The weekly fee is based on the Social Service Department highest banding for residential care, which was provided on the day of the Inspection. There is an additional cost for hairdressing. Radiant Home DS0000006382.V302814.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service user and their views of the service provided… The primary method of inspection used was ‘case tracking’ which involved selecting two service users and tracking the care they received through looking at their records, discussion, where possible, with them and care staff and observation of care practices. This was an unannounced Inspection. The Registered Manager was on duty. Planning for the Inspection included checking on the notifications of significant events sent to the Commission for Social Care Inspection and the last Inspection Report, which had a number of Requirements due to have been acted upon by the time of this inspection. There has been one complaint made about the service since the last inspection regarding night staffing cover and service user care. This was not upheld. The Inspection took place between 9.30 and 15.40 and included a tour of the building, inspection of records and indirect observation of care practices. The Inspector spoke with four service users (though this was limited owing to the difficulty with communicating with service users with a significant level of mental frailty), two members of staff, two relatives and the Registered Manager. What the service does well: There were a number of issues which effectively covered service users needs positive comments were received from service users and the visitors relating to care provided at the home. Care plans are generally in order regarding service users needs and contain information about service users past history which helps staff understand service users as individuals with a unique past. The décor and furnishings in the communal areas are homely and comfortable. The home is clean and tidy throughout. Colour pictorial signs identify different rooms and aid service users. Printed information is available about the home. Radiant Home DS0000006382.V302814.R01.S.doc Version 5.2 Page 6 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. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Radiant Home DS0000006382.V302814.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Radiant Home DS0000006382.V302814.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service user needs are generally well assessed before admission so that staff can meet their needs though more care is needed to ensure Registration limitations are followed. EVIDENCE: The Registered Manager said the Statement of Purpose has not yet been amended to bring it in line with the National Minimum Standard but this was planned and would be carried out in the following months. Assessments were examined and confirmed service users were admitted on the basis of an assessment of service users needs, preadmission visits are arranged and written information about the home’s services is provided in the Service User Guide. Radiant Home DS0000006382.V302814.R01.S.doc Version 5.2 Page 9 Information on file indicated that all four service users have dementia. As the service is limited to having three service users with dementia by the terms of its registration the fourth service user should not have been admitted. The Registered Manager is to write to the Commission for Social Care Inspection so that this situation can be rectified. The service does not offer intermediate care. Radiant Home DS0000006382.V302814.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users health, personal and social care needs are generally met. EVIDENCE: A relative spoken to said that her mother had a Care Plan. The Care plans inspected were found to contain appropriate and relevant information regarding service users needs. There is a personal history section to ensure service users are seen as individuals with a valued past. Staff said they were asked to read them by the Registered Manager though one staff had not read all of them. The Registered Manager said this would be followed up to ensure that staff were aware of all service users needs. Monthly reviews of plans had not been carried out to ensure plans are still relevant to service users needs. The Registered Manager said he was aware of this and it would be carried out in the future. There was evidence of appointments with consultants and GPs in Care Plans. Accident records were viewed. The last recorded accident was in February 2006 though a service user was seen to have a graze on her forehead. The Radiant Home DS0000006382.V302814.R01.S.doc Version 5.2 Page 11 Registered Manager said this had not been recorded and he then carried this out. The service user had not been referred to medical authorities regarding the head injury. The Registered Manager said a medical alert procedure would be drawn up and this followed in future. Medicine records were in good order. All staff that administer medication have received insulin and medication training though the Registered Manager said that refresher training was needed and the pharmacist is due to shortly confirm when this will take place. The inspector observed that medication was issued to service users in a container without proper labelling and without signing the record after every issue of medication. The Registered Manager said this procedure would change to assist with safely issuing medication to service users. There is now a contract in place to ensure regular visits from the Pharmacist to provide proper advice. From the limited communication that was possible with service users, they thought staff provided friendly care. The relatives spoken to said they were fully satisfied with the staff – they were very friendly and always welcomed them when they visited. The service users guide also indicates no restrictions on visiting times. It was observed that a staff member did not knock before entering a service user’s bedroom therefore compromising privacy. The Registered Manager recognised this and said staff awareness of this would be improved. There were a number of instances where service users were called ‘darling’. The Registered Manager said that he always checked whether this was acceptable to service users. This needs to be strictly monitored to ensure that this terminology does not compromise the dignity of service users. The Registered Manager is currently seeking information around service users death and dying wishes to be part of Care Plans so that this process can be properly planned and meet service users wishes. Radiant Home DS0000006382.V302814.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can choose to lead an active lifestyle and exercise choice. EVIDENCE: Service users were seen to be watching the TV of listening to radio. They expressed no preferences regarding activities. Staff said that service users played games and catch soft ball, sat in the garden and went for walks with staff if they wanted. The Registered Manager said that there were frequent outings though the home’s vehicle is awaiting repairs and will be available again from mid July. Service users said that their visitors were made welcome by staff and their relatives took them out. The relatives spoken to confirmed this. Service users indicated that there were no rules in general though one service user was unsure about getting up and going to bed times. A staff member said this service user was often left to sleep if he wished. Service users said they enjoyed the food. There was a separate sheet in the records showing alternatives if they wished, though food records did not show Radiant Home DS0000006382.V302814.R01.S.doc Version 5.2 Page 13 when these alternatives were provided. The Registered Manager said this would be carried out in the future. A service user was seen to be receiving assistance from staff cutting up her food. The food tasted was found to be of a good standard. Staff said service users could have breakfast in their rooms if they wished. Radiant Home DS0000006382.V302814.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users and their representatives can be generally confident their concerns will be properly attended to. EVIDENCE: The visitor spoken with said she would have no hesitation about going to management or staff if they had a problem and was confident it would be properly sorted out. The Complaints book was viewed – this was blank and the Registered Manager stated that the service has had no complaints since the last inspection. The Commission for Social Care Inspection has received one formal complaint about the service though this was not upheld. Upon discussion with the Registered Manager it was ascertained there had been a Vulnerable Adults referral in the past, which had not been referred to the Commission for Social Care Inspection. The Registered Manager said this would be swiftly carried out in the future. The adult protection policy and procedure is now in place to assist with proper reporting of incidents. There is a Complaints Procedure displayed on the notice board, which nearly complied with the National Minimum Standard – the Registered Manager is to alter the procedure to fully comply with the National Minimum Standard. Radiant Home DS0000006382.V302814.R01.S.doc Version 5.2 Page 15 Staff members were asked about their understanding of the adult protection procedures, and demonstrated a generally good understanding of them though they were uncertain as to all the Agencies to contact if required. The Registered Manager said a short procedure would be drawn up and staff again appraised of this essential issue of care practice. Radiant Home DS0000006382.V302814.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a comfortable environment. EVIDENCE: Service users said that they liked their bedrooms, which were homely, containing service users possessions – pictures, photos, ornaments, TV, radio etc. The main lounge was clean, well maintained and furnished with homely fittings and ornaments and a large fish tank. A large homemade calendar and clock was displayed. Colour pictorial signs identify different rooms and aid service users with dementia. The home is commended for this initiative. A sky lounge is available for alternative television channels. Radiant Home DS0000006382.V302814.R01.S.doc Version 5.2 Page 17 A bathroom door lock fitting has still not been installed and this is outstanding from the previous two Inspection Reports. The Registered Manager said he would attend to this. A bathroom floor was sticky underfoot. The Registered Manager said this would be cleaned. Some parts of the home had dim lighting. The Registered Manager replaced some bulbs to rectify this and said it would be monitored in future. There are no radiator covers to prevent scalding or a written Risk Assessment to indicate whether service users are at risk. The Registered Manager said he understood service users with dementia may well be at risk and this would be followed up. All other parts of the home were clean, fresh and pleasant. Radiant Home DS0000006382.V302814.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The deployment of staff and training for staff is not comprehensive and does not protect service users. EVIDENCE: The staffing rota showed which staff are on duty at any time, though there were times when there were only one staff on duty. The Registered Manager said he had not completed rotas properly but there were always two staff on duty. The Registered Manager is on call within the home at night and has nighttime duties, as well as working day shifts. He said that this there was no problem with fatigue as he could sleep during the day when he had time off. The inspector nevertheless recommended alternative arrangements to prevent possible problems with effective staff response to service users needs. Training programmes for staff were not evident or National Vocational Training Qualification (NVQ) programmes in Care. The minimum ratio of 50 trained care staff in NVQ’s achieved for 2005 had not been met. The Registered Manager has obtained documentation to assist in drawing up a proper Training Programme for staff. Staff recruitment files confirmed proper recruitment procedures have now been followed. Staff recruitment files were sampled and contained the required information. Radiant Home DS0000006382.V302814.R01.S.doc Version 5.2 Page 19 Radiant Home DS0000006382.V302814.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Management and administration systems do not fully protect service users. EVIDENCE: From comments received from staff and the visitor there was satisfaction with the performance of the Registered Manager carrying out his role. The Registered Manager is working towards National Vocational Qualification in Management level 4. Staff are still not offered regular formal supervision or an opportunity for an identification of their training needs. The Registered Manager recognised this and a new system is being put in place to cover this – the inspector saw the new forms. Radiant Home DS0000006382.V302814.R01.S.doc Version 5.2 Page 21 Health and safety procedures were inspected and seen to be in generally satisfactory order and staff said they had received training. The are Risk Assessments for safe working practices though none for the risk from hot radiators. There has been a Quality Assurance system carried out this year to check the service for service users and relatives as some completed questionnaires were viewed. It was recommended this process be extended to District Nurses, GPs, Social Workers etc. There are no staff meetings at present. The Registered Manager acknowledged that there have been no service user/relatives meetings but said there were plans to commence these to give service users a voice in the running of the home. Fire checks were not thorough in that fire drills had not been carried out on a three monthly basis or emergency lighting on a monthly basis. Fire bell testing had been carried out on the required weekly basis. The Registered Manager had a fire risk assessment for the home, which is to be reviewed. Records showed fire extinguishers had been serviced this year. A hot water outlet in a first floor bathroom was found to be 45.7c, above the National Minimum Standard of 43c –the Registered Manager said action would be taken to reduce this. Radiant Home DS0000006382.V302814.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 1 9 2 10 2 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 2 Radiant Home DS0000006382.V302814.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP8 Regulation 12 Requirement Health and welfare of service users (1) The Registered Person shall ensure that the care home is conducted so as(a) to promote and make proper provision for the health and welfare of service users To this end - service users need medical assistance summoned when necessary. Timescale for action 07/07/06 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 OP1 Good Practice Recommendations The Statement of Purpose/ Service User Guide needs to DS0000006382.V302814.R01.S.doc Version 5.2 Page 24 Radiant Home include: The number relevant qualifications and experience of staff; The organisational structure of the home; The number and size of rooms; Whether nursing is to be provided; Policy and procedure for emergency admission; Fire precautions and associated emergency procedures; Arrangements for dealing with reviews of the residents care plan. 2. 3. OP11 OP18 Individual’s wishes around death and dying, spiritual needs, rites and functions recorded in their plan of care. Ensure robust Adult Protection policies and procedures are fully understood by care staff and reflect good practice around the Department of Health Guidance ‘No Secrets’. The Registered Person must ensure at all times suitably qualified competent and experienced persons are working at the home in such numbers as are appropriate for the health and welfare of residents: That a copy of the duty roster of person working at the home, showing which staff are on duty and in what capacity is held, is correct. It is recommended that the Registered Manager does not carry out both day and night duties on consecutive nights so as to prevent fatigue. 5. OP28 (1) The Registered Person shall… (b) ensure that the persons employed by the Registered Person to work at the home receive – training appropriate to the work they are to perform – the Registered Manager to review Training programmes for staff, and National Vocational Training Qualification (NVQ) programmes in Care to achieve the minimum ratio of 50 trained care staff in NVQ’s, as per the National Minimum Standard. 6. OP36 The Registered Person shall ensure that persons working at the home are appropriately supervised. Also to develop a supervision format that includes the following: All aspects of practice Philosophy of care in the home. Career development needs The Registered Person to ensure that all aspects of Health DS0000006382.V302814.R01.S.doc Version 5.2 Page 25 4. OP27 7. OP38 Radiant Home and Safety provision – e.g. fire and scalding risks are fully assessed and minimised. 8. OP19 To repair bathroom door lock and sliding door to ensure privacy and dignity. This remains outstanding from the inspection of the 31st August 2005 and the last inspection of November 2005. Radiant Home DS0000006382.V302814.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Radiant Home DS0000006382.V302814.R01.S.doc Version 5.2 Page 27 - 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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