Inspection on 19/06/06 for Rafael

This inspection was carried out on 19th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Rafael 10/09/07

Rafael 09/01/06

Rafael 24/08/05

Rafael 02/11/04

Rafael 24/05/04

Similar services:

Ashlong House

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Edenvale

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Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Rafael 172 Stanley Park Road Carshalton Beeches Surrey SM5 3JR Lead Inspector Deborah Yapicioz Key Unannounced Inspection 19th June 2006 08:50 Rafael DS0000038904.V297191.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 Rafael DS0000038904.V297191.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. Rafael DS0000038904.V297191.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rafael Address 172 Stanley Park Road Carshalton Beeches Surrey SM5 3JR 020 8296 1016 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) jan_farrar@hotmail.co.uk Angel Home Limited Mrs Janice Nichol Farrar Care Home 3 Category(ies) of Learning disability (0) registration, with number of places Rafael DS0000038904.V297191.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th January 2006 Brief Description of the Service: Rafael is a residential care home providing care for up to three adults between the ages 18 and 65 years in the category learning disability. There are currently three service users living at the home. The premises are on Stanley Park Road, which is busy through-route between Wallington and Sutton. It is within walking distance of local shops and transport links. It comprises three single bedrooms, a lounge, a dining room, kitchen, storeroom, bathroom, two toilets plus an office on the second floor. There is a large garden to the rear and a small front area with off-street parking for two cars. The three single bedrooms have been equipped and decorated to National Minimum Standards and include suitable furniture and fittings and décor, but no ensuite facilities. Rafael DS0000038904.V297191.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes first inspection for the year 2006/2007 and was an unannounced visit, which took place on the morning of 19th June 2006. The home was inspected under the National Minimum Standards Care Homes for Younger Adults. The home manager was not on duty and Isabella Murugupullai senior member of the staff team facilitated the inspection. Methods of inspection included meeting with one of the service users, a tour of the premises and a discussion with Mrs Murugupullai. The home manager had completed a Pre Inspection Questionnaire. Records examined included service user plans, care manager assessments, risk assessments, medication records, complaints, staffing records, health and safety and fire records. The inspector would like to thank the service user and Mrs Murugupullai for their help in facilitating the inspection. The cost of a placement at Rafael Home is between £550 and £610. Overall the home continues to provide a good service to the service users. What the service does well: What has improved since the last inspection? The inspector was informed that the home manager has attended the Person Centred Planning for facilitators course run by the London Borough of Sutton and Person Centred Planning principles will be incorporated into the care planning process. Rafael DS0000038904.V297191.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rafael DS0000038904.V297191.R01.S.doc Version 5.2 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 Rafael DS0000038904.V297191.R01.S.doc Version 5.2 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): 1,2,4,5 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home provides good information and introduction opportunities for prospective service users and their families to make an informed choice about moving to the home. Each of the service users is issued with an individual contract setting out the terms and conditions of the placement, which safeguards the interests of both parties. EVIDENCE: Rafael has a statement of purpose and a Service users guide in place. The service users guide is also in a symbol and a taped format. The contents of both documents are reviewed regularly. Service users are only admitted to the home once a full assessment of their needs; compiled by their care manager or other relevant person has been received. The home does not have any vacancies and there have been no new admissions since the last inspection. A care manager’s assessment was seen on the service users files sampled during the inspection. Cultural and religious issues are addressed at the referral stage so that the service user and their family can be sure that those needs will be met. Compatibility with others already living in the home is also taken into account. Any prospective service user would have a gradual introduction to the home with a series of short visits and overnight stays. The time frame would be flexible depending on the service user. Each of the service users has a personal Rafael DS0000038904.V297191.R01.S.doc Version 5.2 Page 9 contract, specifying the terms and conditions of their occupancy that included periods of notice, fees charged, and the cost of ‘extras’ not covered by the basic cost of the placement. The service users spoken to during the inspection confirmed that she had had a series of visits to the home before deciding to move in and had a service users guide. Rafael DS0000038904.V297191.R01.S.doc Version 5.2 Page 10 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): 6,7,9, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users have comprehensive individual care plans with information on their needs and personal goals. Individual care plans include consultation with service users and reflect current needs and service users wishes. The home operates a risk management strategy thus enabling the service users to participate in activities with appropriate support. EVIDENCE: Each of the service users has an individual tailored care plan. The care plans are on the service users file and is a record of their aims and goals as well as their achievements. The inspector was informed that the home manager has attended the Person Centred Planning for facilitators course run by the London Borough of Sutton and Person Centred Planning principles will be incorporated into the care planning process. Care plans are internally reviewed every six months and formally reviewed 12 months. The home staff team make daily entries on service users files, which were seen on the service users files and this information is used to monitor changing needs, and ensuring goal/targets can be met. Rafael DS0000038904.V297191.R01.S.doc Version 5.2 Page 11 The home operates a risk management system and individual assessments where seen on service users files. Risk assessments include using public transport and bathing. The home has a policy that a member of staff remains outside the bathroom when a service user who has epilepsy is bathing in this way privacy and dignity is preserved and the service users safety is maintained. The home has a key worker system. The residents are offered the opportunity to participate in the day to day running of the home through regular meetings and individual discussions with their key workers. Part of the role of the key workers at the home is to ensure the service user individual opinions are put forward. One of the service users spoken to during the inspection said that she liked her key worker and had been able to choose the team member that she wanted. Regular service user meeting are held and service users are encouraged to attend. Notes are taken of each meeting and placed in communal areas. The service users at the home also produce a newsletter with details of recent events at the home. Rafael DS0000038904.V297191.R01.S.doc Version 5.2 Page 12 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): 12,13,15,16,17, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users at the home are offered the opportunity to engage in age appropriate activities with an emphasis on using community based facilities. The service users have a varied programme of social activities organised by the staff team to reflect service users individual interests. The home has an open visitors policy to ensure friendships and family links are maintained. EVIDENCE: The service users are supported to access local day centres where they attend a variety of sessions depending on their individual interests and goals. Details of the service users daily activities and commitments are kept on the service users file. One of the service users spoken to during the inspection helps in the reception area of the day centre and told the inspector that she hopes to get a job in an office in the future. The service users have the opportunity to attend religious services if they wish. The local community is well used by the residents. The local parks, cafes, cinema, pubs, libraries, bowling alley, and shops are accessed. The home arranges for service users to attend clubs. The home is well placed for Rafael DS0000038904.V297191.R01.S.doc Version 5.2 Page 13 accessing public transport links being on a local bus route and fairly close to both Carshalton Beeches and Wallington train stations. The house rules and daily routines are as flexible as possible, bearing in mind the weekday commitments of the service users. The service users are encouraged to choose the menus on offer and to help out with cooking and household chores. There was evidence on service users files and from discussion with the service users that the home encourages good links with family and friends who can visit and are visited regularly. One of the service users was looking forward to visiting her family at the end of the month. Rafael DS0000038904.V297191.R01.S.doc Version 5.2 Page 14 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): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal care is carried out in a way that residents prefer so that dignity and choice are maintained. Residents’ physical and emotional health needs are detailed in personal plans to offer consist care in this area. Residents’ medication is well managed to ensure good health. EVIDENCE: The level of support a service user needs would be detailed at their review meetings and their preferred routines are set out in their files and personal records. Personal care is provided in private, and timings of this are also flexible, for example service users can have a bath when they wish. The home provides consistency and continuity through designated key workers. All service users are registered with a local General Practitioner and the staff team receive training on medication and epilepsy as one of the service users has epilepsy. Seizure activity is monitored and the service user has regular appointments with a neurologist. Another service user also has regular appointments at the eye clinic. Service users have access to relevant professional support to maximise independence, including the Community Team for People with Learning Disability. Significant events and accidents are recorded and monitored. Staff members monitor service user’s health and maintain up to date records. Rafael DS0000038904.V297191.R01.S.doc Version 5.2 Page 15 The home has a policy and procedure in place for the receipt, recording, storage, handling, administration and disposal of medication. All medication records were complete at the time of the inspection. Rafael DS0000038904.V297191.R01.S.doc Version 5.2 Page 16 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): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is complaints policy and procedure, which facilitates good access to the complaints system for the residents, their family or their representatives. The home has the appropriate policies in place to ensure the protection of vulnerable service users. EVIDENCE: The complaints procedure was clear and contained all of the elements required to meet standard 22 including a minimum response time of less than 28 days. There have been no complaints since the last inspection. The home has a copy of the local authority Adult Protection Policy on site. The staff team have attended training on adult protection issues and a record id kept on their files. The staff team are aware of the action they must take if they need to report an incident. Rafael DS0000038904.V297191.R01.S.doc Version 5.2 Page 17 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): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The general décor of the home is good providing a comfortable, clean and safe environment for service users to live in. Service user’s bedrooms provide privacy and reflect individual interests and preferences. EVIDENCE: Rafael is an ordinary family home, situated in a residential area between Wallington and Sutton, which has been extended to provide care to people with Learning disabilities. It is a small family-like care home currently accommodating three service users. Each of the service users in the home has a single room on the first floor, which is decorated and personalised to reflect their individual taste. One of the service users spoken to during the inspection said that she liked spending time in her bedroom and had been able to arrange it in the way that she wanted to. There are many homely touches including pictures and flower arrangements. The office /sleep in room is on the top floor of the house The home’s premises are in keeping with the local community and were suitable for their purpose. Rafael DS0000038904.V297191.R01.S.doc Version 5.2 Page 18 The premises were generally bright, airy and clean on the day of the unannounced inspection. There was suitable domestic lighting and ventilation. There is also a large garden at the rear of the home which the service users spend time in during the summer months. All areas of the premises viewed were clean and free from offensive odours. There are appropriate laundry facilities. Systems are in place for controlling the spread of infection. This includes staff training in this area. Rafael DS0000038904.V297191.R01.S.doc Version 5.2 Page 19 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): 32,34,35, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team at the home have a range of skills and abilities, which enable them to meet the needs of the service users living at the home. EVIDENCE: The senior staff member on duty confirmed that all staff members currently working at the home have had Criminal Records Checks returned and all staff must have criminal records checks before starting work at the home. Staff records contained job descriptions, proof of identity, written references, terms and conditions of employment and all information required under the standards. The job descriptions for staff at the home staff clearly states what is expected of its employees in terms of their roles and responsibilities and the values that should underpin their conduct. The staff rota sent by the home to the Commission for Social Care Inspection Croydon office with the completed Pre Inspection Questionnaire confirmed that there is one member of staff on duty on each of the daytime shifts. At night there is also one member of staff on duty. There is a handover between shifts to ensure consistency. When activities are organised for the service users outside of the home, the home arranges for additional staff to be available. The home has a programme of staff training in place including fire safety, adult protection, health and safety and first aid. A record of staff training is kept by the home and a certificate of attendance on any courses kept on the staff file. A supervision structure is in place and the staff team have received at least six supervisions this year. Rafael DS0000038904.V297191.R01.S.doc Version 5.2 Page 20 The atmosphere in the home is friendly. The service user spoken to during the inspection felt that staff team listened to her and she was clear about who she would speak to if she had a problem. Rafael DS0000038904.V297191.R01.S.doc Version 5.2 Page 21 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): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management style appears to be transparent with clear lines of accountability. In the main health and safety arrangements are adequate to ensure potential risks to service users health and safety are so far as reasonably possible identified and minimised. EVIDENCE: Jan Farrar is the manager of Rafael. She has been in operational day-to-day control of the home since 2002. She has worked for Angel Homes for several years in different care and management positions. The service user at the home felt that the manager was someone they would talk to about any problems as well as other staff members. The home has selfmonitoring systems in place including an annual survey in the form of a questionnaire, which has recently been sent to the service users and their family members. The inspector was informed that the home manager would collate the information once it is returned. Rafael DS0000038904.V297191.R01.S.doc Version 5.2 Page 22 The records required for the safety and well being of service users are in place including accidents, water temperatures, risk assessments, complaints, incidents, food records, staff and service users case files, medication records and so forth Fire drills take place monthly and the home has completed a fire risk assessment. The home carries out fire drills at night as well as during the day. Rafael DS0000038904.V297191.R01.S.doc Version 5.2 Page 23 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 3 2 3 3 X 4 3 5 3 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 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Rafael DS0000038904.V297191.R01.S.doc Version 5.2 Page 24 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 YA12 Good Practice Recommendations The home manager must ensure that all service users have an annual holiday. Rafael DS0000038904.V297191.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Rafael DS0000038904.V297191.R01.S.doc Version 5.2 Page 26 - 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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