Inspection on 26/10/06 for Rainbow

This inspection was carried out on 26th October 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

Rainbow 04/09/07

Rainbow 24/03/06

Rainbow 06/10/05

Rainbow 17/03/05

Rainbow 07/09/04

Rainbow 26/02/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Rainbow 5 Victoria Road Canterbury Kent CT1 3SG Lead Inspector Christine Lawrence Unannounced Inspection 26 and 27 October 2006 10:00 Rainbow DS0000023531.V307329.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 Rainbow DS0000023531.V307329.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. Rainbow DS0000023531.V307329.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rainbow Address 5 Victoria Road Canterbury Kent CT1 3SG 01227 455745 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) L’Arche (Registered Office) Vacant – Tuuliki Ruubas applying Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Rainbow DS0000023531.V307329.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 24/03/06 Brief Description of the Service: Rainbow is a care home providing personal care and accommodation for 5 people. It is operated by L’Arche which is an international community within which are homes for people with learning disabilities. L’Arche Kent is the owner of Rainbow. The home is located close to Canterbury city centre with all of its amenities. The house is a large semi detached property. All the residents have single rooms. There is an enclosed garden to the rear and car parking facilities to the side. Some of the staff are permanent but others come from many different countries to be part of the community within the home and within the area for a specific period of time. Staff and residents are known as Members of the community, some of who are Core Members. The terms staff and residents are used for the purpose of this inspection report. Information about the home, including the last inspection report, will be made available on request. Information provided through the pre inspection questionnaire, received on 12 September 2006, included the current weekly fees of £412.61 to £875.88. Rainbow DS0000023531.V307329.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and started at 15.30 and finished at 18.00 on the first day and from 09.45 until 13.30 on the second day. The inspector looked at various records in the home and also used information sent to the Commission by the manager before the visit (the pre inspection questionnaire). Information from the previous inspection was also referred to. The inspector spoke with several of the residents and was invited to see two bedrooms. A tour of the rest of the building was undertaken. Three relatives/visitors comment card was sent to the commission. One health care professional and two care managers completed comment cards. The home supported three residents to complete their own evaluation forms to provided information for this inspection. The inspector made observations of staff interacting with residents. What the service does well: 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. The summary of this inspection report can be made available in other formats on request. Rainbow DS0000023531.V307329.R01.S.doc Version 5.2 Page 6 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 Rainbow DS0000023531.V307329.R01.S.doc Version 5.2 Page 7 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 good. This judgement has been made using available evidence including a visit to this service. Prospective residents’ needs and aspirations would be assessed. EVIDENCE: Although no new resident has moved into the home for some time it is clear from the systems and procedures in place that this standard would be met for any new resident. Rainbow DS0000023531.V307329.R01.S.doc Version 5.2 Page 8 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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their changing needs will be noted in their individual plans and that they will be supported to make decisions and take risks to enable as independent a lifestyle as possible. EVIDENCE: Individual care plans are in place for each person at Rainbow. They are detailed and individual. They cover a range of assessed needs and provide clear guidelines about how support should be offered. They include photographs of activities and/or people and there is a list of personal preferences (likes and dislikes), which clearly reflects that residents are involved in compiling this information. There were copies of information from placing authorities where appropriate. Where relevant there are guidelines for positive behaviour support. There is a key worker system in place. The care plans/personal profiles were all up to date. Throughout the individual folders Rainbow DS0000023531.V307329.R01.S.doc Version 5.2 Page 9 there is evidence of risk assessments to support residents’ independence or to demonstrate why restrictions are in place. Talking to staff, as well as viewing records showed that residents make choices about their daily routines and get any support they might need to do this. The commission was informed through the pre inspection questionnaire that the organisation provides appointees for three residents although they all also have individual building society accounts. Rainbow DS0000023531.V307329.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are opportunities for stimulation, socialising, leisure and contacts with friends and family which mean that residents lead full and active lives. They will benefit from being offered a healthy diet and a sociable setting for mealtimes. EVIDENCE: Residents attend various day activity provisions, some run by L’Arche in the area for various sessions according to their wishes and needs. Other facilities within the wider community are also accessed. Residents have opportunities to fulfil their spiritual needs. L’Arche is a Christian based community. Practical life skills are included within the individual care plans and how residents are supported in this varies from individual to individual. Residents use local shops and other community provision such as restaurants, churches, theatres and pubs etc. Residents are encouraged and enabled to partake of a range of Rainbow DS0000023531.V307329.R01.S.doc Version 5.2 Page 11 leisure pursuits. There are frequent birthday celebrations and other gettogethers involving friends and families. There is a great deal of socialising within the L’Arche community. The inspector was informed that the evening meal is also very much of a social occasion. Residents at the home enjoy lots of opportunities for holidays as within the wider L’Arche community, residents visit and stay in each other’s homes. Residents are encouraged to maintain contact with friends and family and this does vary according to the personal circumstances of each individual. Visitors who responded to the commission’s request for comments clearly stated that they are made welcome when they visit. Bedroom doors are lockable and residents can choose to use this facility. Mail is put into individual compartments for residents to open and staff will support as required. Privacy is considered important and staff will knock and seek permission before entering a resident’s room. Residents can choose to spend time in their rooms as they wish. People take part in various domestic chores and are encouraged to keep their own rooms clean. There is a fish tank in the main lounge. The evening meal is considered an important social part of the day. Residents take turns to provide the meal sharing this task with a member of staff. Although there is a menu, the choices are based on whoever’s turn it is to cook which encourages variety. Residents’ likes and dislikes are known and an alternative will be offered. The dining table is very large, allowing for everyone to sit together. Rainbow DS0000023531.V307329.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive personal support in the way they prefer and their health care needs are identified and met. Residents are protected by the home’s procedures for dealing with medication. EVIDENCE: Residents seen during this inspection were individual in their appearance and the inspector was informed that individuals make choices about their clothes and hairstyles. Residents’ needs with regard to the level of support they require for personal care varies according to their abilities for instance one person might need lots of help and another might only need encouragement. Information about personal hygiene preferences as well as information about morning routines is provided within the individual plan. The home’s policy is that a male assists a male and a female assists a female. There are sufficient male and female staff for this to happen. The records seen indicate that residents health care needs are identified and responded to with attention from dentists, opticians, general practitioner, community nurses, dietician, Rainbow DS0000023531.V307329.R01.S.doc Version 5.2 Page 13 continence advisor etc. Medication is appropriately stored and administration is properly recorded. The co-ordinator is in the process of introducing better health plans and records for each resident. Rainbow DS0000023531.V307329.R01.S.doc Version 5.2 Page 14 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 and 23 Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. Residents are protected from abuse and their views are listened to and acted on. EVIDENCE: The individual planning, key worker system and regular house meetings are used to ensure that residents’ views and concerns are noted. There are policies and procedures in place regarding complaints. A poster, using pictures, is on display for residents to assist them in knowing who to talk to if they have a problem. There are policies and procedures relating to adult protection and whistle blowing and these were reviewed in October 2005. The home also has the new multi agency procedures from Kent County Council’s social services department. A policy regarding aggression toward staff is in place and was reviewed in September 2004. All members of staff have received NAPPI training and there is an appropriate policy about the use of restraint. A policy regarding bullying is also in place. Rainbow DS0000023531.V307329.R01.S.doc Version 5.2 Page 15 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents would benefit from some improvements to the environment. Residents benefit from living in a clean and hygienic environment. EVIDENCE: The home’s premises are suitable for their purpose and the house is comfortable and homely. Rainbow is situated close to the city centre with all of its amenities. It is in keeping with the local community. A housing society owns the property and undertakes maintenance as required and on a planned basis. There are some minor repairs that need to be completed and much of the gloss woodwork (in communal areas) is chipped and needs repainting. There are no outstanding requirements from the environmental health officer. The fire safety risk assessment has been audited by the fire safety officer. The garden is rather overgrown and needs some attention. Rainbow DS0000023531.V307329.R01.S.doc Version 5.2 Page 16 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 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment and training of staff will have a beneficial impact on residents. EVIDENCE: There is a detailed training programme in place. This specifies the topics or stages; followed by the criteria for participants, goals to be achieved, course content and structure. This allows for supporting staff members who are working for short periods of time as well as those who continue to work within the L’Arche community. The ‘assistants co-ordinator’ is responsible for planning the training and ensuring that staff are enabled to attend. Induction training is provided and this was reflected in the two staff records viewed. The programme includes national vocational qualifications. The records seen reflect a robust recruitment procedure which includes application forms, references, terms and conditions of employment and criminal record bureau checks. The policies and procedures which the organisation has in place cover relevant aspects of recruitment. Rainbow DS0000023531.V307329.R01.S.doc Version 5.2 Page 17 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 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well run home, although the new manager needs to be registered and complete appropriate qualifications, and their health and safety is promoted and protected. EVIDENCE: Tuuliki Ruubas is not yet registered. Although she has only recently taken on the role at Rainbow she has been at the home for over two years. She is being mentored by the previous manager and supervised by her line manager. Although the home can demonstrate that it takes account of the views of residents, the organisation as a whole is still looking at the best way of monitoring quality and providing information about the results. Rainbow DS0000023531.V307329.R01.S.doc Version 5.2 Page 18 Training is provided through a rolling programme to all staff regarding moving and handling, fire safety, first aid and food hygiene. This training forms part of the induction process for all new staff across the organisation. There are written procedures for infection control which also form part of induction. They include health and safety guidelines, dealing with body fluids and a handwashing guide. A spot check on records relating to maintenance and servicing indicates that everything is appropriate and up to date. There are a variety of risk assessments relating to various aspects of health and safety within the home eg using the home’s vehicles, using candles, hot water, hepatitis b, deep frying and slips, trips and falls. Rainbow DS0000023531.V307329.R01.S.doc Version 5.2 Page 19 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 3 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 2 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 3 12 3 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 2 X 2 X X 3 X Rainbow DS0000023531.V307329.R01.S.doc Version 5.2 Page 20 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 2 3 Refer to Standard YA24 YA37 YA39 Good Practice Recommendations Minor repairs and necessary redecoration should go ahead. The manager needs to apply for registration and complete appropriate qualifications The organisation should clarify how quality will be monitored within the home Rainbow DS0000023531.V307329.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Rainbow DS0000023531.V307329.R01.S.doc Version 5.2 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!