Inspection on 20/10/06 for Rainbow Lodge

This inspection was carried out on 20th October 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Rainbow Lodge 27/01/06

Rainbow Lodge 07/07/05

Rainbow Lodge 11/02/05

Rainbow Lodge 03/08/04

Rainbow Lodge 19/02/04

Rainbow Lodge 13/08/03

Rainbow Lodge 13/12/02

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

CARE HOME ADULTS 18-65 Rainbow Lodge 15 Trinity Road Scarborough North Yorkshire YO11 2TD Lead Inspector Karen Ritson Key Unannounced Inspection 20th October 2006 09:20 Rainbow Lodge DS0000007689.V318046.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 Lodge DS0000007689.V318046.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 Lodge DS0000007689.V318046.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rainbow Lodge Address 15 Trinity Road Scarborough North Yorkshire YO11 2TD 01723 375255 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) Ms Catherine Sleightholm Ms Catherine Sleightholm Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Rainbow Lodge DS0000007689.V318046.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th January 2006 Brief Description of the Service: Rainbow Lodge is a large semi-detached property occupying three floors. It provides accommodation for four service users with a learning disability. Each has a single room with bathroom and toilet facilities nearby. Communal space is provided on the ground floor. The home is owned and managed by Mrs Kath Sleightholm. Mrs Sleightholm and members of her family provide personal care, meals, laundry and a domestic service. The home employs no staff. A large private garden is used for outdoor activities. Residents have easy access to the towns facilities and amenities, which are within walking distance. The home also has a car, which is used for outings and day-to-day transport. The home charges fees of £300 per week. Taxi fares and sundry personal expenses are not included in these fees. This information was provided to CSCI on 05/10/06. The latest CSCI report is available at the home. Rainbow Lodge DS0000007689.V318046.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection for this service took 12 hours. This includes time spent gathering information and examining documentation before and after a site visit and in writing the report. The site visit took place on 20th October 2006 between 9:20am and 3:30pm. Information for this inspection was gathered from the following: • A tour of the premises • Observations of care throughout the day of the site visit. • Speaking with service users. • Speaking with the manager and her family. • Case tracking all service users on the day of the site visit. • Looking at information provided by the manager in a pre inspection questionnaire. • Notifications sent to the commission from the home since the last inspection. • Examining policies, procedures and records kept at the home. • Examining information regarding the home on the file kept by CSCI. • Considering comments made by relatives, health care and social services staff. All key standards were looked at during this inspection. The manager was present throughout the day of the site visit. What the service does well: This home offers a very high level of care for service users, within a homely and well -decorated environment. The manager and family get to know the service users well and have a detailed knowledge of what each person needs, which results in good, appropriate care for each individual. A social services manager said: ‘The home provides really good care.’ The home succeeds in providing service users with a range of stimulating activities, which are chosen with each person’s needs in mind. Service users also go out to pursue activities and clubs independently. The meals are particularly good, they are healthy, varied and the service users all said they enjoyed them. One said: ‘We are very well fed.’ The manager and her family support one another in their job and service users and their families feel they can go to the manager if there are any concerns. Any problems are quickly sorted out. The manager is well aware of the needs of this service user group and realises the importance of protecting people Rainbow Lodge DS0000007689.V318046.R01.S.doc Version 5.2 Page 6 from abuse of any kind. The home is well- run and service user health and safety is a priority. Service users, families and professionals alike all commented on how the manager worked hard to create a home from home and made family and friends feel welcome. One family member said of her relative. ‘She has settled so well and she is very happy here.’ 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 Lodge DS0000007689.V318046.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 Rainbow Lodge DS0000007689.V318046.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Quality in this outcome area is good. Service users needs are assessed leading to appropriate care. Information is provided about the home so that an informed decision about admission may be made. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each service user had a needs assessment with risk assessments for relevant areas of care. There has been one new admission since the last inspection. There was written evidence that the needs of this service user had been assessed over a period of time prior to admission. The decision as to whether Rainbow Lodge was a suitable placement had been made the involvement of the service user and family. This was recorded. The needs of the other service users living at the home were also taken into consideration. Family members for one service user visited the home on the day of the site visit. They confirmed that their relatives’ needs had been thoroughly assessed and that they had been confident the home could offer appropriate care. This careful and thorough approach to assessment and to providing the family with the information required about the home had led to an appropriate placement in which the service users needs are met. Rainbow Lodge DS0000007689.V318046.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good. The health and personal care which a resident receives, is based on their individual needs. Care is appropriate for each individual. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans are detailed and regularly reviewed with the involvement of service users and other interested parties. This ensures that the care provided remains appropriate and focused on changing needs. The manager was aware of and had anticipated future care needs based on her specialist knowledge and thorough assessment of each individual. A service user said she was encouraged to make decisions about the way she lived her life. She said: ‘I can go out when I like. I like to go to the shops.’ Another service user said she would only go with one of the other residents, as she was unsure of how to do things on her own. All but one of the service users manage their own personal allowance. Any restrictions on service users choice have been agreed following discussion and risk assessment. This ensures that service users retain independence and make decisions about the way they live their lives whilst being protected. Rainbow Lodge DS0000007689.V318046.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 excellent. Service users are enabled to choose their life style, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet service users expectations. Residents receive a healthy, varied diet, which they enjoy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Those service users who may benefit from it are encouraged to take part in supported employment. One service user works at a hospice shop, another works for a catering company part time. One service user said: ‘Kath took me and introduced me. I like it at the shop, it’s really good.’ The service users have a rich network of friends and contacts outside of the home. They attend Elder street day centre, Brookleigh, which hosts many activities and clubs, and they swap visits with other service users from another home. All the service users said they enjoyed the things they did. One said: ‘I do something almost every day. I like it like that. I go to the gym and have two jobs. I go to clubs and out with Kath.’ Mrs Sleightholm organises many Rainbow Lodge DS0000007689.V318046.R01.S.doc Version 5.2 Page 11 events at the home to which service users, their families, professionals and friends are invited. Service users spoke enthusiastically about the parties they were planning. They were keen to show their costumes for a Halloween party and were looking forward to bonfire night and Christmas. All had been involved in plans. In the summer months there had been barbeques and garden parties. A relative said: ‘She has settled very well and has lots to do. She loves it here.’ A social services manager visited the home during the day of the site visit and said: ‘These service users go out a lot into the community. Kath encourages independence. She responds to what they want to do and helps it happen. The service users definitely live the life they want here.’ This approach ensures service users lives are interesting, stimulating and meaningful. A midday meal was sampled and found to be of a very high standard. Service users were very complimentary about the food. One said: ‘The meals are really nice. We can choose what we want and Kath makes it.’ The service users often go shopping for food either with the manager or on their own. Sample menus were seen which showed a good variety of healthy options on offer. Specialist diets are catered for. The manager often cooks a Sunday lunch to which service users relatives and members of her family are invited. They also go out for meals sometimes or have a takeaway. Service users were without exception enthusiastic about their meals and mealtimes are an obvious occasion. Rainbow Lodge DS0000007689.V318046.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 excellent. Service users receive sensitive care, appropriate to individual needs. Their wellbeing is safeguarded and they make decisions about the way assistance is offered. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager provides a very sensitive and flexible service. Service users particular needs are written in the care plan and support is offered in a way which is appropriate to the individual. A social services manager said: ‘Kath adapts her approach to each person. One service user needs to be spoken to quite firmly at times, another would be really upset by the same approach, so she treats that person differently. She anticipates what each person needs and can see if it is necessary to intervene with certain behaviour.’ The social services manager confirmed that any specialist health care requirements were quickly sought and any changes in health needs were responded to. All access to GPs and other health care professionals is recorded on file along with notes to monitor changes. Service users have had risk assessments regarding medication and are all able to manage their own. Rainbow Lodge DS0000007689.V318046.R01.S.doc Version 5.2 Page 13 Medication is well kept and service users know how to access it. The manager has a good knowledge of the medication each service user is prescribed and monitors how this is taken. This ensures service users retain as much independence as possible whilst risk is minimised. Rainbow Lodge DS0000007689.V318046.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 is good. Residents have access to an effective complaints procedure; their complaints are listened to and acted on. Service users are protected from abuse and have their legal rights protected This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a good complaints policy and procedure. Both relatives of service users and care professionals said the manager was approachable and would listen to any complaints, although all were keen to add that a complaint would be unusual. One service user said: ‘If there was something wrong I’d say, but there isn’t.’ This open approach allows service users to feel confident about saying if there is a problem and expecting it to be put right. The home has an abuse policy and procedure. Both the manager and her daughter have been on abuse awareness training. A relative said of a service user: ‘I am confident she is safe here. If there was any problem outside the home Kath would soon know about it. (Our relative) talks to Kath about things that bother her, she trusts her.’ The manager handles the personal allowance for one service user. Although the manager was recording this she was unsure how to do so accurately without entering a negative balance or recording in minute detail. Following discussion, she agreed to record that the allowance was given each week and would ask the service user to sign when she received it, keeping the system simple. The policies and procedures of the home and the approach of the manager and staff ensure that service users are kept safe. Rainbow Lodge DS0000007689.V318046.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 good. Service users live in a safe, well-maintained and comfortable environment, which encourages independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is well maintained and suitable for those living in it. It is attractively decorated and service users rooms are furnished and presented to their particular tastes. Service users were enthusiastic about their rooms and how they had been decorated. The home has a fire risk assessment and the recommendations of the fire department have been carried out. The home is kept clean and the manager has developed comprehensive policies on infection control and hygiene. The manager described plans for improving the kitchen area and during a tour of the garden pointed out some improvements, which had been made to the area immediately beyond the house and improvements to a summerhouse. Service users said they would be able to watch the fireworks from the summerhouse without having to get cold. Rainbow Lodge DS0000007689.V318046.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. Staff in the home are trained, skilled and in sufficient numbers to fulfil the aims of the home and meet the changing needs of residents. This judgement has been made using available evidence including a visit to this service. . EVIDENCE: The manager’s daughter is in the process of achieving NVQ level 4 in care and management with a view to taking over the management of the home at some time in the future. She has undertaken challenging behaviour, first aid, moving and handling and fire safety training. All certificates are displayed on the wall in the entrance hall of the home. The family have all had CRB checks carried out and these were looked at. There are no staff and the manager has no plans to employ any. All feedback from professionals and family members suggested that the manager and her family are competent individuals who have built up a great deal of relevant experience of how to care for this client group. Service users said they were very happy with their care. Rainbow Lodge DS0000007689.V318046.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 good. Service users benefit from an open style of management based on respect and from the considerable experience of the manager. Service users’ and others’ views inform practice. Their welfare is protected by robust health and safety systems. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has undertaken training in health and safety and other relevant areas of care. She is well qualified by experience to run the home. She has developed a basic quality assurance procedure which she intends to develop to include an annual plan of improvement based upon survey findings. The health and safety of service users is protected by comprehensive policies and procedures. Safety policies were posted on the kitchen wall. Any notifiable occurrences are communicated to CSCI through regulation 37 notices. The welfare of service users is protected. Rainbow Lodge DS0000007689.V318046.R01.S.doc Version 5.2 Page 18 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 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 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 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 2 X 3 X X 3 X Rainbow Lodge DS0000007689.V318046.R01.S.doc Version 5.2 Page 19 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 Refer to Standard YA23 YA37 Good Practice Recommendations The new system of recording residents’ money held in the home should be implemented as soon as possible. The registered provider is reminded of the need for any manager of a care home to have obtained a National Vocational Qualification in care and management to level 4. Rainbow Lodge DS0000007689.V318046.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Lodge DS0000007689.V318046.R01.S.doc Version 5.2 Page 21 - 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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