Inspection on 13/12/06 for Rainbow Lodge Nursing Home

This inspection was carried out on 13th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rainbow Lodge Nursing Home 07/10/08

Rainbow Lodge Nursing Home 07/11/05

Rainbow Lodge Nursing Home 29/06/05

Rainbow Lodge Nursing Home 18/11/04

Rainbow Lodge Nursing Home 28/06/04

Rainbow Lodge Nursing Home 09/02/04

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

CARE HOME ADULTS 18-65 Rainbow Lodge Nursing Home 14 Madeley Road Ealing London W5 2LH Lead Inspector Louise Phillips Key Unannounced Inspection 13th December 2006 10:00 Rainbow Lodge Nursing Home DS0000010960.V323903.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 Nursing Home DS0000010960.V323903.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 Nursing Home DS0000010960.V323903.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rainbow Lodge Nursing Home Address 14 Madeley Road Ealing London W5 2LH 020 8991 5060 020 8567 1414 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) Mr and Mrs Gopaul Mrs Luce Argita Gopaul Care Home 20 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (20) of places Rainbow Lodge Nursing Home DS0000010960.V323903.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 20 mentally ill Date of last inspection 7th November 2005 Brief Description of the Service: Rainbow Lodge is a nursing home for up to twenty younger adults who have a mental health problem. It is situated in a residential area of Ealing close to local facilities and transport. There is a large secluded garden at the rear of the building and parking spaces for several cars in front of the home. The service is owned by Mr and Mrs Gopaul and they are the Registered Providers. Mrs Gopaul is the Registered Manager. At the time of inspection the fees for the home were from £550 - £1012 per week. Rainbow Lodge Nursing Home DS0000010960.V323903.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day with time spent talking to four staff, the owners and six residents. A tour of the premises was carried out and care records were inspected along with other relevant paperwork. Information has also been gained from the inspection record for the home. 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 Lodge Nursing Home DS0000010960.V323903.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 Lodge Nursing Home DS0000010960.V323903.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 and 4 Quality in this outcome area is good. There is a good assessment process for new residents moving to the service to ensure that the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection one new resident has moved to the home. Their care file contains information about the referral and assessment prior to their moving to the home, with details about their mental health, any alcohol problems, personal care, important relationships, etc. In addition there is information about any areas of risks that need to be planned for. New admissions to the service are planned, which take place through day visits and overnight stays, with a month’s trial being given. A care plan is developed for this process and is reviewed after each visit, where the new resident is assessed and their mental state monitored, particularly when interacting with existing residents at the home. Good records are kept of each visit to the home, including what the resident has done, who they have spent time with, medication issues, whether they were anxious or settled, etc. Rainbow Lodge Nursing Home DS0000010960.V323903.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. The resident’s needs are met by the service, and plans are in place to minimise risks to residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care files for four residents were looked at. These are very much ‘working files’, providing up-to-date information about the residents needs, interests and how staff support the resident. The care plans are reviewed regularly, with the frequency of these dependent on the priority of the need. All care plans were signed by the resident. The care plans are individualised and focus on maximising each residents’ independence. Some residents have support needs around daily living skills such as personal hygiene or domestic skills, which are all planned for. In contrast the care plans for other residents have been developed around their social needs, managing money and support with developing relationships or looking for future accommodation. Rainbow Lodge Nursing Home DS0000010960.V323903.R01.S.doc Version 5.2 Page 9 In some cases the mental health history of a resident has been incorporated into a care plan, such as where there are particular concerns about their mental health or any inappropriate behaviours they have that staff need to be aware of. Where there are more specific risks or as a result of an incident, a risk assessment and management plan details the current safety needs of the resident. These include risks such as being making allegations, self neglect or support when outside of the home. One file contained a consent form signed by the resident, to demonstrate that they agree to sharing a room with another resident. This was also confirmed by talking to the resident, who said that they liked sharing with another resident. Rainbow Lodge Nursing Home DS0000010960.V323903.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. The residents have the opportunity to be involved in activities that are planned around their needs, interests and community living. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On arrival at the home the residents were carrying out their daily lives at their own pace and with the support of the staff on duty. Staff were observed being friendly, accessible and had a good rapport with the residents. The nurse on duty described the programme of activities at Rainbow Lodge as “…passive rehabilitation…”. This was reflected in the information in the care files, which contain information about the different rehabilitation programmes that residents pursue throughout the week. These include activities such as tidying room, attending the community meeting, visiting relatives or going to the temple. In addition a record is maintained of what each resident has been doing each day, eg. went to shops, read newspaper, listened to music. Rainbow Lodge Nursing Home DS0000010960.V323903.R01.S.doc Version 5.2 Page 11 The inspector was informed that trips have taken place during the year to such places as Brighton and Richmond park, and that residents have been encouraged to join in the festivals that take place on Ealing Common, which is within walking distance. One resident spoke in detail about a computer course that they had done with at a college, and with the support from staff at the home. Another resident said that they also have the opportunity to “…go home some weekends…”. Staff on duty discussed that the home is working to promote residents to be more involved in preparing and cooking meals. One resident spoke about how they enjoy cooking and have been involved in baking scones and cakes for the other residents. The menu offered by the home is planned with residents at the community meeting. The owner discussed how the home plans meals with the residents in an effort to move away from traditional English meals, and to reflect the cultural backgrounds of the residents. All residents said that they like living at the home and that they are able to eat what they want. One resident described that breakfast is a choice of porridge, toast or cereals and that lunch is a set meal, but that “…we can ask for something else if we don’t like this…”. The owner discussed that all religious festivals are celebrated at the service, where relevant to the resident’s cultural backgrounds, along with national days, such as St Patrick’s day, with special food prepared and a party to celebrate this. Staff and residents also spoke about how the owners are very aware of each resident’s cultural needs and these are catered for via the food provided and through recognising and celebrating relevant festivals, birthdays and religious celebrations throughout the year. Rainbow Lodge Nursing Home DS0000010960.V323903.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. The service responds well to ensure that the personal and healthcare needs of residents are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A majority of the residents are independent when attending to their personal care needs and minimal support is offered to other residents, by way of prompting only. All residents are involved in regular reviews of their care and placement at the home, and all are supported to attend healthcare appointments if they wish to. A record is maintained of all healthcare appointments for each resident, eg. chiropodist, dentist, care programme approach review; with all these having taken place within the last six months. Medication is given by the qualified nurses only and is stored in a locked cabinet attached to the wall in the office. The medication for four residents was checked and the information on the labels found to correspond correctly Rainbow Lodge Nursing Home DS0000010960.V323903.R01.S.doc Version 5.2 Page 13 with the medication chart. The charts were all signed and up-to-date. A list of staff signatures and initials was in place for easy tracking in case of any error. Residents stated that they receive the right support from staff to ensure they take their medication on time. It was observed that the PRN ‘as required’ medication prescribed for one resident was not available. The nurse stated that this is no longer required by the resident and that they will address this with the prescriber. Rainbow Lodge Nursing Home DS0000010960.V323903.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 feel confident to raise areas of concern they have and systems are in place to reduce risks to residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a satisfactory complaints procedure and format for the logging of complaints. Residents spoken said that they knew who to talk to if they had any concerns about the service, and that they were also able to raise issues at the community meeting. The training records for staff indicate that they have received recent training in the Protection of Vulnerable Adults (POVA). There are also policies and procedures in place regarding abuse awareness and what to do in the event of this. Rainbow Lodge Nursing Home DS0000010960.V323903.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. The environment at Rainbow Lodge is welcoming and homely. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The accommodation at Rainbow Lodge consists of four single bedrooms and eight double bedrooms. There are screens for use in the double bedrooms to promote the privacy of the residents accommodated. There are bedrooms on each floor. On the ground floor there is a dining area and a few stairs leading to the lounge area. The dining room is comfortably furnished and is a designated smoking area. The kitchen and laundry are on the ground floor. There is also a second quiet room for use on the first floor. There are toilets and bathrooms on each floor. There are no lifts in the building so it is suitable only for residents with good mobility. Five bedrooms were seen and found to be of a good standard, with adequate furnishings, clean and tidy. The owner said that the residents maintain their Rainbow Lodge Nursing Home DS0000010960.V323903.R01.S.doc Version 5.2 Page 16 own bedrooms with the support of staff and domestic staff are employed to clean the communal areas. Some bedrooms were quite dimly lit. The owner said that the residents choose this, due to their sometimes liking to relax in their rooms during the day. The owner stated that the home is re-painted every year, though more frequently in some bedrooms, where required. On the day of inspection it was observed that the home is cleaned to a good standard throughout. Rainbow Lodge Nursing Home DS0000010960.V323903.R01.S.doc Version 5.2 Page 17 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. The staff receive relevant training for their role and appropriate recruitment checks are carried out to minimise the risks to residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two staff on duty commented that the best thing about the service is the “…good team…” and that “…everyone works well as a team…”. Another member of staff spoke about the amount of training that is provided to develop the staff in their role. The training records indicate that staff have done recent training in the Protection Of Vulnerable Adults (POVA), first aid and basic food hygiene. Rainbow Lodge maintains a complement of staff who have worked at the home for a number of years and have a good working knowledge of the residents, and working with people with mental health problems. On each shift there is a Registered Mental Health Nurse plus three healthcare assistants. Rainbow Lodge Nursing Home DS0000010960.V323903.R01.S.doc Version 5.2 Page 18 The home has recruitment information on each member of staff. Three staff files were examined and found to contain relevant information such as proof of identification, correspondence relating to offer of job, statement of terms and conditions of employment and two references. Rainbow Lodge Nursing Home DS0000010960.V323903.R01.S.doc Version 5.2 Page 19 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, 41 and 42 Quality in this outcome area is good. The home is organised and well-run, taking into account the needs and wishes of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Observations and discussions during the inspection were positive, indicating that the owners are respected and well-liked by the those living and those working at the home. The owners demonstrate a good understanding of the National Minimum Standards for Younger Adults and work well towards meeting these, and this is reflected in the few requirements as a result of this inspection. In addition, the owners showed a genuine caring approach towards the residents and displayed and in-depth knowledge of each resident, their individual preferences and needs. Rainbow Lodge Nursing Home DS0000010960.V323903.R01.S.doc Version 5.2 Page 20 Earlier this year the home carried out a quality audit where they surveyed the residents, relatives, healthcare professionals and staff to seek their views on areas such as privacy, participation in home life, independence and resident’s rights. In the report that followed the audit there was a summary of the responses and actions planned to address any concerns. Recording in the daily care records is of a good standard, with a detailed account being made of what each resident has done throughout the 24 hour period. The home maintains records to demonstrate that appropriate health and safety checks are carried out on the fire system and equipment, fridge and freezer temperatures, electrical installation, gas safety and Portable Appliance Testing, etc. During the inspection the water from the hot tap in bedroom 9 was found to be too hot to touch, and this was rectified at the time. The Health and Safety Executive require that weekly monitoring of the outlet temperature of water be carried out. Therefore, a requirement has been made for Rainbow Lodge to carry out weekly checks of the water temperature from all outlets around the home and a record maintained of these, to ensure the water is dispersed at temperature of no more than 44 degrees centigrade. Guidance suggests that the tap should run for approximately one minute prior to taking the temperature to ensure an accurate temperature reading. Rainbow Lodge Nursing Home DS0000010960.V323903.R01.S.doc Version 5.2 Page 21 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 3 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 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 3 X 3 X 3 2 X Rainbow Lodge Nursing Home DS0000010960.V323903.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO 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 YA42 Regulation 13(4) Requirement The Registered Persons must ensure that a weekly check of the water temperature from all outlets around the home is carried out, and a record maintained of these to ensure the water is dispersed at temperature of no more than 44 degrees centigrade. Timescale for action 31/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Rainbow Lodge Nursing Home DS0000010960.V323903.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection West London Area Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Nursing Home DS0000010960.V323903.R01.S.doc Version 5.2 Page 24 - 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. 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