Inspection on 12/01/09 for Raleigh House

This inspection was carried out on 12th January 2009.

CSCI found this care home to be providing an Excellent service.

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

Raleigh House 17/01/07

Raleigh House 01/03/06

Raleigh House 23/08/05

Raleigh House 01/03/05

Raleigh House 12/11/04

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Edenvale

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Chatsworth Care - Dawson House

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Chatsworth Care - Tudor Lodge

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Raleigh House 9 Raleigh Avenue Wallington Surrey SM6 8HE     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jon Fry     Date: 1 2 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 23 Information about the care home Name of care home: Address: Raleigh House 9 Raleigh Avenue Wallington Surrey SM6 8HE 02086693691 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : d_jesudasan@hotmail.com Mrs Rose Padmani Jesudasan care home 5 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 5 The Registered Person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Learning Disability Code LD The maximum number of service users who can be accommodated is: 5 Date of last inspection Brief description of the care home Raleigh House is a semi detached property located in a quiet street in Wallington. The home is approximately one mile away from shops and bus routes to Croydon and Sutton. The home is registered to provide care for up to five adults who have a learning disability. There is an extension on the ground floor, which includes a bedroom with en-suite adapted facilities. There is a well maintained garden to the rear of the home. A copy of the homes Service User Guide can be obtained on request from the owners, as can the current tariff of fees for the service. Care Homes for Adults (18-65 years) Page 4 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We spent three hours at the home on an unannounced visit and spoke to one person who lives there, two staff members and both of the owners. We received three completed surveys from relatives, friends and advocates. The home sent us an Annual Quality Assurance Assessment (AQAA). This is a self assessment that gives us important information about the service and how it is run. Care Homes for Adults (18-65 years) Page 5 of 23 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 6 of 23 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 7 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed so the home is sure that it can support them properly. Individuals are given good information about living there and can make visits to the service to help them decide if they want to live there. Evidence: Comments from relatives, friends and advocates included very much the needs of residents are met and they are extremely caring and considerate of their needs. Three people have come to live at the home within the last two years. In the AQAA, the manager told us that each persons needs were assessed and they were able to make a number of visits to the service before moving in. We saw that assessments had been completed for two people whose files we looked at. These are completed with input from the individual and the people who know them. We saw that the local authority had also provided the home with its care plan to help them meet the persons needs successfully. Care Homes for Adults (18-65 years) Page 8 of 23 Evidence: There is a guide to the home that is also avaiilable on audio tape to help people use it. We have recommended that the service keeps looking at the guide to see if a version with lots of pictures and photographs could be produced. Care Homes for Adults (18-65 years) Page 9 of 23 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are care plans for each person that help staff meet their needs. The manager and staff help people to take sensible risks and to be involved in the life of the home. Evidence: Comments in surveys included they are extremely happy and well looked after and individual service in a person centred manner. We saw that each person has a care plan and these provide good information about how the individual likes to be supported. We looked at a very good person centred plan with pictures that showed others about day to day needs and individual likes and dislikes. We saw the plans are kept under review and that each person has a key worker who does this. The owner is a trained facilitator in helping people make their own person centred plans and showed us a persons plan made on a wall chart. The manager and staff we talked to clearly know the people who live there very well. Care Homes for Adults (18-65 years) Page 10 of 23 Evidence: They were able to tell us about the things each person likes to do and the support they need to do them. We have recommended that the home keeps looking at how the care plans can be made more person centred and reflect individual hopes and wishes. The manager told us that they are re-organising the files for each person to make sure that they are a usable working document. This will help the staff as the service holds a large amount of information for each person. People living there are helped to take sensible risks in their daily lives and there is a positive can do attitude in the service. We saw that the care files included assessments about possible risks to the person. Care Homes for Adults (18-65 years) Page 11 of 23 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged to lead active lives and are helped to keep in touch with their families and friends. Evidence: The care home provides more activities especially with the things they like to do best was a comment in one survey we received. We saw that the home is very strong in this area and this reflects the ethos of the owners. They told us how important they thought it is for people to lead active lives and have pursued opportunities for people to do varied activities that they enjoy. These include swimming, dancing, cookery and attending Church. One person volunteers at a day centre and two people go to a London museum each week to take part in a project run there. Care Homes for Adults (18-65 years) Page 12 of 23 Evidence: The people who live there are supported to keep in touch with family and friends. All three people who returned surveys said the home helped the person stay in touch with them. Food is freshly prepared by staff and we saw one person having their lunch early before thay went out for the afternoon. Drinks and snacks are available for people to have very much in keeping with a home environment. Care Homes for Adults (18-65 years) Page 13 of 23 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are helped to stay healthy and well. Evidence: We saw that care plans contain good information about the support each person needs. The notes we looked at showed that each person receives help with their personal care as required and their individual health monitored. One person who returned a survey said that they were kept up to date with the persons health needs commenting they were informed if they need the dentist or other needs. Each person has a health action plan in place and a staff member has attended training in facilitating these for individuals. Records in the files we looked at showed that individuals are supported to attend health appointments and to receive treatment as required. one persons records showed that they had recently had the flu jab and another person was attending specialist appointments at a hospital. Care Homes for Adults (18-65 years) Page 14 of 23 Evidence: We looked at the way the home manages medicines for the people living there. Records are kept well showing that people receive the right medication at the right time. All of the medication is kept securely and staff receive training in how to give it safely to individuals. The current system is working but does need to be reviewed by the owners to be in line with current good practice. As per CSCI published advice, secondary dispensing should be avoided wherever possible. Medication should be given from the original container and compliance aids only used in certain circumstances. Guidance is available from the CSCI website about this issue. Care Homes for Adults (18-65 years) Page 15 of 23 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living there are protected by the homes procedures around complaints and safeguarding. Evidence: Ive never had need to do this and we have not had any complaints to make were comments in surveys when we asked if the home responded appropriately to any concerns. The home has a procedure in place for dealing with complaints and this is included in the user guide. No complaints about the service have been received within the last twelve months. Staff records we looked at showed that they have training in safeguarding. The home has copies of the local authority procedures to follow if required. Care Homes for Adults (18-65 years) Page 16 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe, homely and well maintained environment. Evidence: We saw that the the environment is very well maintained and feels like home. The combined lounge, dining and kitchen area is a pleasant place for people to spend time and there is also a well maintained garden area for people to use. We saw peoples bedrooms and these are personalised to each individual. Two people with slight mobility problems have bedrooms downstairs and new adapted bath equipment has been fitted in the ground floor bathroom. A hand rail has also been fitted at the front entrance to help individuals. We saw that the home is kept clean and hygienic for the people who live there. Care Homes for Adults (18-65 years) Page 17 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff are appropriately recruited, trained and given support to do their jobs well. Evidence: We find the staff are experienced as they have a good manager, Rose and the staff are just great and when I have visited, the staff are engaged with the individuals were comments in surveys. The staff we spoke to said they received enough training and support to do their jobs well. They said they received regular individual supeervision with the owners and could always get support from them when required. The staff records are well maintained and we saw that checks are carried out before people can come and work there. These include references and Criminal Record Bureau (CRB) checks. Training for staff has included autism, safeguarding, food hygiene, fire safety and the Mental Capacity Act. Staff are supported to acess NVQ training up to level four. Care Homes for Adults (18-65 years) Page 18 of 23 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is well managed. People who live there benefit from the ethos and positive approach of the owners. Evidence: One person who returned a survey talked about how the people they knew had positively benefited from coming to live at the home saying they now appear very comfortable and contented. A comment from another person was they are the happiest and most confident Ive ever seen. We think that the service is run very well and clearly has an ethos that values and respects the people who live there. Staff have clear leadership and positive role modelling to guide their practice in addition to the training they get. The service has a quality assurance procedure that includes regular checks on documentation, Health and Safety practices and cleanliness. We saw that the people who live there are regularly consulted at house meetings and individual reviews are Care Homes for Adults (18-65 years) Page 19 of 23 Evidence: used to look at the service being provided to each person. Good records are kept around people money and we checked these for one person currently living there. We saw that these records are also checked regularly by someone outside of the home. The home makes regular checks around Health and Safety. Areas looked at include water temperatures, fridge temperatures, fire safety and they also make sure professional checks are carried out for gas and electrical safety. Care Homes for Adults (18-65 years) Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 The home should keep looking at how the guide to the home could be made more accessible. Pictures and photographs of key people and places may help to do this. The service should continue to look at how care plans can be made more person centred and accessible to those people using the service. Work should continue to archive out of date information from each persons file. 2 7 3 20 The homes practice around mediaction should be reviewed. Secondary dispensing should be avoided wherever possible. Guidance from CSCI should be accessed to inform this review. Care Homes for Adults (18-65 years) Page 22 of 23 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 23 of 23 - 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!