Inspection on 17/01/07 for Raleigh House

This inspection was carried out on 17th January 2007.

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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Raleigh House 12/01/09

Raleigh House 01/03/06

Raleigh House 23/08/05

Raleigh House 01/03/05

Raleigh House 12/11/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Raleigh House 9 Raleigh Avenue Wallington Surrey SM6 8HE Lead Inspector Diane Thackrah Key Unannounced Inspection 17th January 2007 2:00pm Raleigh House DS0000007183.V326952.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 Raleigh House DS0000007183.V326952.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. Raleigh House DS0000007183.V326952.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Raleigh House Address 9 Raleigh Avenue Wallington Surrey SM6 8HE 020 8669 3691 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) d_jesudasan@hotmail.com Mrs Rose Padmani Jesudasan Mr Davanthiran Jesudasan Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Raleigh House DS0000007183.V326952.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st March 2006 Brief Description of the Service: Raleigh Avenue is a four bed roomed, semi detached house situated in a quite street in a suburb of Wallington. The home is approximately one mile away from shops and bus routes to Croydon and Sutton. The Registered Provider is Mrs Jesudasan and the Registered Manager is her husband, Mr Jesudasan. The home is registered to provide accommodation and care to three adults who have a learning disability. The home has an extension on the ground floor, which includes a bedroom with en-suite shower facilities. There is a garden to the rear of the building. A copy of the home’s Service User Guide and Statement of Purpose can be obtained on request from the Registered Provider’s, as can a copy of the most recent Commission for Social Care Inspection, inspection report. Fees for the home at the time of writing are £738.66. There are no additional charges Raleigh House DS0000007183.V326952.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on 17th December 2007 between 14.00 and 17.00. Care records were examined and a partial tour of the premises took place. The standards of care were assessed through observation, examination of care records and discussion with the Registered Providers and one staff member. Both service users were present throughout the inspection, however, due to the complexities of the service user’s learning disability, neither were able to share their views on the home. Observations of care practices therefore took place in order to gain an insight into the experiences of the service users. What the service does well: What has improved since the last inspection? What they could do better: Two Requirements have been made as a result of this inspection. There is a need to carry out a fire risk assessment of the home, and a need to ensure that radiator covers are in place in any bedroom occupied by a service user. Raleigh House DS0000007183.V326952.R01.S.doc Version 5.2 Page 6 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. Raleigh House DS0000007183.V326952.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 Raleigh House DS0000007183.V326952.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): Quality in this outcome area is good. (2) This judgement has been made using available evidence including a visit to this service. Information about the home is accessible to service users allowing them to make a more informed decision about were to live. There are good arrangements for ensuring that service users have their assessed needs met. EVIDENCE: The Registered Provider said that there have been no new admissions to the home since the last inspection and therefore needs assessment documentation was not examined during this inspection. Previous inspections of the home have found Standard two to be met. Raleigh House DS0000007183.V326952.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): Quality in this outcome area is good. (6, 7 and 9) This judgement has been made using available evidence including a visit to this service. Service user’s assessed and changing needs and personal goals are reflected in an individual Service User Plan, staff members are therefore clear about how to support service users and meet their needs. Service users receive the assistance they need to enable them to make decisions about their own lives and take risks as part of an independent lifestyle. EVIDENCE: Each service user has a written Service User Plan, which has been generated from a Care Management assessment and covers all aspects of personal and social support and health care needs. Service User Plans for both service users were examined. Both contained detailed information about individual needs and how these needs would be met. There was information including how the service user managed to wash and undress, their dietary needs and mobility. Raleigh House DS0000007183.V326952.R01.S.doc Version 5.2 Page 10 Each Service User Plan included information about how staff members should manage challenging behaviour. Risk assessments were included in Service User Plans, which detailed strategies for managing risks, and there was information about the arrangements for having a key to the home. There are appropriate policies and procedures in place for responding to unexplained absences by service users. There were records detailing that Service User Plans had been reviewed recently. Neither service user is able to leave the home unaccompanied. There were care records detailing that each service user had enjoyed going out to the local church, cafes and to the shops and that staff members accompanied them. There were records detailing that the Registered Provider supports service users to handle their own finances. The Registered Provider has also arranged for service users to receive support from a local advocacy group. Raleigh House DS0000007183.V326952.R01.S.doc Version 5.2 Page 11 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): Quality in this outcome area is good. (12, 13, 14, 15, 16 and 17) This judgement has been made using available evidence including a visit to this service. Service users continue to be encouraged to explore opportunities to enhance their quality of life as well as maintain and participate with friends and the local community, with the aim of integration. Service users receive a healthy diet and enjoy mealtimes, ensuring that their wellbeing is promoted. EVIDENCE: Each service user attends a local day centre on a full time basis, were they are involved in a variety of structured activities. Care notes and Service User Plans detailed that the service users also participate in structured activities in the home including domestic tasks such as laundry and shopping. Care notes also detailed that service users have attended a pantomime at Christmas, celebrated a birthday, visited local cafes and been on a number of ‘drives’ There was music equipment, puzzles, art materials and a television in the home and a comfortable lounge for relaxing in. The home has a pleasant Raleigh House DS0000007183.V326952.R01.S.doc Version 5.2 Page 12 garden and the Registered Provider said that service users spend some time in the garden during the summer time. Both service users have attended a fourday holiday with the Registered Providers this summer. The Registered Providers have recently purchased a new car which service users use as passengers, on a regular basis. Daily routines are reported to be flexible and service users were observed to enjoy freedom of movement within the home. Service users do not have keys for the front door and for bedrooms. The reasons for this are detailed in Service User Plans. There was a menu that detailed that meals are varied and nutritious. A mealtime was not observed during this inspection; however, service users were consulted with about what snacks and drinks they wanted. Raleigh House DS0000007183.V326952.R01.S.doc Version 5.2 Page 13 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): Quality in this outcome area is good. (18, 19 and 20) This judgement has been made using available evidence including a visit to this service. There are good arrangements for ensuring that service users receive personal and health care support in a way that they prefer, and that promotes their well being. There remain good arrangements for the safe handling of medication, which ensure that the wellbeing of service users is protected. EVIDENCE: Service users require full support with personal care. One staff member was able to describe good practice for maintaining dignity and respecting service users whilst providing personal care. Also, there were records detailing that each staff member has received training in dignity and respect, and in providing personal care. Service users have a bedtime routine, however, the Registered Provider said that there could be flexible times for going to bed and getting up. Records indicated that service users had been involved in shopping for their own clothes. Raleigh House DS0000007183.V326952.R01.S.doc Version 5.2 Page 14 There were records detailing that service users are registered with a local General Practitioner and that there is good support for service users to access health care services. Care records indicated that the Registered Providers have been proactive in ensuring that one service user receives the health care that they require. Both service users’ files contained a record of monthly weight monitoring. Medication policies and procedures were examined at previous inspections of the home have been found to be in good order. Medication Administration Records for each service user were examined and also, found to be in good order. Medication seen during this inspection was stored securely and safely and stocks reflected Medication Administration Records. There were records detailing that there has been training in the safe handling of medication for all who work in the home. One staff member spoken with confirmed this. There was a record of medication that enters and leaves the home. Evidence presented at the last inspection of the home detailed that the Registered Providers have consulted with service users and/or their relatives and Care Managers about their last wishes. Raleigh House DS0000007183.V326952.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good. (22 and 23) This judgement has been made using available evidence including a visit to this service. There is a system in place for the effective handling of complaints and service users and their relatives are encouraged to raise any concerns they have. Service users therefore know that their concerns will be acted upon. Arrangements are in place for handling allegations and instances of abuse. This ensures that service users will be protected from harm. EVIDENCE: There are policies and procedures in place for dealing with complaints. Information is made available in the Service User Guide about how a compliant, concern or suggestion should be made, and how this will be handled. This information also includes details about how a complaint may be made to the Commission for Social Care Inspection. No complaints have been made about the home since the last inspection The home has a copy of Sutton Council’s vulnerable adult protection procedures. Records were available detailing that staff members have undergone training in the Protection of vulnerable adults Raleigh House DS0000007183.V326952.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is adequate. (24, 26, 29 and 30) This judgement has been made using available evidence including a visit to this service. Service users live in a homely, comfortable, clean and, in general, safe environment, this promotes their health, safety and wellbeing. However, there is a need for some improvements in order to ensure that comfort, health and safety is fully promoted maintained. EVIDENCE: The home is situated on a residential street and cannot be distinguished from other properties. Is well maintained and provides a pleasant and homely environment to those who live there. There is a well-maintained garden to the rear of the property which is accessible to current service users. There is parking available at the front of the building. There have been a number of environmental improvements since the last inspection including the installation of a combination boiler, a new shower and hand rails in various areas. The Registered Provider said that the London Fire and Emergency Planning authority have not visited the home since 2004. Records detailed that the Raleigh House DS0000007183.V326952.R01.S.doc Version 5.2 Page 17 home had been found to comply with fire safety standards at the time of this visit. Fire fighting equipment and smoke and fire alarms are available throughout the property and there were records detailing that all staff members have undergone fire training. However, there was no fire risk assessment in place. It is necessary that a fire risk assessment be produced in order to provide protection to service users and staff members, and to comply with the recent changes in fire safety legislation. Current service users share a bedroom on the ground floor that has en suite facilities. These service users have shared this bedroom for many years. Two other bedrooms in the home remain vacant. None of the bedrooms in the home currently have radiator covers. This is currently not an issue regarding the two vacant bedrooms, however, there is a need to provide a radiator cover in the bedroom used by service users. It is acknowledged that this bedroom has never had a radiator cover, however, in order to for Standard 26 to be considered met, and in view of the closeness to a service user’s bed, a radiator cover must be fitted. Radiator covers and window restrictors must be fitted in other bedrooms in the home should any new service users be admitted. There is a limited need for specialist adaptations and equipment in the home. Handrails are provided in a number of areas, and there is a call system in the service user’s bedroom. A cot side has been purchased for the use of one service user who has recently experienced a number of falls. The Registered Provider has liaised with the district nurse regarding the use of this cot side. She stated that she has made several unsuccessful attempts to contact the service user’s care manager regarding this issue. It is recommended, as intended by the Registered Provider, to make further efforts to discuss the use of this cot side with the care manager. All areas of the home viewed were noted to be clean and free from offensive odours. Laundry facilities are suitable and there are policies and procedures for the control of infection. Records were available detailing that staff members have received training in infection control. Raleigh House DS0000007183.V326952.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good (32, 34 and 35) This judgement has been made using available evidence including a visit to this service. Staff members are provided in sufficient numbers and the procedures for the recruitment of staff are robust and provide the safeguards to offer protection to people living in the home. There is a very good staff training and development programme that provides staff members with skills necessary for meeting the needs of service users. EVIDENCE: There are currently three support workers, two volunteers, and the Registered Providers who work in the home. There has been no new staff members employed in the home since the last inspection and therefore staff files were not examined. Previous inspections have identified staff files to contain all information and documentation required by Regulation for the protection of vulnerable adults. One staff member, along with the Registered Provider was working in the home on the day of this inspection. This staff member confirmed that they had undergone a number of training sessions since commencing work in the Raleigh House DS0000007183.V326952.R01.S.doc Version 5.2 Page 19 home. The Registered Provider said that one staff member is currently undertaking NVQ Level 3 in Care and there are plans for a second staff member to commence this training. A third staff member is currently undertaking training at NVQ Level 2 in Care. There is an induction and training programme that is in line with ‘Skills for Care’ specifications. There were records detailing that there has been induction, and ongoing training for all staff members. Training has included ‘Effective Communication’ ‘Dementia Awareness’ and ‘First Aid’ Records detailed that the Registered Provider has recently successfully completed the NVQ Level 4 Management. Her husband is an NVQ assessor and is in the final year of a Law degree. There were records indicating that staff members have continued to receive supervision regularly since the last inspection. Raleigh House DS0000007183.V326952.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is good (37, 39 and 42) This judgement has been made using available evidence including a visit to this service. There continues to be open and transparent management with clear lines of accountability, which is aimed at ensuring the well being of the service users. There are, in general, good arrangements for ensuring health and safety and these promote and protect the wellbeing of staff and service users. EVIDENCE: Service users were noted to enjoy relaxed and positive relationships with the Registered Provider and her husband during this inspection. As well as attending a number of training courses, the Registered Provider has recently achieved NVQ Level 4 Management. Her husband has also continued to update his training and professional development. A staff member spoken with said that they received good support and guidance from the Registered Provider. Raleigh House DS0000007183.V326952.R01.S.doc Version 5.2 Page 21 A number of measures are in place for the monitoring of quality in the home. Care plans and risk assessments have recently been reviewed and updated. Service users and staff members attend monthly meetings in the home, records of which were available. This is a small home, were each service user is consulted with on a daily basis, informal feedback about the home is gathered this way. The home has also developed questionnaires for both staff members and service users. Records available detailed that safety checks have occurred on the home’s fire detection systems and fire equipment. Fire drills have occurred regularly. There were records of gas safety checks and the Registered Provider confirmed that a gas safety check has been scheduled. There were records detailing that portable appliances in the home have been safety checked and suitable insurance is in place. Records also indicate that there are good systems in place for ensuring that all staff members are trained in safe working practices including food hygiene, first aid and infection control. Two Requirements have been made regarding the need for improvements in health and safety practices. Refer to Standards 24 and 26 of this report. Raleigh House DS0000007183.V326952.R01.S.doc Version 5.2 Page 22 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 2 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Raleigh House DS0000007183.V326952.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A 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. 2. Standard YA24 YA26 Regulation 23 (4)(a) 13 (4)(a) Requirement The Registered Provider must produce a written fire risk assessment of the premises. The Registered Provider must ensure that radiator covers are in place in any bedroom occupied by a service user. Timescale for action 01/03/07 01/03/07 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 Raleigh House DS0000007183.V326952.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Raleigh House DS0000007183.V326952.R01.S.doc Version 5.2 Page 25 - 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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