Inspection on 21/06/05 for Randall House

This inspection was carried out on 21st June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Randall House 12/11/08

Randall House 23/01/08

Randall House 11/01/07

Randall House 23/11/05

Randall House 18/01/05

Randall House 19/07/04

Randall House 09/02/04

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

CARE HOME ADULTS 18-65 Randall House 75 Randall Avenue Neasden London NW2 7SS Lead Inspector Julie Schofield Unannounced 21 June 2005 2.35pm 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 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 Stationary 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. Randall House Version 1.10 Page 3 SERVICE INFORMATION Name of service Randall House Address 75 Randall Avenue Neasden London NW2 7SS 020 8452 0336 020 8452 8544 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Lucille Rabor Post Vacant CRH PC 5 Category(ies) of LD 5 registration, with number of places Randall House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18 January 2005 Brief Description of the Service: Randall House is situated close to the shops at Neasden. Randall Avenue is close to a bus route and it is within close distance of the North Circular Road. The nearest underground station is Neasden. It is a large detached house with a small area at the front of the house and a garden at the rear of the property. The house has a driveway providing on site parking. There is also parking space available on the street outside the house. The home is registered to accommodate 5 adults with learning disabilities. There are bedrooms on both the ground and first floor with bathing and toilet facilities on both floors. Communal space is situated on the ground floor and consists of a lounge and a separate dining area. There is an office on the ground floor. At the time of the inspection three service users were accommodated in the home and there were 2 vacancies. The manager is also the manager of another of the Randall care homes and the proprietor of 3 care homes and a nursing/domiciliary care agency. Randall House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on a Tuesday afternoon in June 2005 and lasted for 3 hours 30 minutes. The manager was on duty with a member of staff. Only one resident is able to give any verbal comments and they did not want to give any more than a few brief comments during the inspection. A partial site inspection took place and case records and staff records were inspected. What the service does well: What has improved since the last inspection? Since the last inspection the number of residents for which the home is registered has been increased to 5 and one of the newly registered bedrooms includes an ensuite shower and toilet. Since the last inspection the home has started to provide the staff team with protection of vulnerable adults training. Randall House Version 1.10 Page 6 One of the residents has begun to attend college on 2 days per week. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Randall House Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Randall House Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Since the last inspection no new residents have been admitted to the home. EVIDENCE: Randall House Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 Evaluating care plans on a regular basis ensures that changes in the needs of residents are identified and can be addressed. EVIDENCE: The 3 case files were inspected. Each file contained a care plan and the monthly evaluations were up to date. There was evidence of a six monthly review of the placement and either the home or the placing authority had convened this. Randall House Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15, 17 Residents have access to day centres, college and resource centres, which provide an opportunity to develop their social and communication skills. Taking part in activities outside the home gives residents the opportunity to enjoy community facilities. The support of staff enables residents to maintain family contact. Residents have a varied and balanced diet, with dishes to satisfy religious and cultural needs. EVIDENCE: Each of the residents has a day care programme, which covers Mondays to Fridays. The programs include day centres and college attendance. One of the residents attends a day centre and the resident said that a member of staff accompanies them on the journey. Going to day centres or college enables residents to meet with other people and to socialise. One of the residents has expressed a wish to work in a shop and the day centre is responding to this. The manager said that help is given to residents with any benefits/finance problems. Randall House Version 1.10 Page 11 The manager said that residents make use of community facilities including public transport and taxis. Residents go shopping, to the theatre and to the cinema. They attend a club in the evening. Supporting residents outside the home in the evenings or at weekends forms is a recognised part of staff duties. One of the residents has weekly contact with their family and the home provides a member of staff as an escort. The resident confirmed that they had seen their family at the weekend. Another resident visits their family and their family comes to see them at Jerome House. The menu was available for inspection. The home follows a five-week menu cycle. The menu includes African Caribbean foods to meet the cultural needs of residents. It was varied and wholesome. Staff preparing food have taken a food hygiene course. The residents need to have a diet where bones are removed from meat or poultry and food is cut into smaller pieces. The weight of residents is monitored and this may be at the surgery when a resident is unable to weight bear. Randall House Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 20 Residents receive assistance with or prompting with personal care in a manner, which respects their dignity. Residents are supported by staff to take their medication, at the times directed and in the doses prescribed by their GP, in order to promote their general health. EVIDENCE: The level of assistance with personal care tasks depends on the needs of the resident and the manager said that it varies from prompting and encouraging to direct help. There are female staff on duty at all times to assist female residents with personal care. The manager said that problems with continence are dealt with in a discreet and tactful manner. Referrals are made to other health care professionals, as necessary and there are letters on file regarding requests for assessments by a speech therapist, physiotherapist etc. The storage of medication was safe and secure. Medication is either in tablet or liquid form. The tablets are administered from weekly dosette boxes, which have been filled by the pharmacist. Records of the administration of the medication and of PRN medication were completed and were up to date. Records of the disposal of medication were up to date. Randall House Version 1.10 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23 The welfare of residents is promoted and protected by having a complaints procedure in place. An adult protection policy, familiarity with the interagency guidelines and protection of vulnerable adults training for staff contribute towards the safety of residents and the home must ensure that all staff undertake training. EVIDENCE: There is a complaints procedure in place. It includes timescales for each stage of the procedure and advises the complainant of their right to contact other agencies i.e. the CSCI. Contact details for the local office of the CSCI are listed. The manager said that no complaints have been recorded since the last announced inspection. There is an adult protection procedure in place. It includes a link to the local authority interagency guidelines for the protection of vulnerable adults, a copy of which is in the home. The manager said that there have been no recorded allegations or incidents of abuse since the last announced inspection and that most of the staff have undertaken adult protection training. Randall House Version 1.10 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 28, 30 Residents live in a home where the overall standard of maintenance is good and where they have comfortable and “homely” surroundings. A more appropriate way to attach the toilet seat to the toilet is needed. In order that residents can enjoy communal areas and use them to relax, socialise or take part in activities, unnecessary items of furniture must be removed. Residents live in a home where standards of cleanliness are good. EVIDENCE: Residents enjoy a comfortable and homely environment where communal facilities are sufficient in size for the number of residents. Single bedrooms provide residents with privacy and there is sufficient space in which to relax. Residents live in a home where standards of cleanliness are good and where bathing and toilet facilities are appropriately placed. However there was a piece of wire attaching the toilet seat to the pedestal in the ground floor bathroom. There is a lovely garden at the rear of the premises. It has a shaded patio area and there are attractive pots and borders. Randall House Version 1.10 Page 15 The lounge/dining room was “overfilled” with furniture. The home currently accommodates 3 residents and there was a 3 seater settee, 2 comfortable chairs, 3 high backed chairs, a dining table with 3 chairs and 2 dining chairs in front of the radiator. A site visit took place and it was noted that the home was clean and tidy and free from offensive odours. There was evidence on file that staff have undertaken infection control training. Randall House Version 1.10 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35 The skills and knowledge of members of staff needs to be developed and enhanced by NVQ level 2 training and the home must continue to support its program of LDAF training combined with completion of the remaining NVQ modules. The rota demonstrated that there were sufficient staff on duty to support the residents. The recruitment process is not sufficient to protect the welfare of the residents. The home must forward a copy of their training and development plan to the CSCI. The plan must demonstrate that training provided enables staff to meet the objectives contained in the Statement of Purpose and is tailored to meet the individual and changing needs of residents. EVIDENCE: It was observed that there was a friendly rapport between residents and staff. Staff were able to respond to the residents who communicated by body language or facial expressions. Staff have received guidance from the speech therapist about objects of reference to assist communication with a resident e.g. showing an apron when food is about to be served. Staff understood the cultural needs of the residents. Six members of staff in the company, including staff working in Randall House, are undertaking LDAF training and the manager said that they will then go on to complete the remaining NVQ level 2 modules. The rota for week commencing 21/6/05 to 27/6/05 was available. The manager’s hours were included on the rota and it also noted the name of the Randall House Version 1.10 Page 17 manager who was on call when the manager was not on site. During the week the residents have a day care programme and are out of the building. There is always 1 member of staff on duty in the home, including a member of staff carrying out sleeping in duties at night. At the weekend there are usually 2 staff on duty during the day so that residents can take part in activities outside the home i.e. to escort residents to a disco. A resident said that the member of staff on duty was kind and spent time talking with them. There is always a female member of staff on duty to provide assistance with personal care to the female resident. The staff files of 2 carers, who have joined the staff team since the last announced inspection, were inspected. One file contained 1 written reference. The manager said that a verbal reference had been requested but there was no record of this. There was also no enhanced CRB disclosure or POVA check for this member of staff. The manager said that a training plan is being developed for each home in the company and is in draft form. The manager said that the 2 new carers have started their induction training and a manual, produced by the company, is used to record the areas covered. The manager said that although the new carers had not started the LDAF induction and training programme they had access to training courses through the company. She said that 1 of the carers had commenced NVQ level 2 training prior to starting work in the home. Randall House Version 1.10 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 42, 43 The registered manager continues to develop her knowledge through NVQ management training and this contributes towards understanding the needs of residents and staff. The maintenance and servicing of fire precautionary systems and equipment and of electrical installations and training of staff help safeguard residents, staff and visitors. EVIDENCE: The manager discussed her NVQ level 4 training course and she has only 3 modules left to complete. The record of fire drills, which are held on a weekly basis, was up to date. There were valid certificates for the testing or servicing of the fire precautionary equipment, the electrical installation and the portable electrical appliances. A fire risk assessment was available. Staff have received training in safe working practices. The home has not drawn up a business plan, which includes costings and is reviewed and updated on an annual basis. Randall House Version 1.10 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x 2 x 3 Standard No 11 12 13 14 15 Randall House x 3 3 x 3 Standard No 31 32 33 34 35 36 Score x 2 3 1 2 x Version 1.10 Page 20 16 17 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 3 2 Randall House Version 1.10 Page 21 N/A 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. 1. 2. 3. 4. 5. Standard YA23 YA24 YA28 YA32 YA34 Regulation 13.6 23.2 23.2 18.1 19.1 Requirement That all members of staff undertake protection of vulnerable adults training. That the toilet seat is repaired. That unnecessary items of furniture in the lounge/dining room are removed. That 50 of staff achieve an NVQ level 2 or 3 qualification. That 2 satisfactory references and an enhanced CRB disclosure are obtained before a member of staff starts working in the home. That a copy of the home’s training and development plan is forwarded to the CSCI. That the manager achieves an NVQ level 4 management qualification. That a copy of the business plan, including costings, is forwarded to the CSCI. Timescale for action 01 March 06 01 January 06 01 December 05 31 December 05 01 December 05 01 March 06 31 December 05 01 March 06 6. 7. 8. YA35 YA37 YA43 18.1 9.2 25.2 Randall House Version 1.10 Page 22 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. Refer to Standard Good Practice Recommendations Randall House Version 1.10 Page 23 Commission for Social Care Inspection 4th Floor Aspect Gate 166 College Road Harrow HA1 1BH National Enquiry Line: 0845 015 0120 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 Randall House Version 1.10 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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