Inspection on 23/01/08 for Randall House

This inspection was carried out on 23rd January 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 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 11/01/07

Randall House 23/11/05

Randall House 21/06/05

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 Key Unannounced Inspection 08:15 23rd January 2008 Randall House DS0000017486.V357618.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 Randall House DS0000017486.V357618.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. Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Randall House Address 75 Randall Avenue Neasden London NW2 7SS 020 8452 0336 020 8452 8544 rc.homes@btinternet.com 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) Mrs Lucille Rabor Mrs Lucille Rabor Care Home 5 Learning disability (5) Category(ies) of registration, with number of places Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th January 2007 Brief Description of the Service: Randall House is situated within walking distance of the shops at Neasden. Randall Avenue is close to a bus route and there is access to/from the North Circular Road. The nearest underground station is Neasden. Randall House is a large detached house with a small area at the front of the house and an attractive 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 and at the time of the inspection there were 3 vacancies. There are bedrooms on both the ground and first floor with bathing and toilet facilities on both floors. One of the first floor bedrooms has an en suite facility. Communal space consists of a lounge and of a dining area within a large open plan kitchen/diner. There is an office on the ground floor and a small laundry room. The manager is also the manager of another of the Randall care homes and is the proprietor of 3 care homes and a nursing agency. The current level of fees, as of February 2008 are from £1,000 per week depending on the needs of the resident and the service provided. This does not cover personal items of expenditure e.g. toiletries and clothing. The home has information about its services, including a statement of purpose and service user’s guide. Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspection took place on a Wednesday in January and consisted of 2 visits to the home. The first visit started at 8.15 am and finished at 12.20 pm. The second visit started at 4.25 pm and finished at 5.40 pm. During the inspection we spoke with the manager of the home, another manager from the company and members of staff on duty. As the residents are unable to give verbal feedback on the service provided we spent time in Randall House observing the interaction between staff and residents and observed residents at breakfast time and on their return from the day centre. A tour of the premises took place, records were examined and the preparation and serving of the evening meal was seen. Compliance with the statutory requirements identified during the previous inspection in January 2007 was checked. The Inspector would like to thank everyone for their assistance. What the service does well: Although 2 of the residents are unable to communicate verbally the staff on duty were able to demonstrate that they understood the ways in which residents communicated their needs. Residents were able to relax in the home and enjoy company or privacy, as they wished. The home is comfortably furnished and decorated. The manager tries to encourage and to maintain contact between residents and their family members. Although one resident has a grandparent in the Caribbean a member of staff went to visit them, with news of the resident when the member of staff was on holiday. The company continually reviews the documents used, particularly in relation to care planning and has recently introduced a new style Care and Support Plan. This clearly identifies needs and the actions required to meet these needs. Care plans are consistently evaluated on a monthly basis and are subject to regular reviews. The company also encourages staff development through training. Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Any money kept in the home on behalf of a resident needs to be kept under lock and key so that suitable safeguards are in place. Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 7 In order for the kitchen/dining area to have an attractive appearance and for residents to enjoy using this area the kitchen cabinet doors need replacing. Recording on the rota the hours worked by the manager would demonstrate that the manager spent sufficient time on site to monitor the standards of care in the home and to supervise and support staff. 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. Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 8 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 Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 9 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 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. A comprehensive assessment of the needs of the resident, prior to admission to the home, enables the home to determine whether a service tailored to the individual needs of the resident can be provided. EVIDENCE: Both of the residents of Randall House were living there when the home was first registered with the local authority and no new resident has been admitted to the home since the last key inspection in January 2007. However, the home has an admission policy in place. This includes obtaining all the required information about the prospective resident, from the funding authority. In addition, a manager of the company carries out a needs assessment of the prospective resident. The home has previously demonstrated that the policy is put into practice when a referral is accepted. Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 10 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, 9 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Reviewing the care plan and the placement on a regular basis ensures that changes in the needs of residents are identified and can be addressed. The residents’ right to exercise choice in their daily lives is promoted and respected. Safe storage of money being held on behalf of a resident would assure the resident that their financial interests are being protected. Staff support residents to take responsible risks so that residents can enjoy an independent lifestyle. EVIDENCE: The case files of each of the 2 residents living in the home were examined. Since the last inspection a new style Care and Support Plan has been introduced for each resident. It identifies issues, needs, goals, expected Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 11 outcomes and a plan of care. Needs identified covered personal, health and social care. The Plan was subject to monthly evaluations and these were up to date. Files also contained a booklet “My Life, My Plan” which was in a userfriendly format with illustrations and pictures. Within the files there was guidance for staff in the daily plan if care about how each resident preferred to be supported. Each resident’s file contained evidence of an external review meeting convened by the funding authority in 2007, with a copy of the agreed action plan and internal review meetings being held. Relatives were invited to attend review meetings. The home has a key worker system in place. As the residents are unable to communicate verbally the member of staff on duty said that she uses the resident’s body language or facial expressions to determine the wishes of the residents. She said that residents are able to demonstrate when they have made a choice and said that one resident will choose the clothes they want to wear. Offering choice or encouraging residents to take decisions may begin in small areas and grow as the skills of the resident develop. Residents do not have the support of advocacy services. One of the two residents receives assistance with their financial affairs and the manager is the appointee. The family support the other resident. Records are kept of all transactions, with receipts, and these were up to date. It is recommended that receipts and entries be numbered. Money being kept in the home on behalf of a resident was not securely kept and this matter is outstanding from the previous inspection. Case files contained risk assessments. These are now reviewed on a monthly basis and these were up to date. There was a general risk assessment on each file and risk assessments tailored to the individual needs of the resident. These included risk assessments for manual handling, being supported in the community, using the communal areas in Randall House and using their bedroom. The home has a missing persons procedure. Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 12 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, 14, 15, 16, 17 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Attending day centres and using community resources gives residents the opportunity to enjoy an interesting and stimulating lifestyle. Residents are encouraged to maintain contact with their families and friends so that their need for fulfilling relationships is met. The residents’ right to privacy and independence are respected and promoted by staff. Menus respect the religious, cultural and dietary needs of residents. EVIDENCE: Both of the residents attend a day centre on 5 days per week, Mondays to Fridays. On the day of the inspection both residents left in the morning and returned home later in the day. Residents looked forward to the arrival of the transport in the morning, after they had finished their breakfast. Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 13 Residents require support when they take part in activities outside the home. The manager said that residents enjoy going out to the park or to do some shopping. They also attend cultural events being held e.g. Jamaica Day. When they go into the community and transport is needed the residents use taxis or sometimes the manager uses her car. The manager confirmed that the car is insured for business use. Residents’ names are entered on the electoral roll. One of the residents loves music and was happily singing along to the songs playing on the radio while she was in the dining area. Both residents like to go to discos and clubs e.g. the Apple Club. Birthdays and social events are celebrated in Randall House including a Christmas party. Residents did not have an annual holiday in 2007. Proposals for a resident to go to see relatives in the Caribbean were rejected by the local authority. Only 1 of the residents has a regular visit from a relative and sometimes the relative takes the resident home with them for an afternoon. When visits are made to residents and the visit takes place in Randall House they can sit together in the resident’s room or in the lounge. The closest relative of one of the residents lives in the Caribbean and when one of the managers of Randall Care Homes went to the Caribbean earlier in the year the manager went to visit the resident’s relative and took photographs of the resident, a letter from the proprietor and gave the relative news about the progress of the resident. Although residents are encouraged to do what they can for themselves the residents living in the home are dependent on the support of staff for many aspects of daily living. Even though these residents are unable to call out if a member of staff knocks on their bedroom door it was noted that staff respect the resident’s right to privacy. Residents can choose when they wish to spend time in their rooms, alone, and one resident goes to their room when they want privacy. Another resident enjoys listening to music in their room. There is an O.T. who visits the home to work with the residents on an individual basis to encourage and promote independence but only 1 of the 2 current residents participates. Residents have a cooked meal at the centre each day during the week and although they have a cooked meal in the evening the manager said that the carbohydrate content is kept low. The menu was seen (it was part of a 5 week rotation) and the manager explained that usually meals for the company’s 4 care homes were cooked in one home (on a rota basis) unless the meal was unsuitable for the residents of Randall House. Residents in this home require a softer diet and if the meal is unsuitable then the member of staff on duty at Randall House will prepare an alternative. The menu is varied and wholesome and caters for the cultural needs of the residents. It included curried chicken, plantain and dumplings. A record of what the individual resident eats on a daily basis is kept. Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 14 Portion sizes vary according to the appetite of the resident and the member of staff on duty in the evening said that these had been increased for one of the residents after the resident indicated that they would enjoy some more. The evening meal served during the inspection consisted of stewed lamb in gravy with pots, cabbage, carrots and peas. A large platter of fresh fruit was in the kitchen. Each resident had some fruit as a dessert with their evening meal. The member of staff on duty said that the manager encouraged residents to eat fruit as part of health living. Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 15 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, 20 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents receive assistance with or prompting with personal care in a manner, which respects their dignity and privacy. Residents’ health care needs are met through access to health care services in the community. Residents’ general health and well being is promoted by staff that assist the resident to take prescribed medication in accordance with the instructions of the resident’s GP. EVIDENCE: The care plan identifies needs in respect of personal care. Both residents require assistance. It was noted that when assistance was required the member of staff was polite and helpful and did so in a manner that respects the dignity of the resident. Residents were clean and tidy and smartly dressed. The composition of the staff team includes people from the same cultural background as residents and residents benefit from staff with an understanding of their skin care and hair care needs. The member of staff on Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 16 duty in the evening plaited the hair of the female resident and the style looked fashionable. Routines in the home during the week take into account the need to be ready for the transport calling in the morning but in the evening when residents are tired they go to their bedroom. Specialist advice was requested from the speech and language therapist on behalf of one of the residents and a copy of the report was on the case file. Residents’ files contained evidence of access to health care facilities in the community. There were regular appointments for the optician, the dentist and the chiropodist. A record was also kept of appointments with the GP and a note that residents have an annual medical check up. Support is provided when residents have out patient appointments at the hospital clinics. Specialist services are requested as necessary and the physiotherapist has assessed one resident. The manager discussed the advice given. The storage of medication was safe and secure. Residents take their medication in liquid form. The administration of medication records were up to date and the administration of medication taken on a PRN basis were up to date. Staff receive medication training. There are in house sessions including refresher training and the company also sends staff on external training course with an accredited trainer. One of these sessions took place in September 2007. Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 17 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, 23 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. A complaints procedure is in place to protect the rights of residents. An adult protection policy and protection of vulnerable adults training for staff contribute towards the safety of residents. EVIDENCE: A complaints procedure is in place in the home. It includes information regarding the stages and the timescales involved in the process. It also informs the complainant of their right to contact other agencies and includes contact details for the local office of the Commission for Social Care Inspection. The manager said that no complaints have been recorded since the last inspection. However neither of the residents living in the home would be able to use the complaints procedure without the assistance of a family member or an advocate and it is recommended that a referral be made for advocacy services on behalf of the residents. A protection of vulnerable adults procedure is in place. The manager said that no allegations or incidents have been recorded since the last inspection. There was evidence on the staff files that protection of vulnerable adults training has been undertaken and members of staff on duty confirmed that they had Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 18 attended a recent training course run by the local authority. The manager said that the home does not practice restraint. Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 19 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, 30 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents live in a home, which is comfortably furnished and provides a pleasing environment for residents to relax in and enjoy. The replacement of kitchen cabinet doors would provide residents with a kitchen benefiting from a smarter and more up to date appearance. The privacy of residents is respected by the provision of single bedrooms. Residents live in a home where overall standards of cleanliness are good EVIDENCE: A tour of the building took place during the inspection. Levels of heating and lighting were in accordance with the time of the year that the inspection took place. Randall House offers a homely environment for residents and the Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 20 building is well maintained. The furnishings and décor are of a good standard. However, the kitchen cabinet doors are showing signs of wear and are in need of replacement. Each resident has their own single bedroom, with a wash hand basin. One of the bedrooms has en suite facilities. There is a beautiful garden at the back of the house with a patio, lawn area and mature trees and shrubs. A member of staff said that one of the residents loves to use the garden. There are steps up to the front door although there is level access to the home using the door to the kitchen/diner. One of the residents has a wheelchair and when entering or leaving the home uses this door and the passageway around the side of the house that links with the paved area at the front. The resident is accommodated on the ground floor and there are ground floor bathing and toilet facilities. All areas seen were clean and tidy and free from any offensive odours. At the time of the inspection the laundry room was not in use, as repairs were needed to the washing machine. In order to move this out to gain access to the back of the machine a small wash hand basin on the side wall has to be removed. It is recommended that the manager contact the Environmental Health Officer to check whether the basin is required as there is a wash hand basin in the bathroom, adjacent to the laundry room. While these repairs take place laundry is being serviced in one of the company’s other care homes, also in Randall Ave. When the laundry room is in use it does not involve carrying laundry through any area where food is stored, prepared or eaten. A member of staff on duty in the home confirmed that she had received infection control training in 2007 and staff files confirmed that other members of staff had attended this training. Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 21 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, 33, 34, 35 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. NVQ training enhances the general skills and knowledge of carers and the home has met the target of at least 50 of carers achieving an NVQ level 2 or 3 qualification. Although staffing levels were sufficient to meet the needs of the residents, the rota failed to demonstrate that the manager’s hours spent on site were sufficient to supervise staff on a day-to-day basis and to monitor the standard of care. Recruitment practices, which include checks and references, protect the welfare and safety of residents. The home has a training and development plan, which is linked to the aims of the home and new staff receive induction training. EVIDENCE: Although both residents are able to respond to members of staff talking to them they are not able to communicate verbally. A programme of communication skills training is being rolled out for staff and it consists of 3 sessions: the principles of good communication, verbal and non-verbal Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 22 communication and the importance of appropriate communication in a care setting. Of the 6 names of carers listed on the rota the manager confirmed that 4 of the carers have attained an NVQ level 2 or 3 qualification. The home has met the recommended target of 50 of carers achieving an NVQ qualification. Although the home is registered to accommodate up to 5 residents there were 2 residents living in the home at the time of the inspection. The person on duty in the morning was one of the managers of the company and was covering a shift. She explained that there was always 1 member of staff on duty at times when residents are at home. At night the member of staff sleeps in on the premises and is on call in case a resident needs assistance. The hours worked on site by the manager are not recorded on the rota and this matter is outstanding from the previous inspection. Copies of the rotas for the company’s other care homes are kept so that the total hours of members of staff that work in more than one of the care homes can be monitored. The personnel files for 2 members of staff recruited since the last inspection were examined. Each file contained an application form, contract, 2 satisfactory references, an enhanced CRB disclosure, proof of ID (passport details) and the right to live and to reside in the UK had been established. The two staff files examined contained training profiles, including attendance certificates. There was evidence that staff received training in safe working practice topics i.e. manual handling, infection control, first aid, food hygiene and fire safety. There was also training in medication and in protection of vulnerable adults procedures. The home uses a package of induction training for new members of staff and is planning to include any amendments necessary so that it is similar to the Sector Skills Council’s “Common Induction Standards”. The member of staff on duty in the evening confirmed that she had received induction training and that she had worked alongside a more experienced member of staff when she first started to work in the home. A copy of the training plan for 2007-8 was seen. Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 23 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, 42 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The registered manager has developed her knowledge through further training and this contributes towards understanding the needs of residents and staff. Recording on the rota the hours spent by the manager in the home would assure residents that standards of quality were monitored and assure staff of supervision and support. Service satisfaction questionnaires help to monitor the quality of the service provided to residents and contribute towards the development of the service. Training in safe working practice topics enables members of staff to safeguard the health, safety and welfare of the residents. Regular servicing and checking of equipment used in the home ensures that items are in working order and safe to use. Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 24 EVIDENCE: The registered manager has completed her Registered Manager’s Award and has shown evidence of this on a previous inspection. She is also a qualified RGN. She has managed the home since its initial registration. Within the company’s services she is the registered manager for 2 of the care homes in Randall Ave and the manager of the nurses agency. She is the proprietor for 3 of the care homes and for the nurse’s agency. Since the last inspection she has attended recruitment and selection, completion of the AQAA, induction, the Mental Capacity Act and protection of vulnerable adults training. It is of concern that the requirement about the recording on the rota of the manager’s hours spent in the home remains outstanding from the previous inspection. Although the rota records hours spent “on call” it fails to demonstrate whether sufficient time is allocated to monitoring the standards of care in the home or supervising and supporting staff. (See Standard 33). Within Randall House feedback from residents is limited as the residents are unable to take part in a residents’ meeting. Feedback from relatives, acting on behalf of residents, is also limited. The manager has previously said that quality assurance was therefore seen across the company rather than directed on one service. The company has developed satisfaction survey forms. These are distributed on an annual basis to family members of the residents, to social workers and to professional visitors to the homes. Information collected is collated and used in the development of the service. At the moment the home has a business and development plan for the company as a whole and an individual one for Randall House. Copies of both were made available. Certificates for the servicing/checking of the systems and the equipment used in the home were shown. They included valid documents for the fire extinguishers, fire alarm system, Landlord’s Gas Safety Record, the testing of the portable electrical appliances and the electrical installation. Records demonstrate that fire drills are held on a regular basis, including an evacuation of the home, and that the fire and smoke alarms are tested on a weekly basis. The file containing these records contained the records for the company’s other care homes and included records for years prior to this inspection. It is recommended that a separate file be kept for each care home and that where certificates have been replaced by more recent ones the files are archived. A member of staff on duty in the home confirmed that she had received manual handling training in 2007 and the staff files examined included attendance certificates for manual handling training undertaken in 2007. Staff files contained first aid certificates that were issued for a period of 3 years and which were still valid. Training in safe working practice topics was up to date. Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 25 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 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 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 2 X 3 X X 3 X Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 26 YES 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 Standard YA7 Regulation 16(2) Requirement Timescale for action 01/03/08 2 YA24 3 YA33 The registered person must ensure that money held in the home on behalf of a resident is kept in a secure place so that residents are assured that their financial interests are protected. (Timescale of the 5th February 2007 not met). 01/06/08 23(2) The registered person must ensure that the doors of the kitchen cabinets are replaced so that residents are assured of a kitchen/dining area that is pleasant to look at and to use. 01/03/08 17(2)S4(7) The manager must ensure & 18(2) that her hours worked in the home are recorded on the rota (a minimum of 17.5 hours per week) so that residents are assured that standards of care are monitored and staff are assured that supervision and support is given. (Timescale of the 5th February 2007 not met). Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard YA7 YA7 YA30 YA42 YA42 Good Practice Recommendations That receipts and entries in the resident’s financial records are numbered. That advocacy services are arranged for residents who are unable to communicate verbally. That the home contacts the Environmental Health Officer for advice on whether hand washing facilities are required in the laundry room. That each of the company’s care homes has its own separate file for certificates for servicing/checking systems and equipment in use in the home, That where certificates have been replaced by more recent ones a system of archiving information kept on files is in use. Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 Randall House DS0000017486.V357618.R01.S.doc Version 5.2 Page 29 - 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!