Inspection on 23/11/05 for Randall House

This inspection was carried out on 23rd November 2005.

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 4 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 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 Randall House 75 Randall Avenue Neasden London NW2 7SS Lead Inspector Julie Schofield Unannounced Inspection 23rd November 2005 08:40 Randall House DS0000017486.V258331.R01.S.doc Version 5.0 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.V258331.R01.S.doc Version 5.0 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.V258331.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Randall House Address Randall House 75 Randall Avenue Neasden London NW2 7SS 020 8452 0336 020 8452 8544 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 Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Randall House DS0000017486.V258331.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21 June 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 there is access to 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. 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 DS0000017486.V258331.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on a Tuesday morning in November 2005. It started at 8.40 am and finished at 11.55 am. The proprietor was present in the home for part of the inspection and a manager from another Randall care home was present for the duration of the inspection. The Inspector would like to thank the managers, staff and residents who took part in the inspection. During the inspection a partial site visit, inspection of records and discussions took place. Two of the residents left to attend a day centre and 1 resident went out with a member of staff, as part of their day care programme, after the inspection had started. Only one resident is able to communicate verbally and they told the Inspector that they liked living in the home and that they were very happy there. What the service does well: What has improved since the last inspection? Since the last inspection in June 2005 the statutory requirements where the timescale for action was before November 2005 have been met. These Randall House DS0000017486.V258331.R01.S.doc Version 5.0 Page 6 included the removal of surplus furniture in the lounge, a permanent repair of the toilet seat in the ground floor bathroom, protection of vulnerable adults training for all staff, CRB disclosures and 2 written references for all members of staff and the completion of the RMA qualification by the registered manager. Work is ongoing in relation to statutory requirements where the timescale for action has not expired. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Randall House DS0000017486.V258331.R01.S.doc Version 5.0 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 Randall House DS0000017486.V258331.R01.S.doc Version 5.0 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 the following standard(s): 2 An assessment of whether the needs of the resident can be met within the home is made on the basis of information received, prior to an emergency admission. Involving the resident when completing the assessment of daily living skills ensures that their wishes and expectations are recognised. EVIDENCE: A resident was admitted to the home in August 2005 for respite care, on an emergency basis. The case file was inspected and it contained referral details from the placing authority and the psychiatrist’s report. There was a home review report, which had been completed on the day of admission by a manager of the company. The review report included a risk assessment in respect of areas including mobility, nutrition and pressure sores. On the day of admission the home completed an assessment of daily living skills, with the involvement of the resident, and had used this to develop a comprehensive care plan, which has been evaluated on a monthly basis. An initial review by the placing authority has not taken place as the respite care placement was to last for 2 weeks, but has since been extended. Randall House DS0000017486.V258331.R01.S.doc Version 5.0 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 the following standard(s): 7, 9 Standard 6 was inspected on the previous inspection in June 2005. Residents exercise their right to make decisions within their day-to-day living although they may need assistance by members of staff to achieve this. Residents who are unable to communicate verbally would benefit from the support of advocacy services. Staff support residents to take responsible risks so that residents can enjoy an independent lifestyle. Recorded risk assessments must be available for risks associated with daily living. EVIDENCE: Two of the residents are unable to communicate verbally and staff use the resident’s body language or facial expressions to determine the wishes of the residents. They do not have the support of advocacy services. Offering choice or encouraging residents to take decisions may begin in small areas and grow as the skills of the resident develop. The resident who is able to speak has been encouraged to be more assertive and independent and to tell staff what is wanted. Since exercising their right to choose changes have been made to the resident’s menu, as the resident prefers more vegetables. The resident has started to choose their activities and tells staff when they are ready to go out. The resident has their own bank account and manages their own finances, Randall House DS0000017486.V258331.R01.S.doc Version 5.0 Page 10 deciding on the purchases they wish to make. The other residents are assisted with managing their finances and with dealing with any benefit enquiries or problems. The case file of the resident who was admitted to the home in August 2005 was inspected. A risk assessment was included in the home review report, which was completed on the day of admission and based on the information supplied by the placing authority. The areas of risk were then included in the care plan e.g. nutrition and the risk of pressure sores developing and there were risk management strategies. It was noted that a pressure-relieving mattress had been provided for the resident and protective heel pads, to be worn at night. Risk assessments for the provision or non-provision of a bedroom door key and for using community facilities independently had not been completed. Randall House DS0000017486.V258331.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Standards 12, 13, 15, 17 were inspected on the previous inspection in June 2005. The residents’ right to privacy, choice and independence are respected and promoted by staff. EVIDENCE: Although residents are encouraged to do what they can for themselves 2 of 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 the manager said that staff respect their right to privacy. Staff are expected to knock on the door and to speak to the resident before entering the room. Residents choose when they wish to spend time in their rooms, alone, and a resident said that sometimes they like to sit in the lounge or in the dining area and other times they like to go to their room. It was noted that residents who were able to move independently had access to all the communal areas in the home. Staff confirmed that 1 resident enjoyed walking in the garden. One resident is being encouraged to carry out domestic tasks as part of a programme of developing Randall House DS0000017486.V258331.R01.S.doc Version 5.0 Page 12 independent living skills. It was noted that the member of staff, on completion of a task, gave positive feedback to the resident. There is a cooking report, a washing and bathing assessment and a money management report on file. The O.T. who is working with the resident on a twice-weekly basis has completed these. Randall House DS0000017486.V258331.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 Standards 18 and 20 were inspected on a previous inspection in June 2005. Residents’ health care needs are met through access to health care services in the community, and with the support of staff. EVIDENCE: A resident said that a member of staff was available to support them when attending their health care appointments. They spoke of visits to the GP, to the optician and of outpatient appointments at the hospital. The case file included notes of visits made by the O.T. and by the community nurse. There was also a note of appointments with the psychiatrist. There was evidence of routine health screening i.e. blood tests. Randall House DS0000017486.V258331.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Standard 22 was inspected on a previous inspection in June 2005. Protection of vulnerable adults training for staff contributes towards the safety of residents. EVIDENCE: The previous inspection report contained a statutory requirement that all staff undertake protection of vulnerable adults training. All existing staff and all new staff attended training in June and July 2005. A resident confirmed that if they had any concerns they would be able to speak to some one in the home. Randall House DS0000017486.V258331.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 Standard 30 was inspected on a previous inspection in June 2005. Residents have a comfortable environment in which they can relax. EVIDENCE: The previous inspection report contained a statutory requirement that a permanent repair was made to attach the toilet seat to the pedestal (in the ground floor bathroom) and this has now been done. A statutory requirement that the surplus furniture in the lounge was removed and this has now been done. A site inspection of the communal areas took place and these were comfortable and “homely”. A resident said that the house was nice and that they had a “lovely room”. Randall House DS0000017486.V258331.R01.S.doc Version 5.0 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 NVQ training enhances the quality of care provided to residents and the home needs to continue its commitment to supporting staff in their studies. The home’s recruitment policy promotes and protects the safety and welfare of residents. Without a training and development plan the home is unable to demonstrate that the training provided enables staff to meet the objectives contained in the Statement of Purpose and to meet the individual and changing needs of residents. EVIDENCE: The previous inspection report contained a statutory requirement that 50 of the staff team achieve an NVQ level 2 or 3 qualification by December 2005. A discussion took place with the manager regarding the progress in meeting this target. NVQ training is ongoing and the manager thought that the target would be met. Both members of staff on duty during the inspection confirmed that they had successfully completed their NVQ level 2 training and had now started NVQ level 3 training. The previous inspection report contained a statutory requirement that all staff had an enhanced CRB disclosure and the manager said that this has been carried out. In addition they are undertaking pova checks for all their staff. The previous inspection report also contained a statutory requirement that 2 written references are taken for each new member of staff. The manager said that the policy regarding taking a verbal reference has been amended to Randall House DS0000017486.V258331.R01.S.doc Version 5.0 Page 17 include receiving a written reference to confirming the content of a telephone call. The previous inspection report contained a statutory requirement that the home develops a training and development plan. The timescale for this has not expired. The manager said that this is being worked on and will reflect the needs of the client group. She identified the need for training on autism and in relation to challenging behaviour and said that the programme of training in these areas had already begun. Randall House DS0000017486.V258331.R01.S.doc Version 5.0 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 43 The registered manager continues to develop her knowledge through further training and this contributes towards understanding the needs of residents and staff. Without costings in the business plan and without a system of annual reviews the home is unable to demonstrate effective and efficient financial management of the home. EVIDENCE: The manager has completed her Registered Manager’s Award training and her portfolio is waiting for internal and external verification before the awarding body can issue a certificate. The previous inspection report contained a statutory requirement that the home develops a business plan, which includes costings and which is reviewed on an annual basis. The timescale for this has not expired. The manager said that this is being worked on and that the managers of Randall care homes are being assisted by an external company. Randall House DS0000017486.V258331.R01.S.doc Version 5.0 Page 19 Randall House DS0000017486.V258331.R01.S.doc Version 5.0 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 X 3 2 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Randall House Score X 3 X X Standard No 37 38 39 40 41 42 43 Score 3 X X X X X 2 DS0000017486.V258331.R01.S.doc Version 5.0 Page 21 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 YA9 Regulation 13.4 Requirement That a risk assessment for the provision or non-provision of a bedroom door key and for using community facilities independently are completed for the resident admitted to the home in August 2005. That 50 of staff achieve an NVQ level 2 or 3 qualification. That a copy of the home’s training and development plan is forwarded to the CSCI. That a copy of the business plan, including costings, is forwarded to the CSCI. Timescale for action 01/01/06 2 3 4 YA32 YA35 YA43 18.1 18.1 25.2 31/12/05 01/03/06 01/03/06 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 Refer to Standard YA7 YA37 Good Practice Recommendations That advocacy services are arranged for residents who are unable to communicate verbally. That the manager forwards a copy of their Registered Manager’s Award certificate, when issued. DS0000017486.V258331.R01.S.doc Version 5.0 Page 22 Randall House Commission for Social Care Inspection Harrow Area office Fourth 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 DS0000017486.V258331.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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