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Inspection on 01/11/05 for Randell House Care Home

Also see our care home review for Randell House Care Home for more information

This inspection was carried out on 1st 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home was warm and welcoming providing service users with a pleasant environment to live in. There is an ongoing programme of refurbishment in place and some of the bedrooms have been recently refurbished. Service users had positive comments regarding their care. The home has an activity coordinator and there are a variety of activities available that service said they enjoyed. Service users said that the meals were good offering choice and variety. Lunch was taken in the well-maintained communal dining room that most service users attended regularly. The staff retention is good and provided service users with continuity of care. Service users spoke highly of the staff and comments included "the staff are all very good and kind".

What has improved since the last inspection?

It was evident that the home has a rolling programme of refurbishment in place. The carpet in the ground floor corridor had been replaced. A number of rooms have been decorated. The home has ordered replacement of six chairs for the drawing room. All communal bathrooms and toilets have handwashing facilities in place.

What the care home could do better:

It was noted that some of the service users personal care plans and risk assessments were not updated on a regular basis in order to reflect any changes in the needs of service users. The assessment of a newly admitted service user was also lacking and should form part of the care planning process. The home did not have records/evidence of staff employed through the agency to ensure that all the checks had been undertaken and proof of their identities. This may be to the detriment of service users safety.

CARE HOMES FOR OLDER PEOPLE Randell House Care Home Fernhill Road Blackwater Camberley Surrey GU17 9HR Lead Inspector Anita Tengnah Unannounced Inspection 1st November 2005 10:00 X10015.doc Version 1.40 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 Randell House Care Home DS0000036975.V262741.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 Older People. 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. Randell House Care Home DS0000036975.V262741.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Randell House Care Home Address Fernhill Road Blackwater Camberley Surrey GU17 9HR 0207 605 4200 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) The Royal United Kingdom Benificent Association Mrs Janet May Young Care Home 39 Category(ies) of Dementia - over 65 years of age (39), Old age, registration, with number not falling within any other category (39), of places Sensory Impairment over 65 years of age (39) Randell House Care Home DS0000036975.V262741.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th June 2005 Brief Description of the Service: Randell House is a registered care home providing personal care to 39 service users in the older person category.The Royal United Kingdom Beneficent Association owns the service and has another service across the road from Randell House. Accommodation is provided on two floors with a passenger lift that allows access to all parts of the building. The home is situated in Blackwater on the outskirt of Camberley and has some local amenities close by. There are a variety of equipment and adaptations availalable to maintain and promote service users independence and the home is registered to provide service to people with visual impairment. The service also benefits from a well maintained garden and parts are accessible to wheelchair users. Randell House Care Home DS0000036975.V262741.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection took place over one day on the 1st of November 2005. As part of the inspection process a tour of the building was undertaken. The inspection took place over 5 hours. The inspector spoke to 10 service users, staff. The process included examining care records, observing social and meal activities and discussions with service users, staff and visitors. Service users expressed high degree of satisfaction with the care that they were receiving at the home. What the service does well: What has improved since the last inspection? It was evident that the home has a rolling programme of refurbishment in place. The carpet in the ground floor corridor had been replaced. A number of Randell House Care Home DS0000036975.V262741.R01.S.doc Version 5.0 Page 6 rooms have been decorated. The home has ordered replacement of six chairs for the drawing room. All communal bathrooms and toilets have handwashing facilities in place. 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. Randell House Care Home DS0000036975.V262741.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Randell House Care Home DS0000036975.V262741.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The home undertakes pre-assessment of service users prior to admission. However the lack of long-term needs assessments may be detrimental to the welfare of service users. EVIDENCE: Record of a newly admitted service users showed that a pre-admission assessment was undertaken in hospital. The manager assesses all service users prior to admission to the home to ensure that the home can meet their needs. The home must ensure that long- term needs assessments are undertaken on admission and this should form part of the care planning as these were lacking in a service users record seen. Care management assessments should also be secured prior to admission for Social Services funded service users as appropriate . Randell House Care Home DS0000036975.V262741.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Care plans were in place for service users. However the lack of detailed assessments and reviews were lacking and may put service users at risks. The access to healthcare is well managed and input from the district nurses was available. The procedure for the management of medicine was satisfactory. The core values of autonomy and choice with regards to daily living were upheld to the satisfaction of service users. EVIDENCE: Care plans are formulated on admission to demonstrate how the service users care needs would be met. These included personal care needs and pressure areas risk assessments. It was noted that not all care needs and assessments such as nutritional needs, foot care, manual handling were not updated in some of the service users’ records seen. The manager must ensure that all care needs assessments are undertaken and recorded to inform practice. Randell House Care Home DS0000036975.V262741.R01.S.doc Version 5.0 Page 10 All service users are registered with GPS and service users access to healthcare was in place. The wound care plan of one service user seen showed that the district nurse was involved in wound management and recorded in care plans. The home has policy and procedures in place for the management of medication. All staff responsible for medication had undertaken training in order to ensure safe practice. There was one service user who was self medicating. A risk assessment was available and consent from the GP was sought. Eight service users spoken to state that they had autonomy and choice with regards to the activity of daily living. They chose when they went to bed and whether to remain in their rooms or join others in the conservatory for social activities. Service users spoken to say that they are treated with respect. Comments included ”All staff are very nice” “Glad of the help from staff”. “ A happy home”. Another service user said that she wanted a bigger room. The manger had offered her two other rooms as they became vacant but she declined for various reasons and decided to remain in her present room. Randell House Care Home DS0000036975.V262741.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13,15 The visiting procedures are good and service users maintain links with their family and friends. The meals at the home are well managed offering variety and choice to the satisfaction of service users. EVIDENCE: The home has an open visiting policy. A record of all visitors’ evidenced this as maintained at the home. Service users confirmed that their family and friends visit at different times of the day and that there was no restriction. Two service users said that they often use the conservatory or their rooms to receive their visitors. There is a number of rooms that are available to service users and their visitors including the library and quiet areas in the communal lounge. The home has a planned menu in place. Records showed that service users are offered a well- balanced meal with variety and choice. Lunch was observed, the meals were nicely presented and appeared nourishing. Fresh fruits were available in the dining room. Staff were available to offer support with meals as required. Comments from service users were that meals were “very good and always nice and plentiful”. Randell House Care Home DS0000036975.V262741.R01.S.doc Version 5.0 Page 12 The meals continue to be managed in conjunction with the sister home across from the service where most of the meals are prepared. The home has an arrangement that vegetables would be cooked on the premises, however this had not happened lately. The manager had addressed this issue with the catering manager on the day of the inspection and was assured that this would be resumed. The home has a comment book in the dining room to seek the views of the service users. The manager said that any issues regarding are raised with the catering manager and she dealt with them. Randell House Care Home DS0000036975.V262741.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The complaints and adult protection procedures are well managed ensuring that service users are safe. EVIDENCE: The home has policy and procedure in place about raising complaints. A complaint log is maintained and the manager deals with all complaints. The records in the log contained detailed notes of the action taken following receipt of complaints and correspondence entered with the complainants. The home has the Hampshire adult protection procedure in place. Training in adult protection is ongoing for all carers. There has been no allegation of abuse about this home to the commission. The manager and other senior staff are aware of the needs to report and record all allegations of abuse. Randell House Care Home DS0000036975.V262741.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,23,24 The standard of décor was good and provided service users with a warm and homely environment to live in. Service users rooms were personalised and met their needs. Equipment was available to promote service users independence. EVIDENCE: The home’s environment was warm and welcoming. There is a programme of ongoing maintenance and a number of rooms have been recently redecorated. The manager said that service users’ bedrooms are decorated when they became vacant and prior to new admission. The ground floor corridor has been redecorated and has a new carpet fitted. The home has adequate communal space and service users commented that they enjoyed the conservatory where a variety of daily activities take place. Service users rooms were all personalised and furnishing was clean and appropriate to service users needs. Comments included”this is home and I am Randell House Care Home DS0000036975.V262741.R01.S.doc Version 5.0 Page 15 grateful of the help”. Another service user said that she liked her room and surrounds herself with her personal possession she brought into the home on admission. All parts of the home was maintained safely. Equipment such as hoists ane grab rails were available to promote and maintain service users’ independence. The home has a passenger lift in place that allows access to all floors. An area was set aside for the storage of wheelchairs and frames. Randell House Care Home DS0000036975.V262741.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29,30 The recruitment process for permanent staff was well managed. However the lack of records for casual staff can be to the detriment of service users. The home has a training programme in place. The poor uptake of mandatory training can compromise the safety of service users. EVIDENCE: The home has in place a recruitment procedure. All checks as required were undertaken for permanent staff and records were kept. These included references, identification, and Criminal Record Bureau (CRB) checks. All prospective candidates completed an application form. Staff records were maintained securely as per data protection guidance. However it was noted that the home did not have any records of staff who were employed through the agency. This was discussed with the manager who must ensure that all staff have the appropriate checks undertaken to ensure the safety and welfare of service users. The home has an ongoing training programme in place. Recent training included fire safety, abuse prevention, medication. Records of mandatory training showed that only 5 staff had undertaken the update in moving and handling and 12 in fire safety. The manager is aware that staff uptake of mandatory training offered is poor and need to be improved. The home is taking steps to improve this and ensure that service users safety is not compromised. Randell House Care Home DS0000036975.V262741.R01.S.doc Version 5.0 Page 17 Randell House Care Home DS0000036975.V262741.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,35 The home’s internal auditing ensures that views are sought and that he home is run in the best interest of service users. The home has good financial procedures in place to safeguard the welfare of service users. EVIDENCE: The home has in place a yearly audit of service users views as part of their process to monitor the service delivery and to ensure that they are meeting the terms as per their statement of purpose. The responsible individual undertakes monthly unannounced visits and reports to the Commission. There is also an ongoing system of internal audit carried out at regular intervals. Comments from service users included “ the manager always deals with any problems”. Randell House Care Home DS0000036975.V262741.R01.S.doc Version 5.0 Page 19 Service users family/ advocates manage all their financial affairs. A sample of service users personal expenditures for hairdressing and chiropody showed that invoices are raised and receipts are kept of all such transactions. Randell House Care Home DS0000036975.V262741.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 Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 3 3 X X STAFFING Standard No Score 27 X 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X X Randell House Care Home DS0000036975.V262741.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? No 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 7 Regulation 15(2) (b) (c) Requirement The manager must ensure that care plans and risk assessments are reviewed and updated to reflect any change in the needs of service users. The manager must ensure that required information are obtained for agency staff and the records are maintained as per schedule 2 The provider must ensure that all staff undertake mandatory training in health and safety and staff have a training and development assessment profile in place. Timescale for action 15/12/05 2 29 19(1) (a) (b) sch 2. 15/12/05 3 30 18(1) (a) 15/12/05 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 Randell House Care Home DS0000036975.V262741.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Randell House Care Home DS0000036975.V262741.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. 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