Inspection on 12/01/06 for Ranmore House

This inspection was carried out on 12th January 2006.

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.

Other inspections for this house

Ranmore House 19/04/07

Ranmore House 02/08/05

Ranmore House 07/02/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Ranmore House 12 Fir Tree Road Banstead Surrey SM7 1NG Lead Inspector Mary Williamson Unannounced Inspection 12 January 2006 10:00 th Ranmore House DS0000058324.V274834.R01.S.doc Version 5.1 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 Ranmore House DS0000058324.V274834.R01.S.doc Version 5.1 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. Ranmore House DS0000058324.V274834.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ranmore House Address 12 Fir Tree Road Banstead Surrey SM7 1NG 020 8393 7583 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) Mr Maithri Krishantha Jayawardana Mr Ranjith Hikkaduwa Liyanage Mr Maithri Krishantha Jayawardana Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Ranmore House DS0000058324.V274834.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One of the five adults may have a `PD` (Physical Disability) Date of last inspection 2nd August 2005 Brief Description of the Service: Ranmore House is a five bedded detached property situated in Banstead, Surrey. The service is registered to provide 24-hour residential care for five service users in the category learning disability, one of which may have a physical disability. The accommodation for the service users is provided on two floors with five single bedrooms, one of which has en-suite facilities. The living area consists of two lounge/dining areas, which provide quiet areas for service users to spend time in if they wish. The service has a well-maintained and secure garden to the rear. There is ample car parking to the front of the premises. Ranmore House DS0000058324.V274834.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and the second in The Commission for Social Care Inspection programme year 2005/2006. Mary Williamson who is a Regulation Inspector undertook the inspection. The Registered Manager/Provider Mr.Jayawardana was present for the first half of the inspection and Mr. Liyanage the other Provider was present for the second part of the Inspection. A tour of the premises was undertaken and records relating to the care of the service users and the management of the home were examined. Currently there are two service users living in the home and both were spoken to during the inspection. Both have poor communication skills but it was possible through the staff, and gestures to communicate with them to establish that they were happy in the home. There was a relaxed and homely atmosphere in the home and one service user was preparing for his session at the local day centre that afternoon. The inspector would like to thank the service users, staff and management for their positive contribution the inspection progress. What the service does well: The home provides good quality care and support for service users living in the home. The standard of accommodation is excellent providing service users with a comfortable home, and a relaxed atmosphere. The assessment process is good and enables the providers to choose a compatible group of service users, with assessed needs, which the home can meet. The social needs of the service users are identified and outlined in individual plans, which are appropriate to their hobbies and interests. Ranmore House DS0000058324.V274834.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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. Ranmore House DS0000058324.V274834.R01.S.doc Version 5.1 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 Ranmore House DS0000058324.V274834.R01.S.doc Version 5.1 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): 1, 2, 4, and 5. Prospective service users have the information necessary to help them make an informed decision regarding the home. Needs assessments determine the suitability of the placement? EVIDENCE: Both service users have access to a statement of purpose and service users guide to help them and their relatives make an informed choice about living in the home. The manager stated that either himself or his business partner, who is also a qualified nurse, would undertake a detailed needs assessment on all prospective service users prior to admission. A gradual admission process is in place, which first offers initial visits followed by a meal and then an overnight stay until both parties feel comfortable with the placement. Written contracts are in place outlining the terms and conditions of occupancy. Ranmore House DS0000058324.V274834.R01.S.doc Version 5.1 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): 6, 7, 8, and 9. Service users assessed needs are outlined in individual care plans, which also contain risk assessments. EVIDENCE: Both service users living in the home have their assessed needs and personal goals outlined individual care plans. Both care plans were seen and are based on person centred planning. These plans are well written and contain all the relevant information relating to personal, social, and emotional care needs. They are frequently reviewed and updated. The care plans also include all identified risks for developing daily living skills and community awareness. The service users have limited communication skills, and are encouraged to participate in the daily running of the home through the use of pictures and signs. The manager stated that the service users are supported to help clear tables and take part in cleaning their rooms. They also have a choice on how they wish to spend their time. Ranmore House DS0000058324.V274834.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 15, and 17. Service users are supported to take part in appropriate activities. Family links are maintained and nutritional needs are met. EVIDENCE: The service users are able to take part in activities as outlined in individual activities programme. This includes attending a day centre for selective sessions such as computer activities and carpentry. Community participation is encouraged and the service users go the cinema, pub, leisure centre for swimming and various shopping trips to the surrounding towns. Both service users had a holiday in Bournemouth last year and plan another during the summer. Family links are maintained and service users are encouraged to keep in contact with relatives by post and e-mail. Visitors are welcome in the home at any reasonable time. The kitchen is well equipped and domestic in design. The service users are encouraged into the kitchen but require support to do this. The menus are planned on a four weekly basis. Picture aids are used to help the service users plan these. There is support from the dietician and one service user follows a weight reducing diet. The choice of food offered is varied and nutritious. Ranmore House DS0000058324.V274834.R01.S.doc Version 5.1 Page 11 Ranmore House DS0000058324.V274834.R01.S.doc Version 5.1 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 the following standard(s): 18, and 19. Service users physical and emotional needs are met as outlined in their care plans. EVIDENCE: Staff provide sensitive support to service users as outlined in individual care plans with privacy and dignity. One service user likes to have a bath while the other likes to have a shower. Care is flexible and service users are supported to choose the clothes they wish to wear, and when they wish to get up and go to bed. Both service users are registered with a GP and are well supported by him. Chiropody is available at Epsom General Hospital and the special needs dentist is also accessed. The manager stated that the service users wear glasses. However it is recommended that a routine eye test should be available to both service users. Additional specialist services can be offered for example physiotherapy, occupational therapy, speech therapy, and psychology, when necessary. Ranmore House DS0000058324.V274834.R01.S.doc Version 5.1 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 the following standard(s): These standards were not assessed. EVIDENCE: Ranmore House DS0000058324.V274834.R01.S.doc Version 5.1 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 the following standard(s): 24, 25, 27, 28, and 30. The home offers a homely, comfortable and safe environment for service users to live in. EVIDENCE: The home was clean, tidy, and well maintained. The home provides ample communal space to include a large well-decorated, comfortable lounge, and a well furnished dining room. There are bathing and toilet facilities on both floors. Service users bedrooms are of single occupancy one of which is en-suite. These rooms are spacious, well furnished and comfortable. They have been personalised to reflect individual personalities. The home has a utility/ laundry room. This is well equipped and the washing machine has a sluice facility in line with the home’s infection control policy. The garden to the rear of the home is enclosed and there is ample parking provided at the front of the home. Ranmore House DS0000058324.V274834.R01.S.doc Version 5.1 Page 15 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): 31, 34, and 35. The staff on duty were aware of their responsibilities. The recruitment procedure protects the service users. EVIDENCE: The staff on duty ware aware of their responsibilities, and the assessed needs of the service users. There was an opportunity to talk with staff regarding the care they provide to service users. The home has a recruitment policy in place. The staff employment files were examined. Most of the required documentation was in place. However none of the staff have a contract of terms and conditions of employment. A requirement has been made accordingly. The manager stated that all staff had undertaken induction training. Training records were seen and included certificates awarded for fire safety training, food hygiene, abuse awareness, manual handling, and COSHH. All the staff have NVQ training. Two have NVQ Level 2 and three have NVQ level 3. This training was achieved outside the home as most of the staff are par time and have alternative employment. Ranmore House DS0000058324.V274834.R01.S.doc Version 5.1 Page 16 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, 40, 41, and 42. The home is well managed and the health and welfare of the service users id promoted and protected. EVIDENCE: The home is owned by Mr.M.Jayawardana, and Mr. R Liyanage who are both qualified nurses with an RNMH qualification. They both have several years experience in the provision of care to service users with a learning disability. Mr Jayawardana is also the Registered Manager. The home is well managed with both providers providing senior management cover and responsibility at all times. The home has produced a wide range of policies and procedures some of which were sampled throughout the inspection. A requirement was made at the last inspection that a procedure be developed for “a missing person” which is not yet in place. A further requirement has been made. The standard of record keeping is good and all records relating to service users are kept securely when not in use. Ranmore House DS0000058324.V274834.R01.S.doc Version 5.1 Page 17 The home promotes the health and welfare of service users and staff. There is a wide range of policies and procedures relating to health and safety in place and there is evidence in place to support that staff have had training in health and safety, which includes manual handling, first aid, food hygiene and fire safety. All staff are aware of the COSHH procedures and hazardous chemicals are stored in a secure cupboard. Risk assessments are in place for al identified risks and the management promotes safe working practice. The fire safety records were seen. Fire alarms are tested regularly and there is a contract in place for the maintenance of fire fighting equipment. Ranmore House DS0000058324.V274834.R01.S.doc Version 5.1 Page 18 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 3 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 X 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 3 X X 2 3 3 X Ranmore House DS0000058324.V274834.R01.S.doc Version 5.1 Page 19 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 34 Regulation 19 Requirement The registered person must ensure that all staff receive a contract of terms and conditions of employment. The registered person must maintain in the home all the documents specified in Schedule 4 to include a policy on “missing persons” Timescale for action 20/02/06 2. 40 17(2) 20/02/06 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 Refer to Standard 19 Good Practice Recommendations It is recommended with good care practice that provision be made for both service users to have an eye test at least yearly. Ranmore House DS0000058324.V274834.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Ranmore House DS0000058324.V274834.R01.S.doc Version 5.1 Page 21 - 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. 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