Inspection on 02/08/05 for Ranmore House

This inspection was carried out on 2nd August 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ranmore House 19/04/07

Ranmore House 12/01/06

Ranmore House 07/02/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

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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 Catherine Campbell-Ace Unannounced 02 August 2005 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ranmore House H58_s58324_Ranmore House_v230005_020805_stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ranmore House Address 12 Fir Tree Road, Banstead, Surrey, SM7 1NG Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208 3937583 Mr Maithri Krishantha Jayawardana Mr Maithri Krishantha Jayawardana CRH Care Home 5 Category(ies) of LD Learning Disability, 5 registration, with number of places Ranmore House H58_s58324_Ranmore House_v230005_020805_stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. One of the five adults may have PD Physical Disability. Date of last inspection 7 February 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 H58_s58324_Ranmore House_v230005_020805_stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection lasted three hours. The inspector was assisted by service users, the registered manager, registered provider and a staff member. The inspector received an enthusiastic welcome from one of the service users. Two service users were in residence on the day of the inspection. The service users were non-verbal, they were observed to have a close relationship with the staff, who used various communication aids to assist in the daily activities. The staff support them in making snacks and helping them clean their bedrooms as well as escorting them to various venues for activities. Daily records, care plans, Statement of Purpose and the Service User Guide were viewed. Daily living records were inspected and were clearly written to assist the service users in achieving their goals and aspirations. One staff member stated: ‘ it is a relaxed home, friendly with a good atmosphere. We are able to give the residents individual attention.’ The manager said that one of the service user’s behaviour had greatly improved since admission. What the service does well: The home was very homely with a supportive staff team in place. Service users were observed to be relaxed and free to express themselves. They were able to make their own choices and have the freedom of the home and garden. The support afforded to service users included opportunities to take part in a quality of life, which includes aromatherapy, foot spas, football and shopping. Service users are able to attend the local church were there is a service especially for people with learning disabilities where they can express their personalities without restriction. Service users attend day centres and clubs during the evenings. The care planning was viewed and found to be excellent, including risk assessments and strategies for activities such as change in routine and activities which may be cancelled. Service users rooms were homely and spacious. Service users are encouraged to clean and tidy their own bedrooms with support from care staff. Ranmore House H58_s58324_Ranmore House_v230005_020805_stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? Since the last inspection four policies have been developed: • • • • Infection Control Confidentiality Recruitment Bereavement and Care of the Dying. Water checks are carried out weekly, and medication omission codes are written on the MAR sheets. 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 H58_s58324_Ranmore House_v230005_020805_stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Ranmore House H58_s58324_Ranmore House_v230005_020805_stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2 The Service User’s Guide was up to date and set out the aims, objectives and philosophy of the home, its services, facilities and terms and conditions. A full assessment of service user’s needs is made prior to admission, which contains up to date information, which is available to empower service users and their advocates in the choice and suitability of the home. EVIDENCE: The Statement of Purpose and Service users guide was evidenced and found to be comprehensive, and included the philosophy of Ranmore House, aims and objectives, personal growth promotion, integration into the community and facilities and services provided. A copy of the complaints procedure and the latest inspection report from the Commission for Social Care inspection was also available. It was evidenced that a team of Psychologists and Speech Therapists were included in the admission process, together with the person to be admitted and family or advocate. Care plans showed a full assessment of needs had taken place before admission and it was evidenced that the home could meet these needs. They also showed that risk assessments had been made concerning activities of daily living, and strategies were in place for situations potentially upsetting for service users. Ranmore House H58_s58324_Ranmore House_v230005_020805_stage 4.doc Version 1.30 Page 9 Service users needs were reviewed six monthly by Care Managers, Staff, service user and therapists. Ranmore House H58_s58324_Ranmore House_v230005_020805_stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,9 Care plans contained personal goals and reviews of changing needs. Service users were observed to be supported by staff, ensuring that they live as full a life as possible. EVIDENCE: Care plans evidenced were found to be comprehensive and a live document, as they were updated when appropriate and included personal goals and aspirations. The plans included a 6 monthly assessment of needs, which incorporated the care manager, service user or advocate, staff members and therapists. The care plans were evidenced to be of a high standard. The care plans showed risk assessments of daily activities such as outings and change in routine. These forms contained information on the level of risk and the action taken to reduce that risk. Service users at Ranmore House are non - verbal. Care plans are made together with service users, advocates or family members. Pictures were included in care plans to communicate the plan to the service user. For example, pictures showing people bowling, using computers and taking part in other recreational activities were used to identify the activity the service user may enjoy. The care plan stated that this person would point to the particular activity that they wanted to do that day. Ranmore House H58_s58324_Ranmore House_v230005_020805_stage 4.doc Version 1.30 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 standard(s) 15,17 Service users are supported to have a wide variety of social contacts. Families and friends are able to visit without restriction. Service users are offered a healthy and varied diet and are given a choice of meals. EVIDENCE: Service users were able to receive visitors without restriction. One service user’s relatives lived in America. Staff helped this service user to keep in contact by email and letters were read to her by staff. Service users had contact in the community and were encouraged to make friends with people who do not have their disability. The manager said that service users could receive visits by relatives and friends privately in their rooms. Service users help choose the menus for the week. They do not cook for themselves, but are encouraged to make snacks. Menus were viewed and the diet is varied and healthy. One service user is under the care of the dietician, and the carers cater for this diet. Risk assessments in the event of choking were viewed in the care plans, with action plans included. Service users are Ranmore House H58_s58324_Ranmore House_v230005_020805_stage 4.doc Version 1.30 Page 12 offered a choice of meals for the week and alternatives were offered if the service users changed their mind on the day. Ranmore House H58_s58324_Ranmore House_v230005_020805_stage 4.doc Version 1.30 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 standard(s) 20 The home complies with its policy and procedure for the receipt, recording, storage, handling, administration and disposal of medication. EVIDENCE: The home’s medication system was followed and policies were evidenced to be in place. No service user self - administered medication. Medication was observed to be stored correctly, and medication records viewed were maintained accurately. No service user in this home received Controlled Drugs. Staff had received training in the Safe Administration of Medication. Ranmore House H58_s58324_Ranmore House_v230005_020805_stage 4.doc Version 1.30 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 standard(s) 22,23 The home operates in a manner, which includes the service user, family members and advocates. They are able to act for the non - verbal service users, and support them in communication. Service users are protected from abuse by the home’s policies and procedures. EVIDENCE: Service users in this home are non - verbal. Care plans showed that they have family members and advocates who act for them. Staff stated that they know when a service user is unhappy as their behaviour changes. They then spend time with the service user trying to find out the problem. Care plans viewed included risk assessments for situations both inside and outside the home, for example, one service user did not like any one else sitting in her chair, so the plan had a strategy to cope with the service user’s behaviour when this occurs. The home has a complaints policy. It was noted that there had not been any complaints since the two service users had been admitted to the home. Staff had attended training in The Protection of Vulnerable Adults And were aware, when asked, of the procedure to follow if abuse occurred. Ranmore House H58_s58324_Ranmore House_v230005_020805_stage 4.doc Version 1.30 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 standard(s) 24,30 The home offers a homely, comfortable and safe environment. EVIDENCE: The home environment was observed to be clean and well - maintained. The living areas were spacious and service users bedrooms accommodated their possessions. For example, one service user liked trains; he had pictures of trains above the headboard of his bed. He also had photographs of family members displayed on the bedroom wall. The bed linen was personalised to the service users tastes. Furnishings and fittings were observed to be of good quality. The home has a large garden to the rear and the inspector was informed that one of the service users played football there regularly . Ranmore House H58_s58324_Ranmore House_v230005_020805_stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34,35 Service users are supported by the home’s recruitment policy although some employee’s files were not complete. Staff are well trained and able to attend to the daily care needs of service users. EVIDENCE: Recruitment records were evidenced and contained application forms, work permits, and references. One staff file evidenced was missing a second reference. Criminal Record checks had been made. The employment files did not contain terms and conditions of employment. Staff training records were evidenced and contained study days in Eating Awareness, Epilepsy, Fitness and Exercise, Protection of Vulnerable Adults and all mandatory training. The home employs four staff with Registered Mental Health qualification and over 50 of staff achieved the NVQ level three Award. Ranmore House H58_s58324_Ranmore House_v230005_020805_stage 4.doc Version 1.30 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The health, safety and welfare of service users are promoted and protected EVIDENCE: It was evidenced that staff received training in Manual Handling, Health and Safety, Fire Safety and Food Hygiene. Hazardous substances were evidenced to be stored appropriately and testing for Legionella was carried out on a weekly basis. Restrictors had been placed on upstairs windows since the last inspection. The home’s Health and Safety Policy was viewed and accidents had been recorded correctly, with The Commission For Social care Inspection notified accordingly. Ranmore House H58_s58324_Ranmore House_v230005_020805_stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x x x 3 x 3 Standard No 31 32 33 34 35 36 Score x x x 1 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ranmore House Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x H58_s58324_Ranmore House_v230005_020805_stage 4.doc Version 1.30 Page 19 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. 2. Standard 9 34 Regulation 17 19 Requirement That the Registered Persons develop a Missing Persons Policy/Procedure That all staff files contain all information required under Schedule 2 of The Care Homes Regulations (as ammended)2001 That all staff receive a statement of terms and conditions of employment Timescale for action 02/10/05 02/09/05 3. 34 19 02/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Ranmore House H58_s58324_Ranmore House_v230005_020805_stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 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 H58_s58324_Ranmore House_v230005_020805_stage 4.doc Version 1.30 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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