Inspection on 21/07/05 for Ransdale House

This inspection was carried out on 21st July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Ransdale House 16/01/07

Ransdale House 15/12/05

Ransdale House 15/12/04

Ransdale House 20/08/04

Similar services:

Ashlea Mews Residential Home

Harwood House

South Chowdene Care Home

Farmborough Court

St Albans Place (14)

Bisley Drive (18)

Carrdale

The Hermitage

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

CARE HOME ADULTS 18-65 Ransdale House 54 Caversham Road Easterside Middlesbrough TS4 3NU Lead Inspector Christine Moon Unannounced 21 and 29 July 2005 10:00 am st th 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. Ransdale House B51-B01 SN95 RansdaleHouse VN235171 210705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Ransdale House Address 54 Caversham Road, Easterside, Middlesbrough. TS4 3NU 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) 01642 320785 01642 325437 Royal National Institute for Deaf People Mrs Judy Anne Sharples Care Home 6 Category(ies) of SI Sensory Impairment (6) registration, with number of places Ransdale House B51-B01 SN95 RansdaleHouse VN235171 210705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th December 2004 Brief Description of the Service: Ransdale House is run by the Royal National Institute for the Deaf and is registered for the care of six service users who are profoundly deaf, one of whom also has a physical disability. The home is a detached, two storey building, domestic in style, which blends in with the properties in the surrounding area. The home is close to shops and local amenities and there is easy access to local transport into the centre of Middlesbrough. Accommodation is provided in six single bedrooms. Communal space consists of one main lounge with a dining area, plus a conservatory. There is an enclosed garden to the rear of the home, which also has a summerhouse. Service users are able to personalise their own rooms according to preference. All bedrooms have a wash hand basin, sky television and the home is equipped with specialist communication systems. Ransdale House B51-B01 SN95 RansdaleHouse VN235171 210705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over two days spent within the home, a total of 7 hours in all. Three members of care staff, and five residents contributed by way of talking with the Inspector. Those living at the home said that they were ‘very happy’, ‘would not change anything about it’ and ‘do not want to live anywhere else’. Staff felt that the manager and her team are effective in providing a high level of care, and in working to try to ensure a good quality of life within the home. As the Inspection was unannounced, no contributions were received from family and friends. What the service does well: What has improved since the last inspection? Improvements have been made to the bathroom of one service user. Laminated flooring has been fitted to some rooms, and bedrooms have been redecorated to better suit the needs of service users. The garden looked especially tidy and care had been taken to plant up tubs and hanging baskets. Ransdale House B51-B01 SN95 RansdaleHouse VN235171 210705 Stage 4.doc Version 1.40 Page 6 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. Ransdale House B51-B01 SN95 RansdaleHouse VN235171 210705 Stage 4.doc Version 1.40 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 Ransdale House B51-B01 SN95 RansdaleHouse VN235171 210705 Stage 4.doc Version 1.40 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) 2 Individual aspirations and needs are thoroughly assessed at Ransdale House. EVIDENCE: Those care plans viewed at the time of the Inspection, were seen to contain written information about the goals and aspirations of those living at Ransdale House, and the manager said that all residents are aware of their plans. Service user plans were seen to be very detailed and based on a thorough assessment and re-assessment process. There have been no new full-time residents at Ransdale House for some time, but prior to any admission, detailed assessments would be carried out, in consultation with the service user, family if appropriate, and other involved professionals. Ransdale House B51-B01 SN95 RansdaleHouse VN235171 210705 Stage 4.doc Version 1.40 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 standard(s) 6,7,8 and 9 Services users know they have Care Plans, and that their needs and goals are recorded in these. The manager and staff at Ransdale House are good at both listening to and enabling residents to make decisions about their lives, and offering support where needed, in order to promote independence. The Risk Assessment process within the home is rigorous and robust. EVIDENCE: Those living at Ransdale House are aware that their needs, along with other aspects of their daily lives, including risk taking, are reflected in their individual plans. Plans are detailed and thorough, and it was clear that staff see Care Plans as ‘working documents’ to be used to ensure that not only are care needs met, but that care is delivered in the manner in which a service user chooses. For example, for one resident, laminated cards are used, which detail the way in which care is to be provided, to ensure that the same procedure is always followed when providing care. This has proved to be reassuring to the service user, as well as maintaining consistency of care. Ransdale House B51-B01 SN95 RansdaleHouse VN235171 210705 Stage 4.doc Version 1.40 Page 10 Both discussion and observation at the Inspection confirmed that service users are able to make decisions about their own lives. Service users are able to make suggestions about activities, and the issue of risk is addressed by putting in place detailed assessments, alongside input from residents, so that there is awareness and understanding of the process of risk assessment. The manager has a heightened awareness of the need to implement robust risk assessment, but this process does not interfere with personal development and enjoyment of activities, even though risk assessments are carried out on each individual activity. The manager said that staff have worked hard at both understanding and completing risk assessment documentation, and are now competent in preparing these assessments for further discussion with the manager and service user. In respect of daily life within the home, all those who live at Ransdale House are consulted on the daily basis about their views, and in addition more formal meetings take place in order that views may be listened to and acted upon where appropriate. Ransdale House B51-B01 SN95 RansdaleHouse VN235171 210705 Stage 4.doc Version 1.40 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) 11,12,13,14,15,16 and 17 The manager and staff at Ransdale House are good at accessing opportunities for personal development, and leisure activities. Family contact is positively encouraged and supported by staff where needed. Service user rights are central to the ethos within the home. The manager and staff have a conscientious approach to ensuring the provision of a healthy diet. EVIDENCE: Activities offered to those living at Ransdale House are many and varied. From the point of view of continued personal development, two residents choose to continue with college courses to study computer skills, motor mechanics, and skills for daily living. One resident enjoys going to Scope on a regular basis. All appear to enjoy swimming, and regular trips out in the home’s transport, supported by staff. Holidays this year are planned at Cayton Bay and Blackpool, and most residents have enjoyed a holiday in Scotland. One service user visited family on the Isle of Man, supported by two members of staff. Ransdale House B51-B01 SN95 RansdaleHouse VN235171 210705 Stage 4.doc Version 1.40 Page 12 Two residents are keen supporters of the local football team and have Season Tickets to enable them to attend games on a regular basis, accompanied by a member of staff. The manager said that Ransdale House is well supported by local residents, who tend to pop in at Christmas with gifts for those who live at the home. The majority of those living at Ransdale House have regular family contact. This might be visiting family, where both transport and staff support are put in place, or receiving visits from family and friends in their home. The manager and staff at Ransdale House positively encourage regular contact with family and friends, also supporting residents to send letters and cards to further maintain contact. Where appropriate, and where it is the wish of service users, peer group friendships are encouraged and supported by staff, and it is possible for friends to visit the home. Both discussion and observation at the time of the Inspection confirmed that the rights and responsibilities of service users are recognised. Those living at the home are encouraged to keep their rooms tidy, and to assist with daily living tasks, where appropriate. For example, some residents prefer to do their own washing, and this is accomplished with support where necessary. A valuable recreational and educational facility is the summerhouse in the garden. Part of this has been fitted out as a shop, and residents are able to ‘purchase’ items, thereby gaining useful experience in the value of money. The garden was seen to be well maintained and care had been taken to plant up tubs and baskets with flowers – again residents were able to take part in this activity if they wished to do so. In respect of dietary needs, menus are prepared in advance in consultation with service users and are then passed to a dietician to ensure that meals are nutritious and healthy. Residents spoken with had no complaints about meals prepared for them. Ransdale House B51-B01 SN95 RansdaleHouse VN235171 210705 Stage 4.doc Version 1.40 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) 18 and 19 Personal support is given in the manner preferred by residents, and staff work hard as a team to meet both physical and emotional needs. EVIDENCE: The manager said that the provision of individual personal support is always discussed in detail with each service user, and residents are able to state how they prefer support to be given. For example, a female or male carer might be preferred for intimate personal care, and this is respected and provided whenever possible. All residents spoken with were aware of their key-worker, but most also said that should their key-worker not be available, they would not worry about talking to either the manager or any other staff on duty. This is reassuring for those living at Ransdale House, as it is obviously not always possible for key-workers to be available when needed. Key-workers are rotated on a six-monthly basis, to ensure that all care staff are familiar with all care needs, and this does not appear to cause difficulties for residents. Ransdale House B51-B01 SN95 RansdaleHouse VN235171 210705 Stage 4.doc Version 1.40 Page 14 The Care Plans in respect of daily needs are readily accessible to staff, and are used as working documents. Staff are aware of their responsibility in ensuring daily recording is accurate and up to date. Staff spoken with said that they know all residents very well, having had several years experience in caring for them and would be aware of any emotional needs which might arise. In this respect service users would be offered time to talk with staff on a one-to-one basis. Where need indicates, the manager and staff work alongside other involved professionals to ensure both physical and emotional needs are met. Where either visits to the doctor, dentist or local hospital are required, staff accompany and support residents. Ransdale House B51-B01 SN95 RansdaleHouse VN235171 210705 Stage 4.doc Version 1.40 Page 15 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 and 23 Service user views are definitely both listened to and acted upon where appropriate. There is staff awareness of the need to try to ensure that service users are protected from all forms of abuse. EVIDENCE: Observation and discussion confirmed that there is no doubt that service users views are listened to. Residents said that they trust staff, and feel cared for and feel their views are taken seriously. All service users are aware that they can complain, and also that they can complain to an outside source if they feel the need to. This has been demonstrated by the fact that residents have felt able to talk to the Inspector about issues within the home. However, most issues are resolved in-house via discussion with the manager and staff. The manager said that training on the Protection on Vulnerable Adults is shortly to be provided by an in-house trainer and is scheduled to take place on 12th and 13th September 2005. Ransdale House B51-B01 SN95 RansdaleHouse VN235171 210705 Stage 4.doc Version 1.40 Page 16 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) 24,25,26,27, 28,29 and 30 Ransdale House is a homely and comfortable environment, with bedrooms which meet the need of those who live there. Toilets and bathrooms are adequate in number, and there is appropriate shared space which is accessible to all. Specialist equipment is provided where required. The home is clean and hygienic. EVIDENCE: At the time of the Inspection, the home was seen to homely and comfortable. Several improvements to the home have taken place since the last Inspection – one service user has a new toilet, floor and wall tiles. Laminated flooring has been laid in the dining room, and in service user rooms where this has been their choice. Ransdale House B51-B01 SN95 RansdaleHouse VN235171 210705 Stage 4.doc Version 1.40 Page 17 All individual bedrooms were seen and were, without exception, well decorated and suited to the needs of residents. Rooms are highly personalised, reflecting the preferences and taste of their owners. Care has been taken to support residents in their choice so that décor is appropriate, for example, walls painted in colours which will reflect light, which is particularly suitable for one service user. There is a downstairs toilet, which is accessible to all service users, and upstairs there is both a bath and shower room, both containing toilets. One service user has an en suite facility containing a bath and toilet. Shared space consists of a sitting room, dining room and conservatory, all on the ground floor of the home. The garden is enclosed, well kept and it is obvious that staff and residents have worked together to make this area as attractive as possible with the addition of tubs and hanging baskets. The summer house, or conservatory, is useful communal space, for both recreational and educational purposes. Those living at Ransdale House enjoy BBQs in the garden, when weather permits. Supportive equipment is readily available within the home – there is a Mincom telephone, flashing lights alarms systems, vibrating bed pads, magnetic door openers, a hoist for use by one service user, and CCTV which is confined o the entrance of the home. At the time of the Inspection, Ransdale House was seen to be clean, tidy and hygienic. The only area which was seen to be in need of updating was the kitchen, where cupboards and units were seen to look somewhat shabby and in need of refurbishment. Ransdale House B51-B01 SN95 RansdaleHouse VN235171 210705 Stage 4.doc Version 1.40 Page 18 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) 31,32,33,35 and 36 Roles and responsibilities for staff are clearly defined, and service users are supported by competent and well-trained staff, who work hard to meet all aspects of care need. EVIDENCE: Discussion with both the manager of the home and staff, and observation on the day of the Inspection, confirmed that there are clear lines of responsibility, visible to both staff and residents within the home. The manager ‘leads from the front’ and as such, staff are very clear about their roles and responsibilities, and when there is a need to consult the manager of the home. There is an emphasis on training, and evidence was seen that the manager will seek out training opportunities in order to try to ensure that staff are fully competent. From the point of view of National Vocational Qualifications (NVQs) all staff are now qualified to a minimum of Level 2, and three have passed NVQ Level 3. All staff have completed the Safe Handling of Medicines course. A course to address issues around the Protection of Vulnerable Adults is to be held in the home in September. British Sign Language (BSL) training is undertaken where required. Ransdale House B51-B01 SN95 RansdaleHouse VN235171 210705 Stage 4.doc Version 1.40 Page 19 Observation, and discussion with staff indicated that they feel the staff team is effective and works well in supporting residents, feeling that ‘there are no weak links’ in the team. Formal Supervision of staff is carried out by the manager, although staff are able to consult her on a more informal basis at any time should the need arise. Ransdale House B51-B01 SN95 RansdaleHouse VN235171 210705 Stage 4.doc Version 1.40 Page 20 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) 37,38,39,42, and 43 The home is well run, and the manager leads the way in promoting totally person-centred care, based on ensuring the best possible quality of life for those who live at Ransdale House. RNID management is both supportive of the home on a local basis, and accountable in providing detailed reports of monitoring visits to the Commission for Social Care Inspection. EVIDENCE: Inspections over the last year, since the appointment of the present manager, confirm that the home is well run. The manager works hard at ensuring that staff are motivated and competent and that the systems which underpin the care provided in the home are sound. There is an ethos of providing ‘person centred ‘ care, and the manager and staff are to be commended for the way in which they work in the best interests of all residents. It was good to see examples of how service users views and wishes are taken seriously, and acted upon wherever possible. Ransdale House B51-B01 SN95 RansdaleHouse VN235171 210705 Stage 4.doc Version 1.40 Page 21 Discussion with service users has confirmed that they feel staff are caring and trustworthy, and without exception, those spoken with said how much they love both their home and those who care for them. The manager and staff really do try to ensure that residents have the best possible quality of life. From the point of view of health, safety and welfare, robust risk assessment is in place and staff are vigilant in trying to identify hazards within the home. The Registered Manager of the home is well supported by her line manager within the Royal National Institute for the Deaf organisation, who undertakes the Registered Provider (Regulation 26) monthly visits, and very detailed reports of these visits have been received at the local office of the Commission for Social Care Inspection. Ransdale House B51-B01 SN95 RansdaleHouse VN235171 210705 Stage 4.doc Version 1.40 Page 22 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 N/A 2 N/A N/A N/A Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 4 4 4 N/A Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 4 3 4 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 N/A 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ransdale House Score 4 3 N/A N/A Standard No 37 38 39 40 41 42 43 Score 3 4 3 N/A N/A 3 3 B51-B01 SN95 RansdaleHouse VN235171 210705 Stage 4.doc Version 1.40 Page 23 No 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 Regulation Requirement Timescale for action 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 24 Good Practice Recommendations It is recommended that consideration is given to updating the kitchen Ransdale House B51-B01 SN95 RansdaleHouse VN235171 210705 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Unit 1, Advance St Marks Court Teesdale Stockton-on-Tees. TS17 6QX 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 Ransdale House B51-B01 SN95 RansdaleHouse VN235171 210705 Stage 4.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!