Inspection on 13/02/07 for Ranworth House

This inspection was carried out on 13th February 2007.

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.

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

CARE HOME ADULTS 18-65 Ranworth House 1 Prideaux Road Eastbourne East Sussex BN21 2NW Lead Inspector Debbie Sullivan Key Unannounced Inspection 13th February 2007 09.55 Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 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 Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 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. Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ranworth House Address 1 Prideaux Road Eastbourne East Sussex BN21 2NW 01323 644860 01323 644859 jennifer.bro084@pop3.altchiway.com 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) Broadham Care Ltd Jennifer Carey Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is nine (9). Service users must be aged between eighteen (18) and sixty-five (65) years on admission. Service users with a learning disability only to be accommodated. Date of last inspection N/A New service Brief Description of the Service: Ranworth House was registered in 2006 to accommodate a maximum of nine service users who have a learning disability. The home aims to provide a flexible service that recognises the needs, strengths and interests of service users and promotes independence. The home is staffed 24 hours a day. The staffing ratio is good and there are opportunities for individual support, staff are well trained in areas relating to their specific work. Daily and weekly activities for service users are built around their individual abilities and the home promotes healthy living. The house is situated a short distance from the centre of Eastbourne, it has a seven seater vehicle, bus stops are nearby as are local facilities. Accommodation is on three floors. There are two lounges, a small sensory room, laundry, kitchen, dining room, staff office, shower room and toilet on the ground floor; bedrooms are on the other floors, there is a shaft lift. There is a good sized garden at the back of the house. As the house is situated on a busy road, access for service users is off a quite road at the side of the house and the garden is gated for safety. There is a small parking bay and parking is available on roads nearby. The current fee for the service is £1,350 per week, additional one to one hours are £10 per hour, and the manager provided this information during the site visit. Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Deborah Sullivan, Regulation inspector undertook this unannounced Key Inspection over three hours and fifty minutes; it was the first inspection of this new service. During the visit time was spent speaking with the manager and two members of staff, touring the property and reading records and other documents, some observation of the daily running of the house and staff interaction with a service user took place. Due to the nature of the service some judgements about choices and quality of life have been made by using information provided by the manager and staff and available in records. Throughout the visit the manager and care staff were helpful in providing information and were clearly very committed to the service and it’s future development. What the service does well: What has improved since the last inspection? Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 Page 6 This is a new service so this section is not applicable for this report. 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. The summary of this inspection report can be made available in other formats on request. Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 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 Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Potential service users have access to information about the home and visits are welcomed. Needs are fully assessed prior to admission. EVIDENCE: The home was not fully occupied at the time of the inspection and the manager was liaising with sponsoring authorities regarding possible new service users. When an enquiry is made a full assessment of the potential service user’s needs takes place and visits to the home are encouraged. A director and the manager undertake assessments at different stages of the process. Following admission a six week review is held. Two service users had been admitted since the home opened although only one was present for the visit. There was clear evidence on the care plan that needs had been assessed and recorded. The statement of purpose and service users guide give clear information and the guide is set out in a pictorial format. Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 Page 9 Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs of service users are accurately and comprehensively reflected in care plans. Service users are encouraged to participate in the running of the home and gain independence skills. Records are kept confidentially. EVIDENCE: The care plan of the service user currently at the home contained comprehensive recording including background information, risk assessments, Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 Page 11 daily records and entries showing that progress had been made since living at the home. Preferences and likes and dislikes are recorded and there had been consultation with health and other professionals about any changes in needs and necessary action. The amount of detail in the care plan enables staff to have an in depth knowledge of needs. The service user is encouraged to help with running the home in terms of housework, shopping and meal preparation, the opportunity to go shopping was available during the site visit, since living at the hone the service user was now able to make a drink with support. Individual records are kept securely and confidentially. Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are able to participate in a wide variety of activities at home and in the community. Staff respect the rights of service users and choice is promoted. Meals are healthy, nutritious and well planned. EVIDENCE: The homes’ ethos is to provide community based activities geared towards the individual interests and abilities and developmental needs of service users. The manager said that future service users could have the opportunity to access educational, leisure and social activities on an individual basis, due to Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 Page 13 flexible staffing this was possible, an example could be one to one support at college. The current service user’s interests are central to the activities offered, their programme is fluid as it is still early days in establishing a routine and trying out new experiences, it includes going out for snacks and meals, visiting animal centres, visiting local parks, shopping and walks and individual Tai Chi sessions. An activity outside the home is offered daily and the right of the service user to accept or decline accepted. Throughout the site visit staff were respectful and gentle encouragement took place when needed. The home has a pleasant second lounge where private visits can to take place from friends and family, visiting is supported and this will be more evident when there are more service users. Meals are as organic as possible and fresh produce bought several times a week, a menu has been developed that incorporates the service user’s preferences and other nutritious and healthy meals, when more people move in it can be adapted. Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personal and healthcare needs of service users are well met and prefences are respected. Medication procedures are in place and followed correctly. EVIDENCE: Personal and healthcare needs were recorded on the care plan, since the service user moved in good links had been built up with the local multi disciplinary learning disability team who have supported referral for specialist assessments and work is taking place to gradually reduce medication under close supervision, so far this has been positive in improving quality of life for the service user. They had also lost weight and become more mobile due to encouragement to walk rather than use a wheelchair when out, more activity in general and eating healthily. Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 Page 15 Another service user was undergoing assessment in a specialist setting due to changes in needs. Where support is needed with personal care tasks it is given at the service user’s pace and discreetly, they have an ensuite and preference for a shower rather than a bath is met. Behavioural changes or other health concerns are recorded and can be tracked in the daily log by the manager so that any patterns can be established. Daily recording was very detailed and gave an excellent picture of progress and any changes. Medication is stored and administered correctly, future service users will have the option to self medicate subject to a risk assessment. All staff administering medication have been trained to do so. Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to tis service. A clear complaints procedure is in place. Service users are protected from abuse by the homes’ policies and procedures. EVIDENCE: The home has a complaints procedure no complaints had been received since it opened and there had been no adult protection alerts. All the staff had had CRB and POVA checks before they started work, even if they had a very recent CRB in existence. Staff do not start work until a satisfactory disclosure is received. The home is such that it offers a service to people who may exhibit verbal or physical aggression; guidelines and procedures have been put in place to manage this. Adult protection training is due for staff in March 2007 and the home has an adult protection procedure. The manager was advised to obtain a copy of the local authorities’ procedures and did so during the site visit. It recommended that the sponsoring local authority be approached to change the arrangement whereby a director is appointee for a service user. Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 Page 17 Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable, well-furnished, well-decorated and homely environment for service users that is designed to meet their needs. EVIDENCE: The home was fully refurbished before it opened and the standard of comfort and decoration is very high. Specialist advice was taken so that the colour schemes and furnishings used were suitable for the service user group and provide a calm but warm and inviting environment, the overall effect is that of a spacious, homely and welcoming house. Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 Page 19 Shared space comprises of a large and a smaller lounge, large dining room and kitchen, there is small well equipped sensory room. Bedrooms are all ensuite with either a bath or shower, they are again all very well decorated and furnished with slightly different colour schemes, service users moving will be able to choose to redecorate if they want to. The occupied bedroom was clean and had personal items in it. The service user present was comfortable in accessing different rooms during the visit. There is a laundry room that can be used by service users who wish to do their own laundry and to develop this skill. The garden is gated in part to ensure the safety of service users as the house fronts onto a busy road. Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35 and 36 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home’s staff team is well supported and trained and staff are clear about their roles. Recruitment practices are thorough and serve to protect service users. EVIDENCE: The home currently has two staff on duty plus the manager during the daytime and one sleeping and one waking member of night staff. When there are more service users the maximum daytime staffing will reflect this and increase to five. There is a dedicated night staff team. The recruitment process is thorough and the manager spoke of not taking on staff unless she was sure they were right for the role, staff are from a variety of backgrounds and offer individual skills and experience. Staff files read Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 Page 21 included necessary recruitment documents, records of interviews and training certificates induction training is given. Staff spoken with liked working at the home and felt well supported, comments made by them included “ staff all get on really well”, “I can’t fault it” and “the manager is wonderful”. Staff felt training was good, and plenty was available. During the site visit staff maintained a balance of supporting the service user and adapting to their needs without being over attentive due to the amount of time they could offer, this was necessary as possibly due to a disturbed night or the arrival of a stranger (inspector) in the house the planned routine needed to be changed a little. Good quality external training is given by a variety of training providers, including those equipped to provide specialist service specific topics, such as epilepsy training provide by the learning disability team. Senior carers are expected to have gained the NVQ 3 in care. Regular recorded supervision takes place and staff meetings are held, appraisal documentation is in place. Staff were clear about their roles and very knowledgeable about the needs of the service user, they were keen for more people to move in so that they could use their skills and experience more fully. Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41,42 and 43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run in the best interests of service users and staff by an experienced manager. The safety and welfare of service users is protected and promoted. EVIDENCE: Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 Page 23 The home is well run and the manager is experienced and well qualified. The manager has worked hard to build up an effective staff team and is well supported by the two directors. A director visits the home at least once or twice a week a member of staff said, “The directors are in regularly and are very approachable.” The needs of the current and any future service users are central to the running of the home. The ethos of the home is to provide an ethical, enabling and service user led home, this has been established and it is important that the impetus is not lost if no new service users move in soon. Policies and procedures are in place and as time goes by are likely to be adapted as the home develops. A quality assurance survey form is available but hasn’t yet been used; it will need to be made user friendly for service users. The manager said that the home has generous budgets and that the vacancies are not compromising it’s future, it is hoped that vacancies will soon reduce. As the home is still relatively new initial maintenance and equipment checks remain valid and safe working practices were observed. There is a valid insurance certificate. Fire checks and practices are held; it is recommended that all the names of all those involved in practices are recorded. Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 Page 24 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 2 3 4 5 CONCERNS AND COMPLAINTS Standard No Score 22 23 3 3 3 3 X 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 ENVIRONMENT Standard No Score 24 4 25 3 26 4 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 4 33 3 34 4 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000067623.V323708.R01.S.doc LIFESTYLES Standard No Score 11 4 12 3 13 3 14 3 15 3 16 3 17 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ranworth House Score 3 3 3 X 3 3 3 3 3 3 3 Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? N/A 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. 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 2 Refer to Standard YA23 YA42 Good Practice Recommendations It is recommended that the manager explore alternatives to a director being an appointee for a service user with the service user’s sponsoring authority. It is recommended that the full names of all present and taking part in fire practices be recorded. Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Ranworth House DS0000067623.V323708.R01.S.doc Version 5.2 Page 27 - 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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