Inspection on 16/09/05 for Raplea

This inspection was carried out on 16th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Raplea 11/01/08

Raplea 06/09/06

Raplea 17/01/06

Raplea 28/02/05

Raplea 26/07/04

Raplea 04/03/04

Raplea 28/01/04

Raplea 02/05/03

Similar services:

St Vincents

The Cotswold Home

Winton House

Newbeech House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Raplea Farthing Green Lane Stoke Poges Bucks SL2 4JQ Lead Inspector Rob Smith Unannounced 16 September 2005 11:00 a.m. 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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Raplea 20050916_Raplea_UI_Stage 4_S23013_V246418_H53_RS_ces.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Raplea Address Farthing Green Lane, Stoke Poges, Bucks, SL2 4JQ 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) 01753 644459 Mrs Lila Paterson Mrs Lila Paterson Care Home 3 Category(ies) of Old age, not falling within any other category registration, with number (3) of places Raplea 20050916_Raplea_UI_Stage 4_S23013_V246418_H53_RS_ces.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28 February 2005 Brief Description of the Service: Raplea is a care home for older people, which provides personal care for service users who are elderly. The home has three single rooms, two on the ground floor and one on the first floor. The home is annexed to the family home of the owners/manager, Mr and Mrs Paterson. It has a large garden. The home is situated half a mile from Stoke Poges village and three miles from Slough in a rural setting. Public transport is not easily accessible. Raplea 20050916_Raplea_UI_Stage 4_S23013_V246418_H53_RS_ces.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place between approximately 11.00 and 14.00. The inspection involved separate discussion with the manager and the three service users in residence, a check of the physical environment and scrutiny of a selection of key records. What the service does well: What has improved since the last inspection? Attention had been paid to nearly all of the requirements from the last inspection. Particular attention had been paid to redecoration of the home to a high standard. Improved attention had been paid to aspects of health and safety for staff and residents. Care plans had been updated and reviewed. CSCI was being notified of relevant significant events affecting the welfare of residents. Raplea 20050916_Raplea_UI_Stage 4_S23013_V246418_H53_RS_ces.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. Raplea 20050916_Raplea_UI_Stage 4_S23013_V246418_H53_RS_ces.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Raplea 20050916_Raplea_UI_Stage 4_S23013_V246418_H53_RS_ces.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,3 Contracts were in place ensuring clarity about the range of services offered and related costs. Assessments were carried out prior to admission to ensure the appropriateness of any placement in the home. EVIDENCE: Two new residents had been admitted since the last inspection. Their individual files showed evidence of satisfactory pre-admission assessments and the existence of written contracts detailing the range and cost of care provided. Raplea 20050916_Raplea_UI_Stage 4_S23013_V246418_H53_RS_ces.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,9,10 Satisfactory care plans were in place detailing the care needs of residents and how they would be met Medication was safely stored and records maintained generally satisfactorily. The approach of staff led residents to indicate they felt they were treated with appropriate respect and had adequate privacy EVIDENCE: Residents’ personal records were checked and care plans were in place for each. These did provide a satisfactory, if brief, overview of their care needs and how they would be met. These plans were up to date having been recently reviewed by the manager. Medication records and storage were checked and seen to be in order. Only one resident was currently on any regular form of medication and records showed these had been consistently administered. The one minor point raised was the need to ensure that the amount of any mediation arriving with new Raplea 20050916_Raplea_UI_Stage 4_S23013_V246418_H53_RS_ces.doc Version 1.40 Page 10 admission was fully recorded on the home’s medication records to ensure an audit trail of medication usage could be sustained. Residents each had their own room for private space and privacy. Discussion with the three residents indicated they felt well looked after and treated with appropriate respect and dignity. Observations of staff contact and interaction with residents during the inspection confirmed they treated residents with respect and consideration. Raplea 20050916_Raplea_UI_Stage 4_S23013_V246418_H53_RS_ces.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,15 Residents were able to sustain appropriate contact with friends, relatives and the local community An appropriate range and variety of meals were on offer to residents EVIDENCE: Discussions with residents confirmed that where it was feasible they were able to maintain contact with friends and relatives. One resident reported regularly seeing local friends and going out on trips and visits with them. Another resident commented on visits from relatives to the home. At the time of the inspection two of the residents were going out to the local fish and chip shop for lunch. Menus were examined and showed a good range of meals and alternative options when needed. Feedback from residents was of satisfaction with the quality of food supplied and for the one resident staying at home the quality of the lunch time meal provided was seen to be good. Raplea 20050916_Raplea_UI_Stage 4_S23013_V246418_H53_RS_ces.doc Version 1.40 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 The home had an appropriate complaints process in place to help ensure the views of residents would be heard and acted upon The home’s policies and procedures on adult protection were still incomplete leading to potential weaknesses in systems designed to protect residents from abuse EVIDENCE: The home’s complaints procedure had been amended in response to requirements made at the last inspection and now reflected the expectations of the standards and regulations. There had been no complaints made since the last inspection to CSCI or at the home according to records maintained there. The home had not yet developed its own vulnerable adults policy and procedure as required following the last inspection nor had an up to date version of local adult protection policies been obtained. The manager indicated she had tried to obtain more recent guidance from the local authority but had been advised no more recent versions existed. This was subsequently clarified as being inaccurate by the inspector and the manager was advised of who to contact in the local authority to obtain the most recent guidance. Once received the home will still need to develop its own policy, procedure and guidance as indicated in the original inspection requirement. No concerns of an adult protection nature had arisen since the last inspection. Raplea 20050916_Raplea_UI_Stage 4_S23013_V246418_H53_RS_ces.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,23,24,25,26 The physical environment was well maintained, ensuring residents lived in safe, attractive and comfortable surroundings that were suitably equipped to meet their needs EVIDENCE: The home had paid attention to the various requirements relating to the physical environment at the last inspection and a though programme of redecoration had taken place The home was, as a consequence well decorated and comfortably furnished. All the communal areas were clean and tidy and suitably equipped with furniture, as were the individual bedroom areas. Bedrooms were seen to be suitably personalised with a range of items that residents had themselves brought in. Bathroom and toilet areas were clean and odour free and, again, well decorated. Raplea 20050916_Raplea_UI_Stage 4_S23013_V246418_H53_RS_ces.doc Version 1.40 Page 14 The overall physical environment was seen to be well maintained with no evident areas of concern or risk. Raplea 20050916_Raplea_UI_Stage 4_S23013_V246418_H53_RS_ces.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 An appropriate number of staff were on duty to meet the needs of residents There was some inconsistency in the vetting of all adults working with residents in the home EVIDENCE: At the time of the inspection one member of care staff was directly working with the three residents with the manager and her husband readily available for support if needed. Given the relatively straightforward care needs of the current residents this was a satisfactory level of staff and was reflected in the rotas for the home as a usual level of cover. In discussion with the manager and her husband it emerged that very occasional the adult children of the manager might take residents out for a walk or out to the village. While it was accepted that the full range of recruitment checks would not necessarily be appropriate in this situation the adult children had not been CRB checked. It was made clear that until such CRB checks had been carried out the adult children should not be left in sole charge of residents at any time without the presence of appropriately checked staff. Raplea 20050916_Raplea_UI_Stage 4_S23013_V246418_H53_RS_ces.doc Version 1.40 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,38 The manager had not yet achieved the expected level of formal professional qualification to demonstrate her fitness for the role Good attention was paid to the promotion of safe working and living environment of staff and residents EVIDENCE: While the manager was clearly experienced in the management role no firm steps had yet been taken to enrol on formal professional qualification for NVQ 4 or equivalent, which was expected in the standards by 2005. This issue will be followed up separately by the inspector subsequent to the inspection to clarify current CSCI expectations. Raplea 20050916_Raplea_UI_Stage 4_S23013_V246418_H53_RS_ces.doc Version 1.40 Page 17 Attention had been paid to the immediate health and safety matters arising at the last inspection and the manager’s husband confirmed that relevant COSHH information was now in place. Work had started on developing a comprehensive set of generic risk assessments but progress had been slow. Some further explanation of expectations was offered by the inspector and further progress on this area will be expected by the time of the next inspection. No obvious areas of risk or concern were identified during this inspection. Some discussion also took place with the manager and her husband about the need to develop a more substantial system for quality assurance. This will be explored in more depth at the planned announced inspection in early 2006. Raplea 20050916_Raplea_UI_Stage 4_S23013_V246418_H53_RS_ces.doc Version 1.40 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 2 x x x x x x 3 Raplea 20050916_Raplea_UI_Stage 4_S23013_V246418_H53_RS_ces.doc Version 1.40 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 18 Regulation 13 Requirement Timescale for action 31/12/05 2. 29 19 That the home obtains up to date versions of local adult protection policies and procedures and subsequently completes its own related policy procedure and guidance That the home ensures all adults 31/10/05 who have unsupervised contact with residents have been appropriately vetted and checked 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 9 Good Practice Recommendations That the manager ensures all medication coming into the home with new residents is appropriately recorded on medication records Raplea 20050916_Raplea_UI_Stage 4_S23013_V246418_H53_RS_ces.doc Version 1.40 Page 20 Commission for Social Care Inspection Cambridge House, 8 Bell Business Park, Smeaton Close, Aylesbury Bucks, HP19 8JR 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 Raplea 20050916_Raplea_UI_Stage 4_S23013_V246418_H53_RS_ces.doc Version 1.40 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. 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