Inspection on 22/08/06 for Ravenscourt

This inspection was carried out on 22nd August 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ravenscourt 26/08/08

Ravenscourt 28/01/06

Ravenscourt 08/08/05

Ravenscourt 12/11/04

Ravenscourt 06/05/04

Similar services:

Prinsted

Elizabeth House

Kenward House

Boons Park

Winthrop Hall

Life Works Community Ltd

Turning Point

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

CARE HOME ADULTS 18-65 Ravenscourt 15 Ellasdale Road Bognor Regis West Sussex PO21 2SG Lead Inspector Ms Beth Tye Key Unannounced Inspection 22nd August 2006 09:30 Ravenscourt DS0000014677.V309299.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 Ravenscourt DS0000014677.V309299.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. Ravenscourt DS0000014677.V309299.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ravenscourt Address 15 Ellasdale Road Bognor Regis West Sussex PO21 2SG 01243 862157 01243 867126 robin@ravenscourt.org.uk 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) Ravenscourt Trust Mr Robin John Woznicki Care Home 17 Category(ies) of Past or present alcohol dependence (17), Past or registration, with number present drug dependence (17) of places Ravenscourt DS0000014677.V309299.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th January 2006 Brief Description of the Service: Ravenscourt is a care home registered to provide personal care (PC) for up to seventeen service users in the categories A (Past or present Alcohol Dependency) and D (Past or present Drug dependency). The property is a converted and extended premises located on the outskirts of Bognor Regis. Accommodation is provided over three floors. The home offers both single and double rooms. The service is a voluntary organisation named Ravenscourt Trust and the registered manager is Mr R Wozniciki. The responsible person on behalf of the company is Mr J Harman. Ravenscourt DS0000014677.V309299.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During the inspection a tour of the home was undertaken. Care files for three residents were case tracked. The inspector spoke at length to two counsellors on duty and spent time with the homes housekeeper. Three residents were interviewed to gain an insight into their experience of the service. Prior to the unannounced inspection of Ravenscourt information held on file was examined, including the last inspection report and any official documentation relating to the home. Where assessed standards continue to be met, the text of the inspection report will remain unchanged from the last report. This inspection is the first of the inspection year 2006/07. It is called a key inspection and will determine the frequency of visits/inspections hereafter. What the service does well: What has improved since the last inspection? Since the last inspection the home is under going a programme of maintenance and re-decoration. The downstairs toilet is being replaced and new flooring fitted. Some bedrooms have been painted and new furniture brought. Ravenscourt DS0000014677.V309299.R01.S.doc Version 5.2 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. Ravenscourt DS0000014677.V309299.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 Ravenscourt DS0000014677.V309299.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2&5 Pre-admission assessments are completed prior to admission to the home and information gained forms the basis of an on going plan of care. Each resident, signs a contract of Terms and Conditions, prior to them undertaking the programme The quality of this outcome area is good. This judgement has been made from available evidence, including a visit to the service. EVIDENCE: An up to date Statement of Purpose and Service Users Guide is available at the home, which provides all prospective residents with relevant information about the service, prior to admission. Individual care files for three residents were case tracked. Each contained preadmission information, which was relevant and detailed. Records showed residents had attended pre admission interviews with the manager of the service. At this stage individuals were able to view the home and discuss in detail all aspects of their care needs and aspirations. Terms and Conditions for the home are signed by each resident on arrival. Copies of these are held on individual files. This ensures residents are fully aware of their rights and exactly what the home has to offer them. Ravenscourt DS0000014677.V309299.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Examination of care records confirmed that the home meets individuals changing needs and personal goals appropriately. Residents are provided with the opportunity for decision making, in line with agreed risk assessments. The quality of this outcome area was good. This judgement has been made from available evidence including a visit to the service. EVIDENCE: Care records for three residents were case tracked during the visit to the home. Each plan is formed from the initial assessment and contains detailed information relating to the residents assessed care needs including health, personal and social care. Residents have the opportunity to contribute to and review the care planning process through one to one and group sessions. Records include evidence of regular reviews by the therapeutic team. Through this process, objectives and progress are identified and discussed with individual residents. This was evidenced by interviews with residents, completion of written assignments and signed documentation held on file. Daily record keeping is maintained by each of the counsellors and provides an overview for all staff members about the progress of individuals. Ravenscourt DS0000014677.V309299.R01.S.doc Version 5.2 Page 10 Risk assessments are undertaken as part of the pre-admission assessment. This includes detailed information relating to personal history, mental health and behaviours. The service promotes independence as part of a structured programme and in line with assessed risk and agreed limitations. Assessment of risk ensures the manager and staff can provide care within safe boundaries. Ravenscourt DS0000014677.V309299.R01.S.doc Version 5.2 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 the following standard(s): 12 - 17 The residents at Ravenscourt are required to participate in a structured programme, which includes group and individual activities both in the home and wider community. The menu at Ravenscourt offers a range of healthy balanced meals. The quality of this outcome is good. This judgement has been made from available evidence, including a visit to the service. EVIDENCE: Ravenscourt offers a 12 week structured programme which includes ‘free time’ and a range of planned group activities. Residents go on weekly outings each Friday and attend leisure activities in line with their social care needs and agreed risk assessments. Activities include visits to the gym, trips to the beach, spiritual walks, peer group outings, swimming, attendance at local AA and NA meetings (2x weekly) participation in the ‘personal development groups’ and visits to areas of interest in the local community. Ravenscourt DS0000014677.V309299.R01.S.doc Version 5.2 Page 12 Case tracking, interviews and discussion with residents showed the home achieves a good balance between supporting residents to participate in structured activities and encouraging independence where appropriate in line with agreed risk assessments. Weekly community groups for the residents provide the opportunity for individuals to air issues and contribute towards decision making in the home. The programme at Ravenscourt includes work with family members to resolve on going issues and provide support where needed. Information seen on care plans and discussion with the therapists confirmed family contact is promoted where appropriate. An up to date visitors policy supports this. The inspector spent time with the house keeper and examined menus for the home. Meals provided are varied and balanced in nutritional content. Residents are required to assist the house keeper in preparing ingredients and cooking group meals on a daily basis, in order to promote independent living skills. Residents confirmed they are consulted about what they liked to eat prior to menus being drawn up. All residents said they enjoyed the food and the home provided a good variety of meals. Ravenscourt DS0000014677.V309299.R01.S.doc Version 5.2 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 the following standard(s): 18, 19 & 20 Care records were examined and showed that the holistic and health needs of residents are met and reviewed on a regular basis. Medication is stored and labelled appropriately. A requirement has been made for the manager of the home to address gaps and inconsistencies found in medication recording sheets. Overall the quality of this outcome is good. This judgement has been made from available evidence, including a visit to the service. EVIDENCE: Individual care records are formed from the initial pre admission assessment, daily record keeping, weekly care reviews and six weekly care management meetings. Individuals are required to complete a range of written assignments and attend one to one weekly meetings with their counsellors. All aspects of care provided by the home, counsellors and community health professionals are recorded as they occur. The programme provides a routine and daily structure over a 12 week period. Care practice is provided in line with the individuals assessed needs. Ravenscourt DS0000014677.V309299.R01.S.doc Version 5.2 Page 14 Individuals are required to participate in all aspects of the programme and have the opportunity to make choices and demonstrate independence within this. Healthcare records were examined as part of case tracking. All were found to be detailed and in good order. Holistic needs are incorporated in each plan so in addition to health; emotional, psychological and spiritual aspects of care are identified and reviewed regularly. All residents are registered with a local GP and Dentist. Residents are supported to attend appointments as required. Each resident is assigned a counsellor who provides a therapeutic one to one session on a weekly basis. These meetings provide residents with the opportunity to talk through all aspects of their care needs and make supported changes where needed. All information from these sessions is recorded in their on going care plan. Towards the end of the programme residents are supported to move on into second stage care. Counsellors identify on going needs in partnership with individuals and make referrals for continuing care as part of the care planning process. The majority of residents will go directly from Ravenscourt into another long term programme tailored to their identified needs and requirements. Medication at the home was inspected and found to be stored appropriately. Medication charts examined during the inspection showed gaps and inconsistencies. It was noted there was an absence of audit records to show the amount of medication received on arrival for each resident. A requirement has been made for the manager to review the medication records on a regular basis to ensure all entries are accurate. In addition staff may benefit from refresher training in Medication Dispensing to provide consistency in line with the homes medication policies. Ravenscourt DS0000014677.V309299.R01.S.doc Version 5.2 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 the following standard(s): 22 & 23 The inspector concluded that the home has satisfactory systems in place to protect the residents from abuse, neglect and self-harm. The quality of this outcome is good. This judgement has been made from available evidence, including a visit to the service. EVIDENCE: The home has a detailed Complaints policy and procedure, which is included in the Service Users Guide and displayed on the residents notice board in the home. Residents spoken to said they knew how to complain and who to. All stated they felt able to raise issues of concern either on a one to one basis or in a peer group setting. Adult Protection Training is provided at the home and staff spoken to are clear about their responsibilities should an incident occur. County Procedures and an up-dated policy and procedure for the Protection of Vulnerable Adults are available at the home for reference by staff. Weekly one to one meetings and regular residents groups provide individuals with peer support and the opportunity to discuss any issues of concern as they arise. Ravenscourt DS0000014677.V309299.R01.S.doc Version 5.2 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 the following standard(s): 24 & 30 The home offers a comfortable and clean living space for residents. Residents rooms contain personal possessions and all those seen were clean and homely. The quality of this outcome is good. This judgement has been made from available evidence, including a visit to the service. EVIDENCE: Overall the environment at Ravenscourt offers a homely and comfortable environment. Some bedrooms are in need of redecoration. The house keeper stated this is scheduled as part of the on going maintenance programme. Since the last inspection new bedroom furniture has been purchased for some bedrooms. The lounge and dining area are of a suitable size to meet residents needs. A conservatory area and relaxation room provide the residents with a space to socialize. Bedrooms are a reasonable size and some have been decorated since the last inspection. The occupants have personalised their rooms with pictures and possessions from home. Ravenscourt DS0000014677.V309299.R01.S.doc Version 5.2 Page 17 None of the residents bedroom doors have locks as this is considered a risk in relation to their assessed needs. Each room contains a lockable space for residents to store valued possessions if they wish. En-suite facilities are available in some of the bedrooms and there is adequate bathroom and toilet facilities in the home to meet residents needs. Domestic duties at Ravenscourt are completed by residents, as part of their programme. This is overseen by the housekeeper and staff who support individuals to undertake various duties such as washing, cooking and cleaning. Involvement in these duties promotes the residents independent living skills and their investment in their living environment. Training records showed the housekeeper has completed a Health and Hygiene course. This promotes good health and safety practices and minimises the risk of infection within the home. Ravenscourt recently underwent a visit by the environmental health officer who recommended all staff complete Food and Hygiene training. The manager is currently implementing this. The home has a maintenance man who completes jobs around the home as required. All maintenance required is logged and checked off when its completed. Health and safety systems at the home are up to date and regularly monitored by the homes manager. Ravenscourt DS0000014677.V309299.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34, 35 & 36 Residents benefit from a well supported and effective care staff team. A recommendation has been made to ensure non therapeutic staff receive regular supervision from the manager. The quality of this outcome is good. This judgement has been made from available evidence, including a visit to the service. EVIDENCE: All care staff at the home have obtained a counselling qualification prior to being employed at Ravenscourt. In addition to this, the home also runs a training programme, which includes first aid, fire training, adult protection, confidentiality and health and safety courses. The home currently has no staff vacancies and does not use agency workers. The majority of staff have been employed at the home for a number of years. This provides consistency of care to residents. Discussion with two counsellors during the visit confirmed the care team have regular individual supervision sessions with a therapeutic counsellor contracted by the service. This gives staff members the opportunity to reflect on their practice and identify areas of personal development. Ravenscourt DS0000014677.V309299.R01.S.doc Version 5.2 Page 19 In addition the staff group meet weekly as a team and receive supervision from the home manager. Two of the therapeutic staff spoken to said they felt the support (both formal and informal) provided at Ravenscourt was of a high standard and promoted good practice and personal development of care team members. It was noted that the staff who are not part of the therapeutic team would also benefit from regular supervision by the manager as their work involves close contact with the residents. A recommendation has been made to ensure the manger provides this on a regular basis. In respect of the National Vocational Qualification; Level 2, the care team are still awaiting some planned national changes to the existing modules. This will make the qualification more relevant to the staff group at Ravenscourt and better serve the residents. To date none of the staff have undertaken the qualification. Ravenscourt DS0000014677.V309299.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41, 42 & 43 Good practice in the home was evident. This was supported by efficient administrative systems, which promote the health, safety and welfare of the residents in respect of their assessed care needs. The quality of this outcome is good. This judgement has been made from available evidence, including a visit to the service EVIDENCE: The home has up to date policies and procedures in line with current legislation. This gives staff consistent guidance in working effectively with residents at the home. The inspector was unable to examine all health and safety records, as these were locked in the director/managers office in his absence and the administrator (who had access to the files) was off sick during the inspection. However from the available records it is evident that efficient administration and recording systems are in place, which support staff in their practice and ensure accountability in their day to day roles. Ravenscourt DS0000014677.V309299.R01.S.doc Version 5.2 Page 21 Discussions with the care staff confirmed they receive support and direction in their roles from management. Good working practices are promoted through in house training, team meetings and regular staff support. A recommendation has been made to ensure other (non therapeutic) staff at the home receive regular supervision from the homes manager. Residents attend exit interviews which encourage feedback about the service. A residents questionnaire forms the basis of an annual quality assurance report. This information is available to prospective residents and agencies on request. Following examination of the available records and case tracking of care records it is evident that the conduct and management of the home serves the best interests of the residents and continues to provide a good standard of overall care. Ravenscourt DS0000014677.V309299.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 X 3 3 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X 3 3 3 Ravenscourt DS0000014677.V309299.R01.S.doc Version 5.2 Page 23 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 YA20 Standard Regulation 13 (2) Requirement For the manager to ensure staff who dispense medication comply with the homes policies and procedures. Timescale for action 30/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 YA36 Refer to Standard Good Practice Recommendations For non therapeutic staff to receive regular supervision by the homes manager. 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