Inspection on 08/08/05 for Ravenscourt

This inspection was carried out on 8th August 2005.

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

The inspector 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

Ravenscourt 26/08/08

Ravenscourt 22/08/06

Ravenscourt 28/01/06

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 B Tye Announced Monday, 8 August 2005, V236621 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. Ravenscourt H60-H11 S14677 Ravenscourt V236621 080805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Ravenscourt Address 15 Ellasdale Road, Bognor Regis, West Sussex, PO21 2SG 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) 01243 862157 01243 867126 Mr Jonathan David Harman Mr Robin John Woznicki Care Home (CRH) 17 Category(ies) of Past or present alcohol dependence (A) - 17, registration, with number Past or present drug dependence (D) - 17 of places Ravenscourt H60-H11 S14677 Ravenscourt V236621 080805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th November 2004 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. Accomodation 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 H60-H11 S14677 Ravenscourt V236621 080805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Announced Inspection of Ravenscourt took place over 4.5 hours. Prior to the inspection information held on file was examined, including the last two inspection reports and any official documentation relating to the home. During the inspection a tour of the home was undertaken and records relating to the residents care and health needs was examined. The inspector spoke to the Director and Care Manager at length and spent some time with the Office Administrator. Staff files and Health and Safety records were reviewed. In addition, the inspector had the opportunity to talk with five residents at length about their experience of the service. What the service does well: What has improved since the last inspection? Since the last inspection the registered manager Mr Robin Woznicki has completed the National Vocational Qualification award in Management and Care (Level 4). Policies and procedures relating to Confidentiality and Adult Protection have been reviewed and up dated in line with current legislation. Some of the upstairs bedrooms have been re-decorated and carpets replaced. The programme of redecoration is on going in the home. Ravenscourt H60-H11 S14677 Ravenscourt V236621 080805 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. Ravenscourt H60-H11 S14677 Ravenscourt V236621 080805 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 Ravenscourt H60-H11 S14677 Ravenscourt V236621 080805 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) 1 - 5 Pre-admission assessments are completed prior to admission to the home. Prospective residents are provided with relevant information and have the opportunity to visit the home and speak with other service users and staff during their visit. All residents are provided with a contract of Terms and Conditions. EVIDENCE: The inspector viewed an up to date Statement of Purpose and Service Users Guide, which are given to all prospective residents prior to admission. This provides detailed information about the services available to them and helps them to decide whether the home can appropriately meet their needs. All residents spoken to said they attended the home for an assessment prior to admission and had the opportunity to look around and talk to staff. Individual care files contained pre-admission information, which was relevant and detailed. Records showed prospective residents had contributed to the assessment process. Providing the opportunity for them to identify their perceived needs and aspirations prior to admission. Ravenscourt H60-H11 S14677 Ravenscourt V236621 080805 Stage 4.doc Version 1.40 Page 9 Terms and Conditions are provided and signed by each resident on arrival, copies of which was seen on file. This ensures residents are fully aware of their rights and exactly what the home has to offer them. Ravenscourt H60-H11 S14677 Ravenscourt V236621 080805 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 - 10 Residents have the opportunity to contribute to and review the care planning process. Documentation that was examined, and discussion with residents confirmed that the home meets their changing needs and personal goals appropriately. The service promotes independently living as part of a structured programme and in line with assessed risk and agreed limitations. EVIDENCE: The inspector examined five care plans. These are generated from the initial assessment information and completed risk assessment. Each plan relates to all aspects of the residents assessed care needs including health, personal and social care. All plans seen were detailed and easy to follow which means staff can transfer the information into daily practice. Records include written reference to weekly review meetings by the therapeutic team. Through this process, objectives are identified and discussed with individual residents. This was evidenced by the residents completion of written assignments and signed documentation held on file. Each review provides an opportunity for the resident to be consulted and participate in the care planning process. Ravenscourt H60-H11 S14677 Ravenscourt V236621 080805 Stage 4.doc Version 1.40 Page 11 In addition to this, a formal six weekly review is held at the home. Involved professionals are invited to attend these to discuss individuals progress in the programme. Residents are always present and have the opportunity to contribute fully to the process. Individual risk assessments were evidenced on residents files, providing staff with clear guidelines about residents agreed limitations and promoting independence where possible. Residents meet on a weekly basis for a community meeting. This forum enables residents to discuss and resolve issues relating to their living environment. Through these meetings the residents have the opportunity to discuss and contribute to the way the home is run. Ravenscourt H60-H11 S14677 Ravenscourt V236621 080805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11 - 16 The residents of Ravenscourt are required to participate in a structured programme, which includes group and individual activities both in the home and wider community. These are appropriate to their personal development and encourage individuals to take responsibility in their daily lives. EVIDENCE: Records showed that leisure activities and personal family contacts were being provided and maintained according to individual need and circumstance. Part of the programme at Ravenscourt includes work with family members to resolve on going issues and provide support where needed. Residents feedback in relation to their lifestyle and care needs matched the written records and the work being undertaken by the therapeutic team. It is clear each resident has the opportunity to develop their personal goals and is encouraged to do so through group work and individual sessions. Goals have been set out in individual care plans to support this and there is evidence these are reviewed regularly according to the individuals changing needs. Ravenscourt H60-H11 S14677 Ravenscourt V236621 080805 Stage 4.doc Version 1.40 Page 13 Residents are required to attend support groups in the local community where positive relationships with their peers groups can be established. In addition to the therapeutic aspects of the programme residents have the opportunity to develop social and leisure interests such as swimming, attendance at the local gym, and regular day trips to areas of interest. There is a ‘chill out’ room at the rear of the property with a pool table for residents to socialise away from staff. Responsibilities such as domestic tasks and cooking are included in the programme. This gives residents the opportunity to develop their life skills and enhance their independence on completion of the programme. Ravenscourt H60-H11 S14677 Ravenscourt V236621 080805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 - 21 The outcome for residents was good and all standards assessed were met in full. None of the residents require personal care however all have complex emotional health needs. Five care plans were examined and showed evidence that health needs of residents are assessed and reviewed on a regular basis. Appropriate strategies are in place to meet assessed needs, and all records include the contribution of the involved individual. EVIDENCE: Policies and procedures relating to all aspects of healthcare and medication are in place and up to date. Due to the nature of the service no resident self-administers medication. All staff have received relevant training to dispense medication safely. Medication is stored appropriately at the home and medication charts are up to date and in good order. All medication is audited six monthly by the local chemist and this is overseen by the care manager. Care needs including health are detailed on individual plans. All aspects of care provided by the home and community health professionals are recorded. Ravenscourt H60-H11 S14677 Ravenscourt V236621 080805 Stage 4.doc Version 1.40 Page 15 All residents are registered with a local GP and Dentist. Residents are supported to make appointments as required. Each resident is assigned a counsellor who provides a therapeutic one to one session twice weekly, or more often if requested. These meetings provide residents with the opportunity to talk through all aspects of their care needs and make supported changes where needed. The programme provides a rigid daily structure to the residents which is relevant to their on going treatment and complex needs. However individuals have the opportunity to make choices and demonstrate independence within this. An up to date policy and procedure relating to death and dying is available at the home. This ensures staff are clear about their practice should a relevant incident occur. Ravenscourt H60-H11 S14677 Ravenscourt V236621 080805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 It is clear residents spoken to felt listened to in all aspects of their daily lives and all stated they knew how to complain if the need arose. The inspector concluded that the home has satisfactory systems in place to protect the residents from abuse, neglect and self-harm. EVIDENCE: The home has a detailed Complaints policy and procedure, which is included in the service users guide. All residents spoken to said they had received this and where clear about the information provided in respect of complaints. The complaints log was examined and the inspector found one recorded complaint since the last inspection. This had been resolved appropriately within the stated timeframe and no further action was required. The inspector viewed risk assessments for individuals on each file, which highlighted areas of vulnerability for each resident. This information helps staff to make informed choices about protecting residents from potential risks in their daily lives. Staff records showed Adult Protection Training is undertaken twice a year and staff were 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. Regular residents meetings provide individuals with peer support and the opportunity to discuss any issues of concern. Ravenscourt H60-H11 S14677 Ravenscourt V236621 080805 Stage 4.doc Version 1.40 Page 17 Ravenscourt H60-H11 S14677 Ravenscourt V236621 080805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 - 30 The communal areas and residents bedrooms met all parts of the standards and therefore the outcome for residents was good. Improvements have been made to improve the facilities and this will be on going. EVIDENCE: The lounge and dining area were of a suitable size to meet residents needs. A conservatory area and ‘chill out’ room provide the residents with a space to smoke and socialize. Bedrooms are a reasonable size and some have been recently re-decorated. The occupants have personalised their rooms with pictures and possessions. None of the residents bedroom doors had locks as this was considered a risk in relation to their assessed needs. The inspector agreed this was appropriate given the nature of the resident group. It was noted that staff knocked before entering bedrooms and residents privacy was respected. 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. Ravenscourt H60-H11 S14677 Ravenscourt V236621 080805 Stage 4.doc Version 1.40 Page 19 A large garden at the rear of the premises is accessible to all residents and has ramped access to the home. The domestic duties at Ravenscourt are completed by residents, as part of their programme. This is overseen by the homes 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 H60-H11 S14677 Ravenscourt V236621 080805 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 - 36 The staff at Ravenscourt have all been trained and recruited to meet the assessed needs of the residents. Recruitment procedures are in place and records reflected these are adhered to. All staff are supervised and supported to fulfil their roles and responsibilities effectively. EVIDENCE: Residents care plans were detailed the support they required for maintaining and developing all aspects of daily living, free from drugs and alcohol. Observations, discussions and records seen at the home confirmed this matched the care being provided by the staff team. All residents spoken to said the staff were supportive and although they needed to be challenging at times, they always maintained respect for the individual. This approach helps residents to establish positive relationships with staff members at the home and seek support from them when it is needed. Ravenscourt H60-H11 S14677 Ravenscourt V236621 080805 Stage 4.doc Version 1.40 Page 21 All care staff at the home have obtained a counselling qualification prior to being employed. The home also runs a training programme, which includes first aid, fire training, adult protection, confidentiality and health and safety courses. None of the staff have started the National Vocational Qualification; Level 2. This is due to the fact that the current training modules are geared more towards nursing and care homes. The director stated he is currently 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. This will be monitored at future inspections. The home currently has a full staff compliment and does not use agency workers. This provides consistency of care to residents. All staff had job descriptions on file which provides them with clarity and established boundaries in their given roles. Recruitment policies are in place and records showed all relevant staff checks had been obtained and were up to date. This ensures vulnerable residents are protected from potential risks. Staff records showed the care team have regular 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. In addition staff have two annual appraisals and meet regularly as a group. This provides a forum for staff to contribute to the running of the home gain peer support in relation to practice issues. Feedback from residents, staff discussion and observations led the inspector to conclude the residents needs were being met by a competent and qualified staff team. Ravenscourt H60-H11 S14677 Ravenscourt V236621 080805 Stage 4.doc Version 1.40 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 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 -43 Good practice in the home was evident and supported by efficient administrative systems. Completion of regular health and safety checks provides residents and staff with a safe environment in which to live and work. Residents rights and best interests are safeguarded through comprehensive policies, procedures and record keeping. 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 examined all safety records, including risk assessments and concluded they were up to date and in good order. These systems promote all aspects of health and safety and therefore safeguard the residents and staff from potential risk and harm. Ravenscourt H60-H11 S14677 Ravenscourt V236621 080805 Stage 4.doc Version 1.40 Page 23 Discussions and observations confirmed staff receive support and direction in their roles from management. Good working practices are promoted through training and regular staff support. The inspector noted efficient administration and recording systems are in place, which support staff in their practice and ensure accountability in their day to day roles. The confidentiality policy has been recently up dated and training is provided to all staff. All care records are kept in a locked cabinet in the staff office. These measures ensure residents personal information is protected at all times. Quality assurance is undertaken on an annual basis by the Trustees of Ravenscourt and is included in the annual report. This is published on the Internet and a copy is available at the home. The inspector viewed feedback forms from residents whose views underpin regular reviews and on going development of the home. Following examination of all safety records and relevant documentation, the inspector concluded the conduct and management of the home served the best interests of the residents by actively promoting their welfare and safety and providing a good standard of overall care. Ravenscourt H60-H11 S14677 Ravenscourt V236621 080805 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 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 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ravenscourt Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 H60-H11 S14677 Ravenscourt V236621 080805 Stage 4.doc Version 1.40 Page 25 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 Good Practice Recommendations Ravenscourt H60-H11 S14677 Ravenscourt V236621 080805 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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. 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