Inspection on 17/01/08 for Ravenscroft

This inspection was carried out on 17th January 2008.

CSCI found this care home to be providing an Good service.

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

Ravenscroft 30/01/07

Ravenscroft 29/03/06

Ravenscroft 23/11/05

Ravenscroft 30/03/05

Ravenscroft 11/08/04

Ravenscroft 19/03/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Ravenscroft 116 Warwick Road Carlisle Cumbria CA1 1LF Lead Inspector Diane Jinks Unannounced Inspection 17th January 2008 10:00 Ravenscroft DS0000022605.V358393.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 Ravenscroft DS0000022605.V358393.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. Ravenscroft DS0000022605.V358393.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ravenscroft Address 116 Warwick Road Carlisle Cumbria CA1 1LF 01228 520748 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) Linda@paterson116.co.uk Mrs Linda Paterson Mrs Linda Paterson Care Home 3 Category(ies) of Dementia - over 65 years of age (3), Learning registration, with number disability (3), Mental disorder, excluding of places learning disability or dementia (3) Ravenscroft DS0000022605.V358393.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 3 service users to include: up to 3 service users in the category of MD (Mental disorder, under 65 years of age) up to 3 service users in the category of LD (Learning disability, under 65 years of age) up to 3 service users in the category of DE(E) (Dementia over 65 years of age) 30th January 2007 Date of last inspection Brief Description of the Service: Ravenscroft is owned and run by Mr and Mrs Paterson. Mrs Paterson is the registered person and the main carer in the home. The home is registered to provide care and support for up to three adults with learning difficulties who need support with daily living. The large Victorian property is within walking distance of Carlisle city centre and close to public transport routes for buses and trains. The shops, facilities and amenities of the city centre are all easily accessible from the home. There are no obvious signs externally that make the house appear to be different from all the other similar properties in the locality. There are three bedrooms with en-suite facilities on the first floor. Communal accommodation includes two sitting rooms, a dining room and large kitchen. The owners live in the house too. There are front and rear gardens and a patio area at the rear of the property that are all easily accessible. The maximum weekly fees for this home are currently £434.00 per week (January 2008). Ravenscroft DS0000022605.V358393.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The assessment of this service took place over several weeks. It included a visit to the home and a meeting with the manager. People using this service and their relatives were asked to complete surveys. This helped to obtain information relating to their views and experiences of living at Ravenscroft. The manager was asked to complete an Annual Quality Assurance Assessment (AQAA). This document helped to verify the findings of the inspection visit to the home. What the service does well: What has improved since the last inspection? At the last inspection the manager was asked to ensure that people had a detailed and up to date plan of their needs and requirements. The manager was asked to make sure that risk assessments were undertaken too. This work has been completed and the documents are kept under review. This helps to ensure that the support needs and safety aspects of each person are up to date and relevant. The manager has also developed policies and procedures to help ensure that people using this service are protected from harm and abuse. As well as developing these processes, she has attended a training course on the subject of protecting vulnerable adults. These measures will help to make sure that people using this service are safe and protected. Ravenscroft DS0000022605.V358393.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. The summary of this inspection report can be made available in other formats on request. Ravenscroft DS0000022605.V358393.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 Ravenscroft DS0000022605.V358393.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using this service have their health and social care needs assessed before they move into the home. This helps to ensure that the home will be suitable and able to meet their needs and expectations. EVIDENCE: The home has a written Statement of Purpose that contains information about the home. There is an admissions process in place. This allows prospective residents to visit the home for the day or overnight, prior to any decisions being made. People using this service say that they received sufficient information about the service to help them make the decision to live at Ravenscroft. There have not been any new admissions to the home since the last key inspection. At previous inspections of this service, the records confirmed that the needs of people using this service are assessed prior to their admission to the home. Ravenscroft DS0000022605.V358393.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using this service have an individual plan of their care and support needs. This helps to ensure that they have their needs and expectations met in their preferred way. EVIDENCE: A sample of two care files was looked at during the visit to this home. The personal details of each person are recorded. There is a detailed pen picture, which provides very clear background information about the person’s preferred lifestyle. Care plans are included in the files and these provide information of daily routines, care and support requirements. The care files contain some element of risk assessment to help ensure the safety of each person living at the home. Both the risk assessments and care plans are of sufficient detail to meet the current needs of people using this service. Significant events are recorded and show that people have access to healthcare professionals such as the dentist, doctor, optician and audiologist. Social workers have undertaken reviews of the care and support needs of two of the people using this service. This helps to make sure that they receive a suitable service that meets their needs and requirements. One person at the Ravenscroft DS0000022605.V358393.R01.S.doc Version 5.2 Page 10 home does not have a social worker allocated and the manager is trying to address this. Reviews are also undertaken at the day centres they attend. There are no staff employed at the home. The manager provides all the support required by the people that live here. The home provides family style support and accommodation and there are close links between the manager, the people who use this service and their families. The manager fully understands the needs of the people that live at the home. Ravenscroft DS0000022605.V358393.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living at the home are able to make decisions and choices and have a variety of options to choose from. This helps to ensure that they have a full and stimulating lifestyle. EVIDENCE: The two younger residents are involved in the daily domestic routines of family style home life. They help with cleaning and keeping their own personal rooms tidy, helping with the dishes and table laying. They are able to make snacks and drinks with support. The two younger men attend day services each day, which they enjoy and refer to as employment. Another person living at the home is considerably older and is less mobile, although still fairly independent and requiring a minimal amount of support at present. This person spends time at home with the manager but also attends day care at a near by care home for older people. This provides the opportunity to meet and socialise with people of his own age group. Respite care is also provided by this home at times when the managers of Ravenscroft are on holiday. This helps to ensure continuity and consistency of his care. There are risk assessments and Ravenscroft DS0000022605.V358393.R01.S.doc Version 5.2 Page 12 procedures in place to help minimise any risks to people taking part in some activities outside the home. People using this service indicate that they are able to make choices and decisions about their lifestyle. The manager ensures that there are many opportunities to enjoy a full and varied social life. People living at the home are able to maintain close contact with their friends, families and local community and are able to go to stay with their relatives particularly at weekends. They attend parties, discos, go out to the cinema, day trips and take annual holidays. They are also encouraged and able to pursue their hobbies and interests. People living at the home are supported in maintaining strong links with their families and friends. Relatives visit the home regularly and often stay for meals. The owners of the home have close relationships with the relatives of people living at the home and social events both in and outside of the home are attended by all. The home is run in a ‘family style’. There are no set weekly menus. People living at the home help with the shopping and are able to choose what they eat. The manager monitors and advises on food choices to help ensure that a healthy and varied diet is provided, including fresh fruit and vegetables. Ravenscroft DS0000022605.V358393.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using this service are encouraged and supported to take responsibility for their own health and personal care needs. This helps to ensure that their independence and choices are respected and promoted. EVIDENCE: Where possible the people using this service are encouraged to be as independent as possible. There is little intervention from the manager of the home (mostly prompting and checking). Records show that people using this service have access to a variety of healthcare professionals. The manager supports people to access these services where required. She ensures that they keep up to date with their appointments especially with the audiologist appointments. One person in particular, has benefited from new hearing aids and has a much improved concept of his surroundings. One person at the home who now requires some assistance with medication. The manager has developed a system for ensuring that where assistance with administration of medication is given, clear and accurate records are kept. The manager plans to undertake some training to update her skills regarding medication and the administration of medicines. Ravenscroft DS0000022605.V358393.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an open culture. This means that people using this service are able to express any concerns they may have in a safe and understanding environment. EVIDENCE: The home has a simple and brief complaint process in place. The manager was advised to add the contact details of other agencies that people may wish to direct their concerns to if they are unhappy or dissatisfied, for example the local Adult Social Care Team. The ethos at the home is very open and trusting. People using this service and their relatives are able to discuss issues with the manager at an early stage. This helps to make sure that concerns are quickly dealt with before they become a major problem for people. Relatives visit the home very frequently and are included in ‘family life’ at the home. The people who completed surveys say that they know about the complaint process and they know who to speak to if they are concerned about any aspect of their care and support. The manager has reviewed the procedures at the home in respect of safeguarding adults. There is a copy of the local authority’s multi-disciplinary guidelines in place at the home. The manager has attended a training course to update her skills and knowledge in the protection of vulnerable adults and is familiar with the guidelines. This will help the manager to deal with any allegations appropriately and protect the people using this service. Ravenscroft DS0000022605.V358393.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using this service are provided with a warm and comfortable home life. This contributes to their happiness and well-being. EVIDENCE: The home provides a warm and friendly environment for the people that live there. It is a small care home and retains the character and accommodation of a family style home. There are two comfortable lounges, a dining area and the family kitchen. People living at the home each have their own room with ensuite facilities. There is also a large family bathroom, which is warm and pleasantly decorated. The well-equipped laundry is situated on the first floor, away from the kitchen areas. The home is generally well maintained and tastefully furnished and decorated. People living at the home have personalised their bedrooms to their own taste. They are provided with adequate storage facilities, shelving, wardrobes, desks and cupboards. Some rooms are more ‘personalised’ than others, reflecting the ability to choose and the differences in age and needs. Two of the bedrooms are due to have new carpets fitted. The manager said that there is a programme of redecoration in place at the home and this Ravenscroft DS0000022605.V358393.R01.S.doc Version 5.2 Page 16 includes bedrooms and en-suite rooms. One of the lounge areas and the dining area has recently been altered and refurbished. The lounge adjoining the dining area is designated as the smoking lounge. The arrangements were discussed with the manager. Some consideration needs to be given to these arrangements to ensure that they meet the requirements of the smoke free legislation. The people living at the home currently require no aids or adaptations to assist them with their daily living activities. They are fairly independent and require very little physical support. This is an area that the manager will need to keep under consideration as they age and their needs change. Ravenscroft DS0000022605.V358393.R01.S.doc Version 5.2 Page 17 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): There are no extra staff employed at the home. The service is run by the registered persons only. EVIDENCE: Ravenscroft DS0000022605.V358393.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager understands the needs and requirements of people using this service. This means that their rights and best interests are safeguarded and promoted. EVIDENCE: The manager has many years experience of running this home. She has completed National Vocational Qualifications in care and has undertaken some training to improve and enhance her skills and knowledge. She has recently undertaken training in safeguarding adults and she states that she is to undertake further training over the coming year, which will include updating her first aid and food hygiene certificate. She also plans to undertake manual handling training and training in the administration of medication. This will help to ensure that the needs of people using this service continue to be met in a safe manner. As part of the assessment of this service, the manager was asked to complete an Annual Quality Assurance Assessment (AQAA). Most sections of the AQAA Ravenscroft DS0000022605.V358393.R01.S.doc Version 5.2 Page 19 were complete and give a reasonable picture of the service. There are areas where more supporting evidence would have been useful, especially to show what the service has done in the last year and how it is planning to improve in the future. There is no formal quality assurance programme in place at the home. People who use this service and their relatives are constantly encouraged and supported to express their views of the service. People indicated in their surveys that they are listened to and are able to make choices about their daily lives. They are responsible for their own weekly allowances and there are extra arrangements in place for some people where necessary. The maintenance records were sampled during this visit to the home. The fire alarm has been serviced and updated. Fire extinguishers and the fire alarm are checked regularly and the manager has an annual service contract for these. A full check of the electrical system has not been undertaken for some time. Part of the system has been upgraded and the manager has asked her electrician to look at the rest of the system. Visual checks are made of portable electrical items and appliances but these have not been properly tested. The central heating, gas cooker and gas fires have not been serviced. These matters were discussed with the manager. They need urgent attention to make sure that they are in safe working order and that people using this service live in a safe environment. The manager was also asked to consider the current arrangements in place for residents that may wish to smoke. Ravenscroft DS0000022605.V358393.R01.S.doc Version 5.2 Page 20 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 X 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 N/A 32 N/A 33 N/A 34 N/A 35 N/A 36 N/A CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 2 X Ravenscroft DS0000022605.V358393.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NO 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 YA42 Regulation 23 Requirement You must ensure that equipment and domestic appliances at the home are regularly checked and serviced. Equipment must be maintained in good working order to ensure the safety of people living and working at the home. Timescale for action 01/03/08 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 YA20 YA42 Good Practice Recommendations It is strongly recommended that the registered person undertake specific training to update their knowledge in the safe administration of medication. It is recommended that the arrangements in place for people who wish to smoke be reviewed in line with current legislation. This will help ensure that people choosing to smoke are able to and those who do not smoke are protected. Ravenscroft DS0000022605.V358393.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Ravenscroft DS0000022605.V358393.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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