Inspection on 30/01/07 for Ravenscroft

This inspection was carried out on 30th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ravenscroft 17/01/08

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 30th January 2007 10:00 Ravenscroft DS0000022605.V329236.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.V329236.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.V329236.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) 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.V329236.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for 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) 29th March 2006 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. The three residents have their own bedroom with en-suite facilities on the first floor and live as part of Mr and Mrs Paterson’s family in a homely environment. There are two sitting rooms, a dining room and large kitchen for all to use as communal space. Mr and Mrs Paterson are always in residence so that they can fulfil their roles as heads of the household and they have a bedroom on the second floor. 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 £422.00 per week (January 2007). Ravenscroft DS0000022605.V329236.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The assessment of this service included a visit to the home, discussions with the manager and relatives as well as meeting and talking to some of the people living at the home. During this visit all the applicable key standards of the National Minimum Standards were assessed. The registered manager had completed a pre-inspection questionnaire prior to this visit. This assisted in verifying information throughout the inspection. What the service does well: What has improved since the last inspection? 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.V329236.R01.S.doc Version 5.2 Page 6 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.V329236.R01.S.doc Version 5.2 Page 7 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): Standard 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users individual needs, interests and aspirations are assessed prior to admission to the home. This helps to ensure that the home is able to meet their requirements appropriately. EVIDENCE: The service user’s care records were looked at during this visit. Suitable assessments have been undertaken and take into consideration the needs, abilities and wishes of the people living at this home. Any restrictions on choice or freedom have been documented. A brief risk assessment, stating the reasons for any restrictions is included in the assessment. Relative’s interests and needs are taken into consideration as part of the assessment process. This is a small home that provides a homely and family lifestyle service to the people that live here. Ravenscroft DS0000022605.V329236.R01.S.doc Version 5.2 Page 8 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): Standards 6, 7 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager of this home understands the support needs and abilities of the people using this service. EVIDENCE: Support requirements are clearly identified in the assessment document, which has been updated. Records indicate that this may not be as frequently as required. There is some documentation, which provides the basic information necessary to plan resident’s care, but these do not constitute a care plan. The documents include some element of risk assessment, which could be improved upon. The owners of the home provide all the care and support for the people living at Ravenscroft. There are no other staff employed at the home. The relationships between the service users, their relatives and the owners of the home are extremely close and the home provides an ‘extended family’ type lifestyle. The people living at this home can and do make decisions about their lives. They are encouraged to manage their own finances wherever possible and make important choices about their lifestyle. Ravenscroft DS0000022605.V329236.R01.S.doc Version 5.2 Page 9 Where risks have been identified, brief notes have been made of the strategies that will help minimise any risks. The manager has contingency plans in place to help ensure the safety and well being of service users, for example when they are out in public places such as shopping centres. There is a missing person procedure in place at the home should a resident not return home. Recent photographs are kept on file to aid with the description of the person should they be missing. An example of when out shopping was given by the manager. Should the resident and manager become separated, a meeting place is agreed beforehand to help ensure that the service user is safe. Ravenscroft DS0000022605.V329236.R01.S.doc Version 5.2 Page 10 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): Standards 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living at this home are able to enjoy and participate in a true family lifestyle and are encouraged to continue with their hobbies and interests. EVIDENCE: People living at this home are encouraged and supported to take part in suitable activities and opportunities. Residents are given the opportunity to attend workshops and day centres. Close contact with relatives and friends are promoted by the manager and service users often spend time on days out or weekends away with them. The residents holidayed in Cuba last summer with the owners of the home. One resident is not so mobile but does go out each day for a short walk. He enjoys playing his harmonica and is a smoker, which he is also free to enjoy when he wants. There is a designated and comfortable smoking lounge area. Arrangements are made for him to receive respite care at the home where he attends day care, whilst the owners are on holiday. These arrangements help to maintain consistency and continuity in his lifestyle. Ravenscroft DS0000022605.V329236.R01.S.doc Version 5.2 Page 11 Residents at the home frequently go out on day trips, including visits to the theatre, discos and restaurants, with the manager as part of the family. The manager encourages residents to participate in the running of the home especially in keeping their own rooms and personal belongings tidy. Although residents are not able to directly assist with food preparation, they are encouraged to lay the table, empty and load the dishwasher and are able to make drinks and snacks. Because the home is organised as much as possible like a domestic, family environment, meals and mealtimes are spontaneous. Residents are able to choose meals and help with the shopping. A balanced and nutritious diet is provided and nutritional needs are monitored. Ravenscroft DS0000022605.V329236.R01.S.doc Version 5.2 Page 12 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): Standards 18 and 19. Standard 20 is not applicable at the present time. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive support with their personal care in the way they prefer and require. EVIDENCE: The needs assessments of people living at this home identify the level of support and assistance required by each individual. Wherever possible service users are encouraged and supported to be as self-caring as possible with little intervention from the manager. People living at this home are able to choose their own clothes and maintain their own personal identity. There are no staff employed at the home, the owners provide all the care and support. This helps to ensure consistency and continuity in the level of support provided. Records indicate that service users have proper access to healthcare professionals, including regular dental checks, hearing aid checks, opticians, hospital appointments and access to their GP when necessary. The current residents do not require any assistance with medication at the present time. Where assistance has been provided in the past records have been kept of the administration of medicines. Should medication be required the manager obtains advice and support from the local pharmacist. Ravenscroft DS0000022605.V329236.R01.S.doc Version 5.2 Page 13 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): Standards 22 and 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at this home are listened to and their views are taken seriously. EVIDENCE: There is a very brief complaints process, which also forms part of the home’s Statement of Purpose. This document does not include all the necessary information that is expected in order to meet the required standard. There is also a very brief statement in relation to the protection of vulnerable adults. Both these documents would benefit from a review and improvement. People living at the home are closely supported by their relatives, who have a lot of involvement with the home and the manager. Because service users and their relatives are treated as an extended family, there is a very open relationship throughout every aspect of home life. One relative commented that she is very satisfied with the care and service provided. She can relax and continue with her own life and interests too, knowing that her brother is cared for. The manager is aware of adult abuse and the protection of vulnerable adults, but discussions indicate that participation in a training course would be beneficial in updating her knowledge on this subject. Ravenscroft DS0000022605.V329236.R01.S.doc Version 5.2 Page 14 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): Standards 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides comfortable, family style accommodation for the service users. EVIDENCE: The home is warm, homely and comfortable and presents as a friendly, family type home. The house is clean, hygienic and well maintained throughout. There are two lounges – one is designated as a smoking area, dining room and breakfast kitchen, where all visitors were made welcome. Each resident has their own room, which includes en-suite facilities. One of the showers was not working at the time of this visit and is in the process of being replaced. There is also a large family bathroom with bath and shower facilities, which may be used by the residents if they wish. Residents rooms are personalised to their own tastes and are well maintained and decorated to a high standard. The laundry room is situated on the first floor away from the kitchen and dining room and is kept in a clean and tidy manner. There is an infection control procedure in place at the home. A visit by the environmental health officer was made in October 2006; no requirements were made following the visit. There are garden areas at the property and service users may access them if they wish. Ravenscroft DS0000022605.V329236.R01.S.doc Version 5.2 Page 15 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): The home is staffed and managed by the owners, Mr and Mrs Paterson. No other staff are employed at the home. These standards are not applicable. EVIDENCE: Ravenscroft DS0000022605.V329236.R01.S.doc Version 5.2 Page 16 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): Standards 37 and 42. Standard 39 was not assessed on this occasion. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of service users. Service users are supported by people who have a general understanding of their needs and requirements. EVIDENCE: The manager has many years experience of running a care home. She is unable to complete the registered managers award as the home is run as a domestic, family type home and there are no other staff employed. She has participated in some training and is in the process of gaining a National Vocational Qualification (NVQ) at level 3. She has also undertaken food hygiene training and first aid training, although this subject is in need of an update. Discussions with the manager and the relatives of service users indicate that the manager is generally aware of the special needs and conditions of people living at the home. There does not appear to be arrangements in place to ensure that the manager keeps her knowledge up to date. Ravenscroft DS0000022605.V329236.R01.S.doc Version 5.2 Page 17 The manager tries to ensure that the health, safety and welfare of service users and visitors to the home are protected as far as possible. There is some evidence of risk assessments being undertaken but these would benefit from some improvements to ensure that issues identified are clearly documented and include clear procedures for minimising risks. There is a fire alarm system in the home, which is tested from time to time with fire drills also carried out. Ravenscroft DS0000022605.V329236.R01.S.doc Version 5.2 Page 18 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 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 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 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 N/a X 2 X X X X 2 X Ravenscroft DS0000022605.V329236.R01.S.doc Version 5.2 Page 19 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 YA6 Regulation 15, 17 Requirement Timescale for action 31/03/07 2 YA22 22 3 YA23 13(6) The registered person must ensure that an individual plan is developed and agreed with each service user and/or their representative where applicable. The plan must reflect the needs, aspirations and goals of the service user and how they will be met by the home. The plan must be reviewed at least every six months or more frequently if changing needs direct this. The registered person must 31/03/07 ensure that there is a clear and effective complaints procedure, which includes the stages of and timescales for the process of investigating complaints. The complaint procedure must also be produced in an appropriate format for people using this service. The registered person must 31/03/07 ensure that there is a robust procedure for responding to suspicion or evidence of abuse or neglect. The procedure must reflect the local authority multiagency guidelines on safeguarding vulnerable adults. DS0000022605.V329236.R01.S.doc Version 5.2 Ravenscroft Page 20 4 YA37 10 (3) 12 13(6) 13 5 YA42 The registered person must ensure that periodic training is undertaken to maintain and update the skills, knowledge and competence of the manager. The registered person must ensure so far as reasonably practicable the health, safety and welfare of service users. This includes but is not limited to ensuring that risk assessments are carried out for all safe working practices and that significant findings of the risk assessments are recorded. 31/08/07 31/03/07 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 YA23 Good Practice Recommendations It is strongly recommended that the registered person undertake specific training to update their knowledge in the protection of vulnerable adults. 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