Inspection on 29/04/08 for Rawleigh House

This inspection was carried out on 29th April 2008.

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

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

Rawleigh House 21/09/06

Rawleigh House 08/02/06

Rawleigh House 19/09/05

Rawleigh House 05/01/05

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Rawleigh House The Avenue Sherborne Dorset DT9 3AJ Lead Inspector Gloria Ashwell Unannounced Inspection 29th April 2008 10:30 Rawleigh House DS0000059390.V362781.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 Rawleigh House DS0000059390.V362781.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. Rawleigh House DS0000059390.V362781.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rawleigh House Address The Avenue Sherborne Dorset DT9 3AJ 01935 816630 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) Dorset Residential Homes Mrs Caroline Ann Bowen Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6) of places Rawleigh House DS0000059390.V362781.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st September 2006 Brief Description of the Service: Rawleigh House is located in Sherborne, in a residential street close to the town centre; it is operated by Dorset Residential Homes, a registered charitable trust that operates a number of care homes in Dorset. The home is registered to provide accommodation and personal care to a maximum of seven adults who have a learning disability. Residents living at Rawleigh House have access to a wide range of social and leisure opportunities and facilities, supported by staff. Most residents use local authority day services during the week, where they can access further education and life-skills. The home has 3 floors; all residents have their own private bedroom and share communal living rooms; 5 of the bedrooms have en-suite hygiene facilities. A lift operates between the floors ensuring access for wheelchair users. Some car parking spaces are available within the grounds of Rawleigh House and the public road offers unrestricted parking. The fee range quoted in the service user guide at the time of inspection was from £992 per person per week. Up to date fee information may be obtained from the service. Information regarding the subjects Value for Money and Fair Terms in Contracts can be obtained from the web link: www.oft.gov.uk A report entitled Care Homes in the UK - A Market Study is available on web link: http:/www.oft.gov.uk/NR/rdonlyres/5362CA9D-764D-4636-A4B1A65A7AFD347B/0/oft780.pdf Rawleigh House DS0000059390.V362781.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. This inspection was a statutory inspection required in accordance with the Care Standards Act 2000. There have been no inspection visits to the home since the previous key inspection which took place on 20 August 2007. The first visit of this inspection was unannounced; the inspector arrived at 10.30 on 29 April 2008, toured the premises and spoke to residents and staff. By arrangement with the Registered Manager the inspector revisited the home at 10.00 on 30 April 2008 and with the Registered Manager discussed and examined documents regarding care provision and management of the home. To conclude the inspection the offices of the provider organisation were visited at 10.00 on 8 May 2008 by arrangement with the Chief Executive, and together with the Chief Executive the inspector discussed and examined documents relating to the operation of Rawleigh House. The duration of the inspection (all three visits combined) was 4 ½ hours. During the inspection, the care records of all people who live at the home were examined and residents were ‘case tracked’; for example, for evidence regarding Standards 7, 8, 9 and 10 records relating to the residents were examined and the residents spoken with. In advance of the inspection ‘Have Your Say’ questionnaires were issued to service users by the Commission via Rawleigh House; 4 completed forms were returned (3 from residents who had completed the forms with assistance, and one from a health care professional) and the information they contained has been used to inform the findings of this inspection, as has the content of the Annual Quality Assurance Assessment (AQAA) completed by the home and provided to the Commission during November 2007. During this inspection compliance with all key standards of the National Minimum Standards was assessed. What the service does well: Rawleigh House is a well-maintained, clean and comfortable environment where the health and social care of residents is properly supported and Rawleigh House DS0000059390.V362781.R01.S.doc Version 5.2 Page 6 residents are enabled to exercise personal preferences and experience a variety of recreational, social and learning pursuits. In advance of the inspection a health care professional completed a ‘Have Your Say’ survey form stating that the home provides an “Holistic, family environment…..a happy and comfortable home”. 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. Rawleigh House DS0000059390.V362781.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 Rawleigh House DS0000059390.V362781.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Processes are in place to ensure that prior to admission the needs of each proposed resident will be assessed to ensure the home can properly meet them, and prospective residents have opportunities to gradually become familiar with the home, before the decision for permanent admission is made. EVIDENCE: Residents have lived together at Rawleigh House for a number of years and there have been no new admissions during recent years. An admission policy/procedure and pre-admission assessment process in accordance with the systems of the provider organisation (Dorset Residential Homes) are in place to be used by the home for all new admissions and readmissions e.g. following a period of absence as in hospital in-patient care. Rawleigh House DS0000059390.V362781.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): 6,7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Risk assessments form the basis of accurate and comprehensive records and plans of the individual lifestyles, circumstances and care needs of residents and ensure staff have sufficient information and guidance to help residents in their decision making and risk taking and ensure their needs are fully met. EVIDENCE: The care records of all the residents were looked at, and the records for two were examined in detail. Risk assessments form the basis for goal/care plans and daily records describe the care of each person. These documents demonstrated that residents’ needs are being monitored and appropriate levels of support provided to ensure their individual wellbeing. Residents’ independence is encouraged; they are supported to participate in individual and shared chores e.g. cleaning their own bedrooms, washing and drying dishes, laying the tables for mealtimes. Rawleigh House DS0000059390.V362781.R01.S.doc Version 5.2 Page 10 Each resident has a key worker with whom they spend regular and frequent ‘one to one’ time. Residents are satisfied with the standard of care received and from direct observation and discussion with staff and residents there was evidence that they are properly cared for and are treated with respect and have their privacy and dignity protected at all times. Rawleigh House DS0000059390.V362781.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): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have an independent lifestyle, which is free from “institutional rules”. Residents’ activities within the local community, contact with relatives and friends contribute to a positive lifestyle. The quality of the meals provides a well balanced and healthy diet. EVIDENCE: Conversations with residents and staff, and examination of records indicated a range of activities are offered to residents and they are encouraged to be part of the community. Rawleigh House DS0000059390.V362781.R01.S.doc Version 5.2 Page 12 The home has a flexible and positive approach to the lifestyles and preferences of the residents; all able to do so will go on holiday during the year and there are numerous excursions, on a ‘one to one’ and small group basis. Staff speak with residents in a sensitive manner, and constantly promote their privacy and dignity. The kitchen is located to the rear of the sitting room and residents willing and able to do so can join staff in the kitchen, to assist with meal preparation and clearing, in accordance with a risk assessment process. This enhances the essentially domestic and informal atmosphere of the home, and enables residents to be involved with ordinary household processes. Rawleigh House DS0000059390.V362781.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): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ receive good personal support with their physical and emotional health needs met on an individual basis. Residents are protected by medication policies and procedures. EVIDENCE: Personal support is provided to all residents in accordance with their needs; ‘life plans’ comprehensively describe the circumstances of, and necessary staff involvement with each resident. At present the home is in the process of expanding records to include a ‘Person Centred Profile’ reflecting the individuality of each resident and how they are able to express and meet basic emotional and physical needs. Components include ‘looking and listening’, ‘my understanding’, ‘how I communicate’ and ‘things I like to do’. Rawleigh House DS0000059390.V362781.R01.S.doc Version 5.2 Page 14 Records also describe general health needs and show that routine health checks and assessments are reliably carried out for each resident; within the Health, Safety & Wellbeing plan for each resident are their ‘health action goals’. Medicines are securely stored and all medicine handling is carried out by staff trained in this work; medication administration records were properly kept indicating that residents receive prescribed medicines at the correct times and in correct amounts. The registered manager and staff are keen for residents to maintain family links and organise periodic parties known as “family get togethers”. Any relative or friend who cannot get to these gatherings is sent photographs of the party to help maintain contact. Rawleigh House DS0000059390.V362781.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected from abuse and their concerns and complaints listened to and acted upon. EVIDENCE: The home/organisation has implemented policies and procedures for the management of complaints, and the safeguarding of the vulnerable adults in their care. There have been no complaints or safeguarding concerns recorded since the last inspection. Some residents are able to speak about concerns they may have; others may indicate distress by behaviour - the home has recorded details of the behaviours likely to be exhibited by particular residents when they experience anxiety or discomfort. By this understanding, staff are confident they can identify a resident who is unhappy or ill at ease. Rawleigh House DS0000059390.V362781.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a homely, comfortable and safe environment with their personal possessions accommodated in their bedrooms. EVIDENCE: Rawleigh House is modern and was built for its current purpose; there are bathrooms and hoisting equipment to assist residents with impaired mobility. On the day of inspection the home was clean, tidy and comfortable throughout; there were no unpleasant odours. Residents are encouraged to personalise their bedrooms; all rooms seen during this inspection were comfortable and individually furnished and decorated. Rawleigh House DS0000059390.V362781.R01.S.doc Version 5.2 Page 17 The furnishings in one bedroom were in a condition of disrepair, having been damaged by the resident accommodated in that room. It is recommended that at the earliest opportunity this bedroom be provided with furnishings suited to the circumstance and behaviour of the particular resident. Rawleigh House DS0000059390.V362781.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met and they are protected by the recruitment and retention of a trained and experienced staff team. EVIDENCE: At all times the home is in the overall charge of an experienced person. Staffing levels are provided in accordance with the assessed needs of residents to ensure that at all times sufficient staff are available to properly meet their needs. Staff are enthusiastic about their work and feel they provide a good standard of care to residents and are properly supported by the management and training provision. The records of 2 recently employed staff members were examined and found to contain all essential information including an interview assessment, health Rawleigh House DS0000059390.V362781.R01.S.doc Version 5.2 Page 19 details, two written references, evidence of identity and ‘Criminal Records Bureau check’ and induction training. At present 4 of the staff currently employed by the home hold a National Vocational Qualification in care, and another 4 are training for the qualification so that at least 50 of staff will have received this training. The provider organisation has an enthusiastic approach to staff training; there is an annual programme of training in relevant subjects to ensure that all staff have sufficient knowledge and understanding to properly care for the residents. Rawleigh House DS0000059390.V362781.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is properly managed, operates in the best interests of service users and protects them from risks of harm. EVIDENCE: The registered manager of the home is Mrs Caroline Bowen; she receives support and supervision from the Operations Manager who visits frequently on behalf of the provider organisation. The home has extensive processes for quality assurance; the provider organisation has developed and implemented the Dorset Residential Homes Rawleigh House DS0000059390.V362781.R01.S.doc Version 5.2 Page 21 Annual Quality & Care Audit Plan 2008 – 2009 which describes processes of internal audit reflecting aims and outcomes for service users. Records are kept of accidents, details of investigation and periodic audit, to ensure that risks can be identified and minimised. On some recent occasions the home has failed to promptly notify the Commission of incidents that have taken place in the home, affecting the safety and wellbeing of particular residents. This was discussed with the Chief Executive of DRH who agreed to ensure that there will be reliable reporting of any future incidents. Staff trained in First Aid and health care are on duty in the home at all times. During the inspection a sample of records regarding equipment servicing and maintenance were examined and found to be in good order. There are good processes for staff induction and training and for the formal supervision of staff. All staff are supervised and each has a personal profile containing records of appraisal ensuring that performance standards are monitored and training needs are identified, in the interests of providing good care to residents. The home has a written assessment of the ‘Health & Safety’ of the premises and working practices and keeps records of fire safety checks and tests, including drills and staff training. Rawleigh House DS0000059390.V362781.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 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 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 3 33 X 34 3 35 3 36 X 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 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Rawleigh House DS0000059390.V362781.R01.S.doc Version 5.2 Page 23 NO 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. 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 YA26 Good Practice Recommendations At the earliest opportunity the damaged bedroom furniture should be repaired/replaced to provide furnishings suited to the circumstance and behaviour of the particular resident. Rawleigh House DS0000059390.V362781.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Rawleigh House DS0000059390.V362781.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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