Inspection on 22/02/06 for Rayners Residential Care Home

This inspection was carried out on 22nd February 2006.

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

The inspector 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

Rayners Residential Care Home 13/04/07

Rayners Residential Care Home 27/10/05

Rayners Residential Care Home 16/02/05

Rayners Residential Care Home 17/09/04

Rayners Residential Care Home 21/08/02

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Rayners Residential Care Home Weedon Hill Hyde Heath Amersham Bucks HP6 5RH Lead Inspector Nichola Cahill Unannounced Inspection 22nd February 2006 09:30 X10015.doc Version 1.40 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 DS0000023014.V284890.R02.S.doc Version 5.1 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 Older People. 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. DS0000023014.V284890.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Rayners Residential Care Home Address Weedon Hill Hyde Heath Amersham Bucks HP6 5RH 01494 773606 01494 793529 chris@careatrayners.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Rayners (Extra Care Home) Limited Mr Christopher James Matthews Care Home 45 Category(ies) of Dementia (5), Old age, not falling within any registration, with number other category (40) of places DS0000023014.V284890.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. That as of the 5th of October 2005, the home is registered to care for 5 (five) service users with a dementia - type illness. 27th October 2005 Date of last inspection Brief Description of the Service: Rayners (Extra Care home) is family owned and managed. The home was purpose built in 1990 for the care of older people within the county of Buckinghamshire. The home is situated in Hyde Heath, a Chiltern Village two miles from Amersham. The local amenities include a village store, public house and an attractive green. Access to the local town would be via the homes minibus. The home is registered for the care of forty-four older persons, not falling into any other category. The home has forty-four spacious single bedrooms a large percentage of which have en-suite facilities. All bedrooms have a hand washbasin and are in close proximity to toilet and bathing facilities. The second floor of the home is accessible via a five-person passenger lift. Communal space consists of a large lounge and dining area, which are both set in a homely and attractive fashion. A large glazed area opens out onto the terrace and landscaped gardens. The front entrance of the home is welcoming and contains a small seated area for the use of visitors. DS0000023014.V284890.R02.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is a summary of the annual unannounced inspection carried out by Nicky Cahill (lead inspector) and Gill Gentles (inspector) on 22nd February 2006. The inspection visit commenced at 13.35 and was carried out over a period of 2.5 hours. The inspection consisted of an assessment of compliance with requirements made during the last inspection visit, an assessment against core standards not viewed in September 2005, viewing documentation pertinent to the health and wellbeing of service users, health and safety and staff training. Requirements made in September 2005 have been met. All core standards have been assessed in this inspection year with the exception of 6 and 35, which are not applicable to this service. What the service does well: Service users receive a pre-admission assessment. This will ensure that the home is able to meet individual needs. The medication systems in place ensure the safety of service users at all times. An activity programme is in place, visitors to the home are always welcomed and assistance is give to ensure that service users retain links with friends, family and the local community. Service users are empowered in making their own choices regarding day-to-day decisions. The home has 58 of care staff trained to a NVQ level 2 or above. Service users, staff and visitors to the home are protected by the homes robust health and safety polices and procedures. Most areas of training are up to date, this will ensure that the service users are protected by the homes up to date practices. DS0000023014.V284890.R02.S.doc Version 5.1 Page 6 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. DS0000023014.V284890.R02.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000023014.V284890.R02.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Service users receive a pre-admission assessment. This will ensure that the home is able to meet individual needs. EVIDENCE: Two pre-admission assessments were viewed during the inspection. The initial referral is normally received via telephone and preliminary notes are made. This information is taken to the assessment and further notes are added. Prior to admission a pre-admission document is forwarded to the service user or a representative to complete all essential information. This is a comprehensive format, which will allow the home to be fully prepared for the admission to be carried out. From this information a care plan is generated. DS0000023014.V284890.R02.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 The care plans generally give carers the information they need and health care information is recorded. This will ensure that the needs of the service users will be met. The medication systems in place ensure the safety of service users at all times. EVIDENCE: It has been noted there have been marked developments in the detail within care plans over the last inspection visits to the home. Senior care staff appear to take on board any constructive criticisms and action is always taken to rectify any issues noted. During this visit two care plans were initially viewed. It was discussed that the detail within these particular plans did not outline how the care staff would support the individual service user in ensuring that their needs were met. A senior member of staff had been carrying out a considerable amount of work to ensure that other care plans were more detailed, one of which was shared during the visit. DS0000023014.V284890.R02.S.doc Version 5.1 Page 10 This care plan had clearly been reviewed and much thought had gone into its presentation and contents. Several different colour texts had been used to draw attention to certain areas of care. Risk assessments had also been an issue for the home who where informed that these must be more individualised. It was pleasing to note the improvements in both areas and it will be expected that all care plans will have been reviewed in this manner at the next inspection visit. The manager must be mindful that care plans should be written in consultation with service users and that all documentation should be signed and dated. A requirement was made during the last inspection visit that the nutritional needs are assessed and that service users are regularly weighed. Documentation was in place to support that this requirement is now being met. It was clear from daily records that service users received services from external health and social care professionals thus ensuring all needs are met. Two requirements were made during the last inspection visit with regard to two areas of the homes medication practices. The home were required to hold a controlled drugs register where all controlled drugs stored and administered to individual service users must be recorded in accordance with relevant current legislation. The manager has developed individual registers for each service user receiving controlled medications; these records were viewed and appeared to be in order. The home was required to liaise with the diabetes specialist nurse regarding the practices around the drawing up and storage of insulin. It was confirmed through discussions that this had been carried out and that the homes practices were acceptable. It is recommended that the confirmation of practice guidance regarding the drawing up and storage of insulin be documented. DS0000023014.V284890.R02.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 An activity programme is in place, visitors to the home are always welcomed and assistance is give to ensure that service users retain links with friends, family and the local community. Service users are empowered in making their own choices regarding day-to-day decisions. EVIDENCE: From evidence within care plan notes it is clear that service users are encouraged to retain links with their family, friends and the local community. The home has an activities programme and all service users are invited to participate. The activities log showed that service users had participated in bingo, quizzes, physio exercises, sherry mornings and external entertainers brought into the home. DS0000023014.V284890.R02.S.doc Version 5.1 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Core standards 18 and 19 were assessed during the last inspection visit, both standards were being met at this time. EVIDENCE: The manager has been trying to obtain the interagency policy for the protection of vulnerable adults from the local authority for some time without any success. The Commission advised that this was a common problem, however, a copy of the updated policy was now available on the Internet. The Commission has received confirmation that the home now has a copy of this in place to further enhance their own in house policies and procedures. DS0000023014.V284890.R02.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Core standards 19 and 26 were assessed at the last inspection visit and were being met at this time. EVIDENCE: DS0000023014.V284890.R02.S.doc Version 5.1 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 Most areas of training are up to date, this will ensure that the service users are protected by the homes up to date practices. EVIDENCE: The homes training matrix was forward to The Commission following the inspection visit, work has also been carried out to ensure that all staff have an individual record of training. Training matrixes would indicate that most training is up to date. The home has 58 of care staff trained to a NVQ level 2 or above. DS0000023014.V284890.R02.S.doc Version 5.1 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 Service users, staff and visitors to the home are protected by the homes robust health and safety polices and procedures. EVIDENCE: The following health and safety documentation was viewed during the inspection visit. • Hoist servicing had been carried out in November 2005. • Water temperatures are checked bi-monthly. • Gas boilers had been serviced in November 2005. • Fire records were up to date and in order. • The home had received a Gold Award in 2005 for the cleanliness within the kitchen area. • Accident and incident logs were in order. DS0000023014.V284890.R02.S.doc Version 5.1 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X N/A X X 3 DS0000023014.V284890.R02.S.doc Version 5.1 Page 17 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 OP9 Good Practice Recommendations It is recommended that the confirmation of practice guidance regarding the drawing up and storage of insulin be documented. DS0000023014.V284890.R02.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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. Extracts may not be used or reproduced without the express permission of CSCI DS0000023014.V284890.R02.S.doc Version 5.1 Page 19 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!