Inspection on 07/07/05 for Red House Lane, 2

This inspection was carried out on 7th July 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Red House Lane, 2 18/09/07

Red House Lane, 2 11/10/06

Red House Lane, 2 24/01/06

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Red House Lane 2 Red House Lane Bexleyheath Kent DA6 8JD Lead Inspector Keith Izzard Announced 7 July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Red House Lane G51-G01 S62617 Red House V286219 -07-07-05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Red House Lane Address 2 Red House Lane, Bexleyheath, Kent DA6 8JD Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) redhouselane@mcch.org.uk MCCH Mr Andrew John Fitton Care Home 2 Category(ies) of LD registration, with number of places Red House Lane G51-G01 S62617 Red House V286219 -07-07-05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Through the CSCI Inspection process, should the commission identify the need for home to register its own managers then they will be required to do so. Imposed 30/11/04. Date of last inspection na Brief Description of the Service: Redhouse Lane is a purpose refurbished detached bungalow providing long term care for two severely learning disabled people, of either gender, focussing on profound communication problems, sensory impairment, autism and challenging behaviour. The home consists of a large communal lounge, kitchen / diner. bathroom with a toilet and a toilet. Two bedrooms, above the minimum required size, a large entrance and a small office. There is a garden to the rear and a driveway with garage to one side. The home is well situated for access to all local facilities and amenities. Permanent day staff and two waking night staff are employed who are well qualified and experienced to provide appropriate care and are well supported by the community services of the local Community Learning Disability Team and health services. Red House Lane G51-G01 S62617 Red House V286219 -07-07-05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection of this home. It was announced and took place on one day over a period of seven hours. Both residents were at home and staff members and a visiting relative prompted and enabled some communication in view of the sophisticated levels of communication skills of the residents. The home was clean, tidy and safe and staff members were observed to be both caring and professional in the way they related to the residents at home at the time of inspection. This inspection included observation of the care provided and talking to staff members, the manager and the mother of one resident. Also, inspecting records, safety systems and the premises. What the service does well: Staff and the manager communicated positively with a relative and advocate and worked with them and residents to meet individual needs and provide residents with a lifestyle suited to them. Good communications existed with the local Community Learning Disability Team and other health and social service officials to enhance the quality of care provided. Staff received training and supervision to enable them to fulfil their role. Records were well maintained and care plans were up to date and reflected resident needs. Staff spoke respectfully about the residents and showed insight and knowledge into their needs. Red House Lane G51-G01 S62617 Red House V286219 -07-07-05 Stage 4.doc Version 1.40 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. Red House Lane G51-G01 S62617 Red House V286219 -07-07-05 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Red House Lane G51-G01 S62617 Red House V286219 -07-07-05 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1-5 Adequate information was provided about the service in the statement of purpose and service user guide to enable prospective residents to make a decision to the suitability of the service. Admission procedures were in place to comply with these standards. Contracts have not been provided as required for residents. EVIDENCE: The home had a statement of purpose and service user guide that met this Standard. The admission procedures in place complied with requirement and documentary evidence was seen of the admission process for both the new residents in this home. The home must provide contracts for residents in accordance with the specification set down in Standard 5. Requirement 1. Red House Lane G51-G01 S62617 Red House V286219 -07-07-05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6-10 From observations made, the documentary evidence provided, and the comments made by a relative, staff worked positively to meet resident’s individual care needs. EVIDENCE: Care provided to both residents was tracked. Care plans were well written and were supported by up to date assessment of need. It was agreed that some of the considerable information should be better indexed in order to facilitate access to the most relevant and up to date information. Recommendation 1. It was evident in the care plans that residents or relatives/ advocates were involved in care planning. Two staff members interviewed said they endeavoured to involve residents in decision making based on their individual communication and comprehension. This is inevitably restricted by the severe Red House Lane G51-G01 S62617 Red House V286219 -07-07-05 Stage 4.doc Version 1.40 Page 10 communication difficulties of the residents and depends heavily on staff interpretation and historical knowledge of residents likes and dislikes. Staff members were observed communicating with residents and involving them in whatever was going on. Life plans were up to date and had been prepared in the presence of the resident and relatives or advocate. Life plans had clear goals set with planned achievement dates. Resident’s records were well maintained, safely stored and respectfully written. Red House Lane G51-G01 S62617 Red House V286219 -07-07-05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11-17 Attention was given to meeting the leisure and social needs of the residents. Meals provided were varied and planned to meet the resident’s choice and preferences. EVIDENCE: Staff supported residents to develop daily living skills in line with their individual ability. Records showed and the parent of one resident said that both residents were supported to access leisure activities of their choice and to integrate with the community. There were no plans for the current residents to attend further education or to seek employment. Residents attended a variety of regular activities such as Rebound in Gillingham, hydrotherapy, bowling and trips to shops, on a regular basis. One Red House Lane G51-G01 S62617 Red House V286219 -07-07-05 Stage 4.doc Version 1.40 Page 12 resident has communicated his dislike of day centres and in view of this lack of provision, for both residents, it was acknowledged that activities provided for both of them should be carefully recorded and monitored. Specifically, this should differentiate between refusals as a result of challenging behaviour presented or pure decisions of choice. Requirement 2. Staff supported residents to develop daily living skills in line with their individual ability and risk assessments. This included attempts to engage residents in tasks of daily living in respect of some involvement in domestic tasks within the home. Residents were supported to maintain positive relationships with their family. One resident has very regular contact with his mother and this includes trips home on e regular basis. One resident recently lost his father but currently has an advocate. It is very important, therefore, that this advocate is retained for this resident to provide independent representation for him. Requirement 3. Varied and nutritious meals were provided to meet resident preferences. Red House Lane G51-G01 S62617 Red House V286219 -07-07-05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18-21 Resident’s needs were being met based on assessment of need and with the involvement of the resident. Medicines were safely managed EVIDENCE: Care plans and daily records showed how personal care was provided. Staff spoke with knowledge and confidence about resident’s individual needs and preferences. For example, around times for getting up, going to bed, whether they preferred to lie in, preferences for a bath or a shower and mood indicators. Staff also said that they are sensitive to the need for maintaining privacy and dignity for residents. Both residents were registered with a G.P and it was evident from the record seen that they were supported to access other health care such as dental, optical, dietician and chiropody. Specialist health care was accessed through G.P referral and other support through the local Community Learning disability Team and a Health Facilitation officer within Bexley Council. The latter has resulted in good assistance being provided from the Hearing Impairment Team and the Hard of Hearing Team. Red House Lane G51-G01 S62617 Red House V286219 -07-07-05 Stage 4.doc Version 1.40 Page 14 The elements of Standard 21 must be addressed and recorded for both residents at the next review of care unless this would cause undue distress to relatives given the sensitivity of the subject. Requirement 4. Red House Lane G51-G01 S62617 Red House V286219 -07-07-05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22-23 Adequate procedures were in place to ensure complaints were managed and to protect residents from abuse. EVIDENCE: The home had policies and procedures showing how complaints and suspicions or allegations of abuse were managed. A system was in place to record complaints made about the service. Two complaints were made to the home. One was from a neighbour concerned about screaming from one service user. The neighbour was invited into the home and was able to appreciate that this was an example of challenging behaviour and was thereby reassured about standards of care provided within the home. The other was in respect of lateness in turning up for the funeral of a resident’s father. This was acknowledged and the care worker concerned appropriately reprimanded. No complaints have been received by the CSCI. Any allegations or suspicions of abuse would be referred to the Bexley Community Learning Disability Team (CLDT), for investigation under their adult protection procedures. None have been received. Robust systems were in place to safely manage resident’s personal finances and none of the staff acted as appointee for a resident. However, the home does not appear to have a facility for these accounts to be independently audited by the organisation and this must be set up at least on an annual basis. Requirement 5. Red House Lane G51-G01 S62617 Red House V286219 -07-07-05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24-30 The home was clean and provided a pleasant and homely environment and had been fully decorated prior to registration. Equipment and furnishings provided met the resident’s needs and was maintained and serviced. EVIDENCE: The premises were suited to meeting the needs of the current residents. As residents age or develop mobility problems the suitability of the environment must be monitored to ensure it continued to meet their needs. Residents’ bedrooms were laid out in a personalised way and they were encouraged to have personal items in their rooms to reflect their interests and hobbies. The bathing and toilet facilities met the needs of the current residents. A dining/ kitchen room containing a washing machine and a lounge was also provided and all facilities are provided on one floor, as the building is a bungalow. The ability of one resident to access the garden area must be addressed, as the paved area has two levels and this resident has sight impairment and therefore at risk of tripping. Requirement 6. The home was generally clean and tidy and adequately decorated and furnished. Red House Lane G51-G01 S62617 Red House V286219 -07-07-05 Stage 4.doc Version 1.40 Page 17 Red House Lane G51-G01 S62617 Red House V286219 -07-07-05 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31-36 The staff team had the skills, support and training to meet the resident’s needs. All the staffing documentation required under Schedule 2 must be retained within the home EVIDENCE: The new manager had extensive experience of working with residents with learning disability as had most of the staff. Over the past year the residents have had to cope with changes in staff as both had moved in from other establishments although one member of staff had previously worked in the home that one of the residents had come from. Staff members interviewed, presented as clear about their roles and responsibilities and had received adequate training in accordance with this Standard. A good level of training was also being planned for. However, a training needs assessment should be carried out for the staff team in accordance with Standard 35.6. Recommendation 2. Red House Lane G51-G01 S62617 Red House V286219 -07-07-05 Stage 4.doc Version 1.40 Page 19 It was noted that a number of training courses had been cancelled at short notice to participants. This issue should be addressed by the organisation. Recommendation 3. The documentation required under Schedule 2 of the Care Homes Regulations that must be retained in the home to evidence the recruitment process must be provided. Requirement 7. Staff members should be given, individually, copies of the General Social Care Council Codes of Practice. Recommendation 4. Red House Lane G51-G01 S62617 Red House V286219 -07-07-05 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37-43 The manager presented as running the home in an open and inclusive manner. Records, policies and procedures showed attention was given to ensuring the safety of residents and others. Records required by regulation were well recorded and appropriately maintained. EVIDENCE: The manager recently registered with the Commission. Staff members were complimentary about the support they received from the manager. Red House Lane G51-G01 S62617 Red House V286219 -07-07-05 Stage 4.doc Version 1.40 Page 21 A relative of a resident and a visiting professional submitted comment cards that indicated a positive and inclusive working relationship with the service. The policies and procedures in place ensured the safety and protection of residents were addressed. A sample of safety records including fire safety were inspected and showed systems and equipment were maintained and regularly serviced. Whilst the new manager is physically based in this home, the other home he is responsible for is just up the road and this facilitates frequent and easy contact and a speedy response, should an emergency situation arise in either home. How the joint appointment works will be reviewed again at the next inspection but the manager and two staff interviewed felt that the arrangement was working well. The home does not have a quality review system in place to record the views of residents, relatives, advocates and visiting, or involved professionals. This must be introduced, the results published and generally made available. Requirement 8. Red House Lane G51-G01 S62617 Red House V286219 -07-07-05 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 1 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 1 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Red House Lane Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 G51-G01 S62617 Red House V286219 -07-07-05 Stage 4.doc Version 1.40 Page 23 na Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 5 Regulation 5 Requirement The Registered Person must ensure that a written contract is provided for each service user and includes a copy of the service user care plan. The Registered Person must ensure that activities and outings or residents are recorded and monitored. The Registered Person must ensure that one resident retains the provision of an independent advocate. The Registered Person must ensure that the issues identified in this Standard are recorded and covered at the next review meeting, if practical to do so. The Registered Person must ensure that the personal finances of residents are audited at least annually. The Registered Person must ensure that the path into the garden is levelled to ensure the safety of one resident. The registered Person must ensure that all documentation required in Schedule 2 is retained in the home and available for inspection. G51-G01 S62617 Red House V286219 -07-07-05 Stage 4.doc Timescale for action 1st November 2005. 1st November 2005 1st November 2005 1st December 2005 1st November 2005 1st December 2005 !st November 2005 2. 11 16 3. 15 16 4. 21 12 5. 23 13 6. 24 23 7. 34 19 Red House Lane Version 1.40 Page 24 8. 39 24 The Registered Person must 1st ensure a system is in place to December review and improve the quality 2005 of care provided in the home. Outcomes on the quality assurance reviews must be made available to residents, relatives the Commission and others. 9. 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. 3. 4. Refer to Standard 6 35 35 34 Good Practice Recommendations The Registered Person should ensure that care plans are indexed to facilitate easire reference. The Registered Person should ensure that a training needs assessment is carried out for the staff team as a whole. The Registered Person should remedy the cause of a number of training sessions being cancelled at short notice. Staff members should be given, individually, copies of the General Social Care Council Codes of Practice. Red House Lane G51-G01 S62617 Red House V286219 -07-07-05 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Sidcup Area Office River House 1 Maidstone Road Sidcup DA14 5RH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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