CARE HOME ADULTS 18-65
38 Redgate Court Peterborough PE1 4XZ Lead Inspector
Lesley Richardson Unannounced 14 September 2005 @ 3:00pm & 19 September 2005
th th 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. 38 Redgate Court I53 I03 s15130 REDGATE COURT 38 v247470 140905 STAGE 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service 38 Redgate Court Address 38 Redgate Court Peterborough PE1 4XZ 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) 01733 313501 01733 313501 enquiries@sense-east.org.uk Sense East Care Home 6 Category(ies) of Learning Disability (LD), 6 registration, with number Sensory Impairment (SI), 6 of places 38 Redgate Court I53 I03 s15130 REDGATE COURT 38 v247470 140905 STAGE 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Learning Disability only in association with Sensory Impairment Date of last inspection 17th February 2005 Brief Description of the Service: 38 Redgate Court consists of a purpose built property, situated on a residential estate on the north eastern edge of Peterborough. The home is a two-storey, semi-detached property in an accommodation complex catering for adults with learning disability. It is owned by Sense East and provides care and support for up to 6 people with learning disability, associated with sensory impairment. The home has 6 individual bedrooms; 5 on the upper floor and 1 on the ground floor. There is a bathroom with shower and toilet on both floors, an open planned lounge dining area and a kitchen. There is a conservatory leading to the large, well maintained garden, which is shared with the adjoining house. The home is within walking distance of local shops, pubs, a post-office and public transport. Peterborough city centre is about 5 miles away and is easily accessed by public transport. 38 Redgate Court I53 I03 s15130 REDGATE COURT 38 v247470 140905 STAGE 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over 2½ hours and was carried out as an unannounced inspection on 14th and 19th September 2005. The inspection took place over two days because there were no service users present at the home during the first visit and the manager had a prior engagement shortly after the inspection started. The visit to the home on 14th September consisted of a short discussion only with the manager. This was the first inspection of this home for the 2005-2006 year. One and a quarter hours were spent examining records and documents and one and a quarter hours were spent with service users and staff. A brief tour of the building was also undertaken during this time. The manager was present during the inspection. Two people who were living at the home and three of the staff on duty were spoken to during the inspection. However, because of the levels of combined learning disability and sensory impairment in this service user group, it was difficult to obtain their views. What the service does well: What has improved since the last inspection?
Care records for service users are being re-organised to make it easier for new staff members to read information about how best to look after the people that live at the home. Service users care needs are looked at every 6 months or more often if needed, which means any changes are recorded quickly.
38 Redgate Court I53 I03 s15130 REDGATE COURT 38 v247470 140905 STAGE 4.doc Version 1.40 Page 6 The complaints procedure has been updated to give accurate information about how to contact the Commission for Social Care Inspection. The home has tried to get someone independent who can communicate with service users, so they do not rely only on staff members if they are not happy with something. Improvements have also been made in the way medication is recorded when it has been given, although this needs to continue to improve to make sure mistakes are not made. There are still unsightly marks in one part of the home, which they were asked to remove at the last inspection. The home has tried normal methods to remove these, although this has not worked and they are now arranging to have the area re-tiled. 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. 38 Redgate Court I53 I03 s15130 REDGATE COURT 38 v247470 140905 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 38 Redgate Court I53 I03 s15130 REDGATE COURT 38 v247470 140905 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) 2 and 4 Pre-admission assessments of prospective service users, review of the assessment and pre-admission visits by service users ensure the home is able to meet service users needs and enables informed choice. EVIDENCE: Service users are referred to the home by the Learning Disability teams within council social service departments, who provide a detailed assessment about that service user, or they may be contact privately by the service user’s family. An assessment team, within the Sense organisation, assesses referred service users to ensure a specialised Sense home is the most appropriate place for that person to live. An assessment is also undertaken by the home, which makes sure that not only will the home be able to meet the assessed person’s needs, but also to reduce the risk of obvious personality clashes. Prospective service users are encouraged to visit the home for tea visits, day visits and overnight stays so the home is able to fully assess their needs. They are then able to decide if they would like to stay at the home, which is on a temporary basis for the first month and becomes a permanent arrangement following a review and the service user’s agreement. 38 Redgate Court I53 I03 s15130 REDGATE COURT 38 v247470 140905 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, 7 and 8 There is a care planning and risk assessment system in place that provides staff with the information they need to meet service users needs. EVIDENCE: Care plans are written from the information obtained during the assessment period. The home is developing a smaller, summarised file that will contain the most recent assessments, behaviour guidelines and reviews of care conducted by the home. This will ensure new and agency staff members are able to easily obtain information about service users, and will reduce the risk that key details about how to best manage a particular need will be missed. Information that is no longer relevant and previous review documentation will be archived, but will still be available should the need arise. Care records showed a review of service users’ needs is undertaken every 6 months. Service users are given communication assistance in order that they may make decisions about how they would like to live their lives and participate in life in the home. Those service users able to contribute to household activities, such as cooking or laundry, are encouraged and given the opportunity to do so. Activities outside the home are assessed for their purpose, risks and any control measures that may be required. This ensures maximum safety for service users, staff members and the general public.
38 Redgate Court I53 I03 s15130 REDGATE COURT 38 v247470 140905 STAGE 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15 and 16 Social activities provide stimulation and opportunities for community links for people living in the home. Visits from relatives and friends ensure continued social contact. EVIDENCE: Service users access day placement and workshop activities during the day. The home works closely with each placement to ensure there is continuity and the placement is aware of ongoing issues that arise. Service users participate in activities, such as gymnastics and swimming at local venues, and attend clubs and entertainment venues aimed at the general public and their peer group. Staff members interact with service users in a polite way, keeping in mind service users wishes and when they would rather be alone. Service users are able to go to their rooms alone and their movement around the home is not restricted. Participation in housekeeping tasks ensures service users are able to maintain skills and responsibilities for their home.
38 Redgate Court I53 I03 s15130 REDGATE COURT 38 v247470 140905 STAGE 4.doc Version 1.40 Page 11 The home encourages service users to maintain contact with family and friends; they are able to communicate by telephone or letter and visits to stay with relatives are organised by staff members. Care records showed details of telephone contact the home had with family members, so that service users and staff members are able to refer back to conversations. Where it is not possible for service users to stay with relatives, they are invited to the home to visit service users or a neutral environment is considered. 38 Redgate Court I53 I03 s15130 REDGATE COURT 38 v247470 140905 STAGE 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20 The home has systems in place that ensure service users care, health and emotional needs are met in the way they prefer. EVIDENCE: Staff members interact with service users in a positive way, asking if they would like to participate in personal care activities, but respecting their wishes if they decline. Care records show service users have access to a variety of health care professionals to ensure these needs are met. Reviews of care and behavioural guidelines are completed on a 6 monthly basis. These reviews highlight emotional issues that need addressing and ensure issues that have been addressed are also reviewed. The home uses a system of Medication Administration Records (MAR) and blister packs for medication administration. None of the service users presently living at the home self-medicate and this is supported by risk assessment. Records had been signed appropriately and indication was made for medication not administered, although the exact reason was not recorded on one service user’s MAR sheet. This was rectified during the inspection. 38 Redgate Court I53 I03 s15130 REDGATE COURT 38 v247470 140905 STAGE 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 The home has a system that guides staff and others in making and managing complaints. EVIDENCE: The home has a complaint’s procedure that is also printed in picture format, and the manager said a copy in Braille format could also be arranged. However, because of the comprehension difficulties this service user group has, any written procedure would have to be broken down into smaller parts and explained using the communication technique specific to that service user. The home has tried to access suitable advocates, but have found this difficult due to the combined needs of this service user group. The manager said staff members endeavour to resolve issues raised by service users as soon as possible after the issue has become known. This reduces the risk of escalating challenging behaviour. The complaint procedure was updated with current local Commission for Social Care Inspection details during the inspection. The home was encouraged to continue it’s search for an appropriate advocate for service users. 38 Redgate Court I53 I03 s15130 REDGATE COURT 38 v247470 140905 STAGE 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 The standard of the environment within this home is good, providing service users with an attractive and homely place to live. EVIDENCE: The home was clean and tidy on the day of inspection, décor is domestic in appearance and service users are comfortable with the layout. There were no offensive odours and the risk of cross infection is reduced, as access to the laundry is away from the kitchen and eating areas. A donation made to the home recently has provided new garden furniture for service user’s use. This makes the already attractive garden an inviting place to sit. Tiling in the upstairs shower recess remains marked with lime scale deposits. The manager said that despite efforts to remove this with domestic lime scale removers the marks remained. Work to replace tiling in the upstairs shower recess has been sourced outside the organisation to reduce the delay in resolving this issue. 38 Redgate Court I53 I03 s15130 REDGATE COURT 38 v247470 140905 STAGE 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These Standards were not assessed on this occasion. EVIDENCE: 38 Redgate Court I53 I03 s15130 REDGATE COURT 38 v247470 140905 STAGE 4.doc Version 1.40 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 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) 42 The systems in place at the home do not ensure the health and safety of all service users is promoted. EVIDENCE: The laundry room was clean but had a number of open boxes of washing powder stored around the room. The manager said this was due to a recent large delivery of powder and other items and felt that to store all the powder elsewhere would limit service users independence with that aspect of housekeeping chores. Ways to ensure service users were not affected but to ensure the home maintained health and safety requirements, such as placing unopened boxes in a lockable cupboard and leaving one open box in the laundry cupboard, were discussed during the inspection. Although, during a tour of the home, no hazardous objects were found and therefore a previous requirement has been met, hazard assessment systems are not in place to the degree where service users health and safety can be
38 Redgate Court I53 I03 s15130 REDGATE COURT 38 v247470 140905 STAGE 4.doc Version 1.40 Page 17 guaranteed. For example, leaving open boxes of washing powder in areas that all service users can access. 38 Redgate Court I53 I03 s15130 REDGATE COURT 38 v247470 140905 STAGE 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 4 x Standard No 22 23
ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 3 x x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
38 Redgate Court Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x I53 I03 s15130 REDGATE COURT 38 v247470 140905 STAGE 4.doc Version 1.40 Page 19 YES 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 42 Regulation 13(4)(a) Requirement All parts of the home to which service users have access are free from hazards to their safety. Timescale for action 3rd October 2005 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 Good Practice Recommendations 38 Redgate Court I53 I03 s15130 REDGATE COURT 38 v247470 140905 STAGE 4.doc Version 1.40 Page 20 Commission for Social Care Inspection CPC1, Capital Park Fulbourn Cambridge CB1 5XE 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 38 Redgate Court I53 I03 s15130 REDGATE COURT 38 v247470 140905 STAGE 4.doc Version 1.40 Page 21 - 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!
