Inspection on 28/11/06 for 38 Redgate Court

This inspection was carried out on 28th November 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

38 Redgate Court 10/10/07

38 Redgate Court 10/05/06

38 Redgate Court 07/02/06

38 Redgate Court 14/09/05

38 Redgate Court 14/02/05

38 Redgate Court 06/09/04

38 Redgate Court 19/03/04

Similar services:

Coopers Mill Ltd

Pocklington House

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

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

CARE HOME ADULTS 18-65 Redgate Court (38) Peterborough PE1 4XZ Lead Inspector Lesley Richardson Key Unannounced Inspection 28th November 2006 11:50 Redgate Court (38) DS0000015130.V319578.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 Redgate Court (38) DS0000015130.V319578.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. Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Redgate Court (38) Address Peterborough PE1 4XZ 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) 01733 313501 01733 313501 www.sense.org.uk Sense, The National Deafblind and Rubella Association Sally Porteious Care Home 6 Category(ies) of Learning disability (6), Sensory impairment (6) registration, with number of places Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. LD only in association with SI Date of last inspection 10th May 2006 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 and provides care and support for up to 6 people with learning disability, associated with sensory impairment. Fees for the home range between £1,287.63 and £1,777.05 per week. 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. Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 2 hours and 50 minutes, and was carried out as an unannounced inspection on 27th November 2006 by the lead inspector and another regulation inspector. It was the second key inspection for this home for the 2006-2007. There were no residents at home during the inspection and therefore the time was spent with the manager and undertaking a tour of the home. A random inspection and a specialist pharmacist inspection have taken place since the last key inspection, these are commented on in this report. One requirement and no recommendations have been made as a result of this inspection. This requirement has been carried over from the last inspection. What the service does well: What has improved since the last inspection? Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 6 There has been considerable improvement at the home since the last key inspection. Some of this was assessed during a random inspection in July 2006 and further improvement has been found during this inspection. Care plans and documents written to give guidance to staff members about the best way to look after the people who live at the home is clear and easy to read. It contains the correct information, identifies risks, shows how the risk can be reduced and managed, and supports people who live at the home in making their own decisions. These records are stored properly so that information about people who live at the home cannot be seen by people for whom it is not intended. A specialist pharmacy inspection took place in August 2006 and identified a number of concerns about how staff manages medication at the home. Most of these issues have been improved. Security, administration, guidance, storage and training has all improved, which has resulted in a complete reduction in medication errors since the specialist inspection. There has been considerable improvement in the décor and environment of the home. Issues that had been identified at previous inspections and remained unresolved have now been repaired or replaced. Some areas in the home have been redecorated and furniture has been moved to give people who live there more room to move about. A few places around the home were identified at this inspection and need attention, but the new maintenance checks had already found some of these. It is expected the home will attend to all of these areas. Staff members are given a basic training programme before starting work with people who live at the home. A more extensive training programme is then given over a 6 month period, which means they have the knowledge and skills to properly look after people who live at the home. Each staff member is supervised while working and at individual sessions. This means they have the support of the manager and the opportunity to discuss any problems or issues they may have. The manager is now registered with CSCI. She has experience working with other people with learning disabilities and sensory impairment in another Sense home. A survey has been sent out to relatives of people living at the home and people who visit the home, like social care managers and district nurses. This lets the home know what other people think of the service they are providing and means the home can develop to make sure they provide the best possible service. Health and safety checks are completed as needed, and these are recorded to show levels are acceptable. What they could do better: There is one area of medication that the home still needs to address properly. Consent is given for staff to administer medication to people who live at the Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 7 home by the nurse advisor in the Sense organisation. But this is not recorded in residents’ notes. This should be recorded and the resident’s representative should also give consent. Information that the home must obtain before a person starts working there has improved. Not all of this information was available in the home during the inspection for one person whose file was looked at. Records must be kept in the care home unless an agreement has been made for it to be stored elsewhere. 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. Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 8 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 Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 9 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. Guidance is available for staff to assess prospective service users, which means adequate information is obtained to ensure all service users needs can be met. EVIDENCE: The home has a policy and procedure to guide staff members when prospective service users express an interest in living at the home. A pre-admission assessment is obtained from the placing authority, and the home completes its own assessment of needs. Staff said prospective service users are able to visit the home for increasing amounts of time until a decision can be made about whether they can live at the home or not. This is because the communication difficulties and challenging behaviours experienced by people who live at this home can sometimes mean that even if individual needs can be met, this would not be the best outcome for people already living at the home. No new service users have been admitted to the home since the last inspection. Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 10 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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Considerable progress has been made on improving arrangements for the personal and health care needs of service users to be identified and met, thereby ensuring service users receive appropriate care. EVIDENCE: Each person at the home has an individual care plan. Information in the care records has improved since the last key inspection and now contains more detailed information, identifies needs and has actions for staff members to complete to ensure each need is met. Care plans are reviewed by the home at least every last 6 months, or earlier if there have been changes. Improvement in the information contained in care records was also noted at a random inspection conducted on 11th July 2006. No care records were located in areas that are used by any other person than the person to whom the care record refers. Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 11 Assessments are completed for areas where there is an associated risk. These identify the risk and how it should be managed to avoid service users being placed at an unacceptable level of risk. Service users are supported to make decisions about their own lives. All service users are afforded choice to the degree they are able to manage. For example, one person is given limited choice because it is recognised that too wide a variety would prevent him being able to express his choice at all. Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 12 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, 15, 16 and 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 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 swimming and bowling, at local venues, and attend clubs and entertainment venues aimed at the general public and their peer group. Service users are able to go to their rooms alone and their movement around the home is not restricted. Doorbells and flashing lights are fitted to service users room doors to ensure privacy is maintained. Participation in Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 13 housekeeping tasks ensures service users are able to maintain skills and responsibilities for their home. The home encourages service users to maintain contact with family and friends; they are able to communicate by telephone or letter and staff members assist service users to organise visits to relatives. Care records show details of telephone contact the home has 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 staff support service users in meeting at another location. Service users accompany staff members on shopping trips and they help with food preparation. Snacks are available throughout the day and service users, who are able to, can make drinks when they wish. Fresh fruit and vegetables are offered and meals are prepared on a daily basis. A basket of fresh fruit is available in the lounge area. Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 14 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 and 20 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Improvement has been made to the systems for medication administration, storage and staff knowledge. This ensures a greater degree of safety but must improve further for service users to be completely safe. EVIDENCE: Care records indicate service users personal preference in regard to personal care, if they have expressed one. A tour of the home shows service users have individual choices in personal hygiene products. It was not possible to examine this standard fully as no service users were at home during the inspection. A separate file is kept for each person living at the home regarding health issues and medication. Service users have access to a range of healthcare professionals, such as a behavioural specialist, district and practice nurses, GPs and dentists. A specialist pharmacist inspection was conducted in August 2006 and seven requirements were made as a result. There have been some improvements to Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 15 the systems at the home for medication, although not all requirements have been met. Medication is stored appropriately and improvements to key security has been made to prevent unauthorised access to medication. Temperature checks are completed and are all within medicine manufacturers recommended ranges. The home’s medication policy and procedure is available for all staff members and a copy has been placed beside the medication cabinet. Medication administration records (MAR) are completed and improvement has been made in recording changes to MAR sheets. Staff have also improved recording of administration of variable dose drugs, although the name of the medication administered must also be entered into any additional record. Training records indicate all staff members have received the in-house medication training, which is given when staff start working for the organisation. Not all staff members had received refresher training in this area, which should be given annually, although records sent to CSCI indicate no medication errors have been made since the specialist inspection. The manager said consent for staff to administer medication is made by the nursing advisor within Sense, although this is not documented in service users records. Medication is administered in the staff office, which is seen as institutional practice. This was discussed with the manager who was advised to risk assess the practice and consider changing to better accommodate service users. Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 16 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has satisfactory systems to ensure service users and staff can raise concerns or properly manage protection issues. EVIDENCE: The home has policies and procedures that guide staff in dealing with complaints, how to protect service users from abuse and what to do if they suspect this may have occurred. Adult protection training is incorporated into staff induction, but this does not include local guidelines. The manager gave appropriate responses to questions about adult protection and would contact the local team for advice. There have been no complaints made to the home or incidents requiring adult protection procedures. The complaints procedure is available in other formats if required. Service users money and the associated financial records kept at the home were inspected and both recording and checks of individual purses and wallets were correct. Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 17 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 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 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 generally clean and tidy, 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. The layout of the living area has been changed to provide more space for service users, and this also enables staff quick access to service users if required. The environment of the home was assessed during a random inspection in July 2006 and at that time found to have improved considerably. This remains the case, although a few areas were found during a tour of the building that requires repair or replacement. This was discussed with the manager during Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 18 the inspection. However, the home has developed a weekly system for checking maintenance needs, reporting them and following up if no action has been taken, and some issues inspectors identified had already been noted. Areas of concern that had not been identified by staff were regarding the outside area where an inflatable pool was still out and paving leading to the vegetable plot was uneven and presented a trip hazard. In view of the recent improvement by the home a requirement will not be made at this time. Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 19 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 and 36 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Considerable improvements have been made to the systems for staff employment, training and support to ensure staff members have the skills and abilities to appropriately care for service users. EVIDENCE: Staff members complete induction training that covers mandatory health and safety training and gives an introduction to service users needs. Following this, extensive training is given over a period of about 6 months, which is specific to service user needs. The home’s training matrix shows most staff members have received most of the training required for them to safely care for the people living at the home. The manager said further training is scheduled. The staff files were seen for two of the home’s most recently employed staff members. One person’s file contained all of the required information, documents and checks to ensure it is safe for that person to work with vulnerable people. The other person’s file was not complete and did not have Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 20 an application form or references. The manager said the information had been obtained and most likely had yet to be returned from the organisations human resources department. Staff files show that supervision is structured and recorded, and includes practice issues, objectives and training needs. Sessions occur approximately every 2 months, ensuring staff have adequate support. Staffing levels within the home remain adequate, although the manager said there were a number of vacancies at the time of the inspection. Bank and occasionally agency staff are employed to ensure there are adequate numbers on each shift. Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 21 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 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There has been an improvement in the systems for service user consultation, with evidence that service users representatives’ views are sought. EVIDENCE: The home now has a manager who registered with CSCI in October 2006. She has previous experience with service users with learning disability and associated sensory impairment, as registered manager in another home within the Sense organisation. She also has a Registered Managers Award and is currently undertaking a NVQ level 4 qualification. Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 22 A quality assurance survey has recently been sent by the home to staff, service users’ families and healthcare professionals that have contact with the home. The results of this survey are still being collated. Weekly health and safety checks are completed by staff; the deputy manager was checking fire equipment and completing a check of the environment during the inspection. Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 23 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 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 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 2 X 3 X 2 X X 3 X Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES 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 YA20 Regulation 13(2) Requirement The register person must ensure that consent to treatment is obtained and retained on file. (Previous timescale of 30/09/06 not met.) The registered person must maintain in the care home the records specified in Schedule 4. Timescale for action 28/02/07 2 YA34 17(2) 31/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard YA20 YA20 YA20 YA24 Good Practice Recommendations The name of medication administered should be written in any additional records made regarding that medication. The practice of administering medication in the staff office should be risk assessed to identify why medication cannot be taken to service users. Staff should have annual medication refresher training. Health and safety checks or routine maintenance checks should include all areas accessible by service users (indoors and outdoors). DS0000015130.V319578.R01.S.doc Version 5.2 Page 25 Redgate Court (38) 5 YA34 Recruitment checks and records should be kept in the home unless arrangements have been made for them to be stored elsewhere. Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Redgate Court (38) DS0000015130.V319578.R01.S.doc Version 5.2 Page 27 - 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. 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