Inspection on 08/01/07 for Redington House

This inspection was carried out on 8th January 2007.

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

Redington House 28/11/07

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

CARE HOME ADULTS 18-65 Reddington 2 Park Avenue Dover Kent CT16 1ER Lead Inspector Mrs Penny McMullan Key Unannounced Inspection 8th January 2007 09:30 Reddington DS0000067901.V326534.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 Reddington DS0000067901.V326534.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. Reddington DS0000067901.V326534.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Reddington Address 2 Park Avenue Dover Kent CT16 1ER 01303 230102 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) Jennifer Marsh Miss Lara Elizabeth Marsh Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Reddington DS0000067901.V326534.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection New service Brief Description of the Service: Reddington House is a detached house, situated in Park Avenue in Dover. The home is within easy reach of the town centre with access to bus routes, train station, churches, and leisure facilities. There is a small garden at the side and back of the property and limited parking on the drive and Avenue. The home is registered to care for five service users with learning disabilities. Accommodation is situated over three floors, the ground floor offers one en suite bedroom, a bathroom with shower, the staff office, toilet and laundry facilities. The first floor has a large communal lounge/dining room and a small modern kitchen. There is also one bedroom with a dedicated bathroom. The second floor has three bedrooms, two en suite and another bedroom with a dedicated bathroom. The home does not have a lift and is therefore not suitable for wheelchair users. The current fees for the service at the time of the visit are £1400 per week, this fee can be increased to the assessed needs of service users. There are additional charges for chiriopdy, hairdressing, aromotherpay, newspapers and toiletries. Information on the homes services and the CSCI reports for prospective service users/relatives will be referred to in the Statement of Purpose and Service User Guide. The email adress for the service is: lara@ldcdover.co.uk Reddington DS0000067901.V326534.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Reddington House was registered on 14 July 2006 and this is the first unannounced inspection. This report is based on evidence gained from a preinspection questionnaire completed by the home; comment cards received from service users, families, and visiting professionals; and a site visit of 6.5 hours to the home. The site visit includes talking to service users, staff, the Registered Manager; a partial tour of the building; inspection of records; and various observations. As this is a new registration there is only two service users living in the home. The home is registered for 5 service users and further admissions will be taken in the future. Both service users are fully aware of this information. Staffing levels are being monitored and will be reviewed once the home is in full operation. What the service does well: What has improved since the last inspection? What they could do better: The home is newly registered and the Registered Provider has ensured the home meets the National Minimum Standards and Regulations. To provide all staff with infection control training. A recommendation has been made in this report. Service users say there is nothing the home could do better. Reddington DS0000067901.V326534.R01.S.doc Version 5.2 Page 6 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. Reddington DS0000067901.V326534.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Reddington DS0000067901.V326534.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standard 2 Arrangements are in place to carry out a detailed and through assessments of needs of service users prior to admission to the home to ensure that all care needs will be met. EVIDENCE: As this is a new service there are currently only two service users in the home. The service users transferred from another establishment within the organisation and all documentation and their needs identified in previous assessments. The home has a detailed and through assessment form, which becomes part of the care plan. Service users say they visited the home prior to admission and were excited about moving in. Reddington DS0000067901.V326534.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standard 6,7, and 9 There is a consistent care planning system in place to provide staff with the information they need to meet service users needs. The home promotes service users rights and choices. Service users are supported to take responsible risks within the homes risk assessment management strategy. EVIDENCE: The care plans give detailed information with regard to all aspects of health and social care. The plans include details of multi disciplinary input including positive behavioural assessments and health care professionals. One service user demonstrated her awareness of the care being provided and daily reports record detailed information in regard to mood, activities and visits from and to Reddington DS0000067901.V326534.R01.S.doc Version 5.2 Page 10 external professionals. There is evidence that service users are involved and they have signed their plans. The plans have been reviewed and any changes recorded and agreed with the service users. Feedback from postal survey indicates that relatives are consulted in the care and important matters in their relative’s care. Services users are aware of their limitations and are supported to understand why restrictions on their daily lives are in place. Service users gave examples of choice, with regard to getting up and going to bed, menu choices and activities. Currently there are only two service users in the home and the staff are able to ensure they have flexible routines. Where appropriate service users are involved in their own individual risk assessments. Multi agency input is also used to minimise the risk to service users and staff. The risk assessments are accessible to staff and reviewed on a regular basis. Service users are able to understand why the risk assessments are in place and why they may need additional support with some of their activities. Environmental risk assessments are also in place. Reddington DS0000067901.V326534.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standard 12,13,15,16,17 Service Users are supported and encouraged to take part in activities of their choice. Service users are supported to maintain family contact and assisted to exercise choice over their lives. Nutrition is well managed, promoting health eating with choice and variety. EVIDENCE: The service users are encouraged to develop their own personal goals within the limits of their assessed needs and risk assessments. Service users indicate they have a fulfilling activity programme which helps them with their confidence and daily life skills. They say they are able to take part in activities Reddington DS0000067901.V326534.R01.S.doc Version 5.2 Page 12 they choose and have enjoyed attending college; they have their certificates of achievement displayed in the home. The service users say they are able to go out for meals and invite their friends to the home for a meal. Staff support the service users with their personal relationships with friends within the community. With the support of the staff service users visit the local shops, and often go into the town of Dover. The staff encourages family involvement in the home. Feedback from relative comment cards indicates the home is welcoming and relatives can be seen in private and overall they are satisfied with the care being provided. Service users were moving freely around the home and are supported with individual choices. They are able to complete some household chores and enjoy cooking with supervision. These activities are recorded and agreed in their individual care plans. Service users have keys to their rooms and staff interaction is respectful. At the residents meeting the service users requested a fish tank for the lounge, which has now been provided. Although there is a planned menu in the home the service users are able to change the menu and be flexible with the meals. Service users accompany the staff for the shopping and are being supported to assist in meal preparation in line with the risk assessments for each individual. Service users say the food is good and they enjoy the cooking. The home promotes healthy eating and meals are eaten around the activities of service users. The service users are planning an evening meal to invite their friends around. Likes and dislikes of are clearly recorded in the care plan and where appropriate dietician advice has been given. Reddington DS0000067901.V326534.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standard 18,19 and 20 The health needs of Service Users are met with evidence of good multi disciplinary working taking place on a regular basis. Personal care is offered in a way protect Service Users privacy and dignity and promote independence. The medication at this home is well managed promoting good health. EVIDENCE: Staff support service users with their personal care. The home is currently addressing the issue of gender to gender care as there are only currently two female service users in the home and at times no female member of staff is on duty. The home is actively recruiting for staff and numbers will be increased once the home is full. Arrangements are in place for the service users preferences to be carried out when female staff are on duty. Reddington DS0000067901.V326534.R01.S.doc Version 5.2 Page 14 All health care and support is recorded and monitored in the service user plan. Service users say the staff are good and they help them in all aspects of their care. There is clear evidence of multi disciplinary working with health care professionals and care managers, which is detailed in the service user plan. Service users discussed going to the dentist and attending health care appointments escorted by the staff. The home uses the monitored dosage system for the administration of medication. Homely remedies are used from time to time, but this is checked with the individual resident’s doctors to ensure there will be no side affects when taken in conjunction with prescribed medication. MAR sheets are in good order and medication is appropriately stored. The sheets are checked and audited every day at each shift change. All staff administering the medication have received training. Reddington DS0000067901.V326534.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standard 22 and 23 The home has a satisfactory complaints system in place. Arrangements are in place to ensure service users are protected from abuse. EVIDENCE: Service users say they would talk to the senior on duty or the Registered Manager if they had any concerns. They have no complaints and the home has not received any complaints since the registration in July 06. The complaints procedure is part of the service user guide and is in a pictorial format. All surveys from Service Users, Care Manger and relatives indicate they do not have any complaints. The home has an Adult Protection Policy, which includes whistle blowing, and all staff have received Adult Protection. Each service user has an inventory of their belongings and staff have received POVA first checks. Reddington DS0000067901.V326534.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standard 24 and 30 The home is newly registered and has been decorated and furnished to a high standard creating a comfortable environment for those living there. Laundry facilities are satisfactory and policies and procedures are in place to control the risk of infection. EVIDENCE: The home was registered on 14 July 2006 and was decorated completed for the admission of service users. Service users participated in the redecoration by picking colour schemes and their rooms. Rooms are bright and airy and all have radiator guards. The rooms are personalised to individual taste and the home is situated very close to the town centre with good transport links. The home is not suitable for wheelchair users. The home is well furnished with new furniture and is comfortable and homely. Reddington DS0000067901.V326534.R01.S.doc Version 5.2 Page 17 The premises are clean and tidy with no offensive odours. There are policies and procedures in place for infection control and laundry facilities are satisfactory. The home needs to ensure that all staff receive infection control training. Reddington DS0000067901.V326534.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standard 32,34 and 35 The staff have a good understanding of Service Users support needs. Arrangements are in place to ensure that service users are supported and protected by the homes recruitment policies and procedures. The arrangements for the induction of staff and training of staff are in place with the staff demonstrating a clear understanding of their roles. EVIDENCE: The home has a programme of NVQ and has over 50 of the staff group who have completed or are in the process of completing the award. Service users say the staff supports them well and staff on duty demonstrated their understanding of the service users needs. The staffing levels are under review due to the new registration and the home is working towards ensuring that service users preferences with regard to gender to gender personal care are provided. The home is in the process of recruiting new staff. Reddington DS0000067901.V326534.R01.S.doc Version 5.2 Page 19 Service user says they are able to have some influence in choosing staff as part of the recruitment process. Staff files viewed contained the required information including, POVA first checks, and Criminal Records Bureau (CRB), Checks. Training certificates were also on file. The home has a training matrix in place and the majority of mandatory training has been provided. The home needs to ensure that all staff receive infection control training. A recommendation has been given in the report. Staff have received specialised training in epilepsy and challenging behaviour. The home has an induction in place, which is being reviewed in line with Skills for Care for the next inductee. This has not been used, as there has been no recruitment in the home due to staff transferring from homes within the organisation. Reddington DS0000067901.V326534.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standard 37,39 and 42 The home is run in the best interests of service users. The Company regularly reviews aspects of its performance to ensure service users views have an influence on the homes development plan for the future. The home is providing a safe environment for service users to live in. EVIDENCE: The Registered Manager Lara Marsh has many years experience at management level. She is a qualified Manager and is also the Registered Manager of The Little Glen, another small home within the organisation. Staff feedback indicates they feel supported by the Management team. Reddington DS0000067901.V326534.R01.S.doc Version 5.2 Page 21 The Quality Assurance system has not been fully implemented as service users only moved in October. They have completed quality assurance questionnaires with a positive response. One service user confirmed that a resident meeting had taken place. The home is in the process of implementing a formal quality assurance programme to include stakeholders, visitors and relatives. On completion the results will be published and forwarded to the Commission. A sample of the safety checks was carried out and all were in place for the registration of the premises. There are minor shortfalls in accident recording forms, although on two occasions the accident form had not been completed, the in house incident form showed a detailed account of the accident which was tracked through to the daily records and the appropriate action was taken. The fire book was in good and weekly fire tests have been completed. The induction is being revised in line with Skills for Care. Reddington DS0000067901.V326534.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 x STAFFING Standard No Score 31 x 32 x 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 x 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Reddington DS0000067901.V326534.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 YA35 Good Practice Recommendations To provide all staff with infection control training Reddington DS0000067901.V326534.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Reddington DS0000067901.V326534.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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