CARE HOME ADULTS 18-65
Redmayne House Redmayne Close Off Station Road Wigton Cumbria CA7 9AF Lead Inspector
Cath Wilson Unannounced Inspection 07 and 15 December 2005 9.30 Redmayne House DS0000022576.V265928.R01.S.doc Version 5.0 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 Redmayne House DS0000022576.V265928.R01.S.doc Version 5.0 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. Redmayne House DS0000022576.V265928.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Redmayne House Address Redmayne Close Off Station Road Wigton Cumbria CA7 9AF 016973 49313 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) redmaynehomes@c-i-c.co.uk Community Integrated Care Mrs Ruth Elspeth Chapman Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Redmayne House DS0000022576.V265928.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 3rd March 2005 Brief Description of the Service: Community Integrated Care provides the services and care at Redmayne House for five service users who have a learning disability. The home is a detached bungalow and is comprised of a lounge, dining room, kitchen, bathroom with toilet, shower room and toilet, laundry/utility area and office. There are five single occupancy bedrooms. Redmayne House is located off a side road from the centre of the town of Wigton. It is situated in a cul-de-sac with access to local amenities and facilities. There is an enclosed garden area to the rear of the building. Car parking facilities are available to the front of the home, with ramped access to the front door. Redmayne House DS0000022576.V265928.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that was completed over two days. This was due to service users and staff being out of the home on the first morning as there was some redecoration-taking place in the home. I was able to look around the home at both private and communal living areas and assess some of the home’s records and documents. What the service does well: What has improved since the last inspection? What they could do better:
The home continues to experience difficulty in maintaining consistent numbers of staff available to comprehensively meet the needs of service users. This
Redmayne House DS0000022576.V265928.R01.S.doc Version 5.0 Page 6 must be addressed so that service users have ongoing access to all facilities and staff are not overstretched in constantly covering the shortfall. Ensure that the Person Centred Planning documentation is progressed. 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. Redmayne House DS0000022576.V265928.R01.S.doc Version 5.0 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 Redmayne House DS0000022576.V265928.R01.S.doc Version 5.0 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 the following standard(s): These standards will be assessed at the next inspection. EVIDENCE: Redmayne House DS0000022576.V265928.R01.S.doc Version 5.0 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 the following standard(s): 6 and 9 Some progress has been made on implementing the Person Centred Planning care plans. There is much more that needs to be done so that any potential risk to service users is greatly limited. EVIDENCE: The manager is informed of people’s personal needs and is working with the staff to ensure that all details of people’s individuality is comprehensively recorded. This will enhance the lives of service users and support the need for additional staff when required. Both the manager and staff are fully aware of the shortfalls in staff availability and it is often their good will in completing additional shifts that ensure people’s needs are met. Although work has begun on updating people’s care plans there more progress needed. The manager informed me that this is now a priority for the home. This will enable the health, welfare and safety of people in the home to be comprehensively documented and attended to in an up-to-date manner. Relevant professionals are involved with people to assist in developing their life skills and coping strategies. Preventative measures are addressed in relation to assessing any risk for people and these are recorded. Redmayne House DS0000022576.V265928.R01.S.doc Version 5.0 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 the following standard(s): 12 and 13 There are social activities organised that are creative and provide stimulation and interest for people living in the home. EVIDENCE: Service users are encouraged and supported to have a range of interests and encouraged to maintain and develop appropriate relationships within the community. Staffing shortages can lead to priorities having to be made so having enough staff on duty means all the residents have their needs met on a comprehensive and ongoing basis. Redmayne House DS0000022576.V265928.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 18, 19 and 20 Health care issues are well managed and service users wishes are respected. EVIDENCE: Service users had a full range of access to general health care services and more specialised services when needed. Medication is securely stored and administered and staff are following the home’s policy and procedure for this. The manner in which people’s health care is provided shows that at the time of this unannounced inspection people are safeguarded. Redmayne House DS0000022576.V265928.R01.S.doc Version 5.0 Page 12 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 the following standard(s): These standards will be assessed at the next inspection. EVIDENCE: Redmayne House DS0000022576.V265928.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 24, 25, 26, 27, 28, 29 and 30 People are provided with a homely, comfortable, and clean environment with their own rooms personalised in a manner of their choosing. EVIDENCE: The home provides a comfortable and homely place that is well maintained and clean. Work is underway to decorate where appropriate and new furnishings have been purchased. People are supported to have their bedrooms arranged the way they want them and these are maintained in a personal and individualised manner. Health and safety matters are well maintained and the home is also risk assessed. Redmayne House DS0000022576.V265928.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33 and 35 There is not always access to sufficient numbers of staff to be on duty to meet the comprehensive needs of service users. EVIDENCE: The home endeavour to ensure that there are enough staff on duty but records show that this has not always been possible. Staff do sometimes complete extra shifts to ensure people’s needs are met but this places great pressure on staff in the long term and can limit the wider activities service users can be involved with. A requirement regarding this has been made. Staff are provided with a training and development programme and this includes NVQ Qualifications. Redmayne House DS0000022576.V265928.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 39 Service users benefit from a home that is generally well run considering the shortfalls in staff availability. Ensuring a full compliment of staff would greatly benefit the overall running of the home and more importantly comprehensively enhance the lives of people living in the home. The organisations operations manager carries out monthly audits and reports these to the Commission for Social Care Inspection. EVIDENCE: Redmayne House DS0000022576.V265928.R01.S.doc Version 5.0 Page 16 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 X X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X 3 X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 2 X 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Redmayne House Score 2 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X X X DS0000022576.V265928.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard 33.1 Regulation YA33 Requirement There must always be a sufficient number of staff available to comprehensively meet the needs of service users. Timescale for action 01/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Redmayne House DS0000022576.V265928.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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