Inspection on 04/07/05 for Richmond House

This inspection was carried out on 4th July 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Richmond House 23/07/07

Richmond House 31/08/06

Richmond House 26/01/06

Richmond House 02/11/04

Richmond House 09/04/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Richmond 31 Richmond Street Heamoor Penzance Cornwall TR18 3ET Lead Inspector Ian Wright Unannounced 4 July 2005 1600 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. Richmond D52-D04 S8912 Richmond V227169 040705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Richmond Address 31 Richmond Street Heamoor Penzance Cornwall TR18 3ET 01736 331005 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) Royal Mencap Society Christian Samual Burridge Care Home 5 Category(ies) of Learning Disability (5) registration, with number of places Richmond D52-D04 S8912 Richmond V227169 040705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2.11.04 Brief Description of the Service: Richmond’ provides care for up to 5 adults with learning disabilities. The home is situated in Heamoor, Nr Penzance. The registered provider is Mencap, which operates several care homes in Cornwall. An application for the registered manager is currently being determined by the Commission for Social Care Inspection. All service users have their own bedrooms and there are suitable shared facilities. Service users have suitable day activities. Richmond D52-D04 S8912 Richmond V227169 040705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over four and a half hours. The inspection was carried out on an unannounced basis. The inspector was able to speak to the majority of service users, and the staff members on duty. The inspector examined the medication system, care records, and inspected the building. What the service does well: What has improved since the last inspection? The home continues to be well run, and service users are happy with the care provided. Service users now all have locks on their bedroom doors to improve their privacy and security. All service users have terms and conditions of residency / contract. This ensures service users and their representatives are aware of their rights and responsibilities living in the home. All service users have more comprehensive risk assessments. This ensures any risks are minimised and any restrictions placed on people are well thought through and regularly reviewed. A test on the electrical circuit (hardwire test) has been completed. This ensures service users know the home’s electrics are safe and the fire risk from the electrical circuit is minimised. Richmond D52-D04 S8912 Richmond V227169 040705 Stage 4.doc Version 1.30 Page 6 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. Richmond D52-D04 S8912 Richmond V227169 040705 Stage 4.doc Version 1.30 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 Richmond D52-D04 S8912 Richmond V227169 040705 Stage 4.doc Version 1.30 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) 2,3,4,5 The registered provider has an appropriate assessment procedure, and service users have the opportunity to visit / stay at the home before formal admission is arranged so service users know their needs can be met. An appropriate contract / statement of terms and conditions has been issued to all service users so service users are aware of their rights and responsibilities. The registered provider has developed a suitable staff training programme and a suitable network of external professional support to meet service users care needs. EVIDENCE: Service users have a copy of terms and conditions of residency or a contract on their files. The Deputy Manager also said a copy of these had been issued to service users and/or their representatives. Service users also have an assured tenancy agreement guaranteeing considerable security of tenure. The registered provider has a satisfactory pre admission assessment procedure. There have been no recent admissions. The Deputy Manager said prospective service users are able to visit the home before admission. This would include overnight stays as applicable. The Deputy Manager said there was appropriate links with external professionals such as social workers, community nurses etc. and suitable records regarding these contacts were observed. The registered provider has an appropriate training programme for staff. This includes access to National Richmond D52-D04 S8912 Richmond V227169 040705 Stage 4.doc Version 1.30 Page 9 Vocational Qualifications in care. The Deputy Manager said the majority of staff had completed at least NVQ 2 in care. Richmond D52-D04 S8912 Richmond V227169 040705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9, 10 Appropriate policies and procedures, and documentation is in place regarding care planning and risk assessment. Documentation is stored confidentially. Service users receive appropriate support to develop their skills, take appropriate risks, and to be consulted about their lives. EVIDENCE: A copy of a care plan is contained in each service user’s file. These are reviewed appropriately. Service users stated they are enabled to make decisions e.g. regarding day activities and major decisions in their lives. Service users said there are regular residents meetings, which enable them to make comments about life in the home. Minutes are kept of these meetings. Service users said they are encouraged to take appropriate risks e.g. go out on their own. Suitable risk assessments are maintained on each service user’s file, and these are reviewed appropriately. All information is stored confidentially. Richmond D52-D04 S8912 Richmond V227169 040705 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 13, 15, 17 Suitable opportunities are provided for service users to develop their skills, be part of the community, and have a wide range of day activities available to them. Contact with service users family and friends is encouraged. Suitable arrangements are in place so service users have a varied and healthy diet. EVIDENCE: Service users said they receive appropriate opportunities to attend religious services e.g. chapel. Service users also are encouraged to maximise their skills so they can be as independent as possible e.g. opportunities to cook, shop and maintain the house. Service users said they are given suitable opportunities to participate in the community for example village events, and using local facilities such as leisure centres, pubs and clubs. Service users had the opportunity to vote in the recent general election. Service users said they have appropriate opportunities to maintain links with their families and friends. Visiting arrangements are appropriate. Richmond D52-D04 S8912 Richmond V227169 040705 Stage 4.doc Version 1.30 Page 12 The inspector shared a meal with service users. This was to a good standard; homemade curry followed by raspberries and ice cream. The member of staff said what is for dinner is decided on a day to day basis according to what service users wished to eat. Service users are involved in the preparation of food. Appropriate records are maintained, and these demonstrate a balanced and healthy diet. Special diets are catered for. Richmond D52-D04 S8912 Richmond V227169 040705 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20 The staff team ensure appropriate links are maintained with relevant professionals so service users physical and emotional health needs are met. An appropriate medication system is in operation. EVIDENCE: No service users have pressure sores and there have been no major accidents, which have for example resulted in hospital admission. The accident book is appropriately maintained. Staff stated links with general practitioners, and other professionals such as social workers are satisfactory. Suitable records are maintained regarding hospital and other health care appointments. The registered provider has a suitable policy regarding the storage and handling of medication. An appropriate medication system is in operation, storage is appropriate and satisfactory records are maintained. The Deputy Manager said all staff have received formal training regarding medication in the last two years. Richmond D52-D04 S8912 Richmond V227169 040705 Stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23 The registered provider has suitable complaints and adult protection policies, which are implemented as appropriate. Suitable measures are taken to inform and train service users and staff as appropriate. EVIDENCE: The registered provider has developed an appropriate complaints procedure, and a user friendly version is issued to service users. Staff also remind service users of the policy regularly in residents meetings. The registered provider has also developed a suitable adult protection policy. The Deputy Manager said some staff have attended Cornwall County Council training regarding the prevention of abuse. Newer staff complete Mencap’s ‘Protect Me’ training as part of their induction / foundation training. All staff have received a Criminal Records Bureau check. Richmond D52-D04 S8912 Richmond V227169 040705 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24-30 The home is a suitable environment for service users accommodated there. The kitchen units still need to be replaced, and the registered provider must action this previous requirement. EVIDENCE: The building was inspected. The home offers a pleasant and homely environment for service users. The home was clean and hygienic on the day of the inspection. The kitchen units are shabby and in need of replacement. Although the housing association has visited regarding the kitchen, no action has yet been taken. The previous requirement is subsequently renotified. Service user bedrooms are pleasantly decorated according to individual tastes. Locks are fitted to all bedroom doors, and service users are issued with a key where this is appropriate (i.e. as long as there are no health and safety risks to the user concerned). Appropriate environmental adaptations are in place such as thermostatic valves to prevent the risk of burning. Richmond D52-D04 S8912 Richmond V227169 040705 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32, 33, 35, 36 Staff have clear roles and responsibilities to ensure the home is run effectively. Staff appear to be recruited appropriately. There is a appropriate induction and training procedure-although records could not be inspected on this occasion. Due to the changing needs of service users the registered provider must review current staffing levels. Staffing levels currently do not appear to meet the needs of service users accommodated and could put them at risk. EVIDENCE: All staff are issued with a job description when they commence employment. Staff appear to have a clear understanding of their roles. The Deputy Manager said the majority of staff have completed at least NVQ 2 in care. A copy NVQ of certificates should be placed on individual staff files. Rotas suggest there is only one member of staff on duty for significant periods of the waking day. Due to the changing needs of service users this does not appear to be adequate. One service user appeared to be quite challenging. Other service users will subsequently spend considerable times in their bedrooms. Staff stated other service users could at times not have enough support, as staff had to prioritise the needs of one particular service user. Incident records show a significant number of incidents of verbal and physical aggression in recent months. A requirement is made for the registered provider to review staffing levels due to changing service user needs. Richmond D52-D04 S8912 Richmond V227169 040705 Stage 4.doc Version 1.30 Page 17 The Deputy Manager provided a summary of training completed by staff. Staff appear to have received appropriate training-although one member of staff needs to complete food hygiene training as a matter of priority. The Deputy Manager said staff receive formal one to one supervision on a monthly basis. Day to day supervision appears appropriate. A deputy manager is designated to manage the home on a day to day basis, and a registered manager works across this and a nearby home. The inspector was unable to inspect recruitment, induction and training records as the Deputy Manager is not provided with a key to access these. The deputy manager should be provided with a key to access this information. Richmond D52-D04 S8912 Richmond V227169 040705 Stage 4.doc Version 1.30 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37-42 Although the manager’s registration application is currently being determined service users benefit from a positive management culture, and a staff team that appears to work well together. Policies, procedures, and records kept were observed to be suitable. There are appropriate health and safety precautions so service users live in a safe environment. EVIDENCE: The Commission for Social Care Inspection is currently determining the application for a registered manager. The Commission is awaiting references and a Criminal Records Bureau check disclosure. The inspector observed a positive atmosphere between staff and management, and between staff and service users. Service users spoke positively regarding the support they received. Staff were positive regarding the support they received from managers in the home. There is evidence of regular staff and residents meetings. The registered provider has a satisfactory equal opportunities policy. Richmond D52-D04 S8912 Richmond V227169 040705 Stage 4.doc Version 1.30 Page 19 The staff team have a satisfactory approach to quality assurance. Service users and other stakeholders such as external professionals involved in the care of people living in the home, have completed satisfaction surveys. People appeared to be satisfied by the service provided from the questionnaires completed. There are regular residents meetings, and established contacts with relatives of service users. Care plans are reviewed regularly, and formal care reviews are held at least annually. The inspector could not find a copy of a Mencap quality assurance policy. A copy of the quality assurance policy is requested; and if the registered provider does not have a policy, one should be developed. Otherwise, Mencap generally appears to have a suitable range of policies and procedures, and suitable records are maintained. Mencap has a suitable approach to preventing any health and safety risks. Suitable procedures are in place to test fire prevention, gas and electrical equipment, and there is satisfactory evidence that testing is completed. For example the electrical circuit (hardwire test) was completed in September 2004. Suitable health and safety risk assessments were completed in July 2004. Appropriate checks appear to be in place regarding the prevention of Legionella. Appropriate health and safety training generally appears to have been completed by all staff; although one member of staff requires training in food handling /hygiene. Richmond D52-D04 S8912 Richmond V227169 040705 Stage 4.doc Version 1.30 Page 20 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 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 x 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score 3 3 1 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Richmond Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 x D52-D04 S8912 Richmond V227169 040705 Stage 4.doc Version 1.30 Page 21 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 21 Regulation 12 Requirement The registered provider is required to expand the homes death and dying policy to cover the care of service users who are aging,with reference to the national minimum standard. (Timescale of 31.1.05 not met 3rd Notification.) The registered provider must replace kitchen units (Timescale of 1.4.05 not met 2nd Notification.). The registered provider must review staffing levels so they satisfactorily meet the needs of service users accommodated. A copy of the registered providers report must be provided to the Commission by 1.9.05. Any recommendations must be agreed with CSCI and implemented within the timescale for action date. Timescale for action 1.1.06 2. 24 16,23 1.1.06 3. 33 18 1.10.05 4. 5. 6. 7. Richmond D52-D04 S8912 Richmond V227169 040705 Stage 4.doc Version 1.30 Page 22 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. Refer to Standard 32 34,35 39 Good Practice Recommendations A copy NVQ of certificates should be placed on individual staff files. The Deputy Manager should be provided with a key to access staff information (e.g. recruitment and training). A copy of Mencaps Quality Assurance policy should be provided to the Commission for Social Care Inspection. If such a policy does not exist the registered provider must develop an appropriate policy. Richmond D52-D04 S8912 Richmond V227169 040705 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 Richmond D52-D04 S8912 Richmond V227169 040705 Stage 4.doc Version 1.30 Page 24 - 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. 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