Inspection on 28/02/06 for Ridgmont

This inspection was carried out on 28th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ridgmont 07/06/07

Ridgmont 03/09/05

Ridgmont 28/02/05

Ridgmont 23/09/04

Ridgmont 24/02/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Ridgmont 8 Ridgmont Road St Albans Hertfordshire AL1 3AF Lead Inspector Claire Farrier Unannounced Inspection 28th February 2006 8:30 Ridgmont DS0000019510.V286912.R02.S.doc Version 5.1 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 Ridgmont DS0000019510.V286912.R02.S.doc Version 5.1 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. Ridgmont DS0000019510.V286912.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ridgmont Address 8 Ridgmont Road St Albans Hertfordshire AL1 3AF 01727 811159 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) www.pentahact.org.uk PentaHact Ian Frederick Head Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Ridgmont DS0000019510.V286912.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd September 2005 Brief Description of the Service: Ridgmont is a care home providing personal care and accommodation for six younger adults with learning disabilities. It provides a specialist environment for people with ASD (autistic spectrum disorder) and associated challenging behaviour. The home was opened in 1991 and consists of a semi-detached Victorian family house with three storeys and a basement that houses the laundry. It is run by PentaHact, which is a voluntary organisation. The building is owned and managed by Stoneham Housing Association. PentaHact provides the care and employs the staff. The home is located in a residential area south of St Albans city centre. All the community services are within easy reach. The home has a minibus and there are good transport links nearby for the city centre, other Hertfordshire towns and London. All the home’s bedrooms are single and none have en-suite facilities. The home does not have a lift and would not be suitable for service users with mobility difficulties. The home has an enclosed garden with lawn, flower beds, summerhouse, brick built barbeque and garden furniture. Ridgmont DS0000019510.V286912.R02.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over one morning, and including preparation time, a total of four hours was allocated to it. The inspector spoke with one resident and three members of staff, including the manager, carried out a brief tour of the premises and checked care plans and staff records. This was a positive inspection. The home continues to provide a good quality of care. The residents were seen to be to be happy and relaxed in the home. The staff have good access to relevant training opportunities and said they felt very well supported and supervised. Two requirements have been made, concerning quality assurance and staff records. This was the second inspection of the year. Core standards that were not inspected on this occasion were assessed to have been met in the previous inspection report, to which reference can be made. What the service does well: What has improved since the last inspection? What they could do better: Ridgmont DS0000019510.V286912.R02.S.doc Version 5.1 Page 6 The lack of recent quality assurance audits and surveys mars what is otherwise an excellent service. The provision of a comprehensive system for monitoring and assessing the quality of care provided by the service could indicate a need for fewer inspections in the future. 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. Ridgmont DS0000019510.V286912.R02.S.doc Version 5.1 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 Ridgmont DS0000019510.V286912.R02.S.doc Version 5.1 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): 1 The Service Users’ Guide provides information about the home in a format that is relevant for each resident. EVIDENCE: The format of the Service Users’ Guide has been revised in order to make it more relevant and understandable for the residents. A separate document is being produced for each resident, using pictures, photographs and language relevant for each person. The example seen includes photographs and personal information on the staff of the home, and it states that the resident’s room is “massive”, which is the word that he himself uses to describe it. It is intended to laminate each resident’s copy of the Service Users’ Guide, and to provide a copy for their families. The next project is to update the tenancy agreement to a similar user-friendly format. Ridgmont DS0000019510.V286912.R02.S.doc Version 5.1 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 The good quality of information in the residents’ files has been maintained. The residents’ care plans contain detailed information on all their personal care and health care needs which enables the staff to provide a good quality of care. EVIDENCE: Detailed case tracking was carried out through the files of one resident, which showed what care is provided for the residents and how it is recorded. The care plan seen contained comprehensive information on all the service user’s assessed needs, including detailed guidelines for procedures such as the administration of medication and managing behaviour. The care plan (called the individual learning plan) contains appropriate goals with the objective for each goal, details of how to carry out the activity, and the rationale for each goal and procedure. The care plans cover development of skills for independence and social needs and activities. The care plan that was inspected included goals to develop the ability to shave with an electric razor and to develop and maintain the ability to wash clothes, both broken down into steps towards the end goal. Daily recording for each shift reports on communication, socialising, activities and living skills, and there is also a daily written report from the day centre. Ridgmont DS0000019510.V286912.R02.S.doc Version 5.1 Page 10 Appropriate risk assessments are in place concerning all aspects of each person’s behaviour, including leaving the home, travelling and tidying their bedroom. The care plans contain good details and procedures for behaviour management, but there is no reference in the care plan to the appropriate risk assessments. Care plans should make reference to the risk assessments where appropriate in order to ensure that the staff are aware of them. The manager is considering the most effective way to achieve this, whether by a reference in the care plan, or by a note on each person’s daily timetable where a risk assessment is in place for an activity. Ridgmont DS0000019510.V286912.R02.S.doc Version 5.1 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 the following standard(s): These standards were not inspected on this occasion, but evidence was seen of individual activities for each resident. EVIDENCE: Ridgmont DS0000019510.V286912.R02.S.doc Version 5.1 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 The home has sound policies and procedures for the safe handling and administration of medication that protect service users’ interests. EVIDENCE: The home administers the medication for all the residents. It is stored in a locked cupboard attached to the wall in the dining room and accurate recording was seen for the administration. Medication is supplied in nomad monitored dosage boxes for each service user. PRN (when required) medications are supplied in separate containers. One resident has only liquid medication as he would refuse to swallow tablets. The administration of his medication was observed, and two members of staff checked that the correct dosage was administered and recorded. Ridgmont DS0000019510.V286912.R02.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 The home also has up to date policies and procedures on adult protection in place. Staff understand the basic principles of adult protection and are aware of their individual responsibilities to protect the residents. This means that residents should be protected from abuse. EVIDENCE: A copy of the Hertfordshire inter-agency adult protection procedure is in the home and the company’s policy describes the different forms of abuse that may occur. In addition the home has a written whistle-blowing policy that includes information on contacting outside organisations such as the CSCI. The staff spoken to confirmed that they have had training in prevention of abuse. They are aware of the basic principles of adult protection and understand their duties in responding to allegations or suspicions of abuse or neglect. All the staff were trained in SCIP techniques for reacting to aggression from service users. Physical intervention is never used for control and restraint. The policy on management of challenging behaviour (physical intervention) has very clear information on different behaviours, and on the planned use of physical intervention for emergencies, for example to prevent a resident from stepping into the road. No incidents of physical intervention have been recorded in the home. Ridgmont DS0000019510.V286912.R02.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The home provides a comfortable and well maintained environment for the residents. EVIDENCE: The home is a semi-detached Victorian family house with three storeys and a basement. It is in keeping with the surroundings and the accommodation meets the standards for younger adults. Ridgmont provides a domestic environment for the residents, and the interior design, decoration and furnishing meet the needs of the individual residents, some of whom may not be able to cope with too much furniture or pictures on the wall. Ridgmont DS0000019510.V286912.R02.S.doc Version 5.1 Page 15 The premises are owned by Stoneham Housing Association, which is responsible for maintenance, repairs and redecorations. There is a history of Stoneham taking a long time to carry out required repairs and refurbishments, and requirements were made in the three previous inspection reports concerning essential maintenance, refurbishment of the first floor bathroom and repair of the front driveway. These have now been completed, and a shower has also been installed in the ground floor bathroom. There is also agreement to refurbish the top floor bathroom and, with the agreement of the Fire Service, to remove the fire escape that takes up a large part of the garden and poses a health and safety risk for the residents. Ridgmont DS0000019510.V286912.R02.S.doc Version 5.1 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 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 and 34 The home is staffed by experienced support workers who are appropriately trained to meet the needs of the residents. PentaHact practices a thorough recruitment procedure that ensures that residents are protected by staff that are fit to work in a care home EVIDENCE: The file for one member of staff who transferred from another PentaHact home during the last year was inspected. It contained a reference from previous manager, but there was no evidence of identity, application form, health declaration or CRB (Criminal Record Bureau) disclosure. The manager confirmed that he has seen all the documents, and he called PentaHact headquarters during the inspection to confirm that all the required information is in place, and will be provided to the home as soon as possible. Four of the ten support workers have a NVQ qualification at level 2 or 3, and three more are working towards the qualification. There is an expectation that all new staff register for NVQ qualifications, and the remaining staff will register for the qualification when the PentaHact assessor is able to support them. Ridgmont DS0000019510.V286912.R02.S.doc Version 5.1 Page 17 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, 39 and 41 The home is well run by a competent manager who leads a dedicated and enthusiastic staff group. The management within the home is secure and effective ensuring that the needs of the residents are met and that the home meets its aims and objectives. The quality assurance system ensures that views of the residents and their families contribute to the review and development of the home, but the process has not been completed during the past year. EVIDENCE: The manager communicates a clear sense of direction and leadership. He was deputy manager in the home before being appointed as manager. He is studying NVQ level 4 NVQ in management and he has a City and Guilds qualification in community care and a counselling qualification. Ridgmont DS0000019510.V286912.R02.S.doc Version 5.1 Page 18 The home maintains appropriate records for the health and safety of the residents and staff in the home, with the exception of appropriate staff records (see Standard 34). PentaHact has a comprehensive system for quality assurance in its homes, which includes annual surveys of residents and other stakeholders. Most of the residents of Ridgmont are unable to understand and complete the questionnaires, and PentaHact PCP (person centred planning) co-ordinator is starting to work with some of the residents to improve their involvement. The manager completes regular self-assessment audits of the home and the company carries out regular service audits and monthly Regulation 26 monitoring visits. The National Autistic Society (NAS) also audits the service provided by the home. PentaHact produces a development plan that includes findings from the quality assurance process and recommendations and requirements from CSCI and the NAS. Due to changes in management in the company, there has been no quality assurance audit since December 2004, and the last Regulation 26 monitoring visit was in December 2005. Ridgmont DS0000019510.V286912.R02.S.doc Version 5.1 Page 19 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 3 2 X 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 X 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 3 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 2 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X 3 X 2 X 2 X X Ridgmont DS0000019510.V286912.R02.S.doc Version 5.1 Page 20 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 YA39 Regulation 24 & 26 Requirement PentaHact has a comprehensive system for quality assurance in its homes, but the has been no quality assurance monitoring since 2004, and no Regulation 26 monitoring visits since December 2005. The registered person must ensure that an annual quality assurance survey is carried out that focuses on the consultation with the service users and other involved people, and provides feedback on the process and the results of the consultation. The proprietor must make monthly monitoring visits to the home and reports of the visits must be sent to CSCI. Timescale for action 31/08/06 Ridgmont DS0000019510.V286912.R02.S.doc Version 5.1 Page 21 2 YA41 17(2) & 19(1)(b) The staff files seen did not contain satisfactory evidence of the fitness of the person to work in the home. All the required information on staff, as listed in Schedule 2 and Schedule 4(6) of the regulations, must be kept in the home, including evidence of identity, confirmation of the person’s health and evidence of satisfactory CRB checks. 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA9 Good Practice Recommendations The care plans contain good details and procedures for behaviour management, but there is no reference in the care plan to the appropriate risk assessments. Care plans should make reference to the risk assessments where appropriate. Ridgmont DS0000019510.V286912.R02.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Ridgmont DS0000019510.V286912.R02.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!