Inspection on 22/09/06 for Rielly`s House

This inspection was carried out on 22nd September 2006.

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

The inspector 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

Rielly`s House 09/03/09

Rielly`s House 17/11/05

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

CARE HOME ADULTS 18-65 Rielly`s House 30 St Vincent St Stoke Plymouth PL2 1JH Lead Inspector Jane Gurnell Unannounced Inspection 22nd September 2006 10:15 Rielly`s House DS0000063791.V317206.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 Rielly`s House DS0000063791.V317206.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. Rielly`s House DS0000063791.V317206.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rielly`s House Address 30 St Vincent St Stoke Plymouth PL2 1JH 01752 568578 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) Miss Angela Clayton Mr Paul Victor Rielly Mr Paul Victor Rielly Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Rielly`s House DS0000063791.V317206.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Age restricted to Service Users from the age of 30 to 65 years of age. The home is registered as a Care Home only (PC) providing care for people falling within the category MD (Mental Disorder). 17/11/05 Date of last inspection Brief Description of the Service: This 3 bedded home was first registered on 21/04/2005. The home is a 1970s mid terrace house near to Stoke Village, in the centre of Plymouth. A full range of amenities and facilities are available within walking distance and within the greater Plymouth area. The home can accommodate up to three residents over three floors. The home is entered on the ground level where there is one bedroom, an office and the main bathroom with toilet. There are then stairs to a lower ground floor level and the communal areas. Stairs rise from the ground floor hallway to the first floor and two further bedrooms and a shower room with toilet. The two communal areas in the home are a lounge and also a kitchen/dining area. There is an area of enclosed garden and patio to the rear of the building. There is also a patio area to the front of the lower ground floor area. Residents are free to smoke under shelter to the front and back of the building but not inside. The service offered by the home is for men and women with mental health issues over the age of 30 and under the age of 65. The service provided at Rielly’s House is not designed to meet the needs of people with significant mobility issues but there is physical disability access to the ground floor facilities. The service is designed to be small and domestic in style. The present weekly fees range from £500 to £550. Information regarding the service is made available to prospective service users directly from the home or by post upon request. Rielly`s House DS0000063791.V317206.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place during the day on 22nd September 2006. Prior to this visit, survey forms were sent to each resident to allow them to comment anonymously about their experiences: 2 were returned and both commented favourably about living at Rielly’s House. Two of the residents’ care plans were examined in detail. All 3 residents currently living at Rielly’s House were spoken to and conformed they are well supported. Miss Clayton was present throughout the inspection. A tour of the building was made and documents relating to the maintenance of the building were inspected. What the service does well: What has improved since the last inspection? What they could do better: Access to the kitchen and one of the bathrooms is restricted to safeguard the welfare and health and safety of the residents. These restrictions should be recorded in more detail in the Statement of Purpose and Service User Guide. Residents’ care plans should be amended to provide a full description of the residents’ care needs and the action required by staff to meet those needs. Staff would benefit from receiving more formal training relating to mental health conditions ensuing the have the skills to recognise change in a resident’s condition. The risk assessments relating to unrestricted window opening should be amended to reflect the actual risk to each resident. The gas fire in the lounge should be serviced. Rielly`s House DS0000063791.V317206.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. Rielly`s House DS0000063791.V317206.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 Rielly`s House DS0000063791.V317206.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): 1, 2 and 3. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Amendments to the Statement of Purpose and Service User Guide are necessary to reflect agreed environmental restrictions to safeguard the service users’ health and welfare. EVIDENCE: The Statement of Purpose and Service User Guide are the documents by which the owners describe the services provided by Rielly’s House. These documents gave a good description to prospective service users but now that the home has been open for over a year, some restrictions have been implemented with the current residents’ agreement to safeguard their welfare and health and safety. These restrictions relate to access to the kitchen and one of the bathrooms. As it is expected that 2 of the service users will remain living at Rielly’s House, these restrictions will remain in place for the foreseeable future and should be recorded in the documents to inform prospective service users. Pre-admission assessments were undertaken by Miss Clayton to support the information received from social services and to ensure that the staff were knowledgeable about the service users’ needs. Rielly`s House DS0000063791.V317206.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): 6, 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are well supported, however their care plans did not reflect the knowledge gained by the staff over the past year. EVIDENCE: Residents spoke highly of their life at Reilly’s House and the support they receive. One resident who is moving to more independent living said that she would “recommend Reilly’s House to anyone”. She said without the level of support and encouragement she had received she would not have had the confidence to move to her own flat. Residents said that they are free to come and go as they please and the routines of the home are flexible. It was clear from talking to Miss Clayton that she had a great deal of knowledge about the residents and how their mental health conditions affected their abilities to live independently as well asthe coping strategies that had Rielly`s House DS0000063791.V317206.R01.S.doc Version 5.2 Page 10 been adopted to overcome anxieties and compulsive behaviours. The care plans, however did not reflect this information in detail and should be updated to ensure that the plans provide a full description of the needs of the residents and the action required by the staff to support these needs, including any restrictions necessary to protect the resident. Miss Clayton was aware of anti-discriminatory practices and felt confident that within such a small home individual resident’s needs, whether they be cultural, religious or related to their sexuality would be supported and respected. Rielly`s House DS0000063791.V317206.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): 11, 12, 13, 14, 15, 16, and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ rights are respected. Meals are nutritious and varied. EVIDENCE: Residents spoke highly of the care and support they receive. They said that the staff were kind, friendly and respectful. One resident described how she was being encouraged to write poetry again and how much she was enjoying this. Residents are supported and encouraged to become involved in community activities with or without support from staff. Examination of residents’ daily care notes indicated that residents go out to local places of interest and into the City. Family and friends are welcome at Rielly’s House. Residents said the food was plentiful and very good. Despite access to the kitchen being restricted, residents said they could have drinks and snacks at any time. Rielly`s House DS0000063791.V317206.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health and personal care needs are being met. Medication practices are safe. EVIDENCE: Residents said they were satisfied with the care and support they receive and are encouraged to maintain their independence. Preferred daily routines and likes and dislikes are recorded making all staff aware, ensuing support is offered in a consistent manner. Expert advice for residents and staff regarding managing mental health conditions on a day to day basis is offered from the local Community Mental Health Team. Individual coping strategies were documented in the care plans ensuring all staff were aware of how to support a resident at particularly stressful times and also to recognise when a resident’s mental health was deteriorating. One resident is able to maintain responsibility for her own medication but prefers that it be held for safekeeping by the home. Medication is stored safely and the records relating to administration were accurate. Rielly`s House DS0000063791.V317206.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that there views are listened to and any concerns are taken seriously and dealt with promptly. EVIDENCE: Residents said the owners and staff were very approachable and they had confidence any concerns would be taken seriously and dealt with promptly. Neither the home nor the Commission has received any complaints regarding the service since the last inspection. The home has the appropriate anti-abuse policies and procedures in place and Miss Clayton was knowledgeable about her responsibilities should she believe a resident is at risk from abuse. Evidence was available that Miss Clayton had dealt appropriately with a possible abusive situation from a member of the public and had involved the Commission and social services. Rielly`s House DS0000063791.V317206.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a well maintained and pleasant home with sufficient facilities to meet their needs. EVIDENCE: Rielly’s House is a well-maintained terraced house that provides a pleasant home for residents. To the rear of the building is an enclosed and safe garden area of a reasonable size. To the front is a second small patio area with cover used by the clients mostly as a smoking area. Smoking is not allowed anywhere inside the home. The bedrooms are of a good size, well furnished and have been personalised. The quality of the living environment, and the standard of decoration and fixtures in the communal areas are good. The home was very clean. All the bathroom and toilet doors are fitted with locks that can be overridden from the outside to ensure the residents safety. All the bedroom doors are fitted with individual locks. As discussed previously access to the kitchen and one bathroom is restricted: these restrictions are in place with the residents’ agreement to protect their welfare and safety. Rielly`s House DS0000063791.V317206.R01.S.doc Version 5.2 Page 15 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): 31, 32, 33, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by well-trained staff in sufficient numbers to meet heir needs. EVIDENCE: Residents said that the staff are kind, supportive and respectful. Three staff files were examined and contained all the necessary pre-employment checks to ensure as far as possible only suitable staff were employed. It was evident from the files that in addition to obtaining written references, Miss Clayton spoke to each referee to assure herself that the prospective member of staff had the skills to support people with mental health conditions: this demonstrates very good practice. All staff have either obtained or are in training to receive a National Vocational Qualification. Mental health training is provided in-house by the owners and from the Mental Health Community Team regarding individual residents. Miss Clayton was advised that staff would benefit from more formal mental health training to ensure they have the skills to recognise symptoms of mental health conditions and signs of improvement or deterioration. Rielly`s House DS0000063791.V317206.R01.S.doc Version 5.2 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42 and 43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home is effective, ensuring that residents’ needs are met. EVIDENCE: Rielly’s House is owned by Mr Paul Rielly and Miss Angela Clayton. Mr Rielly holds the registered manager role. He has obtained an NVQ 4 in Care and the Registered Managers Award demonstrating he has the knowledge to run a care home. Residents said the home was well run and they were satisfied with the communication between themselves and the owners. The owners ensure that there is an open positive and welcoming atmosphere within the home. The interaction between the residents and Miss Clayton throughout the inspection showed that the needs of the residents are paramount to the management. Rielly`s House DS0000063791.V317206.R01.S.doc Version 5.2 Page 17 All the residents have their own individual named bank accounts and any personal money kept safe by the management is kept individually. Records are generally well maintained in the home. Documents relating to the maintenance of the building and servicing of equipment were available for inspection. The fire safety system was well maintained and had been tested and serviced as necessary ensure it was in good working order. The gas fire in the lounge room was still to be serviced and should be done before the weather becomes cold. Miss Clayton was advised to amend the risk assessments regarding the risk to residents from unrestricted window openings as these did not fully reflect the risk in general or specifically to each person. Rielly`s House DS0000063791.V317206.R01.S.doc Version 5.2 Page 18 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 2 2 3 3 3 4 3 5 3 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 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 3 3 2 3 Rielly`s House DS0000063791.V317206.R01.S.doc Version 5.2 Page 19 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 YA1 Good Practice Recommendations The Statement of Purpose and the Service Users Guide should be amended to reflect the restrictions in place to safeguard the residents’ welfare and safety. Resident’s care plans should be amended to provide a detailed description of the residents needs and the action required by staff to nee those needs, including any necessary restrictions to protect their welfare and safety. Staff should received training in mental health conditions. The gas fire in the lounge should be serviced. 2. YA6 3. 4. YA32 YA42 Rielly`s House DS0000063791.V317206.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Rielly`s House DS0000063791.V317206.R01.S.doc Version 5.2 Page 21 - 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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