Inspection on 09/03/09 for Rielly`s House

This inspection was carried out on 9th March 2009.

CSCI found this care home to be providing an Good service.

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 22/09/06

Rielly`s House 17/11/05

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Rielly`s House 30 St Vincent St Stoke Plymouth Devon PL2 1JH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jane Gurnell     Date: 0 9 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 24 Information about the care home Name of care home: Address: Rielly`s House 30 St Vincent St Stoke Plymouth Devon PL2 1JH 01752568578 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Angela Ruth Rielly,Mr Paul Victor Rielly care home 3 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is 3. The registered person may provide the following category of service only: Care home providing personal care only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Mental disorder, excluding learning disability or dementia - (Code MD) - maximum of 3 places Date of last inspection Brief description of the care home 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 people over three floors. The Care Homes for Adults (18-65 years) Page 4 of 24 Over 65 0 3 Brief description of the care home 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 Riellys 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 pounds per week. Information regarding the service is made available to people interested in moving to the home directly from the home or by post upon request. Care Homes for Adults (18-65 years) Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The previous inspection of Riellys House was undertaken on 22nd September 2006 when the service was judged as providing good outcomes to the people living there. This inspection was unannounced and took place during the day on 9th March 2009. Mrs Rielly, one of the owners who manages the home on a day to day basis was present. All three people living in the home were spoken with and the records relating to their care and support were looked at. A tour of the building was made and documents relating to staff recruitment and training and the maintenance of the building were inspected. Care Homes for Adults (18-65 years) Page 6 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –03000 616161. Care Homes for Adults (18-65 years) Page 7 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with sufficient information to make an informed choice about whether the home is right for them. Peoples specific support needs are known before they move in. Evidence: The Statement of Purpose and Service User Guide are the documents by which the owners describe the services provided by Riellys House. These documents gave a good description to prospective residents, and along with a visit to the home, allow people to make an informed decision about whether the home was suitable for them. Pre-admission assessments were undertaken by the Mrs Rielly, the Manager, to support the information received from social services and to ensure staff were knowledgeable about the persons needs before they moved in. Care Homes for Adults (18-65 years) Page 9 of 24 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are well supported and care plans provide clear information to ensure consistency in staff support. Evidence: People spoke highly of their life at Reillys House and the support they receive. One person said this is my home, I love it here. People are free to come and go as they please and the routines of the home are flexible. It was clear from talking to Mrs Rielly that she had a good understanding of how peoples mental health conditions affected their abilities to live independently. Coping strategies had been developed in agreement with each person to overcome anxieties and compulsive behaviours, as well as to maintain safety and reduce the risk of social isolation. All three care plans were looked at in detail at each provided a full description of the persons needs and the action required by the staff to support these Care Homes for Adults (18-65 years) Page 10 of 24 Evidence: needs, including any restrictions necessary to protect people. Mrs Rielly was aware of anti-discriminatory practices and felt confident that within such a small home individual needs, whether they be cultural, religious or related to their sexuality would be supported and respected. Care Homes for Adults (18-65 years) Page 11 of 24 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples rights are respected. Meals are nutritious and varied. Evidence: People spoke highly of the care and support they receive. They said that the staff were kind, friendly and respectful. People are supported and encouraged to become involved in community activities with or without support from staff: it was evident in the care plans that people had made significant progress in their ability to independently cope with activities of daily living and community activities. Examination of daily care notes indicated that people go out to local places of interest, the local shops and into the City. People are encouraged and supported to be involved in meal preparation and domestic chores around the home. Family and friends are welcome at Riellys House. People said the food was plentiful and very good. Access to the kitchen is restricted Care Homes for Adults (18-65 years) Page 12 of 24 Evidence: during the night to protect peoples health and safety, but people could have drinks and snacks at any time during the day, and on request during the night. Care Homes for Adults (18-65 years) Page 13 of 24 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples physical and mental health needs are being well met. Medication practices are safe. Evidence: People 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 staff aware of peoples preferences and choices, ensuring support is offered in a consistent manner. Expert advice for managing peoples mental health conditions on a day to day basis is offered from the local Community Mental Health Team, the Consultant Psychiatrist and the GP. Individual coping strategies were well documented in the care plans ensuring all staff were aware of how to support each person at particularly stressful times and also to recognise when a persons mental health condition was deteriorating. One document was particularly useful to indicate changing needs as it described in very clear terms a persons ability when they were well and how this changed with changes to their mental health stability. Care Homes for Adults (18-65 years) Page 14 of 24 Evidence: Medicines are held for safekeeping to be administered by the homes staff team, all of whom have had in-house training in safe medication practices by Mrs Rielly who reviews their practice periodically. Medication is stored safely and the records relating to administration were accurate. Care Homes for Adults (18-65 years) Page 15 of 24 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that their views are listened to and any concerns are taken seriously and dealt with promptly. Evidence: People 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 Mrs Rielly was knowledgeable about her responsibilities should she believe someone is at risk from abuse. Staff had received in-house training in the protection of vulnerable adults, and Mrs Rielly confirmed further training had been arranged with social services. Care Homes for Adults (18-65 years) Page 16 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well maintained and pleasant home with sufficient facilities to meet their needs. Evidence: Riellys House is a well-maintained terraced house that provides a pleasant home. 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 people 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: Mrs Rielly confirmed the stair carpet was due to be replaced as it was showing signs of wear and tear. The home was found to be very clean. All the shower rooms and toilet doors are fitted with locks that can be over-ridden from the outside by staff in an emergency to ensure peoples safety. All the bedroom doors are fitted with individual locks. Care Homes for Adults (18-65 years) Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by well-trained staff in sufficient numbers to meet their needs. Evidence: People said that the staff are kind, supportive and respectful. There is one member of staff on duty during the day and evening, with a sleeping-in member of staff available during the night. Mrs Rielly confirmed that staffing was flexible and an extra member of staff was available to cover specific activities or appointments. The recruitment file for the most recently recruited member of staff was looked at, as were the training files for all three staff members. It was evident all the necessary pre-employment checks had been carried out to ensure as far as possible only suitable staff were employed. Mrs Rielly had contacted 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, a nationally recognised care qualification. Mental health training is provided in-house by Mrs Rielly with reference to information available through the internet from specialist sites as well as external training facilitators from social services and the Primary Care Trust. Care Homes for Adults (18-65 years) Page 18 of 24 Evidence: Mrs Rielly works alongside each staff member on a day to day basis to offer guidance, support and to monitor their work performance and individual training needs. Care Homes for Adults (18-65 years) Page 19 of 24 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of the home is effective, ensuring that peoples needs are met. Evidence: Riellys House is owned by Mr and Mrs Rielly. Mrs Rielly holds the Registered Manager role and manages the home on a day to day basis. She has obtained a NVQ 4 in Care and the Registered Manager Award demonstrating she has the skills and knowledge to run a care home. People said the home was well run and they were satisfied with the communication between themselves and the owners. Mrs Rielly ensures that there is an open, positive and welcoming atmosphere within the home. The interaction between the people living in the home and Mrs Rielly showed peoples are needs were paramount. People 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. Individual risk assessments identified risks relating to activities of daily living and the Care Homes for Adults (18-65 years) Page 20 of 24 Evidence: persons abilities, as well as specific risks such as smoking. 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. Care Homes for Adults (18-65 years) Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 23 of 24 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 24 of 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. 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!