Inspection on 19/07/05 for Rivendell [Chudleigh]

This inspection was carried out on 19th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Rivendell [Chudleigh] 04/10/07

Rivendell [Chudleigh] 06/12/06

Rivendell [Chudleigh] 17/01/06

Rivendell [Chudleigh] 11/08/04

Rivendell [Chudleigh] 11/02/04

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 Rivendell Woodway Street Chudleigh Newton Abbot TQ13 0NE Lead Inspector Mark Sharman Announced 19 and 20 July 2005 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. Rivendell D54-D07 S3790 Rivendell V224122 190705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Rivendell Address Woodway Street, Chudleigh, Newton Abbot, Devon, TQ13 0NE 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) 01626 853943 01626 854621 hftrivendell@hft.org.uk HFT Margaret Lesley Wick Care Home 36 Category(ies) of Learning disability (36) registration, with number of places Rivendell D54-D07 S3790 Rivendell V224122 190705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 22/2/05 Brief Description of the Service: Rivendell is one of a number of homes provided by HFT (formerly Home Farm Trust), and is registered to accommodate up to 36 adults (aged 18 to 65) with a learning disability. The campus is located just outside the small town of Chudleigh, and comprises three residential units (each of two houses) around a core building. Most of these houses were built about 20 years ago and are domestic in style. In addition there are three more modern day services buildings and some offices. Three former residents also live on site as tenants of HFT (under the Supporting People arrangements). A wide range of day services is offered on site for the residents, and also for the residents of a smaller satellite home in Kingsteignton also run by HFT. The Rivendell site has very extensive grounds and is in a rural location with attractive views of the surrounding countryside. There is ample car parking available on site. Rivendell D54-D07 S3790 Rivendell V224122 190705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection which took place over one day and the following morning. A pre-inspection questionnaire completed by the manager was received before the inspection, which contained a lot of information. Ten completed comment cards were also received, five from residents and five from relatives. About twelve residents and several staff were interviewed. A tour of the grounds and buildings was made, including a few of the residents’ bedrooms (with their agreement). Some time was spent at the weekly meeting (of staff and residents), and in some of the activities taking place. A sample of records was seen, including care records. What the service does well: What has improved since the last inspection? Rivendell D54-D07 S3790 Rivendell V224122 190705 Stage 4.doc Version 1.40 Page 6 No requirements or recommendations were made following the last inspection of the home. 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. Rivendell D54-D07 S3790 Rivendell V224122 190705 Stage 4.doc Version 1.40 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 Rivendell D54-D07 S3790 Rivendell V224122 190705 Stage 4.doc Version 1.40 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. The needs, abilities and aspirations of potential new residents are thoroughly assessed before a decision on admission to the home is made. EVIDENCE: There have been few new admissions to the home in recent years because there have been few vacancies, but one new resident is being admitted currently. In this case the introduction process is taking many months, and a stage has been reached where he is spending Mondays to Fridays at Rivendell and then returning to his parents’ home for weekends. His needs and aspirations have been assessed by a local authority care manager, and also an assessment has been carried out by Rivendell staff and by HFT’s principal social worker (based in Bristol). Rivendell D54-D07 S3790 Rivendell V224122 190705 Stage 4.doc Version 1.40 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 standard(s) 6, 7 and 9. There is a thorough care planning system which provides staff with the information required to meet residents’ needs. The residents are consistently encouraged and supported to make their own decisions, and are enabled to take part in activities involving an element of risk. EVIDENCE: Rivendell uses a person centred planning approach, and the residents spoken to were well aware of their care plans. They are fully involved in the formulation of their plan and in their reviews, and relatives and care managers are also consulted. A small sample of residents’ personal files was examined, and in each there was clear evidence of the setting of personal goals and of regular reviews taking place with the resident. The major annual review will also normally include the resident’s relatives, care manager, unit manager from Rivendell, and is chaired by a representative from HFT head office. One recent review (seen) had been conducted in pictorial form (Powerpoint presentation) because the resident concerned was more comfortable with this and it was more comprehensible to him. From observation during the inspection it was very clear that the staff take time to encourage residents to make their own decisions in all areas of their lives, for example as to what activities they wish to join in. This includes Rivendell D54-D07 S3790 Rivendell V224122 190705 Stage 4.doc Version 1.40 Page 10 activities which may carry an element of risk. One resident described how she walks into Chudleigh on her own, catches a bus on her own into Newton Abbot and Exeter etc. Many of the residents take part in activities such as swimming and horse riding. Risk assessments are carried out in respect of activities and a personal risk assessment is carried out for each resident (some were seen). Rivendell D54-D07 S3790 Rivendell V224122 190705 Stage 4.doc Version 1.40 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) 12, 13, 15 and 16. There is an emphasis on creating as normal a lifestyle as possible for the residents, including opportunities for education and work. They are able to have appropriate relationships with relatives and friends, and there is substantial contact with the local community. EVIDENCE: Several of the residents spoken to described the paid jobs or work placements which they have outside Rivendell. Several are now employed part-time on a paid basis at a local restaurant, one works (paid) in a care home kitchen, one at a local playgroup (paid), one for a building company (paid), one doing forestry work (paid) etc. Employment opportunities are co-ordinated by the day services manager. Educational opportunities are also available at the local adult education centre, Teignmouth and Dawlish colleges and the Newton Abbot training centres. A large number of staff are employed to run day services at the home on weekdays and a wide range is available, including computers, crafts, music, pottery and many others. Rivendell D54-D07 S3790 Rivendell V224122 190705 Stage 4.doc Version 1.40 Page 12 The home has its own transport provision and many activities take place in the local community. Local amenities are used when possible, for example shops, general practitioner surgery, dentists, swimming pool; and some residents go into Chudleigh on their own. Some of them explained that they are members of the local Lions Club. Many of them enjoy regular contact with their relatives, which they spoke about. One described her recent holiday in Greece with her brother. The Rivendell Association of relatives and friends meets at the home regularly. Rivendell D54-D07 S3790 Rivendell V224122 190705 Stage 4.doc Version 1.40 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) 18 and 19. Personal support is provided by staff in a way that maintains the dignity and independence of the residents as far as possible. Their health needs are monitored closely, and external professional help is requested when thought necessary. EVIDENCE: Most of the staff have worked at Rivendell for several years (many for longer) and most residents have lived there for a long time. Staff thus have detailed knowledge of residents’ abilities, aspirations and likes and dislikes, and residents were very complimentary about the attitude of staff towards them. A key worker system is used. The personal files inspected contained a lot of information for staff on how the residents prefer to be supported. All residents are registered with local general practitioners, and have regular checks at the local surgery’s Well Person clinic. Residents’ personal files contain a health recording sheet, and health needs are always dealt with in reviews (some reviews were seen). Staff reported that there is regular contact with specialists from the local learning disability team (including consultant psychiatrist), and indeed this was confirmed by a glance through the visitors’ book. Community nurses from that team have been running a Men’s Group and a Women’s Group for residents recently. The input from health professionals in respect of one resident who has dementia has been increased Rivendell D54-D07 S3790 Rivendell V224122 190705 Stage 4.doc Version 1.40 Page 14 lately, and was described by staff. A special mattress has been obtained for her. Disability equipment is obtained as necessary, for example bath hoists for certain residents were seen. Rivendell D54-D07 S3790 Rivendell V224122 190705 Stage 4.doc Version 1.40 Page 15 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 and 23. Residents appear confident that their views are taken seriously, and there are satisfactory arrangements to ensure that they are protected from abuse. EVIDENCE: The residents spoken to said they were sure that staff would try to help them if they were worried or unhappy about something. The home’s complaint procedure is included in the Residents’ Charter and is presented in a (hopefully) comprehensible format. The residents’ views are always sought, and for example they may attend a weekly meeting with staff in the day services unit. This took place on the first day of this inspection, and was chaired by one of the residents. Another resident said that she regularly attends meetings in Exeter (the Service Users’ Regional Forum). A monthly meeting on self-advocacy is being run in the home by a local advocacy charity. Currently one complaint from a former resident’s parents is being dealt with by staff from the HFT head office. There is no central record at Rivendell of complaints made, and this is recommended. There are appropriate policies in relation to adult protection and abuse, including a policy on physical restraint, and staff who were questioned were aware of these policies. Individualised procedures are in place to ensure an appropriate response to behaviours presented by certain residents. Residents’ personal money accounts are audited by staff from HFT head office three times per year. Rivendell D54-D07 S3790 Rivendell V224122 190705 Stage 4.doc Version 1.40 Page 16 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 and 30. The home is well located, provides homely, comfortable accommodation and was clean. EVIDENCE: The home has the best of both worlds, being in a rural location and yet only a very few minutes walk from the centre of Chudleigh. With one exception the residential houses were built about twenty years ago and are of ordinary domestic design. Thus residents live in groups of about six people, each having his/her own bedroom. Each house has a bathroom and communal WC on both the ground and first floors. The grounds are very extensive, offering some pleasant walks, and were looking attractive with plenty of flowers. All the parts of the home seen were reasonably clean, and there is a central laundry room containing commercial equipment. This is used for heavily soiled clothing – the houses are each equipped with a domestic washing machine and dryer. These should not be used for soiled items, since they are installed in the kitchens as in an ordinary domestic situation. Rivendell D54-D07 S3790 Rivendell V224122 190705 Stage 4.doc Version 1.40 Page 17 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) 34 and 35. The home operates a robust recruitment procedure. Training is regarded as a priority, and the training provided is appropriate for working with this client group. EVIDENCE: A number of Criminal Records Bureau disclosures and written references was examined in relation to the most recently employed staff. The registered manager confirmed that she holds a training budget, and one of the unit managers said that he is responsible for co-ordinating staff training. A list of the training which has taken place in the last year was produced, with the names of the participants. This included training on epilepsy, first aid, moving and transferring, challenging behaviour, dementia, autism, medication and communication. A good percentage of the staff have now achieved NVQ level 2 or above, and two of the unit managers have NVQ level 4 in management. The NVQ programme is ongoing. A number of staff said that training opportunities with the organisation were very good. Rivendell D54-D07 S3790 Rivendell V224122 190705 Stage 4.doc Version 1.40 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, 39 and 42. There are satisfactory quality monitoring systems in place, and satisfactory arrangements for ensuring the residents’ health and safety. EVIDENCE: Quality monitoring includes constantly seeking the views of the residents. This is a constant daily process, and also takes place in a more focussed way at the time of care plan reviews. The mother of a resident said that she is always included in this review process, and that the staff keep her in the picture throughout the year. Residents attend a meeting each week about that week’s events. One of these meetings took place during the inspection, and it was clear that residents’ input is encouraged. The HFT assistant director makes regular quality assurance visits to the home, and monthly reports on the running of the home are now made by the service manager. In addition the HFT regional health and safety officer carries out an extensive annual health and safety audit. All staff receive training in first aid, moving and transferring, food hygiene and fire safety (although this last should be held more frequently). Senior staff have had four day first aid training. Upstairs Rivendell D54-D07 S3790 Rivendell V224122 190705 Stage 4.doc Version 1.40 Page 19 windows are restricted (some were inspected), and the temperature of hot water to baths is regulated. A few of the radiators on the premises have been covered on a risk assessment basis. The potential hazard posed by hot radiators should be kept under review. Rivendell D54-D07 S3790 Rivendell V224122 190705 Stage 4.doc Version 1.40 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 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 4 3 x 3 3 x Standard No 31 32 33 34 35 36 Score x x x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Rivendell Score 3 4 x x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 3 x D54-D07 S3790 Rivendell V224122 190705 Stage 4.doc Version 1.40 Page 21 No. 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 42 Regulation 18 Requirement Fire safety training must be provided to all staff at the frequency recommended by the Devon Fire and Rescue Service. Timescale for action 31/12/05 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 22 Good Practice Recommendations A central record should be kept of all complaints made with details of any investigation made, action taken and outcome. Rivendell D54-D07 S3790 Rivendell V224122 190705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Rivendell D54-D07 S3790 Rivendell V224122 190705 Stage 4.doc Version 1.40 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. 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