Inspection on 21/06/05 for Riverswey

This inspection was carried out on 21st June 2005.

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

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

Other inspections for this house

Riverswey 16/01/07

Riverswey 07/12/05

Riverswey 24/01/05

Riverswey 03/08/04

Similar services:

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Insight - Eastchurch

Southfields

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

CARE HOME ADULTS 18-65 Riverswey Newark Lane Ripley Surrey GU23 6DL Lead Inspector Sandra Holland Announced 21 June 2005 10:00 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. Riverswey H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Riverswey Address Riverswey Newark Lane Ripley Surrey GU23 6DL 01483 224099 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) Care Solutions Limited Connaught House, 850 The Crescent, Colchester Business Park, Colchester, Essex, CO4 4YQ Ms Louise Irene Palmer Care Home (CRH) 3 Category(ies) of Learning disability (LD), 3 registration, with number of places Riverswey H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the persons to be accommodated will be under 65 years of age Date of last inspection 24 January 2005 Brief Description of the Service: Riverswey is a home accommodating up to three younger adults who have a learning disability. It is situated in a semi-rural position on the outskirts of Ripley village, a few miles from Guildford and Woking town centres. Care Solutions Limited, which is part of the Care UK company, operates the service and Hyde Housing Association own and maintain the building. The home is a single storey building set in level gardens with fields to the rear. The acommodation consists of two single bedrooms, a communal lounge, a spacious kitchen/dining room and a bathroom. Incorporated within the house is a single, self-contained flat. This enables a service user to have supported independence. An office which is also used as a sleepover room for staff and a small laundry room are provided. The home has a car to transport service users and staff as there is no public transport immediately accessible. Riverswey H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was the first to be carried out in the Commission for Social Care Inspection year April 2005 to March 2006. The inspection was carried out by Mrs. Sandra Holland, Lead Inspector for the service and took place over five and three quarter hours. Ms. Louise Palmer, registered manager was present representing the service. A number of records and documents, including care plans and staff files were examined and a tour of the home took place. Both service users and three members of staff were spoken with. The inspector thanks the service users and staff for their hospitality, time and assistance. What the service does well: What has improved since the last inspection? What they could do better: A complaints procedure is available in the home but it is not suited to the specific needs of the service users as it is only available in written or diagram format. Riverswey H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 Page 6 A review of the quality of the service provided by the home, to include the views of service users, their representatives and other people in the community who have contact with the home, has not been carried out. 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. Riverswey H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Riverswey H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3, 4 and 5. Prospective service users are fully assessed and given the opportunity to visit the home before moving in. EVIDENCE: The manager advised that a new service user would be moving into the home a few days after the inspection and that she had visited her at her present home to assess her needs. A comprehensive needs assessment has also been carried out by the care management team. An advocate has supported the prospective service user during the stages of her move. The new service user had visited her prospective new home to meet the service users living there and to have lunch. A service user mentioned that she had known the prospective newcomer for some years and was looking forward to her moving in. Members of staff advised that they had prepared the service users for the new arrival, by having individual discussions with them and notes about these meetings were seen. Both service users told of the new home present they would be giving to the new member of the household to welcome her. Each service user now has a contract/statement of terms and conditions of residence. These were seen and it was noted that one service user’s contract did not have the signature page present. For one service user who was not Riverswey H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 Page 9 able to sign, staff had signed the contract and written on it that the contents had been explained to the person concerned. A recommendation has been made – please see page 25. Riverswey H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9. A comprehensive individual plan is drawn up for each service user. Risks to the service users are assessed. EVIDENCE: Each service user has a detailed individual plan, which is based on “person centred planning”. This informs the staff and others involved, of the support needs of each individual. Support given is also recorded in the plan, along with changes to needs or goals. Both of the service users permitted their individual plans to be seen. The plans are reviewed each month by the service user’s key-worker, with the involvement of the service user. Both service users had signed their plans to show their involvement. It was clear from the individual plans that staff support service users to make decisions, such as handling their own finances, taking part in activities and work. Risks to the health or welfare of service users are identified and assessed, in order that the level of any risk can be minimised. A number of risk assessments were seen and although they had been recently updated, many Riverswey H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 Page 11 had not been signed. Provision was made for all staff to sign some risk assessments to show their awareness, but this had not been completed. some identified risks, an assessment has not been drawn up. A requirement has been made – please see page 25. For Riverswey H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 16 and 17. Staff provide support to service users to develop their skills and to lead active and fulfilled lives. EVIDENCE: Service users were seen being supported to carry out household tasks, including making refreshments, looking after the home’s pets and tidying the lounge. One service user lives in the self-contained flat within the home and he advised that he is supported to be as independent as possible. He was pleased to show his purchases from a shopping trip on the day of inspection. The service users talked enthusiastically about the variety of classes and activities they attend and one of the service users told of working at a local restaurant for short periods at the weekend. Staff advised that service users enjoy their holidays away from the home and one service user had recently returned from a holiday with two members of staff. He was very complimentary about the support he received on holiday. Riverswey H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 Page 13 The manager advised that service user’s are encouraged and supported to be independent and make choices in as many aspects of their lives as possible. Both service users are addressed by their preferred name. Service users said they are encouraged to be involved in and to assist with the household food shopping and meal preparation. Riverswey H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 Page 14 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. Service users are supported in the way they prefer and their healthcare needs are well met. EVIDENCE: It was clear from observing the staff and service users together that the support provided by staff, is given in a manner that promotes independence, privacy and dignity. Staff were seen to have a relaxed, informal, but appropriate approach towards the service users. A number of healthcare professionals are involved in the support of the service users, including general practitioners (G.P.’s), speech and language therapists, opticians, dentists and hospital specialists. Letters and referrals to and from various healthcare professionals were seen in service user plans. Staff confirmed that service users go out to some appointments and healthcare professionals also visit the home. Riverswey H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 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. A complaints procedure is in place. Staff are aware of their role in the protection of service users. EVIDENCE: The complaints procedure that is available was seen to be in a written or diagram format. The manager explained that the home is considering obtaining an audio version of the procedure for ease of use by service users. Discussion took place about the use of a pictorial format. The inspector advised that until a suitable format was obtained, staff should explain the procedure to service users and document this in their individual plans. Service users who are able should sign to show that the explanation took place. To protect service users, the manager advised that the home follows the Surrey Multi-Agency Protection Of Vulnerable Adults (POVA) procedure. Some staff have attended the associated training this year and others have attended on previous occasions. Staff members stated that they were aware of the actions to take if they had any concerns about service users and would not hesitate to raise them. The staff members spoken to advised that there is an open atmosphere in the home and they feel able to speak out if necessary. Guidelines are in place to assist staff to manage a variety of behaviours. Service users are encouraged to be involved in managing their own finances. Safeguards, such as the checking of service user monies held for safekeeping are in place. These records were checked during the inspection and were correct. A requirement has been made – please see page 25. Riverswey H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 Page 16 Riverswey H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 Page 17 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, 25, 26, 27, 28, and 30. The overall décor and furnishings in the home provide a well-cared for and homely environment for the service users. EVIDENCE: The home is family sized and is attractively decorated, cheerful, bright and airy. All areas were well presented, clean and hygienic. The communal lounge is comfortably furnished and a large bird-cage houses the service user’s pet parakeets. The day of inspection was hot and sunny and the service users were able to enjoy the garden, with patio tables and chairs and parasols providing shade. Seasonal flowers, plants and tomatoes had been planted and service users were seen being supported to tend these. Both service users were happy to show their accommodation. One service user has a single bedroom, decorated in her choice of colour scheme, she advised and another service user has a self-contained one-bedroom flat within the house. Each individual had made their room(s) personal with their own belongings, including pictures, ornaments, televisions and music facilities. Riverswey H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 Page 18 Service users hold keys to their accommodation and staff were seen to knock before entering. There are two bathrooms in the house, one in the self-contained flat. The general bathroom is fitted with a separate shower and bath. Riverswey H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 Page 19 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) 33, 35 and 36. Service users are supported by an effective and stable staff team. EVIDENCE: The staff team is made up of the manager, deputy manager and a small team of support workers. The staff advised that they all share the roles within the house. They provide support with personal care and household tasks, in addition to accompanying or transporting service users to classes and leisure activities. The manager advised that staffing levels are regularly reviewed to reflect the needs of the service users and may be increased to accommodate the needs of the new service user. There is a balanced mix of genders amongst the staff team. Staff advised that to ensure consistency of support to service users, most vacant shifts are covered by the home’s staff. Having looked at the staff rota, a discussion took place between the manager and inspector, about the high number of hours a member of staff was working. The manager advised that staff have signed the Working Time Directive disclaimer to show that if they work more than forty-eight hours per week, they are doing so voluntarily. The manager was advised to monitor the hours that individual staff members work, Riverswey H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 Page 20 as continuously working a high number of hours may affect safety and performance. The majority of the staff are undertaking National Vocational Qualification (NVQ) courses and the home is likely to reach the target of 50 trained staff by the end of 2005. Riverswey H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 Page 21 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 and 38. Standard 39 is commented on although not fully assessed. The home is managed in an open and inclusive way and service users and staff made positive comments about the manager. EVIDENCE: The manager has worked at the home for a number of years and has developed a stable staff team. Records seen show that most of the staff have been employed at the home for at least two years and some for many more, providing the service users with stability and continuity. The manager advised that she is undertaking the NVQ in care Level 4 and the Registered Manager’s Award and is aiming to complete both by the end of 2005. Informal but appropriate interaction between the service users, staff and manager was observed. Riverswey H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 Page 22 It was pleasing to read an unsolicited letter from a hospital specialist, praising the staff team for their person centred approach and commitment. A service user comment card from CSCI was issued to each service user prior to the inspection. These were completed and contained positive comments about the service received. Riverswey H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 3 2 Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score 3 x 3 x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Riverswey Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x x x H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 Page 24 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 9 Regulation 13 (4) (c) Requirement The registered person shall ensure that unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. Specifically, risk assessments must be drawn up for identified risks, be fully completed and signed by staff as appropriate. The registered person shall establish a complaints procedure that must be appropriate to the needs of service users. Timescale for action 22nd July 2005 2. 22 22 23rd September 2005 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 5 Good Practice Recommendations It is good practice to obtain and retain a service users signature on their contract/statement of terms and conditions of residence. Riverswey H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Riverswey H58 S13765 Riversway V221973 210605 Stage 4.doc Version 1.30 Page 26 - 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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