Inspection on 22/02/06 for RNID

This inspection was carried out on 22nd February 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

RNID 02/12/08

RNID 20/02/07

RNID 20/09/05

RNID 27/01/05

RNID 09/09/04

Similar services:

Foxley Lane (121a)

Avenues (The) (Neave Crescent)

Banstead Road South (21)

Rela Goldhill Lodge

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

CARE HOME ADULTS 18-65 RNID 113 Brondesbury Road Kilburn London NW6 6RY Lead Inspector Monica Saunders Unannounced Inspection 22nd February 2006 09:45 RNID DS0000017431.V284337.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address RNID DS0000017431.V284337.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. RNID DS0000017431.V284337.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service RNID Address 113 Brondesbury Road Kilburn London NW6 6RY 020 7328 8540 020 8372 8965 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) RNID Anthonia Adamma Oguh Care Home 6 Category(ies) of Sensory impairment (6) registration, with number of places RNID DS0000017431.V284337.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users will be male only. Date of last inspection 20th September 2005 Brief Description of the Service: 113 Brondesbury Road is care home run by the RNID and provides support and accommodation for 6 residents who are hearing impaired, some with additional sensory impairments. The staff are also trained to support additional needs that include visual impairment, mental health issues, mild physical disabilities and learning disabilities. The house is located in Kilburn and is close to local shops, tube and bus routes. The house is a modernised semi detached property in a quiet residential area. The accommodation is on three floors with the communal rooms being on the ground floor. There is no wheelchair access. There are 6 single rooms with bathroom and toilet facilities on each floor. There is a small well kept garden to the rear of the house with a patio area and barbecue for the residents use. RNID DS0000017431.V284337.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over two days. On the first day the inspector was accompanied by an interpreter to provide “hands on” and signing to assist in communicating with the residents. Two of the residents were able to talk to the inspector through the interpreter. Information was obtained from them about their experiences of living in the home. There were 4 residents, three staff and the manager at the home on the day of the inspection. Information was obtained by examining staff records, care records, policies and procedures and from talking to the Manager and staff. A partial tour of the premises took place. The second day’s inspection was carried out by the CSCI Pharmacy inspector who looked at the home’s medication systems. The Inspector’s would like to thank the residents, staff and manager for their time during the inspection. What the service does well: What has improved since the last inspection? Many of the issues raised in 2005 relating to the homes medication systems had been addressed. The home has obtained filled weekly dosette boxes from the supplying pharmacist and recording of medication received into the home and the handling and reporting of medication errors has improved. The home has completed two of the requirements from the last inspection. RNID DS0000017431.V284337.R01.S.doc Version 5.1 Page 6 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. RNID DS0000017431.V284337.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection RNID DS0000017431.V284337.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not assessed EVIDENCE: RNID DS0000017431.V284337.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 9 The residents assessed needs and goals were recorded in their care plan. Potential risks were identified and appropriate support given by staff to manage these. This enables the residents to be as independent as possible. EVIDENCE: The inspector discussed through the BSL interpreter with one resident his understanding of any changes to his care plan. The resident stated,” the plan is for me to move into my own flat around March/April”. Two care plan files were sampled. Risk assessments were seen to be done as part of the care planning and covered a wide range of activities for the resident. The form used for the risk assessment did not show how the risk level had been arrived at. Following the inspection a copy of the updated format was sent to the CSCI. Risk assessments should be reviewed on their due date. This is to ensure that the information in them is current and that no other actions need to be taken by staff. Decisions from reviews and monthly summaries were viewed. Key worker session recordings were irregular, dates noted December 2005 & February 2006. The resident’s information is held in individual box files, but papers had not been filed making it difficult to case track consistently. It is strongly recommended that the key workers review the care files and create a working RNID DS0000017431.V284337.R01.S.doc Version 5.1 Page 10 care plan folder where only current or ongoing information is kept such as recent reviews, care plan, risk assessments, current medical/ health care information, health care records, recent monthly summaries etc. There was evidence in the files that the residents are registered to vote. Two residents were spoken to through the BSL interpreter who said, “I can talk to staff using signing” RNID DS0000017431.V284337.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,16,17 Residents receive a healthy diet of foods that are to their liking and choice. Residents are supported to participate in and choose from a range of activities in the local community. EVIDENCE: The inspector was informed that residents help to decide what would be on the menus and could go to the local supermarket with staff to buy the food. Fresh produce was used as much as possible. The menu was on display and indicated that breakfast, lunch and supper were light meals with the main meal being served during the evening. Residents spoken to through the BSL interpreter said that the food was very good and that they enjoyed their meals. One resident said they could have something different. “I am allowed to choose what I want”. Another said “Good food. Yes I have a choice in deciding what I eat. There is normally a choice of two meals on the menu”. The kitchen was clean, tidy and well equipped. There was a good supply of food, including fresh produce. Records of temperatures of the fridge and freezer were seen. RNID DS0000017431.V284337.R01.S.doc Version 5.1 Page 12 Both resident’s indicated through the interpreter that they participated in various activities within the community and are supported to do so by staff if necessary. They commented on their activities as follows: “I go to the theatre. Tomorrow I am going in the car to eat out at Redbridge”. “I have been to France, on a boat, to Wales, Scotland, on a coach. “I brought new clothes to go to Spain, I looked around it was really lovely” “I am not expecting to go on holiday this year as I am expecting to move”. “I don’t attend any day centres. I just go to have a chat with my friend who is a hairdresser”. “I normally watch TV. I’ve just brought on for £89”. “I attend a deaf club in Willesden once per month”. “I am going camping in Farnham in July 06. I’ve been to America and Wales with staff and I have pictures”. The residents shared his holiday pictures with the inspector and the BSL interpreter. Examination of the resident’s activities timetable differed with activity records on individual case files. The timetable on display showed for one resident that on Wednesdays he was doing shopping/relaxing, cleaning and tidying his bedroom. The individual records showed gym and swimming. The home should ensure that activity records are updated on individual files to reflect actual activities carried out . RNID DS0000017431.V284337.R01.S.doc Version 5.1 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 the following standard(s): 18, 19, 20 Daily routines met the needs of residents. Resident’s personal and healthcare needs are identified and delivered in a sensitive manner EVIDENCE: The routines of daily living were flexible and resident led. Through the BSL interpreter residents commented. “I do not need to have a bath every day”. “I do not need help to have a shower every day”. The care plans examined identified the resident’s personal care needs. Observations were made during the inspection of staff supporting residents with personal care in a respectful manner. Residents were allowed to make decisions about their choice of clothes as well as hairstyles. The resident’s haircuts are obviously done to their own taste and style when they attended their visits to the barbers. One resident said through the interpreter “I have my hair cut at a barber/hairdressing shop once a month. I let staff know when I want to go, and they take me”. The resident further commented “I buy my own clothes with my money. I go to the bank every Friday, and choose what I want to buy”. The other resident said, “I decide what I want to wear in the mornings. When I go shopping with staff I decide where I buy my clothes. I like Arsenal clothes”. The healthcare needs of the residents were identified and documented in the RNID DS0000017431.V284337.R01.S.doc Version 5.1 Page 14 care plan. There were good links with other professionals. Health checks are carried out through the GP, and residents also had regular appointments with local opticians; chiropodist; and dentists. Through the BSL interpreter one of the residents said he is able to administer his own medication and is monitored by staff. Staff said this is an area being worked on to assist him in achieving greater independence to managing his own medication when he moves to the community. The CSCI pharmacist inspector carried out an inspection of the home’s medication systems and practices. Medications were stored securely. All staff were awaiting medicines management training. Records generally showed medication was administered safely. The home’s policies and procedures were awaiting an update. A separate report was sent to the home and the requirements and recommendations made are in the requirements section of this report. RNID DS0000017431.V284337.R01.S.doc Version 5.1 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 the following standard(s): 22, 23 Resident’s are aware of the homes complaints procedure. Resident’s are protected from abuse through the homes’ policy and procedure for staff. EVIDENCE: The inspector viewed the homes complaint procedure and records indicated the home has not had any complaints since the last inspection. Through the BSL interpreter one of the residents complained he has waited for five years for his own accommodation. He said he has been advised that he needs to look through the locator magazine for a suitable property to make a bid. The home should offer more support to ensure that the resident is able to access a copy of the magazine to put forward his bid. A member of staff spoken to said they would inform the manager if they suspected any form of abuse, and is aware of the homes whistle-blowing and POVA procedures . RNID DS0000017431.V284337.R01.S.doc Version 5.1 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 the following standard(s): 24,28 Resident’s bedrooms suit their individual lifestyles. The home is clean and hygienic. The resident’s bedrooms were not heated at the time of the inspection. EVIDENCE: There was a range of equipment to assist the residents with their communication needs. These included a flashing light ‘alarm’ system for fire and front door and a buzzer entry system to the front door. Equipment is serviced on a regular basis. Resident’s bedrooms are individually furnished. One resident showed the inspector and the interpreter his bedroom and said, “I chose the colour blue”. “I can lock my door for my own privacy”. Another resident said through the interpreter he also chose the colour blue for his room and has a key to his bedroom and said. “I always keep my door locked”. Lounge had been stripped in preparation for redecoration, which was planned to take place in June when the residents go on holiday. The manager said the housing association were not in agreement to carry out any redecorations to the property and that staff had agreed to decorate the lounge during the residents holidays. Washable flooring in the dinning room has not replaced the RNID DS0000017431.V284337.R01.S.doc Version 5.1 Page 17 carpeted area. Folowing the inspection the manager informed CSCI that the carpet was to be replaced in June. The heating to the home is controlled by two separate boilers. On the day of the inspection the heating on the ground floor was adequate, the radiators to the bedrooms upstairs were cold causing the bedrooms and upper hallway temperature to feel cold. This was brought to the attention of the manager who said she had not been aware of this, and immediately requested staff assistance in dealing with the heating. RNID DS0000017431.V284337.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33,36 The numbers and skill mix of day staff on duty were sufficient to meet resident’s needs although the homes sleeping in arrangements should be reviewed to safeguard the residents from harm. Staff receive appropriate training to enable them to undertake their duties with competence. EVIDENCE: The duty rota was examined and found to be consistent with the staff complement in duty. There was a minimum of 1 manager and 2 members of staff on duty during the day, two staff during the evening and weekends and a ‘sleep-in’ duty during the night. The sleep-in room is situated on the ground floor. Discussions with the manager indicate that the sleep-in person would not be aware of any issues arising upstairs during the night unless another resident alerted staff. The home must review sleep-in arrangements to ensure residents are safeguarded during the night. No new members of staff had been recruited since the previous inspection. Two staff files were sampled; one for a long standing member of staff and one for the newest staff member and were found to be in order. Each member of staff had an individual training file that recorded the training undertaken and on what date. Full CRB’ s were in place and an induction checklist seen. Supervision records were not assesed on this occasion. RNID DS0000017431.V284337.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 42 The manager had appropriate experience and qualifications to ensure that the home was well managed. EVIDENCE: EVIDENCE: The registered manager keeps herself up to date by attending training courses and by attending a Manager’s Forum twice a year. There was an operational plan for the home that indicated what issues would be developed over the next 12 months. The plan was linked to improving outcomes for residents and included: local learning opportunities; leisure activities and residents meetings. There were two items outstanding from the last inspection relating to health and safety issues. Premises risk assessments must be carried out The manager is advised to discuss the progress on the action plan from the health and safety audit carried out in February 2005 with the service manager at his next visit RNID DS0000017431.V284337.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 2 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X X X X 2 X RNID DS0000017431.V284337.R01.S.doc Version 5.1 Page 21 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 2 Standard YA6 YA20 Regulation 17 13.2 Requirement The manager must ensure that key workers keep their key worker sessions up to date The medication policy needs to include a homely remedies policy. This must be agreed and signed by the GP. (Previous timescale of 31/10/05 not met The manager must ensure that the contract with the local pharmacist is renewed (Previous timescale of 31/10/05 not met) The medicines policy must be further expanded to include: • Information on how medicines are managed away from the home • How medication errors are handled and reported • Information on how staff are to risk assess residents who may wish to fully or partially self medicate. All medicines must be accurately recorded when administered. If not administered the correct endorsements must be used DS0000017431.V284337.R01.S.doc Timescale for action 30/04/06 01/05/06 3. YA20 13 01/05/06 4. YA20 13.2 01/05/06 5. YA20 13.2 24/02/06 RNID Version 5.1 Page 22 6 7. 8 YA24 YA28 YA28 23(2)(p) 23 23 9 YA33 18 10. YA42 23 The manager must ensure that the home is adequately heated in all areas The lounge must be redecorated (Previous timescale of 31/10/05 not met) The dining room carpet must be replaced with more appropriate washable flooring (Previous timescale of 31/10/05 not met The home must review sleep-in arrangements to ensure residents are safeguarded during the night Premises risk assessments must be carried out (previous timescaleS of 31/3/05 & 30/11/05 not met 30/04/06 30/06/06 30/06/06 30/04/06 31/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations It is strongly recommended that the key workers review the care files and create a working care plan folder where only current or ongoing information is kept such as recent reviews, care plan, risk assessments, current medical/ health care information, health care records, recent monthly summaries etc. The home should ensure that activity records are updated on individual files to reflect actual activities carried out. The pharmacist should be requested to label the actual container in addition to the outer packaging The manager should request from the GP that all service users are on the same monthly cycle DS0000017431.V284337.R01.S.doc Version 5.1 Page 23 2. 3. 4. YA12 YA20 YA20 RNID 5. 6. 7. 8. YA20 YA22 YA35 YA42 That the home should check the prescriptions before sending to the pharmacist for dispensing The home should ensure that the resident who wanted a specific publication is supported to access a copy of the magazine to put forward his bid for housing. It is recommended that training on understanding learning disability and challenging behaviour be included in the staff training programme (outstanding form last inspection) The manager is advised to discuss the progress on the action plan from the health and safety audit carried out in February 2005 with the service manager at his next visit. (Outstanding from January 2005) RNID DS0000017431.V284337.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 RNID DS0000017431.V284337.R01.S.doc Version 5.1 Page 25 - 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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