Inspection on 11/11/08 for Robinsfield

This inspection was carried out on 11th November 2008.

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

Robinsfield 19/11/07

Robinsfield 15/08/06

Robinsfield 23/01/06

Robinsfield 25/10/05

Robinsfield 31/08/04

Robinsfield 15/04/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Robinsfield Robinsfield 35 Whyteleafe Road Caterham Surrey CR3 5EJ     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: Ruth Burnham     Date: 1 1 1 1 2 0 0 8 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. the things that people have said are important to them: They reflect 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 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Robinsfield 35 Whyteleafe Road Robinsfield Caterham Surrey CR3 5EJ 01883330070 01737644959 chris.stringer@welmede.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Jacky Barker Type of registration: Number of places registered: Welmede Housing Association Ltd care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - LD Date of last inspection Brief description of the care home Robinsfield is a large property located in Caterham within walking distance of local shops and bus routes. The home is located on the ground floor of the property, with the first floor being occupied by tenants of supported living flats, run separately to the home. The main entrance to the property is shared with the supported living tenants and the laundry and staff sleep-in room is located in the entrance hall. The main door to the home is kept locked at all times to ensure the safety and security of the tenants. The home is owned and managed by Welmede Housing Association and provides Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 6 Brief description of the care home accommodation and care to six tenants who have a learning disability and also physical disabilities. The accommodation comprises of six single occupancy bedrooms, a large kitchen/diner, a comfortable lounge, two bathrooms and a shower room. There is a good range of adaptations and facilities fitted throughout the home to enable the home to meet the needs of the tenants. There is a well-kept garden to the rear of the property, shared with the supported living tenants, and parking for several cars to the front. The home has recently been provided with a new vehicle, which is used by tenants for various activities including days out. Tenants are picked up and dropped off by the transport of the various Day Centres they attend. The fees for the service range from 1.200 to 1.500 pounds per week according to individual need. Care Homes for Adults (18-65 years) Page 5 of 26 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 Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the care home was an unannounced Key Inspection. The inspector arrived at the service at 08.30 and was in the home for three hours and a half hours. It was a look at how well the home is doing. It took into account detailed information provided by the homes manager, and any information that CSCI has received about the service since the last inspection. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. Care Homes for Adults (18-65 years) Page 6 of 26 Documents sampled during the inspection included the care/person centred plans, daily records and risk assessments, medication procedures, staff recruitment folders, staff training records, and individual finance records. The home has submitted the Annual Quality Assurance Assessment (AQAA) prior to the inspection, some details of which have been added to the report. There have been no complaints about the service since the last inspection. From the evidence seen by the inspector and comments received, the inspector considers that the home is able to meet the needs of individuals who have diverse religious, racial or cultural needs. There are no Required Developments in this Report. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspector would like to thank the residents in the home and the staff for their time, assistance and hospitality during this inspection. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 26 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 9 of 26 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. The homes admission and assessment procedures ensure the needs of people who may consider moving into the home in the future will be appropriately identified and met. Evidence: There have been no admissions to the home since the last inspection. Clear admissions policies and procedures show how people who may consider moving into the home in the future will be assessed to ensure the service will be suitable for them and can meet their individual needs. The home has policies, which set out the steps to be followed when a new person moves into the home and also a policy providing guidance if anyone who currently lives in the home moves elsewhere. Care Homes for Adults (18-65 years) Page 10 of 26 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 who live in the home can be confident their individual needs are understood. They are encouraged and supported to make decisions about their lives and protected from harm through effective risk management systems. Evidence: People who live in the home can be confident their needs are understood through good person centred care planning and regular review. Three care plans were sampled. These are well written and detail individual care needs with clear guidance to help staff meet these needs in line with individual wishes and preferences. The care plans had been developed using a person centred approach involving each person in the process according to each persons understanding and abilities. All plans are reviewed every three months. Care plans include preferences about how people would like to be addressed, information about their relatives or advocate contact details, likes and dislikes and how each person communicates, personal histories and the support and assistance they need from the staff. Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: During the visit two people were seen before leaving for their day centres. One person chose to stay in and enjoy a relaxing day at home. Staff on duty during the visit know each person well and are clearly committed to promoting their welfare. Although people who live in the home have communication difficulties, good care planning and a stable staff team who know each person well means people are empowered to take as much control over their own lives as they are able. They are supported to make decisions about the activities of daily living through a variety of means tailored to individual communication skills. People who live in the home are protected from harm through effective risk management systems. Care plans include individual risk assessments providing staff with clear guidance when supporting people with their personal care, mobility, eating, using the wheelchair or hoists and for the use of bedrails. Care Homes for Adults (18-65 years) Page 12 of 26 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. People who live in the home have opportunities for personal development and are encouraged to take part in a wide range of activities. They are supported with local community activities and family and friendship links are encouraged. Evidence: People who live in the home are unable to take up employment however two people attend a local college and others attend a day centre. Certificates are displayed in one persons bedroom showing her life skills accomplishments. Community links are maintained. People are supported to visit local shops at the weekend to choose and purchase toiletries for their personal use and some household items such as milk or fruit. Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: People who live in the home benefit from the opportunity to take part in a variety of social and leisure activities. These include visits to the cinema, restaurants and bowling. Staff support people to choose holidays, photographs of these trips are displayed in their bedrooms and around the home. In house entertainment is also available including visits from The music man. Records show that trips to the pantomime have been booked during the coming holiday season. One person attends church regularly with their family. Family and friends are actively involved with the home. A number of people visit their families for regular breaks away from the home. The home promotes healthy eating taking account of individual choices and preferences. A good choice of fresh fruit and vegetables is available. The home can cater for special diets which included gluten free, healthy eating plan to reduce weight and a pureed food diet for one resident. The home has access to a dietician to help support people who require a special diet. Care Homes for Adults (18-65 years) Page 14 of 26 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. People who live in the home benefit from the commitment of staff and management to promoting their health and wellbeing in consultation with relevant health and social care professionals. Personal care is provided in such a way as to promote peoples privacy and dignity. People are protected from harm through safe systems for managing medication. Evidence: The person centred plan developed by the home clearly documents the ways in which people prefer to their personal care to be delivered. Staff understand and promote peoples privacy and dignity when providing personal care. Equipment is available in the home to help staff support the residents and this includes height adjustable beds and hoists. People can be confident their health will be monitored and action taken when necessary to consult with health care professionals. Four responses form healthcare professionals involved with the home were received as part of the inspection process. All responses were very positive and praised the home for their care and support of Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: the people who live there. Individual health action care plans clearly document each persons needs and include information on appointments to the optician, dentist and GP appointments. Everyone who lives in the home has a six month review with the GP, these reviews are all documented in peoples individual plans. People are protected through safe systems for handling medication. The medication cupboard is located in a safe place within the home and is locked to ensure security.The home has a clear medication policy and procedures; each per sons medication administration chart contains their photograph. Staff who handle medication receive appropriate training. The GP reviews everyones medication every six months. Care Homes for Adults (18-65 years) Page 16 of 26 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 who live in the home are listened to and encouraged to offer comment or complaint. They are protected from abuse. Evidence: The home has a clear complaints policy and this is available to all relatives or representatives. There have been no complaints about the service, the manager is aware of the need to maintain a log of complaints should any be received. People who live in the home are protected from abuse. There is a copy of the local authority multi agency procedures for safeguarding adults. There have been no safeguarding referrals under the safeguarding adults procedures. Records seen show that safeguarding training takes place for all staff at regular intervals. Staff have a clear understanding of what abuse was and how to report any incidents. People are protected from financial abuse through clear policies and procedures for managing their personal allowances. None of the people who live in the home are able to manage their own finances. The area manager was in the home during the visit to carry out an audit. Records are clear and receipts are kept of all transactions carried out on behalf of people who live in the home. Care Homes for Adults (18-65 years) Page 17 of 26 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 benefit from the clean, well designed, homely and safe environment. Evidence: People who live in the home benefit from the attractively furnished and decorated communal and private areas of the home. There is a large kitchen with ample room for a dining table in the centre where people can enjoy meals together. Adjacent to this is a spacious lounge looking out over the large and accessible rear garden. Each person has her own bedroom, these are attractively decorated, clean and comfortable. Staff said colour schemes are chosen in line with peoples personal taste. The home is well designed and equipped with aids for mobility to enable people to move freely around their home. The home has one communal bathroom, one shower room and a smaller bathroom for the personal use of one resident. A new assisted bath has been ordered for the communal bathroom so everyone will be able to access this bath in comfort and safety. The assisted shower room still needs updating to make it easier for staff to support Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: people more efficiently and eliminate the need for staff to wear waterproof clothing such as the Wellington boots which are stored there. It is strongly recommended that the shower room be refurbished for the comfort of the residents and the staff. Care Homes for Adults (18-65 years) Page 19 of 26 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 who live in the home benefit from the support of the committed and enthusiastic staff team. People are protected through robust recruitment and selection procedures. Evidence: During the visit there was one support worker and a senior on duty. Staff are well trained to meet peoples individual care needs and are knowledgeable about specific individual needs of individuals to ensure peoples safety and well-being is promoted. People are supported by a well trained staff team. The majority of staff have obtained relevant National Vocational Qualifications. The skill mix of the staff is taken account of when planning the rota. Responses to surveys sent to staff before the visit show staff are happy working in the home, are provided with a range of training opportunities and are well supported by the management to carry out their roles successfully. People are protected from harm through robust recruitment procedures. Two staff files were examined. Each contained all the necessary documentation including evidence that references are taken up and Criminal Record Bureau checks are carried out before appointment. Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: Welmede offers plenty of opportunities for staff to attend training sessions. Some discussion took place about the possibility of increasing opportunities for staff to access training on the specific mental health issues affecting people who live in the home. The home accommodates people with physical disabilities and manual handling training is provided specific to the individual needs of people who live in the home to ensure staff understand how to use equipment in the home safely. Induction training takes place for all new members of staff, this is documented and records kept in recruitment folders. The recruitment folders also show regular supervision sessions take place with the manager. These sessions also enable staff to identify training needs and this is also well documented. Care Homes for Adults (18-65 years) Page 21 of 26 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. People benefit from living in this well run home and can be confident their views are taken into account. People are protected through safe working practices, effective risk management and regular maintenance of equipment and installations. Evidence: During the course of the visit it was clear that the pace of the home is designed to meet the needs of the people who live there. The manager is knowledgeable and has the skills and experience to ensure the safety and well being of all who live and work in the home. The manager completed the Annual Quality Assurance Audit (AQAA) for the Commission prior to the inspection. This provided all the information we asked for. Observation and records sampled during the visit confirmed the contents of the AQAA and the effectiveness of the homes quality assurance systems. People who live in the home are protected through safe working practices. Staff are Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: trained in food hygiene, health and safety including infection control, moving and handling, first aid and fire safety. Refresher courses are arranged at appropriate intervals. The safety of equipment and installations is checked regularly. A fire safety check was conducted during the visit. Staff still use a communal towel although this practice has been risk assessed in respect of risk of cross infection. The recommendation previously made in regard to this matter has been repeated at the end of this report. Care Homes for Adults (18-65 years) Page 23 of 26 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 24 of 26 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 1 27 It is recommended that the shower room is refurbished so that staff no longer need to wear Wellington boots to shower residents and the room is made brighter for the enjoyment of the residents living at the home. It is recommended that the home consult with the appropriate environmental health authority to discuss the continued use of communal towels in some areas of the home to minimise risk of cross infection. 2 42 Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk 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 © (2008) 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 26 of 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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