CARE HOME ADULTS 18-65 Robinson House 24c Fordham Road, Soham Ely Cambridgeshire CB7 5AQ
Lead Inspector Alan Buttery Unannounced 18 April 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. Robinson House Version 1.10 Page 3 SERVICE INFORMATION
Name of service Robinson House Address 24c Fordham Road, Soham, Ely, Cambridgeshire, CB7 5AQ, 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) 01353 624330 01353 723599 Conquest Care Homes (Soham) Ltd to be appointed Care Home 10 Category(ies) of Learning Disability registration, with number of places Robinson House Version 1.10 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 24th January 2005 Brief Description of the Service: Robinson House is a purpose built home for 10 adults with learning disabilities, and is in the small Cambridgeshire town of Soham. Within the local community, there are a number of shops, pubs, restaurants and other leisure facilities, and the home makes full use of these as well as the facilities in the nearby larger towns of Newmarket, Ely and Cambridge. Robinson House Version 1.10 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced visit, and the first inspection of the current year. Since the last inspection, a new manager has been appointed, and the inspection took place on her first day. It was therefore agreed that the inspection would concentrate on issues outstanding from the last inspection and that the next inspection, in August 2005 would be an announced visit. The allocated inspector was accompanied By Cathryn Bramham, Regulation manager, and started at 12.30 lasting about two hours. Some of the service users were in the home, but a number were at various day services they attend. What the service does well: What has improved since the last inspection?
In light of the appointment of the new manager, it is unfair to look in detail at what has improved, but this will be considered at the next inspection However, it should be noted that concerns around the standard of food, and very few permanent staff team have now been addressed. Since the last inspection the home have recruited a number of new staff, and some have already started, which should lead to a more stable team and benefit the service users.
Robinson House Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Robinson House Version 1.10 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 Robinson House Version 1.10 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) 1, 2 and 3 Service users living in the home are encouraged to make choices, and detailed assessments have been undertaken to ensure the home is able to meet their needs. EVIDENCE: Since the last inspection, the homes Statement of Purpose and service user guide have been re-written to reflect the changes made to the service, but will require further updating when the manager’s application for registration with the CSCI is processed. At the time of the inspection, the reviews of Care plans had not been recorded in the home, and although it is understood that some work on the care plans has been done, no evidence of this was available. However, the local Learning disability partnership, who have placed most of the service users in the home have completed reviews of all the service users living in Robinson House, and this will give the home the opportunity to reassess the needs of all the service users to make sure they are meeting the needs that have been identified. Robinson House Version 1.10 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, Service users are encouraged to make choices, but more detailed care planning is required to ensure these choices are followed through. EVIDENCE: As discussed above, some care plan reviews have apparently been done, although no evidence of this was available, and the local Learning disability team have reviewed all the service users assessments. Further work is needed to make sure that the service users are involved in the care planning, and the home must demonstrate how this is achieved, and how the service users are offered choice. Robinson House Version 1.10 Page 10 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) None These standards were not assessed on this occasion EVIDENCE: These standards and outcomes were not considered on this occasion, but will be looked at in detail when the next inspection takes place, in August this year Robinson House Version 1.10 Page 11 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) None These standards were not assessed on this occasion. EVIDENCE: Again, these standards were not looked at in a detail on this visit, and will be considered in detail later. Robinson House Version 1.10 Page 12 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 Service users do not have sufficient information to support them in making their views known, however once the new staff team are all in place, and have received training, this can be dealt with. EVIDENCE: The homes complaints policy continues to show incorrect information, and does not meet the standards. This is again a requirement that will be carried forward and must be addressed. All the new staff will need suitable adult protection training to ensure that they are familiar with the local authority policies Robinson House Version 1.10 Page 13 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 in need of refurbishment and decoration started must be completed to provide a more comfortable environment for the service users. EVIDENCE: A number of environmental issues remain outstanding from previous inspections, and an action plan detailing how and when the changes are being made must be sent to the CSCI. There is evidence in the home that redecoration has started, but there appears to have been little change since the last inspection in January 2005. The home was however clean and free from any offensive odours on the day of the inspection. Robinson House Version 1.10 Page 14 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) 32, 33, 34, 35 and 36 A new staff team has been recruited, and with suitable training and supervision, should meet the needs of the service users. EVIDENCE: It was clear in discussions with the new manager that the company have recognised the staffing issues in the home, and a number of new staff have been recruited, or are about to start. The recruitment process is detailed and ensures new staff are suitable for the job they will be doing, and that the service users are not put at risk. The new staff will need a detailed training programme, and a copy of this should be sent to the CSCI as soon as possible. Supervision has not been taking place on a regular basis, and the new manager must ensure that this is now happening. Robinson House Version 1.10 Page 15 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) 41 and 43 The home has a new manager, and working with the responsible individual, the CSCI and the local authority, the home should be able to address the long term issues in the home. EVIDENCE: Since the last inspection, a new manager has been appointed, and an application to register her with the CSCI must be submitted. The responsible individual must ensure that in the future all significant events are notified to the CSCI, and that regular monthly visits take place in accordance with the regulations. A development plan must be provided to the CSCI, which shows the future plans and financial viability of the home. Robinson House Version 1.10 Page 16 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 x x Standard No 22 23
ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 1 x x x x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 1 x x x x x 3 Standard No 11 12 13 14 15
Robinson House x x x x x Standard No 31 32 33 34 35 36 Score x 2 2 3 2 1 Version 1.10 Page 17 16 17 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x x x Standard No 37 38 39 40 41 42 43 Score x x x x 2 x 1 Robinson House Version 1.10 Page 18 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 YA6 Regulation 15(1), 15(2) Requirement Carried forward as timescale of 31.03.05 not met. The care plans must be updated and reviewed and demonstrate consultation with the service users or their representatives Carried forward as timescale of 31.03.05 not met. The homes complaints policy must include up to date contact details for the CSCI Carried forward as timescale of 31.03.05 not met. A programme of maintainance and refurbishment must be established to bring the home up to an acceptable standard, and a copy of the programme forwarded to the CSCI Carried forward as immedaite implementation timescale not met. A programme of supervision must be introduced to ensure staff receive appropriate supervision in accodance with the regulations. Carried forward as timescale of 31.03.05 not met. The registered person must submit to the CSCI evidence of
Version 1.10 Timescale for action 31/07/05 2. YA22 22(7) 31/07/05 3. YA24 23 31/07/05 4. YA36 18(2) 30/06/05 5. YA43 25(1)(2), 30/06/05 Robinson House Page 19 6. YA43 26, 37, 39(a),(b), (c),(d) the continued financial viability of the home, including annual accounts and a business development plan, Carried forward as original timescale of 31.03.05 not met. The registered person must ensure that the CSCI are notified of all significant events, and the monthly management report sent to the CSCI in accirdance with the regulations. 30/06/05 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 YA32 Good Practice Recommendations A training plan should be submitted to the CSCI with details of the training arranged for all the staff team. Robinson House Version 1.10 Page 20 Commission for Social Care Inspection CPC1, Capital Park Fulbourn Cambridge CB1 5XE 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 Robinson House Version 1.10 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
