Inspection on 09/08/05 for Robinson House

This inspection was carried out on 9th August 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

Robinson House 01/11/07

Robinson House 02/08/06

Robinson House 18/04/05

Robinson House 24/01/05

Robinson House 04/08/04

Robinson House 31/03/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Robinson House 24c Fordham Road Soham, Ely Cambridgeshire CB7 5AQ Lead Inspector Alan Buttery Announced 9th August 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 I53 I03 s15104 ROBINSON HOUSE v233301 090805 STAGE 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Robinson House Address 24c, Fordham Road, Soham, Ely, Cambridgeshire, CB7 5AQ 01353 624330 01353 723599 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) Conquest Care Homes (Soham) Limited To be appointed Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Robinson House I53 I03 s15104 ROBINSON HOUSE v233301 090805 STAGE 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 18th April 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 I53 I03 s15104 ROBINSON HOUSE v233301 090805 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 undertaken by 2 inspectors and lasted from 10.00 until 13.00. During this inspection the requirements that featured on the previous inspection report were assessed. It was of concern to note that four of the requirement had not been met. During the inspection 4 service users and 5 members of staff were spoken to. Documentation was read and a tour of the building and the garden was undertaken. Questionnaires were sent to relatives and service users as part of this inspection and 6 completed questionnaires were returned from relatives and 3 from service users. Responses were mostly positive. One relative stated that “there seems to be a much happier at Robinson House under the new manager… who is very supportive and enthusiastic. What the service does well: What has improved since the last inspection? What they could do better: Areas of the home still require refurbishment and there are outstanding maintenance issues. A programme of maintenance and refurbishment must be submitted to the Commission for Social Care Inspection. A formal system of supervision, ensuring that all staff receive supervision at least six times a year must begin and accurate records of monies held on behalf of service users Robinson House I53 I03 s15104 ROBINSON HOUSE v233301 090805 STAGE 4.doc Version 1.30 Page 6 must be kept. The care planning system is currently being reviewed and at the time of this inspection five care plans had been written using the new format. The remaining care plans must be reviewed and all of the care plans must be working documents by 31 October 2005. 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. Robinson House I53 I03 s15104 ROBINSON HOUSE v233301 090805 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 Robinson House I53 I03 s15104 ROBINSON HOUSE v233301 090805 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) 1,5 The Service User Guide needs revising to include all of the required information to ensure that service users and their representatives are provided with full details about the home and a statement of terms and conditions detailing the services must also be provided. EVIDENCE: The home has a satisfactory Statement of Purpose which includes all of the required information. All service users have received a copy of the Service User Guide but the document seen did not include a copy of the complaints procedure. Since the last inspection there have been no changes to the service users in the home. A policy is in place to detail the arrangements for any new admission, which includes detailed pre admission visits and assessments, and this would be used in the event of any future changes. The inspectors did not ask to see this policy. Two service user files were inspected and they did not contain a contract/statement of terms and conditions between the home and the service user. Robinson House I53 I03 s15104 ROBINSON HOUSE v233301 090805 STAGE 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 Service users are encouraged to make choices but more detailed care planning is required to ensure that these choices are followed through. EVIDENCE: At the time of this inspection the care planning format was being reviewed and care plans using the new format had been written for five of the service users. These care plans are comprehensive and will provide staff with guidance about how to meet service users needs but are not yet operational. The current care plans do not include all of the information required by the standards and it was disappointing to note that the new care plans have not been implemented even though two dates set by the Commission for Social Care Inspection for the care plans to be updated has passed. None of the service users in the home manage their financial affairs. Two service users’ personal monies were seen with records of transactions and balances. In both cases there were inaccuracies between the monies counted and the recorded balance. Service users living in the home are supported as far as possible in making informed choices about their lives. The manager stated that the new care Robinson House I53 I03 s15104 ROBINSON HOUSE v233301 090805 STAGE 4.doc Version 1.30 Page 10 planning format will provide comprehensive information about choices made by service users. The home has policies and procedures in relation to the assessment of risk and during this inspection the risk assessments seen were satisfactory. Robinson House I53 I03 s15104 ROBINSON HOUSE v233301 090805 STAGE 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14, 15,16,17. Service users are offered a range of opportunities for personal development and leisure activities to ensure that their needs and aspirations are met. EVIDENCE: Service users in the home are encouraged to take part in a variety of appropriate activities including local resources and including in some cases specific day services. The majority of service users attend either Larkfields Day Centre of the Ida Darwin Workshops during the week and three of the service users have their day activities coordinated by staff in the home. During the evenings and weekends service users have a choice of pursuing activities either within or outside of the home. The manager stated that activities available within the home include gardening, board games, and cooking. Service users who chose to spend time outside the home during the evenings and weekends enjoy bowling, visiting pubs and restaurants, using the local shops, going to seaside resorts and the ‘Funky Flamingo’ event which is held at the ‘Junction’ in Cambridge. Robinson House I53 I03 s15104 ROBINSON HOUSE v233301 090805 STAGE 4.doc Version 1.30 Page 12 All service users have the opportunity to have a annual holiday and destinations visited this year include Hastings, Yarmouth and Hunstanton. Family and friends of service users are welcome to visit the home at any time and visitors may be entertained in either the service users bedroom or the communal areas of the home. The home operates a four weekly rotating menu and service users likes and dislikes are taken into account when planning the menu. Menus have recently been revised and service users discussed with staff the food that they wished to be available in the home. Alternatives to the menu are provided and service users who require special diets are also catered for. Fresh fruit is available and service users are able to access the kitchen with support from staff where necessary. Staff with the assistance of service users prepare the meals and all staff who handle food have received training in Basic Food Hygiene. The menus were inspected and were satisfactory. Robinson House I53 I03 s15104 ROBINSON HOUSE v233301 090805 STAGE 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 Systems are in place to ensure that the healthcare needs of service users are met. EVIDENCE: The new care plans being implemented in the home at the time of this inspection provide comprehensive details of the health care needs of the service users and how these needs are met. Service users are registered with a local GP practice and are also supported by health care professionals such as a Diabetic nurse, District Nurse and Speech and Language Therapists. The manager stated that the home has an excellent relationship with the GP’s. Staff are assisted in their roles by the training provided in health related matters specific to service users in the home. Medication training is provided to all staff who administer medication. The home uses a monitored dosage system of medication and medication records inspected were satisfactory. The home has comprehensive polices in respect of the receipt, administration, storage and disposal of medication. Robinson House I53 I03 s15104 ROBINSON HOUSE v233301 090805 STAGE 4.doc Version 1.30 Page 14 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) 22,23 The home has suitable polices and procedures in place to manage any complaints received effectively and efficiently ensuring service users and relatives are kept informed of developments but the complaints procedure must be amended to show the correct contact details of the Commission for Social Care Inspection. EVIDENCE: During the tour of the home it was noted that information about how to make a complaint was on display in the hallway. This information included details of how people can contact the Commission for Social Care Inspection. The address and telephone number of the commission was not accurate and must be amended. The manager stated that no complaints have been made against the home since the previous inspection – the Commission for Social Care Inspection has not received any complaints. The six relatives who completed a questionnaire as part of this inspection stated that they knew how to make a complaint. Training records showed that the majority of staff had received training on protection of the vulnerable adult from abuse and that a date for training for the remainder of the staff had been set. Robinson House I53 I03 s15104 ROBINSON HOUSE v233301 090805 STAGE 4.doc Version 1.30 Page 15 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) 24,25,26,30 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 inspection and an action plan detailing how and when changes are being made must be sent to the Commission for Social Care inspection. Since the previous inspection three of the bedrooms have been redecorated and on the day of this inspection a bath was due to be replaced. The manager said that orders had been placed for a replacement refrigerator, freezer and dishwasher and that there were plans for the kitchen to be refurbished. The garden has been tidied up and on the day of inspection one of the service users was spending time in the garden. All bedrooms are single rooms and are in the process of being redecorated. One of the service users was keen to show the inspectors his bedroom and was pleased with the décor which he had chosen. It was noted that not all bedroom doors are lockable. The manager gave reasons why these doors did Robinson House I53 I03 s15104 ROBINSON HOUSE v233301 090805 STAGE 4.doc Version 1.30 Page 16 not have locks on them. Risk assessments must be undertaken so that there is a record of why locks are not fitted. All areas of the home were clean and there were no offensive odours. Robinson House I53 I03 s15104 ROBINSON HOUSE v233301 090805 STAGE 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,34,35,36 The number of staff on duty is sufficient to meet the needs of service users but a formal system of supervision needs to be implemented to ensure that staff receive support and professional guidance. EVIDENCE: Since the previous inspection the number of agency staff used in the home has decreased at the time of this inspection the home was fully staffed. The rota was inspected and it showed that there are sufficient staff on duty at all times to meet the needs of the service users. There are a minimum of four members of staff on duty during the day and this rises to five when all service users are in the home and there is a waking member of staff and sleep in member of staff on duty during the night. Staff meetings are held monthly and these are minuted. The files of two staff were inspected and these contained all of the information required by the Care Homes Regulations 2001. It was noted that three of the references seen were on Craegmoor headed paper. It was recommended to the manager that either the referee is requested to provide further identification with the reference or that the referee is contacted to confirm that they have provided the reference. Robinson House I53 I03 s15104 ROBINSON HOUSE v233301 090805 STAGE 4.doc Version 1.30 Page 18 Since the previous inspection the training opportunities available to staff have increased and there is now a structured induction, training and development plan. All new staff undertake an induction which last for six weeks. Mandatory training provided to staff includes Moving and Handling, Fire Safety, Health and Safety, Control of Substances Hazardous to Health (COSHH), Basic Food Hygiene, Protection of Vulnerable Adults, Infection Control, Equal Opportunities Awareness and Challenging Behaviour. Staff have the opportunity to undertake NVQ training. Two staff hold NVQ Level 2 in Care and two staff are working towards gaining this award. Although a system of supervision has been implemented in the home it was of concern to note that 11 members of staff had not received formal supervision since April and that the supervision did not take into account the National Minimum Standard stating that staff should have regular recorded supervision meetings at least six times a year. Robinson House I53 I03 s15104 ROBINSON HOUSE v233301 090805 STAGE 4.doc Version 1.30 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 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) 37,38,39,42,43 Staff and service users feel that their ideas are listened to and service users are kept safe by attention to matters of health and safety. EVIDENCE: The manager has been in post since April 2005 and her application to be registered as the manager of the home is currently being processed by the Commission for Social Care Inspection. The manager is currently working towards gaining the Registered Managers Award and during this inspection she showed a good understanding of the Care Homes Regulations and National Minimum Standards. Several records were inspected. Apart from the records of monies held and the care plans which are mentioned in this report all of the records were satisfactory. The records inspected were the staff rotas, records of staff employed, refrigerator and freezer temperatures, staff training records and records of medication received into the home, administered and disposed of. Robinson House I53 I03 s15104 ROBINSON HOUSE v233301 090805 STAGE 4.doc Version 1.30 Page 20 Policies and procedures are in place to manage the health and safety of service users in the home and regular checks of equipment are made. All accidents and incidents are recorded and risk assessments are carried out for all safe working practices. The financial viability of the home was not discussed during this inspection but the requirement for the registered person to submit evidence of the continued financial viability of the home to the Commission for Social Care Inspection has been carried forward from the previous inspection report. A valid certificate of insurance was on display in the home. Robinson House I53 I03 s15104 ROBINSON HOUSE v233301 090805 STAGE 4.doc Version 1.30 Page 21 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 2 x x x 1 Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 2 x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 3 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Robinson House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 3 3 x x 3 2 I53 I03 s15104 ROBINSON HOUSE v233301 090805 STAGE 4.doc Version 1.30 Page 22 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. 3. Standard 1 5 6 Regulation 5(1)(e) 5(b)(c) 15(1)(2) Requirement The Service User Guide must include a summary of the complaints procedure Service users must be issued with a contact/statement of terms and conditions. The care plans must be reviewed and updated and demonstrate consultation with the service users or their representatives. Timescale of 31/07/05 not met. Accurate records of money held on behalf of the service users must be maintained. The homes complaints policy must include up to date contact details for the CSCI. Timescale of 31/07/05 not met. A programme of maintenance and refurbishment must be established to bring the home up to an acceptable standard and a copy of the programme forwarded to the CSCI. Timescale of 31/07/05 not met. Bedroom door locks must be fitted unless a risk assessment states otherwise. Arrangements must be made for all staff to receive supervision at least six times a year. Timescale for action 30/09/05 31/10/05 31/10/05 4. 5. 7 22 17(2) 22(7) 10/08/05 31/08/05 6. 24 23 30/09/05 7. 8. 26 36 23 18(2) 30/09/05 30/09/05 Robinson House I53 I03 s15104 ROBINSON HOUSE v233301 090805 STAGE 4.doc Version 1.30 Page 23 9. 43 25(1)(2) The registered person must submit to the CSCI evidence of the continued financial viability of the home including annual accounts and a business development plan. Timescale of 30/06/05 not met. 30/09/05 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. 2. Refer to Standard 34 Good Practice Recommendations References received on Craegmoor headed paper should be verified. Robinson House I53 I03 s15104 ROBINSON HOUSE v233301 090805 STAGE 4.doc Version 1.30 Page 24 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 I53 I03 s15104 ROBINSON HOUSE v233301 090805 STAGE 4.doc Version 1.30 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. 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