Inspection on 05/07/07 for Russell Hill

This inspection was carried out on 5th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Russell Hill 16/05/06

Russell Hill 12/12/05

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Russell Hill 33 Russell Hill Purley Surrey CR8 2JB Lead Inspector Emma Dove Key Unannounced Inspection 5th July 2007 11:00 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 Russell Hill DS0000064951.V340934.R01.S.doc Version 5.2 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. Russell Hill DS0000064951.V340934.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Russell Hill Address 33 Russell Hill Purley Surrey CR8 2JB 020 8763 2611 020 8288 3614 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) Independence Homes Limited Gemma Tevlin Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Russell Hill DS0000064951.V340934.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th May 2006 Brief Description of the Service: 33, Russell Hill is a registered care home for up to seven adults with learning disabilities and epilepsy. Seven people are currently living there. Russell Hill is owned, managed and staffed by Independence Homes Limited, a private organisation who have three similar services in the local area. The home is in a residential area of Purley, close to shops, leisure facilities and public transport systems. Accommodation is provided over two floors with seven single bedrooms with ensuite toilet and wash hand basin. Communal areas include a lounge, dining room, a multi use therapy room, a multi sensory room and an enclosed garden. A shower room is available on the ground and an adapted bathroom on the first floor. A kitchen and laundry room are also available. A lift serves the ground and first floor with a stair lift on the first floor. The fees are varied depending on the package of care and therapy individuals receive. Information about fees is included in the contract of residence. Details of the CSCI and inspection reports are available. Russell Hill DS0000064951.V340934.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over eight hours on the 5th July 2007 by one regulation inspector. The inspection included examination of records, looking around communal areas and some bedrooms, speaking with residents, staff and the registered manager. Questionnaires were sent to three relatives, three placing social workers and two health professionals. Two questionnaires have been received, comments from these are included in the relevant sections of this report. Three concerns have been raised about staffing levels and deployment of staff. These are being investigated by the organisation and the local authority. What the service does well: What has improved since the last inspection? What they could do better: The daily recording systems should be reviewed to ensure they include all information. The behaviour monitoring charts should include details of staff present in the room at the time. Review staff practices to ensure people’s privacy and dignity is maintained. Medication must be signed at the time of administration. The carpet in the lounge needs replacing to keep the environment at a good standard. A cover must be provided for the light in the shower room to ensure people remain safe. Staff must receive regular supervision. A copy of the monthly visit must be sent to the CSCI and be available at the home. Russell Hill DS0000064951.V340934.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Russell Hill DS0000064951.V340934.R01.S.doc Version 5.2 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 Russell Hill DS0000064951.V340934.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 4 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service understands the importance of having sufficient information when choosing a care home and has developed a Statement of Purpose and Service Users Guide to help people make a decision. Assessments are completed prior to admission and a detailed transition plan is developed to support individuals when moving in. EVIDENCE: The Service Users Guide contains information about the aims of the service, the services provided, the facilities available, security, privacy and dignity, how to make a complaint and details of the registered provider. This Guide must be updated to include the last inspection report. Assessments are completed before admission with information received from the placing social worker, relatives and a representative from the organisation. A detailed transition plan is developed to ensure the move is at the pace of the individual. Visits to the person in their current home and visits to Russell Hill to meet staff and other people who use the service is included in the transition plan. Russell Hill DS0000064951.V340934.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, and 9 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Care plans are person centred and easy to understand. People who use the services have separate goals, which are reviewed regularly. Risk assessments are in place and updated as necessary. EVIDENCE: Case files contain detailed information about the individual and their needs including: their preferred activities; a care plan noting the support and assistance required with personal care tasks and any equipment used and daily records which detail the activities, food the individual has eaten and any health needs and epileptic seizure activity. Case files also contain protocols for supporting people with bathing, swimming and how to manage seizures. Where people who use the service have goals, which are developed with the therapists, these are recorded in a separate file. Goals should be recorded in Russell Hill DS0000064951.V340934.R01.S.doc Version 5.2 Page 10 peoples care plans to ensure all staff are aware of the goals and support people in achieving them. Behaviour management systems are in place where necessary, staff note down any inappropriate behaviours and what was happening before, during and after. This behaviour record should include details of staff present in the room at the time to assist with analysing peoples behaviour. Two questionnaires indicated that the service ‘always’ and ‘usually’ supports people to live the life they choose and that the service ‘always’ and ‘usually’ responds to individuals different needs. Russell Hill DS0000064951.V340934.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service has a commitment to enabling people who use the services to develop their skills including their social and independent living skills. People who use the service have access to a range of activities within the home and in the community to meet their needs. Individuals are supported to develop by identifying goals and working to achieve them. EVIDENCE: Each person has a daily timetable of activities and therapy, which have been developed to meet their individual needs and takes into account their likes and dislikes. People were seen going out with staff, sitting in the lounge watching television, spending time with staff talking and doing jigsaw puzzles. Staff were seen giving people choices in their leisure activities. Russell Hill DS0000064951.V340934.R01.S.doc Version 5.2 Page 12 People who use the service can access the club the organisation runs one day a week which includes art and craft sessions, exercises and a disco. The home operates an open visiting policy and supports people to keep in contact with family members and friends. The ‘Well Being Manager’ is in regular contact with some family members to keep them up to date with the individuals eating and seizure activity. The menu has been developed with dieticians to ensure peoples health and medical needs are fully met. People were seen to enjoy a mixed diet including fresh fruit and vegetables. Russell Hill DS0000064951.V340934.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use this service receive adequate quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People who use the service have access to health care services both within the home and in the community. Peoples health needs are monitored with appropriate action and intervention taken. Staff complete training in medication and epilepsy. A medication policy is in place and records are generally up to date. EVIDENCE: Peoples health care needs are clearly recorded in their case files and include details of the actions staff should take in the event of emergencies. Two questionnaires noted that the service ‘always’ seeks advice and acts upon it to meet individuals health care needs and that the service ‘always’ meets peoples health needs. Staff were seen providing support to someone in the lounge. The practice of assisting people in communal areas should be reviewed to ensure peoples privacy and dignity are maintained. Staff were also seen talking over a person rather than talking to the individual or moving away while they had a Russell Hill DS0000064951.V340934.R01.S.doc Version 5.2 Page 14 conversation. Two questionnaires noted that the service ‘always’ respects peoples privacy and dignity. Appropriate medication policies and procedures are in place. Staff complete training in the administration of medication, emergency medication and the different types of epilepsy and seizures individuals may have. Medication Administration Record Sheets were signed with three gaps noted. Some medications were labelled ‘as directed’, this does not ensure that staff have up to date information about the dose and time medication should be administered. The medication cabinet should be attached to a wall. One questionnaire noted that it is difficult for the service to support people to manage their own medication but that staff manage peoples medication well. Russell Hill DS0000064951.V340934.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service has a clear complaints procedure and is provided to relatives and placing social workers. Records are kept of complaints and actions taken, although not always of the outcome. Staff complete training in the protection of vulnerable adults. EVIDENCE: The complaints procedure is included in the Service Users Guide. Records are kept of complaints received. No complaints have been received at the home or by the CSCI since the last inspection. Two concerns were raised to the CSCI during the inspection process which are still being dealt with by the organisation and the local social services department. Two questionnaires noted that the service ‘always’ responds appropriately to concerns. All staff complete training in the protection of vulnerable adults as part of their induction and have to complete refresher training at regular intervals. The manager is aware of how to respond to allegations of abuse and the procedures to be followed. Some money is held for safe keeping for people who use the service. The records and balances were checked for three people, both were up to date and correct. Russell Hill DS0000064951.V340934.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28 and 30 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Russell Hill provides appropriate accommodation for people, which is generally well maintained. Bedrooms are single and people can personalise their rooms to their taste. EVIDENCE: The home is in a quiet residential road a short distance from local shops and public transport links. A notice board is in the entrance hall and this has photographs of staff on duty, although it was not up to date on the day of this visit. The certificate of registration was displayed. People who use the service have a single bedroom and access to a lounge, dining room, sensory room, therapy room and garden. Bedrooms have been personalised to the individuals taste and contain a bed, wardrobe, a chest of drawers and have a ensuite toilet and wash hand basin. All bedrooms have a monitor to enable staff to hear if individuals have a seizure and respond Russell Hill DS0000064951.V340934.R01.S.doc Version 5.2 Page 17 appropriately. Care needs to be taken with these monitors to ensure they do not have an impact on peoples privacy. People were seen to be comfortable in their rooms and in the lounge and garden. A shower room is provided on the ground floor with an adapted bathroom on the first floor. A lift serves both floors. The home was seen to be clean and fresh and is generally kept in good state of repair with a few issues noted, including the shower room light needing a cover and the lounge carpet needing replacing. Russell Hill DS0000064951.V340934.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 People who use this service receive adequate quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Staffing levels were seen to be sufficient to meet peoples needs. The service ensures all staff receive relevant training. Staff recruitment procedure meets regulations and the National Minimum Standards. EVIDENCE: The published staff rota the week of the visit noted seven members of staff on duty plus senior staff and the manager Monday to Friday with five staff on duty at the weekend. Staffing levels were seen to be sufficient to meet people’s needs. Two questionnaires noted that staff ‘always’ and ‘usually’ have the right skills and experience to meet peoples needs. The shift plan during the visit was seen to change to meet peoples changing needs and staff were seen to be flexible in their approach. Some staff were observed to have a good knowledge of people and how to meet their needs. Staff files confirmed appropriate recruitment process in place to protect people who use the service. Staff files contained an application form, two or three written references, a clear Criminal Records Bureau and a POVA first check, a Russell Hill DS0000064951.V340934.R01.S.doc Version 5.2 Page 19 copy of the induction the individual had completed, a recent photograph, proof of the individuals identity, a copy of the work permit where required and a copy of the contract of employment. New staff complete a two week induction at the organisation’s head office which includes training in epilepsy, medication, protection of vulnerable adults and manual handling. Staff also complete training in first aid, Picture Exchange Communication System, Signalong and crisis intervention. Staff training records did not confirm that all staff have completed all mandatory training. Some staff are new in post and are still completing their training after their induction. Records indicated that staff supervision is not given every two months, although staff reported that they generally feel supported in their work. Russell Hill DS0000064951.V340934.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The manager has the required experience to run the home. The manager has a clear understanding of the key principles and focus of the service. Good systems are in place to monitor health and safety with records up to date. EVIDENCE: The manager has been at the home nine months and has previous experience in similar services. A number of issues were raised at the home during the period without a registered manager, these issues have been addressed and the service should be improved with a regular manager and senior staff in post. The position of a ‘Well Being Manager’ has recently been recruited to. This person liaises with relatives, is available to offer support to staff and is to Russell Hill DS0000064951.V340934.R01.S.doc Version 5.2 Page 21 be service user focussed, to involve people in meetings and the day to day running of the home. Staff have been holding monthly residents meetings, although it may be better to meet with individuals or small groups of people who use the service to seek their opinions and involve them in the day to day running of the home. Reports from monthly visits, by a representative from the organisation were not all available, copies have not been sent to the CSCI. One monthly visit report noted that staff supervisions and appraisals were overdue and this has remained an issue for a few months. Health and safety records are maintained in good order with checks of the electrical equipment, gas safety, hoists, water and the fire alarm service up to date. Russell Hill DS0000064951.V340934.R01.S.doc Version 5.2 Page 22 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 2 2 3 3 X 4 3 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 3 26 X 27 2 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 2 X 3 X 3 X X 3 X Russell Hill DS0000064951.V340934.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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 4 5 6 Standard YA18 YA20 YA24 YA27 YA36 YA39 Regulation 12 (1) 13 (2) 16 (2) c 23 (2) c 18 (2) 26 (4) c & (5) a Requirement Staff must maintain people’s privacy and dignity when providing support. Medication must be signed at the time it is administered. The carpet in the lounge needs attention. The light in the shower room must have a cover. All staff must receive supervision. A copy of the monthly visit must be available in the home and sent to the CSCI. Timescale for action 31/08/07 31/08/07 28/09/07 31/08/07 31/08/07 31/08/07 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. 3. Refer to Standard YA1 YA6 YA20 Good Practice Recommendations The service users guide should be made accessible to service users, be updated to include the CSCI report. The goals and therapy folders should be included in the daily folder for each person. The medication cabinet should be fixed to the wall. DS0000064951.V340934.R01.S.doc Version 5.2 Page 24 Russell Hill Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: 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 © 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 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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