CARE HOME ADULTS 18-65
Russell Lodge 18 Russell Gardens, Ley Street Ilford Essex IG2 7BY Lead Inspector
Helen Fontaine Unannounced Inspection 12 October 2005 15:00 Russell Lodge DS0000025924.V257593.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Russell Lodge DS0000025924.V257593.R01.S.doc Version 5.0 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 Lodge DS0000025924.V257593.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Russell Lodge Address 18 Russell Gardens, Ley Street Ilford Essex IG2 7BY 020 8554 4858 020 8518 4545 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) Care One Ltd Mrs Ragini Sivakumar Care Home 5 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (1) of places Russell Lodge DS0000025924.V257593.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. People with mild to moderate learning disabilities and associated mild to moderate physical disabilities. One named person beyond the age of 65 to be accommodated. Date of last inspection 21st July 2005 Brief Description of the Service: Russell Lodge is a care home providing accommodation and support for residents with a moderate learning disability. The home is registered to accommodate up to five residents. The home is a semi-detached property situated in the Ilford area of the London Borough of Redbridge. The area is well served by public transport and there are many easily accessible facilities within the local area. There are three single rooms on the first floor and two on the ground floor, one with en-suite facility. The home aims to integrate the residents into the community life and support them to access and participate in mainstream as well as specialist resources in the community in which they live within their individual capabilities. Russell Lodge DS0000025924.V257593.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection took place in accordance with the annual inspection programme for this home. The previous inspection took place in July 2005 and was an unannounced inspection, there where six requirements from this inspection. These were met at this inspection, and 2 further requirements made at this inspection. A tour of the home was undertaken where a number of the Service Users were seen and communicated with. A number of documents were seen and one member of staff was spoken to. The Manager was present during the inspection and the inspector would like to thank everyone for their input during the inspection. What the service does well: What has improved since the last inspection? What they could do better:
There are two main areas that the home need to improve and both are Requirements from this inspection. Russell Lodge DS0000025924.V257593.R01.S.doc Version 5.0 Page 6 There is an odour in the home, there is a Service User with an incontinence problem, and the home does need to find a way to resolve this problem. During the tour of the home, the fridge and freezer were inspected, it was found that foods that had been opened were not decanted into a container and were not labelled and dated. 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. Russell Lodge DS0000025924.V257593.R01.S.doc Version 5.0 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 Lodge DS0000025924.V257593.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Service Users have their needs assessed by the home prior to moving into the home. EVIDENCE: The most recent Service User admitted to the home was in May this year and during the inspection this file was looked at. The file was examined and it was found to contain a detailed assessment that had been undertaken by the Manager prior to their admission to the home. The home had also received an assessment and care plan from the Social Worker including involvement with the Service User’s relative. The Manager said that despite these assessments there were areas that they found, that had not been identified during the assessment process. However the home has made great efforts with this by the staff and the Manager said the Service User has developed new skills and settled really well. Russell Lodge DS0000025924.V257593.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 8 The care plans are detailed and provide staff with the information they need to identify and meet resident’s social and health needs. EVIDENCE: During the inspection the newest Service Users file was looked at, there was no photo of this Resident on the file. The Manager said that the Service User had refused to have it taken and the Manager is currently discussing with the Service User how they can achieve this. During the tour of the building this Service User agreed to the Manager showing the inspector their room and there were notices on the door asking staff not to put the heating on. On the Service Users file it was seen that a representative of the Service User signed an agreement with the Resident for the provision of Gender Care by a carer of the opposite sex. This Service Users Care Plan informed staff to explain what they are doing and to give the Resident choices. Russell Lodge DS0000025924.V257593.R01.S.doc Version 5.0 Page 10 During the inspection the Residents meeting minutes were looked at, these take place every two months and issues are discussed and agreed, areas covered were activities and meals. Russell Lodge DS0000025924.V257593.R01.S.doc Version 5.0 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 16 Service Users take part in social and leisure pursuits that are actively promoted and supported by staff. The respects and recognises residents responsibilities in their daily lives. EVIDENCE: Service Users each have planned activities, which takes into account their preferences, interests, experiences, age, peer and are culturally appropriate. The Service User whose files were looked at, had chosen not to attend the day centre. Other Service Users attend day centres and the home has other activities that help the Residents access to the community, which include shopping and walks. The home has an ethos of respecting the rights of all the Residents and a great deal of time and effort is made to achieve this. The newest Service User has developed skills and is achieving more independence with mobility and personal care. This has taken the home some time to help the Service User achieve this, especially around the issue of personal care. The Service User is
Russell Lodge DS0000025924.V257593.R01.S.doc Version 5.0 Page 12 now happy to have a bath and have their hair washed and even agreed that they have their very long haircut. Russell Lodge DS0000025924.V257593.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19 The Service Users physical and emotional health needs are monitored and this ensures that Residents’ needs are met. EVIDENCE: All the Care Plans examined recorded referrals and appointments to specialist health care professionals are kept. Records indicated that Service Users attend routine health screening and are seen by dentists, opticians and chiropodists. One of the Service Users in the home who had a health condition has now improved, following the improved review of their health needs. The Resident is now not falling as the risk has been identified and minimized. Currently there is a Service User in the home that has been identified by the Social Worker as moving to independent living. The home are supporting the Resident in making a decision, this is a big step and the Service Users is understandably anxious about doing this. Russell Lodge DS0000025924.V257593.R01.S.doc Version 5.0 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 the following standard(s): 22 and 23 The home makes every effort to deal with any problems or concerns and make sure that Service Users feel confident that their complaints are listened to. Training for staff in Adult Protection is being undertaken to protect Service User from abuse. EVIDENCE: The home is using their amended policy on complaints and all complaints are recorded and include all details of investigations, any action taken and the outcome for the complainant. The staff member spoken to during the inspection said that any complaint or concern would be dealt with immediately. This member of staff also felt confident that any complaint or concern they had would also be listened to. Service Users met during the inspection were happy and participating in activities and when asked if they had any complaints indicated that if they had any would be dealt with. The home does have a policy and procedure for dealing with allegations of abuse, the member of staff spoken to did have an understanding of the procedure and knew what to do. The Manager said that the home is in the process of extending the Adult Protection training and currently the staff have their names down for a course. Russell Lodge DS0000025924.V257593.R01.S.doc Version 5.0 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 the following standard(s): 24, 25 and 30 The homes furnishings and fittings are of a good standard and provide a comfortable and homely place for residents to live. The home is clean and hygienic, but does have an odour. EVIDENCE: During the tour of the home it was seen the Service Users live in a very comfortable, homely and safe environment. Each Resident had their own room and one room that the Service User agreed could be looked at was individually personalized. This Service User does have mobility problems and has a room on the ground floor, he does not like the heating on and there are notices advising staff to keep the heating off, as this is his preference It was noticed during the tour however that there is an odour in the home; the Manager said that one of the Service Users’ has an incontinence problem. The home does need to find a resolution to this and it will be a Requirement from this inspection. Russell Lodge DS0000025924.V257593.R01.S.doc Version 5.0 Page 16 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 36 Staff are trained and competent to support the Service Users, there is also good staff recruitment policy and practice. All staff receive good supervision as well as support from the Manager. EVIDENCE: Staff files looked at during the inspection identified a number of training certificates and one member of staff had training on Basic Oral Hygiene, while another had Food hygiene, Care Assistant and Nursing roles. The Manager said the staff benefit from her husband who is a trainer and does training for the staff at the home. The Manager also produced and said that a number of staff are booked to attend additional training in Adult Protection. The newest member of staff’s files was looked and this contain a CRB and two references. The Manager said that any new members of staff go through a rigorous induction and work along side the Manager on shifts, until they are happy that they are competent to work alone. Russell Lodge DS0000025924.V257593.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 The home is not protecting the Service Users in the area of food stored correctly. EVIDENCE: During the tour of the building the fridge in the kitchen was looked at and it was found that foods were either not stored or labelled appropriately. The home does need to make sure that all foods are stored appropriately and that all containers opened are labelled and have an expiry date. This will be a Requirement from this inspection. Russell Lodge DS0000025924.V257593.R01.S.doc Version 5.0 Page 18 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 X 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 3 X X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 X X X X 2 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 X 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Russell Lodge Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score X X X X X 2 X DS0000025924.V257593.R01.S.doc Version 5.0 Page 19 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard YA30 YA42 Regulation 16(2) 16(2) Timescale for action The Registered Person must 12/01/06 ensure that the home is kept clear of odours. The Registered Person must 12/01/06 ensure that foods are stored appropriately Requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Russell Lodge DS0000025924.V257593.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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