Inspection on 21/07/05 for Russell Lodge

This inspection was carried out on 21st July 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Russell Lodge 24/10/07

Russell Lodge 30/11/06

Russell Lodge 12/10/05

Russell Lodge 16/12/04

Russell Lodge 06/05/04

Russell Lodge 30/03/04

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 Lodge 18 Russell Gardens Ley Street Ilford Essex IG2 7BY Lead Inspector Gwen Lording Unannounced Inspection 21 July 2005 15:00 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. Russell Lodge G55_S0000025924_Russell Lodge_V240469_210705_Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Russell Lodge Address 18 Russell Gardens, Ley Street, Ilford, Essex IG2 7BY 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) 020 8554 4858 020 8518 4545 Care One Ltd Mrs Ragini Sivakumar CRH Care Home 5 Category(ies) of LD Learning disablility (4) registration, with number LD(E) Learning disability - over 65 (1) of places Russell Lodge G55_S0000025924_Russell Lodge_V240469_210705_Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. People with mild to moderate learning disabilities and associated mild to moderate physical disabilities 2. One named person beyond the age of 65 to be accommodated Date of last inspection 16 December 2004 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. Ther 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 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 G55_S0000025924_Russell Lodge_V240469_210705_Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 3pm. It took place over three and a half hours during the afternoon and early evening. The inspector spoke to three residents and was able to communicate with two other residents with the assistance of staff. Discussion took place with the registered manager and two members of care staff. The responsible individual joined us at the end of the inspection for the feedback. A tour of the home was made and a number of staff and care records were looked at. The inspector would like to thank the residents and staff for their input during the inspection. What the service does well: What has improved since the last inspection? The front exterior of the home has been re-painted. An area of the rear garden has been concreted with ramped access to this part of the garden for residents to use during the summer months. Following a recent visit by officers of the London Fire and Emergency Planning Authority (LFEPA) new door closures have been fitted inside the home. Staff have received training in essential areas, such as food hygiene, health and safety, infection control and adult protection/ abuse awareness. At the previous inspection there had been seven areas in which the home had to improve. The home had taken action on all these areas and this represents a very positive response and demonstrates the homes commitment to work with the Commission in order to further raise the standards at the home. Russell Lodge G55_S0000025924_Russell Lodge_V240469_210705_Stage 4.doc Version 1.40 Page 6 What they could do better: 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 G55_S0000025924_Russell Lodge_V240469_210705_Stage 4.doc Version 1.40 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 Russell Lodge G55_S0000025924_Russell Lodge_V240469_210705_Stage 4.doc Version 1.40 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) 2 and 5 The assessments completed by the home and the information and reports received from other health and social care professionals means that the staff have detailed information to enable them to determine whether or not the home can meet a prospective resident’s needs. EVIDENCE: Three of the current residents have been resident in the home since 1998 and one service user was admitted in 2003. The most recent resident was admitted to the home in May this year (2005). This file of this resident was examined and it was found to contain a detailed assessment that been undertaken by the manager prior to his admission to the home. The home had also received an assessment and care plan from the referring agency including involvement with the resident and his mother. At the last inspection a requirement was made for the manager to ensure that information in respect of fees charged by the home is included in the contract and that the contract be signed by both the manager and the resident or their relative/ representative. Examination of resident’s files indicated that this requirement has been met. Russell Lodge G55_S0000025924_Russell Lodge_V240469_210705_Stage 4.doc Version 1.40 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 and 8 Care plans are detailed and provide staff with the information they need to satisfactorily identify and meet resident’s personal, social support and health care needs. Staff provide residents with information, assistance and support to enable them to make decisions about their own lives. EVIDENCE: Each resident has an individual plan of care and the care plans of all five residents in the home were examined. The care plans cover in sufficient detail all aspects of personal, social support and health care needs of the individual resident. Care plans were being evaluated and regularly reviewed and updated accordingly to reflect changing needs. Reviews are held and involve the resident, their relatives/ representatives and Care Management. The outcome of reviews is recorded and maintained on file. Residents meetings take place approximately every two months and issues discussed and agreed are recorded. Russell Lodge G55_S0000025924_Russell Lodge_V240469_210705_Stage 4.doc Version 1.40 Page 10 Residents require varying degrees of support with their finances and at the last inspection a requirement was made for this information to be included in the individual’s care plan. Where support is needed, the reasons for, and manner of support is being documented in the individual care plan. The manager must ensure that the level of support required is regularly reviewed. The home is small, friendly and operates as a “family unit”. Food, activities, house routine and house issues are discussed on a daily basis and fully involve all members of the home. The daily routine is adapted dependant on the movements and preferences of individuals. Some of the residents have difficulty communicating, but staff in the home have a good understanding of individuals support needs and are able to communicate easily and effectively. Russell Lodge G55_S0000025924_Russell Lodge_V240469_210705_Stage 4.doc Version 1.40 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) 13 and 14 Opportunities for social and leisure pursuits and personal development are actively promoted and supported by staff for all residents to enable them to participate in the wider community in which they live. EVIDENCE: Each resident has a planned activity programme, which takes account of the resident’s preferences, interests, experiences, age and capabilities related to their disability. Residents attend specialist day centres and participate in leisure activities in the community including, shopping and eating out. One resident spoken to had just returned from a day centre and staff showed a keen interest in hearing how she had spent her day. Another resident had been supported by staff to attend her regular hairdressing appointments at a local salon. Staff were seen to support residents to pursue their individual interests. For example one resident has a wide screen television in her room and has a large collection of videos. She particularly enjoys watching musicals. Another resident is keen on football and staff support him to purchase magazines. Russell Lodge G55_S0000025924_Russell Lodge_V240469_210705_Stage 4.doc Version 1.40 Page 12 One resident who has been living at the home for over seven years had expressed, through her social worker, a wish to live more independently. She is due to move to supported living accommodation very soon. The manager was concerned, as she would have wished to have been more involved in the resident’s transitional plan for moving on. However, all the arrangements have been co-ordinated by her social worker in line with the resident’s wishes. Russell Lodge G55_S0000025924_Russell Lodge_V240469_210705_Stage 4.doc Version 1.40 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 and 20 The residents’ physical and emotional health needs are closely monitored and this ensures that residents’ needs are recognised and met. The medication policies and procedures are clear and all staff receive medication training during their induction training. There is some inconsistent recording, which may result in unsafe practices. EVIDENCE: All the care plans examined recorded referrals to specialist health care professionals and that appointments are being kept. Records indicated that residents attend routine health screening and are seen by dentists, opticians and chiropodists. There is one resident with a deteriorating health condition who is being regularly reviewed by health care professionals. His mother does not want him to move from the home as she is “ very happy” with the care he is receiving. However, the manager must ensure that risk assessments are regularly reviewed and as routine following each incident of a fall. It is strongly recommended that a referral be made to the Falls Co-Coordinator at the local Primary Care Trust (PCT) to advise on minimising any identified risk/ hazard. Russell Lodge G55_S0000025924_Russell Lodge_V240469_210705_Stage 4.doc Version 1.40 Page 14 There are policies and procedures for the handling and recording of medicines in the home. Staff receive medication training during their induction training. There were a number of isolated omissions on the recording of medication on the Medication Administration Records (MAR) charts. It was not clear whether the resident had refused the medication or it had not been administered by staff. Staff must ensure that if medication is not administered the reason why must be clearly recorded on the MAR chart. All hand written entries on MAR charts, whether new items prescribed or alterations or items discontinued, are to be signed and dated by the person making the entry i.e. GP, manager, care worker. Russell Lodge G55_S0000025924_Russell Lodge_V240469_210705_Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The manager and staff make every effort to sort out any problems or concerns and make sure that residents and their relatives feel confident that their complaints and concerns are listened to and will be acted upon. Some staff in the home have received training in Adult Protection/ Abuse Awareness. However, this training must be extended to include all staff working in the home to ensure that there is a proper response to any suspicion or allegation of abuse. EVIDENCE: Since the last inspection the complaints policy has been amended and now all complaints, both verbal and written, are recorded and include full details of investigation, any action taken and the outcome for the complainant. Two residents spoken to about what they would do if they were unhappy with anything said they would “speak to Ragini or Siva” (the registered providers) There is a written policy and procedure for dealing with allegations of abuse and whistle blowing. The manager and several of the care staff have received training in Adult Protection/ Abuse Awareness. This must be extended to all staff working in the home and should be included in the induction training for all new staff. Those staff spoken to during the inspection were aware of the action to be taken if there were concerns about the welfare and safety of residents. Russell Lodge G55_S0000025924_Russell Lodge_V240469_210705_Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 The décor, furnishings and fittings in the home are of a good standard and provide a comfortable and homely place for residents to live. EVIDENCE: The standard of the décor, furnishings and fittings in the home are maintained to a good standard. There is a large lounge /dining room with comfortable seating areas and a folding wooden partition which can be used to divide the room if required. Throughout the inspection all areas of the home were found to be clean, tidy and free from odour. Russell Lodge G55_S0000025924_Russell Lodge_V240469_210705_Stage 4.doc Version 1.40 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) 33 and 34 Staffing levels are satisfactory and there is sufficient staff on duty to meet the current needs of the residents. The procedures for the recruitment of staff are robust and provide safeguards for people living in the home. EVIDENCE: At the last inspection a requirement was made for staffing levels in the home to be reviewed with particular reference to peak activity homes. The duty rota indicated that there is now one additional member of care staff during the morning. However, due to the deteriorating health condition of one resident, the staffing levels, both day and night, must be kept under regular review. This will ensure that the individual and collective needs of all residents will be met. The duty rota must record the full name of each member of staff and must reflect the hours worked each day by the manager. The staff files of two staff members employed since the last inspection indicated that the home is undertaking all the necessary recruitment checks to ensure the protection of residents. Russell Lodge G55_S0000025924_Russell Lodge_V240469_210705_Stage 4.doc Version 1.40 Page 18 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 and 39 and 42 The home is well managed and residents benefit as the home is run in their best interests and provides a safe environment for residents in the home. EVIDENCE: The manager is well experienced to manage the home and demonstrates a clear understanding of the needs of the residents. She has recently resumed her studies towards the Registered Manager’s Award. The home is well maintained and provides a safe environment for residents and staff. Inspection of records indicated that regular tests to fire alarms and hot water outlets had been carried out. Following a recent visit by officers of the London Fire and Emergency Planning Authority (LFEPA), new door closures have been fitted inside the home. Russell Lodge G55_S0000025924_Russell Lodge_V240469_210705_Stage 4.doc Version 1.40 Page 19 The registered provider also checks the quality of care in the home through monthly Regulation 26 monitoring visits. A report is produced and a copy is sent to the Commission. Russell Lodge G55_S0000025924_Russell Lodge_V240469_210705_Stage 4.doc Version 1.40 Page 20 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 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x 3 3 x x x Standard No 31 32 33 34 35 36 Score x x 2 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Russell Lodge Score 3 2 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 3 x G55_S0000025924_Russell Lodge_V240469_210705_Stage 4.doc Version 1.40 Page 21 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. Standard 19 Regulation 14(2) (a) and (b) Requirement The assessment of the resident with a deteriorating health condition must be kept under regular review to ensure that his needs can be safely and adequately met. All hand written entries on Medication Administration Records (MAR) charts, whether new items prescribed or alterations or items discontinued, are to be signed and dated by the person making the entry i.e. GP, manager, care worker. If medication is not administered the reason why must be clearly recorded on the MAR chart. All staff working in the home must receive training in Adult Protection/ Abuse Awareness. The duty rota must record the full name of each member of staff and must record the hours worked each day by the registered manager. Staffing levels in the home both day and night must be kept under regular review to ensure that the individual and collective needs of all residents will be Timescale for action 21/07/05 and ongoing 2. 20 13 31/08/05 3. 4. 5. 20 23 33 13 18 17 Schedule 4 18 21/07/05 and ongoing 30/09/05 21/07/05 and ongoing 21/07/05 and ongoing. 6. 33 Russell Lodge G55_S0000025924_Russell Lodge_V240469_210705_Stage 4.doc Version 1.40 Page 22 met. 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 19 Good Practice Recommendations It is strongly recommended that a referral be made to the Falls Co-Ordinator at the local Primary Care Trust (PCT) to advise on minimising any identified risk/ hazard to the resident with a deteriorating health condition. Russell Lodge G55_S0000025924_Russell Lodge_V240469_210705_Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Ferguson House 113 Cranbrook Road Ilford Essex IG1 4PU 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 Russell Lodge G55_S0000025924_Russell Lodge_V240469_210705_Stage 4.doc Version 1.40 Page 24 - 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!