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Inspection on 16/02/06 for Ryan Q.C. Homes, Farthings

Also see our care home review for Ryan Q.C. Homes, Farthings for more information

This inspection was carried out on 16th February 2006.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

A consistent and committed core staff team care for residents, some of who have lived at this home for several years. Care needs are well planned for and reflect individual wishes and preferences.

What has improved since the last inspection?

Staff spoken to are clear around the duty manager system. Staff also confirmed that there is now a system in place to ensure guidance from G.P.s regarding medication is truly reflected on both labels and administration records. All planning and recording documents within resident`s files have now been fully reviewed and updated. Some policies and procedures have also been reviewed and updated since the last inspection. Individual files were found in good order.

What the care home could do better:

A log should be kept of low-key issues of concern raised by residents or their families. The recording of fire safety system checks should be within one current log.

CARE HOME ADULTS 18-65 Ryan Q.C. Homes, Farthings 86 Lumbertubs Lane Boothville Northampton Northants NN3 6AH Lead Inspector Mrs Mary Timms Unannounced Inspection 16th February 2006 10.30a Ryan Q.C. Homes, Farthings DS0000012905.V282083.R01.S.doc Version 5.1 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 Ryan Q.C. Homes, Farthings DS0000012905.V282083.R01.S.doc Version 5.1 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. Ryan Q.C. Homes, Farthings DS0000012905.V282083.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ryan Q.C. Homes, Farthings Address 86 Lumbertubs Lane Boothville Northampton Northants NN3 6AH 01604 643726 01604 492770 laurierqch@aol.com 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) Mrs Margaret Laurie Duggan Mrs Margaret Laurie Duggan Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Ryan Q.C. Homes, Farthings DS0000012905.V282083.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st January 2006 Brief Description of the Service: The Farthings is one of two homes run by Ryan Q.C. Homes and provides personal care for up to six younger adults who have learning disabilities. The home is situated in a residential suburb of Northampton and is indistinguishable from neighbouring houses. The home is a detached house with large private gardens and provides all single occupancy bedrooms. Ryan Q.C. Homes, Farthings DS0000012905.V282083.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection made during the morning and lasting approximately two hours. Time was also spent prior to the visit reviewing previous inspection reports and the service history. This is the second statutory inspection visit to this home made during the current inspection year, and readers will find that key areas not covered within this report were referred to in the November 2005 inspection report. Two residents were present during the visit supported by two members of care staff. Due to the level of disabilities the inspector was unable to interview residents on this occasion. Observations of care practice inform this report and discussions were held with one member of care staff and the Registered Manager. A selection of records were also viewed during this visit. What the service does well: What has improved since the last inspection? What they could do better: A log should be kept of low-key issues of concern raised by residents or their families. The recording of fire safety system checks should be within one current log. Ryan Q.C. Homes, Farthings DS0000012905.V282083.R01.S.doc Version 5.1 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. Ryan Q.C. Homes, Farthings DS0000012905.V282083.R01.S.doc Version 5.1 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 Ryan Q.C. Homes, Farthings DS0000012905.V282083.R01.S.doc Version 5.1 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 There are good systems in place to ensure care planning is based on current assessed needs. EVIDENCE: Residents care arrangements are reviewed within a multi-agency framework on an annual basis. The Registered Manager also confirmed that an internal review takes place on a six monthly basis. One file viewed held copies of care management assessments and a nursing assessment from the previous placement. Plans are reviewed regularly and updated as needs arise. Ryan Q.C. Homes, Farthings DS0000012905.V282083.R01.S.doc Version 5.1 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): 9 Residents are supported to access new experiences, whilst potential risks are well planned for. EVIDENCE: Although it was not possible to interview residents during this visit it was apparent from discussions with staff that residents are supported to take on new experiences and attend a range of community resources. Observations were made of staff encouraging and supporting residents to go out on activities during the inspection visit. Records demonstrate that potential risks are well planned for with detailed guidance provided for staff to support care practice. . Ryan Q.C. Homes, Farthings DS0000012905.V282083.R01.S.doc Version 5.1 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not appraised during this inspection visit. EVIDENCE: Ryan Q.C. Homes, Farthings DS0000012905.V282083.R01.S.doc Version 5.1 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19 The arrangements to ensure personal care is provided in line with resident’s wishes are good. A committed staff team prioritise health care needs. EVIDENCE: Care plans were found to be extremely detailed in relation to personal care, setting out clearly each area of care support required and individual preferences. These plans are produced in a simple format with pictures to aid resident’s comprehension. Both residents present during this visit appeared well cared for. Records also evidence full details of health care planning and assessed needs in relation to health. Areas of health care need are supported by guidance and background information for staff caring for residents. Staff have attended training in relation to epilepsy and the administration of stesolid, which is supported by written delegated responsibility from a health professional. It was evident from discussion with staff and the Registered Manager that there is a commitment to accessing the best possible outcomes for residents in relation to health care issues; the Registered Manager is currently working through a difficult issue to obtain the required response from one G. P. and also to arrange medication reviews for all residents. Ryan Q.C. Homes, Farthings DS0000012905.V282083.R01.S.doc Version 5.1 Page 12 A shortfall was identified during the previous inspection where there was a discrepancy between guidance on medication administration record and the label on a specific medication. This has now been resolved and staff confirmed this highlighted issue is now checked regularly. Ryan Q.C. Homes, Farthings DS0000012905.V282083.R01.S.doc Version 5.1 Page 13 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): Appropriate systems are in place in relation to the protection of residents. Whilst resident may feel comfortable raising a concern, improvements could be made regarding the recording of such issues. EVIDENCE: The home has appropriate complaints policies and procedures, which are reflected into the Statement of Purpose and also set out in a leaflet for any complainant. Work is apparently underway to develop this document into a more easily understood format for residents. Whilst acknowledging the home has received no serious complaints around the service, it is advisable to keep a central log of more low-key issues of concern raised by residents, to enable the Registered Manager to monitor for trends and actions taken by staff in response to issues raised. The Registered Manager is aware of the locally agreed reporting procedures regarding the protection of vulnerable adults. A flowchart of actions to be taken is readily available for staff. Some staff have attended training in relation to the protection of vulnerable adults, and planning is underway for the remaining staff to attend as soon as possible. Recorded risk management strategies were noted to be very detailed. Ryan Q.C. Homes, Farthings DS0000012905.V282083.R01.S.doc Version 5.1 Page 14 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): These standards were not appraised during this inspection visit. EVIDENCE: Ryan Q.C. Homes, Farthings DS0000012905.V282083.R01.S.doc Version 5.1 Page 15 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): 34 The systems operated in this home in relation to the recruitment of staff ensure residents are safeguarded. EVIDENCE: Two files were viewed during this inspection visit which demonstrate robust recruitment procedures are followed, including required checks with the Criminal Records Bureau. Ryan Q.C. Homes, Farthings DS0000012905.V282083.R01.S.doc Version 5.1 Page 16 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): There are good arrangements to capture feedback from residents, staff and families to inform the development of services. Whilst there are some good systems in place in relation to health and safety, some areas of shortfall identify poor recording practice. EVIDENCE: A recent review of some policies and procedures involved consultation with residents and families. Residents, families and staff were also fully involved in the recent redeveloped of planning and recording documents. The Registered Manager described how she undertakes “spot checks” on the home, including reviewing planning and recording documents. The home has an arrangement with a local organisation to provide a “whole system” in relation to infection control; this includes policies and procedures as well as products used in the home. Infection control is apparently discussed Ryan Q.C. Homes, Farthings DS0000012905.V282083.R01.S.doc Version 5.1 Page 17 within staff meetings, and new staff are provided with training via a video guide. The fire safety record viewed on this occasion showed that no fire evacuations or tests on the emergency lighting have been undertaken since April 2005, and that there are various gaps in the requirement for fire alarms to be tested on a weekly basis. The Registered Manager later informed the inspector by telephone that she had identified that some further fire safety checks had been undertaken and recorded in an “old book”. This issue clearly needs to be reviewed by the Registered Manager to ensure the checks are being undertaken appropriately and that the recording is accurate. Ryan Q.C. Homes, Farthings DS0000012905.V282083.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 3 3 X 4 X 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 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X X X 3 X X 3 X Ryan Q.C. Homes, Farthings DS0000012905.V282083.R01.S.doc Version 5.1 Page 19 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. Standard Regulation Requirement Timescale for action 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 YA37 YA22 Good Practice Recommendations The Registered Manager should continue to complete the National Vocational Qualification Level 4 in Management. A central log of issues of concern raised by residents, or their families, should be kept to enable the Registered Manager to have a clear oversight of the actions taken by staff in response to such issues and to monitor for any trends she should be aware of. It is vital that the recording of fire safety systems is accurate to provide a clear view that required checks are being carried out. 3 YA42 Ryan Q.C. Homes, Farthings DS0000012905.V282083.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Ryan Q.C. Homes, Farthings DS0000012905.V282083.R01.S.doc Version 5.1 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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