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

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ryan Q.C. Homes, The Elms 14/01/08

Ryan Q.C. Homes, The Elms 15/01/07

Ryan Q.C. Homes, The Elms 26/09/05

Ryan Q.C. Homes, The Elms 30/12/04

Ryan Q.C. Homes, The Elms 17/05/04

Ryan Q.C. Homes, The Elms 15/03/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Ryan Q.C. Homes, The Elms The Elms 10 Repton Court The Arbours Northampton Northants NN3 3RQ Lead Inspector Mrs Mary Timms Unannounced Inspection 16th February 2006 08.40 Ryan Q.C. Homes, The Elms DS0000037246.V282086.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, The Elms DS0000037246.V282086.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, The Elms DS0000037246.V282086.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ryan Q.C. Homes, The Elms Address 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) The Elms 10 Repton Court The Arbours Northampton Northants NN3 3RQ 01604 411858 01604 499720 laurierqch@aol.com Mrs Margaret Laurie Duggan Mrs Margaret Laurie Duggan Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Ryan Q.C. Homes, The Elms DS0000037246.V282086.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. There is currently one Service User within the category of LD. By agreement there will not be any further admissions of Service Users under the age of 30 years. 26th September 2005 Date of last inspection Brief Description of the Service: The Elms is one of two homes run by Ryan Q.C. Homes and provides personal care for up to three young adults who have learning disabilities. The home is situated in a cul-de-sac in a residential area of Northampton and is indistinguishable from neighbouring houses. The home is a bungalow with all bedrooms single occupancy. Ryan Q.C. Homes, The Elms DS0000037246.V282086.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 early 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 September 2005 inspection report. Three residents were present during the early part of the visit, supported by two members of care staff. The inspector sat with residents who were content to discuss their view of the service whilst eating their breakfast, feedback from one resident was restricted by the level of disability. Discussion was also held with one member of care staff and the Registered Manager. A review of the medication administration system was undertaken during this visit, a selection of other records were appraised including one individual file looked at in detail. What the service does well: What has improved since the last inspection? The Registered Manager and staff on duty confirmed that no-one under the age of 21 is now left in charge of the home. The front pathway to the home has been replaced, where damaged. The lighting in one particular residents bedroom has now been improved, by changing her lampshade. A record of supervision is now kept within staff files. Ryan Q.C. Homes, The Elms DS0000037246.V282086.R01.S.doc Version 5.1 Page 6 All planning and recording documents within resident’s files have now been fully reviewed and updated, where improvements were identified as necessary. Some policies and procedures have also been reviewed and updated since the last inspection visit. 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. Ryan Q.C. Homes, The Elms DS0000037246.V282086.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, The Elms DS0000037246.V282086.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, The Elms DS0000037246.V282086.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): 8 and 9 Residents are supported and encouraged to take some risks whilst being monitored and safeguarded by staff. They are consulted and feel involved in the decision making process’s operated within this home. EVIDENCE: Personal files and recording documents have been redeveloped recently, which has involved lengthy consultation with residents to ensure the documents were appropriate to their needs. A range of policies and procedures have also been reviewed recently, this too involved consultation with residents, where appropriate. Residents commented that there are many occasions where they are able to make choices around their daily living. They feel involved in decision making within the home and able to make suggestions. Residents made reference to a range of structured daily activities they have undertaken recently including college courses, activities within the home and day-centre attendance. Ryan Q.C. Homes, The Elms DS0000037246.V282086.R01.S.doc Version 5.1 Page 10 Files viewed were noted to hold detailed risk assessment documents with clear guidance for staff. Ryan Q.C. Homes, The Elms DS0000037246.V282086.R01.S.doc Version 5.1 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): These standards were not appraised during this inspection visit. EVIDENCE: Ryan Q.C. Homes, The Elms DS0000037246.V282086.R01.S.doc Version 5.1 Page 12 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 20 Personal care support is well planned for, with individual preferences prioritised within both the planning and delivery of care. EVIDENCE: Residents spoke positively regarding the way personal care support is delivered, speaking highly of staff and clarifying their wishes are always acknowledged within the care they receive. 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. Ryan Q.C. Homes, The Elms DS0000037246.V282086.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): 22 and 23 Appropriate systems are in place in relation to the protection of residents. Residents feel comfortable raising a concern, however, 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. Residents spoken to confirmed they feel able to raise a complaint should they need to. 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. Residents confirmed they feel safe and that staff support them at all times. Recorded risk management strategies were noted to be very detailed. Ryan Q.C. Homes, The Elms DS0000037246.V282086.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. However, it was clarified that the lighting in one residents bedroom has been improved since the last inspection visit. EVIDENCE: Ryan Q.C. Homes, The Elms DS0000037246.V282086.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): These standards were not appraised during this inspection visit. EVIDENCE: Ryan Q.C. Homes, The Elms DS0000037246.V282086.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): 39 and 42 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. A member of staff on duty confirmed that staff are consulted in relation to the development of new policies and procedures. The Registered Manager described how she undertakes “spot checks” on the home, including reviewing planning and recording documents. It was noted during this visit that only a shared cloth towel was provided in one of the toilets, which is not best practice in relation to infection control. Ryan Q.C. Homes, The Elms DS0000037246.V282086.R01.S.doc Version 5.1 Page 17 On the day of this visit the fire safety system checks were unavailable for inspection. Copies were however, faxed through to the inspector on the following day demonstrating that fire checks are undertaken as required. Ryan Q.C. Homes, The Elms DS0000037246.V282086.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 X 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 X 3 X X X 3 X X 3 X Ryan Q.C. Homes, The Elms DS0000037246.V282086.R01.S.doc Version 5.1 Page 19 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. Shared cloth hand towels should not be used within the home, to restrict any opportunities of spreading infection. 3 YA42 Ryan Q.C. Homes, The Elms DS0000037246.V282086.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, The Elms DS0000037246.V282086.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. 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!