Inspection on 12/12/08 for Ryde Cottage

This inspection was carried out on 12th December 2008.

CSCI found this care home to be providing an Adequate service.

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

Ryde Cottage 05/01/06

Ryde Cottage 13/12/05

Ryde Cottage 04/08/05

Ryde Cottage 10/01/05

Ryde Cottage 29/09/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Ryde Cottage Binstead Road Ryde Isle Of Wight PO33 3NF     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Nick Morrison     Date: 1 2 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Ryde Cottage Binstead Road Ryde Isle Of Wight PO33 3NF 01983614892 01983564008 daverobinson@rydehouse.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr John Raymond Clewley,Mrs Miranda Cruz Clewley Type of registration: Number of places registered: care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Ryde Cottage is a residential home providing care and accommodation for up to seven younger adults with learning disabilities. It is managed by Mr David Robinson on behalf of the proprietors Mr and Mrs Clewley. The home is approached via an extended private drive off the main Binstead to Ryde road, which provides easy access to Ryde and bus routes to other parts of the Island. The house is located within the extensive private grounds of Ryde House with access to a private beach. Accommodation within the cottage is arranged on two floors providing seven single bedrooms and a range of communal facilities and bathrooms. There is a patio area at the rear with seating available for use by the residents. The home does not have a lift. Fees at the home range from #360 to #419 per week and service users are responsible for purchasing their own toiletries and items of a personal nature. 7 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 26 Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This report represents a review of all the evidence and information gathered about the service since the previous inspection. This included a site visit that occurred on 12th December 2008 and lasted five hours. During this time we toured the premises, looked at the files of three service users, met with four service users and observed the support they were receiving. We also met the Manager and two members of staff and observed interaction between staff and service users. All records and relevant documentation referred to in the report was seen on the day of the inspection visit. We also referred to services own self-assessment of the home. Care Homes for Adults (18-65 years) Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from having their needs and aspirations assessed prior to moving into the home. Evidence: The home requires a full care management assessment for each person before they move into the home. In addition to this, the home does its own comprehensive skills assessment and identifies peoples support needs. Records showed that all assessments were in place prior to the person moving in and that service users and their families had been involved in the assessment process. Care Homes for Adults (18-65 years) Page 9 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from having clear care plans and risk assessments in place and from being supported to make their own decisions Evidence: Individual care plans were in place for each person living in the home and were clearly related to the initial assessment and the ongoing information the home had gathered on each person over time. Service users were involved in the care planning process and those spoken with said they understood their care plan. Care plans are reviewed on a monthly basis and are also updated in the meantime if necessary. Service users were involved in reviewing their care plans and signed to agree with the reviews where appropriate. All staff sign to say they have read and understood each persons care plan. There was a Keyworker system in place and they were responsible for ensuring the care plans for people were up to date and relevant. The Manager also reviewed care plans periodically. The home Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: is in the process of introducing a person centered planning system and some very good work has already taken place on implementing this. Staff are beginning to record good information about the aspirations of service users in a person centered way and they are making good use of pictures to ensure that each persons plan is accessible to them. From observation during the inspection it was clear that people living in the home were supported to make their own decisions about their lives. This included day-to-day decisions about what they wanted to eat and what activities they took part in as well as what time they wanted to go to bed and get up. Staff spoken with and observed throughout the inspection demonstrated an understanding of the need to help people make decisions rather than make decisions for them. Care plans were clear about how service users made decisions and about what things were important to them. Risk assessments were clearly written and reviewed on a regular basis. Staff were clear about risk assessments for each person and the importance of supporting people in line with the risk assessments. Risk assessments were used to promote independence and support people living in the home to be involved safely in the activities they wanted to do. Staff sign to say they have read and understood each persons risk assessments. Care Homes for Adults (18-65 years) Page 11 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from having their rights respected and from balanced and nutritious meals. They also benefit from having the opportunity to engage in a wide range of activities both inside and outside of the home. Evidence: Records of activities and discussion with service users showed that they were supported to make use of a wide variety of local facilities and to be involved in the activities they had chosen. The service has its own resource centre on site from which daytime activities are planned. Individual preferences about activities were recorded in peoples care plans and it was clear that the activities arranged for each person reflected their interests. Records of activities demonstrated that activities were individual and that sufficient staff support was allocated. Service users were involved in a wide range of activities such as eating out, shopping, using the local pub, hiking, Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: art, games and bowling. Service users spoken with said they had very busy social lives and never got bored because they always had something to do if they wanted to. On the day of the inspection people living in the home were having to decide between two possible social events that evening. People living in the home were supported to maintain contact with their friends and families. Records were kept of visits from families and of people going to stay with families. People were also supported to maintain contact with their families over the telephone. Menus showed that food in the home reflected the identified preferences of each person living there. People had individual meals according to their preferences and were able to make choices on the day about what they wanted if they did not want what had been identified on the menu. Staff ensured that mealtimes were a relaxed, enjoyable and social occasion for people and provided the support each person needed. Service users spoken with said the meals in the home were very good and that they always had enough to eat. Care Homes for Adults (18-65 years) Page 13 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from having their healthcare needs met and are protected by the homes medication policies and practices. Evidence: Care plans contained information on how people preferred to be supported with their personal care. The files of people living in the home demonstrated that healthcare needs were monitored and that people were supported to use healthcare services as necessary. Each service user had a Health Action Plan in place which was regularly monitored. There were comprehensive records relating to each persons health. Each persons healthcare needs were monitored and recorded on a regular basis. Where people had used healthcare services there were records detailing the time and date, the reason why they attended and any outcomes as a result of the consultation. Staff in the home liaised closely with healthcare professionals in the interests of people living in the home. Service users spoken with said staff always supported them to use healthcare services whenever necessary. The home also liaised closely with healthcare professionals regarding the psychological support needed by people living there. There were clear records demonstrating how advice was sought from professionals regarding Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: peoples behavioural needs and how this advice was built into behavioural support plans and subsequently into the way staff worked with individual behaviours. The system for administering medication in the home was clear and was stated in the homes policies. Staff who were involved in administering medication had received good training and demonstrated that they had a good understanding of medication issues. Medication records were clear and up-to-date and all medication was stored appropriately and safely. There was a comprehensive system in place for monitoring medication with regular checks and crosschecking to minimise the possibility of any errors occurring. Since coming into post the new Manager had introduced more positive ways of supporting people with difficult behaviour and consequently one person living in the home had not needed to have as necessary medication to help him calm down since July. Prior to this he was having the medication on a regular basis. Care Homes for Adults (18-65 years) Page 15 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from having their views listened to and are protected by the homes policies and practices Evidence: The home has a complaints policy in place and service users spoken with said they were clear about how to complain if they wanted to, but had not felt the need to make formal complaints, as issues were resolved in house meetings or in conversation with the Manager or their keyworker. The home had received five complaints in the last ten years. There was a clear process ibn place for recording and responding to complaints and they had all been dealt with in a timely manner. The outcome of each complaint was also recorded. Staff working in the home had received training in protecting vulnerable adults and the home had very clear policies relating to protecting the people who live there. The service does look after the money of people living there and has a system in place to manage this. During the inspection we looked at the records of transactions for individuals living in the home and found that only four of the seven records demonstrated that the persons money was looked after well and accounted for. For the other three people there were various mistakes made and discrepancies between the amount the records said the person should have and the amount they actually had. Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: The records contained some scribbling out and overwriting and were not particularly clear. One persons money was quite different from the amount that the records said she should have and it was not even possible from the records to work out where mistakes had been made. We discussed this at length with the Manager and have made a requirement regarding the recording system in place in the home. Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from living in a clean and comfortable environment that would be made safer by radiators being covered. Evidence: The house is very homely and comfortable. Service users rooms were well equipped and they were able to bring their own possessions with them to the home. Each of the rooms looked very different and reflected the character of the person whose rooms they were. The home was clean throughout, while remaining comfortable and homely. There were cleaning rotas in place for each day of the week to ensure that cleanliness was maintained. Service users were supported to be involved in the cleaning of the house if they had identified this as something they had wanted to do. There was liquid soap, paper towels and protective gloves available throughout the home to assist with infection control. The home has a clear Infection Control Policy in place which all staff have signed to say they have read and understood it. On inspecting the building we found that there was sealant and grouting in the downstairs bathroom which needed replacing. The Manager informed us this would be addressed. Care Homes for Adults (18-65 years) Page 18 of 26 Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from being supported by adequate numbers of well-trained staff and are protected by the homes recruitment policies and practices. Evidence: Examination of staff files during this inspection showed that all necessary preemployment checks were in place prior to people beginning to work in the home. There were two members of staff on duty throughout each part of the day and at night there was one person sleeping-in. In addition the Manager was available during the daytime. Service users spoken with said there were sufficient staff available in the home to meet the needs of the people living there and to ensure that they could go out and use local facilities at specific times during the week. Staff training was well managed and good records were kept of the training that each member of staff had received, what training they still needed to do and when updates were required. Since coming into post the new Manager had improved the recording of staff training. National Vocational Training (NVQ) was given a high priority in th service and the new Manager is an NVQ assessor. Discussion with a member of staff on the day of the inspection visit, as well as reference to staff files, demonstrated that all staff received regular support and supervision sessions with the manager and that records were kept Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: of these sessions. We were also told that the manager was always available for advice and support and that staff found her to be very supportive throughout their work. Staff interaction with people living in the home was very positive and demonstrated that they knew people well and had the skills and information to communicate with them effectively. Service users spoken with spoke highly of all members of staff and observation of interaction between staff and service users showed that service users felt very comfortable in the presence of staff. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from living in a well managed home that is safe and responsive to their needs. Evidence: The Manager of the home has been in post since July 2008, but is not registered as she has not submitted an application to become registered. She has told us an application will be submitted by the end of January 2009. The Manager told us the previous Registered Manager left the home about twelve months ago. Since coming into post the Manager has demons rated a clear understanding of the improvements needed to the service and has made improvements to staff meetings, service user meetings, the rota, support and supervision for staff, updating risk assessments, updating individual staff training records, implementing communication passports for service users, organising Health and Safety checks and introducing a very good Quality Assurance system. The Quality Assurance system is very comprehensive and is based on seeking the views of people who live in the home and people who have an interest in the home. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: Quality Assurance questionnaires have already been sent out to service users, families and professionals. The Manager has a good system for collating these to give an overall picture of peoples views. Plans are in place to analyse the information and develop an action plan for the service based on the views expressed. This will then be shared with all interested parties and then implemented, monitored and reviewed. The Manager plans to complete this process each year. Health and safety was generally well managed within the home and few concerns were highlighted throughout the course of the inspection. While looking around the building we found that some radiators were very hot and the Manager informed us that this may be a hazard for some of the people living in the home and she has asked that covers be put on them. There was also central heating pipe work in the downstairs bathroom that was uncovered and ran down the wall next to the light switch. We have made a requirement that these issues be addressed in order to ensure the safety of the people living in the home. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 23 13 The home must ensure there 30/01/2009 is a safe system in place for recording and managing the money it looks after on behalf of service users. To ensure that service users can be sure that their money is looked after well and that mistakes are not made with their money. 2 42 13 The home must ensure that any radiators or pipework that present a risk to people living in the home are covered To ensure the safety of service users 27/02/2009 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - 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!