Inspection on 13/11/07 for Ryde House

This inspection was carried out on 13th November 2007.

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 found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ryde House 20/10/08

Ryde House 17/10/06

Ryde House 29/11/05

Ryde House 16/06/05

Ryde House 08/12/04

Ryde House 08/04/04

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Hillview Farm

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

CARE HOME ADULTS 18-65 Ryde House Binstead Road Ryde Isle Of Wight PO33 3NF Lead Inspector Mick Gough Unannounced Inspection 13th November 2007 10:00 Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 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 Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 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. Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ryde House Address Binstead Road Ryde Isle Of Wight PO33 3NF 01983 564004 01983 564008 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) Mr John Raymond Clewley Mrs Miranda Cruz Clewley Mrs Miranda Cruz Clewley Care Home 24 Category(ies) of Learning disability (0) registration, with number of places Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning Disability (LD). The maximum number of service users who can be accommodated is 24. 17th October 2006 Date of last inspection Brief Description of the Service: Ryde House is a residential care home providing care and accommodation for up to twenty-four people with learning disabilities. The home is a Grade 2 listed building that is approached via an extended private drive, and has extensive grounds leading through gardens and woods to a private beach. There is a golf course adjacent to the drive and a garden centre in the grounds. Ryde House is owned by Mr and Mrs Clewley and managed by Mrs Miranda Clewley. Weekly Fees at the home range from £390 - £1,727 per week, this is dependant on need and residents are responsible for paying for their own toiletries, hairdressing and items of a personal nature. Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report details the evaluation of the quality of the service provided at Ryde House and takes into account the accumulated evidence of the activity at the home since the last inspection, which was carried out on the 17 October 2006. The inspection took into account the information that we have received, or asked for, since the last key inspection and this included: Information received in an anonymous complaint, information received from social services and information contained in the homes Annual Quality Assurance Assessment (AQAA) that was returned prior to an unannounced site visit to the home, which took place on the 13 October 2007. Evidence for this report was obtained from reading and inspecting records, touring the home and from observing the interaction between staff and service users. It was also possible to speak with 5 members of staff and 3 users of the service and also the homes manager and her deputy who assisted the inspector during the visit. The home is registered to provide support for 24 residents and at the time of the inspection there were 16 people living at the home. What the service does well: What has improved since the last inspection? As a result of visits to the home by the Isle of Wight (I.O.W.) Social Services department a number of areas for improvement have been identified and this has resulted in the home organising a comprehensive induction and training programme for staff. Since the last inspection the home has commenced refurbishment and redecoration and this is an ongoing programme, which will result in the reduction of residents from 24 to 10. Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 6 New staff have been employed and a new induction system has been introduced. An additional mini bus has been purchased for the use of residents to enable them to access the community. What they could do better: This report will make 7 requirement to the home and other points which need to be addressed to help improve the service provided for service users are contained within the main body of the report, general observations were: It was noted that care plans contained a lot of information that was not current and there is a need to remove old information to avoid confusion for staff. Care plans for residents could be improved with more information on the exact type of support required so that staff has the information they need to provide the correct type and level of support. Currently the recording in care plans does not always provide good evidence of care delivery and improvements could be made with more regular and detailed recording and this would show how the plan was working for the individual. The home should establish a policy on cross gender care so that the home can demonstrate that personal care is delivered by a person of the same gender where possible and respects the residents wishes. The home should compile a list of those staff members who are authorised to administer medication and specimen signatures should be held to enable a clear audit trail to be established. Infection control procedures could be improved by ensuring that soap and towels are available in all bathrooms in addition to the hand gel dispensers and by providing clear information for staff on the procedures to be followed when dealing with any soiled laundry items. The home carries out quality audits of its residents, however the views of other interested parties are not sought to see how the home is meeting its aims and objectives and the homes quality assurance systems could be improved by seeking the views of other stakeholders. There is a lot of refurbishment work being carried out and the homes maintenance man is in the process of carrying out a fire risk assessment for the building and this will also include a risk assessment to cover generic risks in the home, this needs to be put in place as soon as possible to improve the health, safety and welfare of residents and staff. It should be noted that as the plans in place to address these issues are new it is not yet possible to establish a sustained improvement in the home. Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 8 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 Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a detailed assessment of their individual needs before they move into the home. EVIDENCE: There have been no new residents to the home since the last inspection. The last person to move into the home did so in 2005. The homes completed AQAA stated that the home has a referrals and admissions policy and this was seen by the inspector. The home obtains care management assessments and also carries out their own assessments. The homes statement of purpose and service users guide also give details of the admission procedure. The manager stated that the home has discussions with the funding authority and identifies any additional support, which may be required. There is also a policy and procedure in place for emergency admissions. Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans are in place for all residents and these provide information for staff on the support they require, however the recording systems do not provide evidence of care delivery and the lack of clear strategies for managing the behaviour of residents who challenge the service puts them at risk. Residents are supported to make informed choices and there are risk assessments in place to enable staff to support them to take informed risks on a daily basis. EVIDENCE: Care plans were seen for 3 residents and these gave staff information on what support was required and how and when this should be given, however these could be improved with more information on the exact type of support required. Some care plans had detailed information while others did not provide information on what support was required, information just said “ongoing support” and this did not provide staff with clear information. It was acknowledged that the home was working through care plans to provide clear information for staff and that work on care plans is being carried out. It was Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 11 noted that care plans contained a lot of information that was not current and the need to remove old information was discussed with the manager who understands the need to remove out of date information to avoid confusion for staff. Recording was carried out on a number of different sheets and this was normally done each week, there was no recording carried out on a daily basis or at the end of each shift and current recording does not provide evidence of care delivery and there was not always information on what support had been given or what residents had been doing during the day. The care plans for 2 of the residents seen indicated that they could become physically aggressive and there was information recorded indicating that physical restraint had been used on some residents, however it was established that staff at the home had not received training on restraint or for managing challenging behaviour, although this has now been booked. The inspector discussed this with the manager and deputy and explained that need for clear guidance and strategies for staff to manage challenging situations without using restraint until staff had received suitable accredited training. Care plans were reviewed monthly by key workers, however there is no evaluation on how the care plan is working or information if any change to the plan had been made. Staff support residents to make their own decisions about their lives as much as they are able. The home operates a key worker system, which enables residents to have a one to one relationship with a member of staff. In discussion with the manager and her deputy it was stated that residents are able to make choices on a daily basis, this includes what time they want to go to bed and get up, what clothing they will wear, what activities they want to be involved in and recording in care files provided evidence that residents had been able to make informed choices. The inspector observed staff supporting residents throughout the visit and residents were able to make their own decisions. The inspector was informed that there is an independent advocate service available to residents to provide advice and support, however this service was not advertised in the home and the manager stated that she would provide details of this service to all residents. Risk assessments were in place in residents files and these were clearly written and gave information to staff on the identified risks and what support was required to minimise any potential risks. The risks assessments were discussed with the manager and deputy and some would benefit from more information for staff on ways to minimise any identified risks. Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to access the local community and to be involved in appropriate activities and they benefit from support to maintain social contacts. Daily routines at the home respect resident’s rights and responsibilities and meals at the home are flexible and provide a balanced diet. EVIDENCE: The activities enjoyed by residents are detailed in their support plan and activities identified included trips out into the local community to pubs and cafes, walks, swimming, bowling, shopping, cinema, arts and crafts and bingo. One residents spoken to said that he enjoyed bowling and liked to play bingo. Another said that they liked to go out in the mini bus and liked to go for walks on the beach. There is a resource centre in the grounds of the home and this has its own staff team, however some residents are supported by staff at the home for one to one support. The resource centre provides cooking and independent living skills and each resident has their own timetable for activities. The inspector was informed that no residents currently attend any Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 13 college or education course and no one has any form of employment. The home has 2 mini buses and 2 cars available to enable residents to go out into the local community. Each resident had a plan of their daily routine in their care plan and the inspector was informed that some residents help out around the home but loose interest very quickly. During the unannounced visit residents were observed accessing all areas of the home and staff were seen to support residents appropriately. Staff were observed calling them by their preferred name. Mail is given to residents unopened and key workers provide support if required. Residents are encouraged to maintain family links and the home has a visiting policy and visitors are welcome at any time. The deputy manager stated that at least eight people have varying contact with their family, which includes overnight and weekend stays plus holidays. One resident told the inspector that “I am going to my mums for the weekend and I am going to stay with her for Christmas”. The home has a four-week rolling menu, which is changed seasonally. The inspector was informed that the home knows residents likes and dislikes very well and these are taken into consideration when menu’s are made out. The main meal of the day is at lunchtime and the inspector observed residents sitting in the dining room together for lunch and this was a social occasion. The residents that the inspector spoke with confirmed that they liked the food at the home and said, “the food is always good” Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents receive personal support in the way they prefer and their physical, emotional and health needs are generally met. The homes procedures for storing and administering medication is generally sound however the procedure for administering “when required” medication used for controlling behaviour needs to be improved. EVIDENCE: Residents personal support needs are contained in their individual care plans and these gave staff information on the support required by residents. The staff team are flexible round the times when residents want their personal support and there are no set routines, however there is a daily routine to help with consistency. One residents file stated that he wanted to be supported by a male carer, however the home does not have a policy on cross gender care and the need for this to be implemented was discussed with the manager and her deputy. The inspector was informed that residents are offered care by staff of the same gender wherever possible. Each resident had a health care file and this contained information on the health needs of resident’s. Information included details of all medication, the Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 15 reason for its use and also the possible side effects. There was information on medical visits, records of appointments and details of GP’s and other healthcare professionals. All residents are registered with the same GP surgery and dental care is offered by a local NHS dental clinic. Eye checks are with a local optician and audiology is through the local hospital. The home receives support from the local learning disability team and district nurse services and other health care professionals are accessed through GP referral. For the past month the community learning disability team and community nurses have been monitoring the medication procedures at the home as a result of shortfalls, which were identified by the local social services department and as a result of these visits medication procedures have improved and they are currently happy with the medication procedures at the home. The home uses a monitored dose system provided by a local pharmacist and the deputy manager is responsible for the ordering and monitoring of medication. The home has a medication procedure and also a procedure for administering any “when required” medication, however this is currently being reviewed by the local learning disability team who are offering advice and assistance with regard to when medication used to control behaviour is administered and when and how it should be recorded. Some staff have received training on medication and the remainder of staff are booked to complete this training in the next 2 weeks. Currently there is no list of those staff members who are authorised to administer medication and specimen signatures are not held and therefore it would make it difficult for a clear audit trail to be established. The home currently has no residents who self medicate and the home does not hold any controlled drugs. Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a complaints procedure in place, however this requires some amendment to ensure that all complaints whether they are written or verbal are recorded and investigated. Resident’s are not safeguarded by the homes procedures regarding the use of restraint and this places residents at risk. EVIDENCE: The home has a complaints procedure and the home has supplied a copy to all residents in a pictorial format. The inspector was informed that all relatives are given a copy of the homes complaints procedure and a copy seen by the inspector contained all of the required information and gave details of how to contact the CSCI. The homes completed AQAA stated that there have been no complaints made to the home since the last inspection, however there has been an anonymous complaint made to the CSCI. The home has a complaints log and the inspector was informed by the manager that any complaints received would be recorded, however after discussions with the homes manager it was not clear how verbal complaints would be recorded and the home will need to make some amendments to its complaints procedure so that it is clear how and when all complains both written and verbal are recorded. 3 residents spoken to said that they would speak to their key worker or another member of staff if they had a complaint and staff said that they would support residents to make a complaint. The home has a policy on adult protection and all residents files included copies of the Isle of Wight (IOW) multi agency protocol regarding adult protection. There is currently an adult protection investigation being carried Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 17 out by IOW social services and the home is co-operating in this matter. Not all staff at the home have received training on safeguarding and adult protection issues, however all staff are booked on this training, including those who have received training in the past and this should be completed by the end of October. Adult protection issues are logged on an incident form and this gives details of the incident, behaviour prior to the incident, any precipitating factors, the names of people involved and of those who gave assistance and also details of who the incident had been reported to. As detailed in the “individuals needs and choices” section of this report. Staff have use restraint techniques on residents and staff have not received training in this area, nor have they received training on how to deal with residents who challenge the service. The home is in the process of arranging training in Strategies for Crisis Intervention and Prevention (SCIP)and this will provide accredited training for all of the staff in the home. Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Generally residents live in a safe and well-maintained environment and have access to comfortable indoor and outdoor facilities, however the décor in parts of the house is poor and needs to be addressed in the planned refurbishment. EVIDENCE: The inspector toured the building and during the tour it was clear that many areas of the home were in need of decoration and the inspector was informed that there was a programme of refurbishment for the home and once this has been completed only 10 people will be accommodated. The inspector observed that there was refurbishment work being undertaken in a bathroom and also in a bedroom. The bedrooms seen were personalised to suit the individuals taste and interests. All bathrooms and WC’s had gel dispensers in place, however not all WC’s had other hand washing facilities, the inspector discussed this with the manager and although it is recognised that the gel dispensers help to improve infection control they should be used alongside normal hand washing facilities and she agreed that soap and towels would be put in all bathrooms. Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 19 The laundry at the home is situated in the basement and this contains 2 industrial washing machines and tumble driers. Residents are encouraged to bring their own laundry down to the utility room and staff support them to do their washing. However there is no information for staff on the procedures to be followed when dealing with any soiled items. This issue was discussed with the manager and her deputy who will ensure that a procedure is drawn up to provide clear information for staff. The home has an infection control policy and training in this area has been booked for all staff. Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is undertaking suitable recruitment checks but staff are not always given all the training they need to undertake their role. EVIDENCE: The home employs a total of 15 care staff and out of these 8 have completed an NVQ and a further 5 are due to commence NVQ shortly. NVQ training is accessed through local training organisations and the home supports staff with NVQ training. On the day of the visit there were 5 staff on duty between 0800 – 1500, and 5 on duty between 1500 and 2200. Between 2200 – 0800 there is 1 member of staff awake throughout the night and 1 member of staff who sleeps in but is available if required. In addition to the care staff there was the homes manager, 1 cook, 4 domestic staff, 3 maintenance staff and 1 administrator. Staffing numbers were discussed with the homes manager and she said that with the current numbers of residents staffing levels were adequate. The inspector was informed that residents who require one to one care or support are supported by staff on the duty rota with extra staff being brought in if required for planned outings and for specific activities. Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 21 Staff records were inspected for 3 staff members and these contained all of the required information including 2 x references, application form and CRB/POV checks The home has recently introduced a new induction procedure and staff complete a 12 week induction based on skills for care and the induction booklet identifies statutory training that must be completed during the induction period and these include: Food hygiene, safeguarding, moving and handling, infection control and fire safety. The home has its own training coordinator who has organised training for all staff in statutory training and all staff will complete this by the 18 January. Training is also being arranged for SCIP, challenging behaviour, dementia in learning disability, care practices, medication and in house training on recording. The manager stated that all staff will have a training and development plan and any relevant training will be organised as it becomes available. Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The homes management potentially puts people living at the home at risk due to the restraint methods used to control challenging behaviour and shortfalls in the lack of training for staff. Other areas highlighted in the report indicate that the management of the home is not always effective. The lack of an effective quality assurance system may have resulted in shortcomings at the home, which could have been identified earlier. The home has policies and procedures to promote the health, safety and welfare of residents and staff, however generic risk assessments are needed to ensure that as far as reasonably practicable they are protected. EVIDENCE: The manager is a registered learning disabilities nurse and has owned and worked in the home for the last twenty years and has experience of working Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 23 with people with learning difficulties. She has initiated a new induction procedure and has arranged for a comprehensive training programme to be implemented, however shortfalls in these areas were identified by the social services department before the manager took action. The home carries out quality audits of its residents, however the views of other interested parties are not sought to see how the home is meeting its aims and objectives. All staff now receives health and safety training as part of the induction process and refresher training is being organised for all staff at the home. There is a lot of refurbishment work being carried out and the home had not carried out a fire risk assessment for the building and there is no generic risk assessment for the hazards in the home during the refurbishment work. The manager stated that the maintenance man was in the process of carrying out a fire risk assessment for the building and this will also include a risk assessment to cover generic risks in the home. The fire logbook was inspected and this stated that the date of the last fire drill was 1/11/07, however this did not give details of who took part in this exercise. Regular checks of fire equipment had been carried out appropriately and the fire certificate was dated 4/9/07, the gas safety certificate 21/9/07, electrical wiring was in date for test and private electrical equipment was tested in October 2007. Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 24 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 2 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 2 X 2 X 2 X X 2 X Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 25 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 YA6 Regulation 15 Requirement The home must ensure that service users plans provide clear information as to how service users needs in respect of their health and welfare are to be met. This will enable staff to have the information they need to offer the correct level of support. Service users plans of care must be regularly reviewed and recording should provide written information to evidence that care has been delivered effectively The home must ensure that staff have a clear protocol with regard to administering “when required” medication and this protocol should give guidance on how and when medication used to control behaviour is administered and recorded. The home must ensure that there is a procedure in place for considering complaints and ensure that all complains both written and verbal are recorded and investigated. Residents must be safeguarded by suitably trained staff, DS0000012530.V353335.R01.S.doc Timescale for action 21/12/07 2 YA6 15 & schedule 3 13 21/12/07 3 YA20 21/12/07 4 YA22 22 14/12/07 5 YA23 13(6) 28/02/08 Ryde House Version 5.2 Page 26 6 YA23 13 (6)(7)(8) 7 YA35 18 (c) including staff that has training to enable them to care for those residents with challenging behaviour. Any person living at the home 28/11/07 subject to restrain must only have this carried out as agreed by a multi disciplinary team and by staff trained in its correct application and this must be documented as part of care planning as well as after each event The registered person must 28/02/08 ensure that all persons employed to work at the home receive training appropriate o the work that they are asked to perform. This will help to ensure that residents are at all times supported by suitably trained staff. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ryde House DS0000012530.V353335.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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