Inspection on 16/06/05 for Ryde House

This inspection was carried out on 16th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Ryde House 20/10/08

Ryde House 13/11/07

Ryde House 17/10/06

Ryde House 29/11/05

Ryde House 08/12/04

Ryde House 08/04/04

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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 Neil Kingman Unannounced 16th June 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ryde House H55-H04 S12530 Ryde House V217996 160605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ryde House Address Binstead Road, Ryde PO33 3NF Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01983 564004 01983 564008 Mr John Raymond Clewley and Mrs Miranda Cruz Clewley Mrs Miranda Cruz Clewley Care Home 24 Category(ies) of Learning disability (24) registration, with number of places Ryde House H55-H04 S12530 Ryde House V217996 160605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 8/12/04 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. Ryde House H55-H04 S12530 Ryde House V217996 160605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Ryde House took place unannounced over 5½ hrs. Most residents were at the Ryde House Resource Centre or other day services, while others were in the home. The inspector toured the building with the manager, inspected a sample of the home’s records and spoke with three members of staff on duty. Many of the residents do not have the cognitive ability to give informed views about life in the home. However, the inspector was able to have conversations with three in the home, and went to the resource centre to speak with another. Views were generally very positive and reflected the help and support the home provides residents to lead a full and active lifestyle. What the service does well: What has improved since the last inspection? What they could do better: The home needs to establish a system of monitoring the recording and administration of medication to ensure that any errors are detected and resolved at the earliest opportunity. Ryde House H55-H04 S12530 Ryde House V217996 160605 Stage 4.doc Version 1.30 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ryde House H55-H04 S12530 Ryde House V217996 160605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Ryde House H55-H04 S12530 Ryde House V217996 160605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 4 The manager ensures that the care needs of the people who live at Ryde House will be met by undertaking a proper assessment prior to them moving into the home. The home’s admissions process includes an invitation for prospective residents to visit the home to meet staff and existing residents before making a decision to move there. EVIDENCE: Ryde House provides a service for long-term residents and unplanned admissions are avoided. It happened that a new resident was moving into the home on the day of the inspection. Prior to that there had been no new admissions for at least two years. This situation provided an opportunity for the inspector to see the home’s admissions process in action. The manager confirmed and records showed that the new resident had made four preadmission visits to ensure that she would be able to settle and that the home could meet her needs. A pre-admission assessment was available together with an assessment from the mental health team. Records also showed that as much information as possible about the needs of the new resident had been obtained prior to her moving in. A flexible placement had been secured for her at the Ryde House Ryde House H55-H04 S12530 Ryde House V217996 160605 Stage 4.doc Version 1.30 Page 9 Resource Centre and while a three month settling in period was the norm a six week review was planned to monitor the success of the placement. The inspector spoke with the new resident after she had moved her personal possessions into her room. While she was not able to fully converse she was able to confirm that the move went well. Ryde House H55-H04 S12530 Ryde House V217996 160605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 9 The home develops a comprehensive plan for each resident, which describes how individual health, social and personal needs will be met. Staff enable residents to take responsible risks, details of which are included in their individual plans. Risk assessments contain guidelines for staff on how risks are to be managed. EVIDENCE: The inspector looked at a sample of three individual care plans, which were set out in a ‘person centred’ format. Plans covered a range of needs including personal care, mobility, health, communication, social and leisure. They set out guidelines for staff in the management of challenging behaviour and contained appropriate risk assessments. Additionally, they identified skills and set out aims to be achieved. A weekly timetable of suitable activities is drawn up for residents according to their capabilities. There was an opportunity to look at the arrangements in place to manage the risks identified with the new admission to the home, which were found to be appropriate. Ryde House H55-H04 S12530 Ryde House V217996 160605 Stage 4.doc Version 1.30 Page 11 It was difficult, due to the cognitive abilities of the residents to obtain any detailed views of life at Ryde House, and those spoken with were unable to make comment about their care plans. Ryde House H55-H04 S12530 Ryde House V217996 160605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15,16 and 17 The home encourages and helps residents to maintain links with family and friends. Residents are given freedom of choice and movement within the scope of their abilities and identified risks. Food served is well cooked, varied and appealing. Although offered three times daily, there is flexibility to allow for residents who attend the resource centre and other outside activities. EVIDENCE: Records showed and residents were able to describe having regular contact with family and friends either by telephone, receiving visits at the home or trips out. A minibus is available for excursions. Residents spoken with showed an interest in activities away from the home such as bowling, pubs, the cinema and eating out. Staff confirmed in interviews that residents have an active social life. Residents are accompanied to a variety of venues where they are able to meet with people who do not have disabilities. One resident described how he greatly enjoyed a recent holiday at Butlins on the mainland. Ryde House H55-H04 S12530 Ryde House V217996 160605 Stage 4.doc Version 1.30 Page 13 The inspector noted during the inspection that residents had freedom of movement around the home and would come and go between the home and the resource centre. On the day of the inspection most residents in the home congregate in the main lounge where the atmosphere was very sociable. Staff were always on hand to assist where needed. There is a small lounge, which can be used for visits where people can have quiet and privacy if they wish. The inspector had an opportunity to speak with the chef and sample some of the food on offer. The chef is relatively new to the home and has brought with him culinary skills, which residents and staff said they enjoy. Food served was seen to be well cooked and presented. Menus showed food to be varied and nutritious with some emphasis on healthy eating. The chef confirmed that he was in the process of reviewing the menus having had an opportunity to assess residents’ likes, dislikes and dietary needs. Ryde House H55-H04 S12530 Ryde House V217996 160605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 Residents are assessed as being unable to retain, administer and control their own medication. While medication is held under secure conditions a breach of the regulations relating to the recording of the administration of medication was identified. This had the potential to place residents at risk. EVIDENCE: At the time of the inspection medication for residents was held in appropriate, secure conditions. Staff take the responsibility for the administration of medication to all residents except those requiring insulin injections, in which case the District Nurse visits the home to assist. The inspector noted several gaps in the records of medication administration. The manager recognised the problem, which had occurred over one weekend, and agreed to address it with the member of staff involved at the earliest opportunity. Ryde House H55-H04 S12530 Ryde House V217996 160605 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 The home’s policies, procedures and practices ensure that residents are safeguarded from abuse. Procedures for responding to suspicion or evidence of abuse are robust. EVIDENCE: Ryde House has an adult protection policy and procedure, which accords with the Social Services policy guidance. Staff spoken with during the inspection said they felt supported by the home, and showed a good understanding of what constitutes abuse and what to do if they had any concerns. They recognised that some residents may be physically or verbally aggressive and confirmed that the home provided training to manage such events, Incidents, which had occurred in the home in recent months had been appropriately dealt with by the home. Ryde House H55-H04 S12530 Ryde House V217996 160605 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 30 All areas of the home are generally clean, hygienic and free from unpleasant odours. EVIDENCE: The inspector toured the home with the manager. While the building is old it was seen generally to be clean and hygienic with no unpleasant odours. An extractor fan has been fitted to a ground floor WC to deal with a problem that had been identified at the last inspection. The laundry, which is sited away from food preparation and eating areas is equipped with commercial machines capable of coping with very hot washes. Its floor has been repaired since the last inspection to make it impermeable over the whole surface. Ryde House H55-H04 S12530 Ryde House V217996 160605 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Staff at Ryde House have appropriate skills and experience to meet the needs of the people who live there. EVIDENCE: The inspector looked at a sample of staff training profiles and development plans, which showed a wide range of statutory and care related training. All staff are scheduled to receive training and refreshers in first aid, food hygiene, manual handling and infection control. They take advantage of other courses as and when they become available, e.g., Downs Syndrome, Autism, Adult Protection and managing challenging behaviour. Records showed that 50 of support workers have achieved an NVQ at level 2. Four are qualified at level 3 and six are currently doing the level 2 training. The manager and staff confirmed that training is well under way for the Learning Disabilities Award Framework (LDAF). Induction training for new staff follows the appropriate TOPSS Induction Foundation Programme. A sample of the evidence books was available for inspection. Ryde House H55-H04 S12530 Ryde House V217996 160605 Stage 4.doc Version 1.30 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 and 42 The registered manager is experienced and competent to run the home. However, she has not yet achieved the Registered Managers Award. Policies, procedures and staff training are in place to ensure so far as is reasonably practicable the health, safety and welfare of residents and staff. EVIDENCE: The manager, who is also joint owner of the home, is a registered learning disabilities nurse. She has successfully managed Ryde House for nineteen years and has almost completed the Registered Manager’s Award. She keeps abreast of a wide range of issues relevant to managing the service and to the specific needs of the people living at the home by attending day courses as and when they are available. There are policies and procedures in place to ensure safe working practices in the home and all care staff undertake statutory training, which includes health and safety, food hygiene, first aid and manual handling. A sample of records was viewed including accidents, TOPSS induction training, fire alarm tests and adult protection, all of which were in good order. Ryde House H55-H04 S12530 Ryde House V217996 160605 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x 3 Standard No 11 12 13 14 15 16 17 x x x x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ryde House Score x x 2 x Standard No 37 38 39 40 41 42 43 Score 3 x x x x 3 x H55-H04 S12530 Ryde House V217996 160605 Stage 4.doc Version 1.30 Page 20 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 20 Regulation 13 Requirement The registered person must establish a system of monitoring to ensure staff adhere to procedures, for the recording and administration of medication. Timescale for action 16/6/05 Immediate requiremen t notice served. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Ryde House H55-H04 S12530 Ryde House V217996 160605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Ground Floor, Mill Court Furrlong Newport Isle of Wight PO30 2AA 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 Ryde House H55-H04 S12530 Ryde House V217996 160605 Stage 4.doc Version 1.30 Page 22 - 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. 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