Inspection on 29/11/05 for Ryde House

This inspection was carried out on 29th November 2005.

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

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

Other inspections for this house

Ryde House 20/10/08

Ryde House 13/11/07

Ryde House 17/10/06

Ryde House 16/06/05

Ryde House 08/12/04

Ryde House 08/04/04

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Fairways

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Kestrel House, St Anne`s Opportunity Centre,

Pinta

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 Inspection 29th November 2005 10:30 Ryde House DS0000012530.V249048.R01.S.doc Version 5.0 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.V249048.R01.S.doc Version 5.0 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.V249048.R01.S.doc Version 5.0 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 (24) registration, with number of places Ryde House DS0000012530.V249048.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named person can be accommodated in the category of MD as agreed by CSCI 16 June 2005 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. Ryde House DS0000012530.V249048.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two inspections for the year at Ryde House and took place unannounced over 4 hrs. Core standards not assessed on this occasion had been assessed at the last inspection. The home’s manager was on holiday and the deputy was in charge of the home. Shortly after the arrival of the inspector the deputy manager returned from the hospital with one of the residents he had accompanied for a health check. While several residents were in the home for most of the day others were at the Ryde House Resource Centre or other day services. The majority spent the lunch period in the home, which provided an opportunity for the inspector to take lunch with the residents and watch their interactions with the staff. The inspector toured the building with the assistant 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, one with particularly good verbal communication was very positive about the service. From the inspector’s observations during the day, examination of records and conversations with staff it was evident the home is providing a good service, in line with its aims and objectives. What the service does well: What has improved since the last inspection? Plans are in place for a major development of the service in line with current best practice. Work is scheduled to commence in 2006. Therefore the proprietors, while maintaining the environment are not undertaking any significant improvements to the building as it stands. Ryde House DS0000012530.V249048.R01.S.doc Version 5.0 Page 6 Staff training is ongoing and the home has now accessed Learning Disability Award Framework (LDAF) training for the staff group. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ryde House DS0000012530.V249048.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ryde House DS0000012530.V249048.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The home ensures that residents’ needs are met with the skills and experience of the staff, effective communication and access to specialist services. EVIDENCE: There have been no new service users admitted to Ryde House since the last inspection and all current residents are long term. They all have cognitive impairments and most have minimal verbal communication. The home provides long-term care/support and not dedicated intermediate care. Staff skills are developed with statutory training and short courses in Downs Syndrome, Autism, challenging behaviour and Adult Protection. Three support workers are undertaking Learning Disability Award Framework (LDAF) training. Currently 55 of the staff group are qualified at NVQ level 2 or above. The home offers a place only to people whose needs can be met, a good example being the most recent admission. The home applied for a variation to accommodate this individual whose needs fall within the mental health category. It was clear from speaking with staff in the home and also a visiting outside support worker that the resident was well settled at Ryde House and her needs were being met. Ryde House DS0000012530.V249048.R01.S.doc Version 5.0 Page 9 The inspector looked at a selection of personal plans, which demonstrated that where specialist interventions are required the home will access appropriate health care professionals, including the advocacy service. Ryde House DS0000012530.V249048.R01.S.doc Version 5.0 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 the following standard(s): 7 Residents are enabled to take control of their own lives within the limits of their cognitive ability. Management and staff support those with intellectual impairment and/or limited communication skills to make decisions. EVIDENCE: The inspector spoke with a resident with good verbal communication who was very clear that she was able to make her own decisions. She described what she liked about the home and some of the choices she was able to make, as well as showing the inspector some published information about forthcoming events that she was looking forward to attending. Staff encourage residents to do what they want to do within a risk assessment framework. Support plans give details of restrictions imposed for a minority of residents at risk of self-harm. The inspector looked at an example where a series of guidelines had been developed by a psychologist to help staff support one particular resident. It was evident that some residents are keen to attend day services either regularly or occasionally, and some are not. This is also true of evening and weekend leisure activities. Ryde House DS0000012530.V249048.R01.S.doc Version 5.0 Page 11 Ryde House has its own day service in the grounds. This is popular with most residents, although some will travel to other services where it can be arranged. Ryde House DS0000012530.V249048.R01.S.doc Version 5.0 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 the following standard(s): 12 and 13 All but one of the residents at Ryde House lack the capacity to take up employment or education opportunities. However, they lead active lives and maintain regular links with the community. EVIDENCE: One resident has been in paid employment for some years. A taxi service is provided as part of his support package. Personal plans provide information on a range of activities for residents, which are set out in weekly routines. Residents attend clubs, church and day centres on the Island according to their varied interests and abilities. Staff said they accompany them to pubs, the cinema, bowling and cafes etc, either using public transport or Ryde House vehicles. A number of residents have been to a holiday centre on the mainland this year and others are due a Christmas break at a similar venue in December. Ryde House DS0000012530.V249048.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19 All residents are independently mobile and require minimal physical support from staff. Guidance and support regarding personal hygiene is limited to encouragement and reassurance. Residents’ health care needs are regularly addressed. EVIDENCE: Only one older resident requires the support of a frame to occasionally aid his mobility. There is a mix of male and female staff at Ryde House to provide residents with flexible personal support as and when required. Staff confirmed, and records showed that residents receive checks from their GP, dentist, optician and specialist health care professionals. They are registered with local health clinics and dental practices. All health care needs of residents are identified in their personal plans and all visits from medical/health care practitioners take place in the privacy of their own rooms. In circumstances where a resident requires a hospital visit a key worker or senior support worker goes with them. This was in evidence on the morning of the inspection when the deputy manager returned from the hospital with a resident. Ryde House DS0000012530.V249048.R01.S.doc Version 5.0 Page 14 During the tour of the building the inspector noted that all rooms were quite different in their personalisation, reflecting the individual characters of those who occupied them. Staff confirmed that residents choose their own clothes and are very clear about what they like and do not like. Ryde House DS0000012530.V249048.R01.S.doc Version 5.0 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 the following standard(s): 22 The home has a clear complaints policy and procedure in place. EVIDENCE: The deputy manager confirmed there had been no complaints from residents or representatives in the last year. He said that the home maintains good liaison with families to ensure any issues are picked up and addressed. In the event of a complaint being made staff would make a record of the issue together with details of the action taken and outcome. The inspector noted the last recorded complaint to be May 2003. Ryde House DS0000012530.V249048.R01.S.doc Version 5.0 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 the following standard(s): 24 Ryde House is not purpose built but has been adapted over the years to provide an accessible, safe and well maintained environment for the needs of those currently living there. EVIDENCE: The inspector toured the building with the assistant manager, looking at all rooms and communal areas. It is recognised by the proprietors that the building does not fit with current best practice. Being an old building accommodating up to twenty-four residents none of the bedrooms have ensuite facilities so a communal lifestyle is the norm. The proprietors have plans to develop the service in 2006 to provide purpose built high quality en-suite facilities to accommodate a maximum of ten people sharing common facilities. In terms of the environment as it stands, the inspector found rooms to be reasonably maintained and decorated, and personalised to suit individual tastes and interests. Communal areas are large, comfortable and appropriately furnished. The home is within walking distance of Ryde town and has transport available including cars and mini-buses Ryde House DS0000012530.V249048.R01.S.doc Version 5.0 Page 17 Ryde House DS0000012530.V249048.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 34 Staff at Ryde House have the necessary skills and experience to meet the needs of the people who live there. A robust recruitment procedure ensures residents are protected. EVIDENCE: The inspector looked at a sample of staff training profiles, which showed a wide range of statutory and care related training. All staff are scheduled to receive training and refreshers in first aid, health and safety, food hygiene, manual handling and infection control. They take advantage of other courses as and when they become available, e.g., challenging behaviour and advanced medication B/Tech. Records showed that currently three support workers are undertaking Learning Disability Award Framework (LDAF) training. 55 have achieved the NVQ at level 2 or above. The deputy manager confirmed that four more are currently enrolled on an NVQ programme. Induction training for new staff follows the appropriate Skills for Care Induction Foundation Programme. Qualification certificates were available on files for inspection. The inspector spoke with three support workers, all of whom appeared interested, motivated and committed. One in particular demonstrated a knowledge and understanding of the specific conditions of several residents. Five new staff had been recruited in the last year. Their recruitment records were checked and found to be in order. Ryde House DS0000012530.V249048.R01.S.doc Version 5.0 Page 19 Ryde House DS0000012530.V249048.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 The Ryde House group has an annual development plan and a process of establishing residents/representatives’ views about the service. EVIDENCE: The inspector returned to the home to complete the assessment of this standard when the manager returned from holiday. The home has achieved the Investors in People Award, which was last assessed in February 2004. The manager and staff said they regularly consult with residents about the home and planned activities or holidays, as far as is possible considering cognitive limitations. Each resident has a named key-worker who gets to know him or her well. This person is involved in all decisions about the service provided for their particular key resident. Residents are included in their care reviews. The inspector looked at the last service user survey, which was completed in 2003. The manager said that the format of this kind of survey was being reviewed to try to ensure more meaningful outcomes. A representative of the Ryde House DS0000012530.V249048.R01.S.doc Version 5.0 Page 21 group monitors the conduct of the home by carrying out monthly regulation 26 visits. This same individual is involved in regular reviews of policies and procedures. The home has an annual business development plan, which includes for 2006 a new environmental and service development in line with current best practice. Ryde House DS0000012530.V249048.R01.S.doc Version 5.0 Page 22 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 x 3 x x Standard No 22 23 Score 3 x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x 3 x x x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x 3 x 3 x x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ryde House Score 3 3 x X Standard No 37 38 39 40 41 42 43 Score x x 3 x x x x DS0000012530.V249048.R01.S.doc Version 5.0 Page 23 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ryde House DS0000012530.V249048.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW 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. 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