Inspection on 30/06/05 for The Firs

This inspection was carried out on 30th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

The Firs 22/05/07

The Firs 20/12/05

The Firs 18/01/05

The Firs 01/11/04

Similar services:

Flint House

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

The Cotswold Home

Fairways

Treloar College

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

CARE HOME ADULTS 18-65 FIRS - RAVENSWOOD Ravenswood Village Nine Mile Ride Berkshire RG45 6BQ Lead Inspector Stewart Mynott Unannounced 30 June 2005 10:10am th 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. FIRS - RAVENSWOOD H52-H01 S33978 The Firs V229137 300605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Firs - Ravenswood Address Nine Mile Ride 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) 01344 755579/80 Mrs Norma Brier Norwood Ravenswood Foundation Mr Ernesto Paulo Pantaleao Cartaxo Care home only (PC) 11 Category(ies) of Learning disability (LD) registration, with number Physical disability (PD) of places FIRS - RAVENSWOOD H52-H01 S33978 The Firs V229137 300605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 18 January 2005 Brief Description of the Service: The Firs is part of Ravenswood Village and is registered to provide support and care for eleven adults with learning disabilities. The Jewish faith is central to the daily life of the village. The home is a spacious purpose built, two-storey building which includes a two bed roomed self-contained flat. All the home’s bedrooms are single. The aims and objectives of the home is to provide a secure and comfortable home; encourage and support residents to make decisions and choices in their lives; support and assist service users to make and maintain satisfying relationships; assist service users to develop their skills; and enable service users to engage in valued day time occupation and use the community facilities. FIRS - RAVENSWOOD H52-H01 S33978 The Firs V229137 300605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which lasted for 6 hours. The visit included a tour of the home, discussion with service users and staff on duty. Service users care records and some of the homes records were examined. Seven service users were spoken to of which five were able to take part in discussions, some of which included staff assistance. Four staff were spoken to and time was spent in discussion with the Registered Manager throughout the day. What the service does well: What has improved since the last inspection? The homes staffs now receive more regular supervision to assist them with continuing to meet service users needs. Staff and service users have continued work on the fishpond and surrounding planting which has greatly enhanced the appearance of the garden. FIRS - RAVENSWOOD H52-H01 S33978 The Firs V229137 300605 Stage 4.doc Version 1.30 Page 6 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. FIRS - RAVENSWOOD H52-H01 S33978 The Firs V229137 300605 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 FIRS - RAVENSWOOD H52-H01 S33978 The Firs V229137 300605 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 home ensures comprehensive assessments are undertaken with planning for identified needs occurring in advance. The team’s knowledge of this information is evidenced before admission of new service users. EVIDENCE: Discussion with the manager, a staff member and examination of records in relation to an admission took place. The new admission benefited from comprehensive assessments and planning meetings. These were reviewed before admission. Some requirements identified were implemented to support independence prior to admission. The service user had the opportunity to visit the home on a few occasions in a manner, which prevented undue stress. The staff team were debriefed in detail in regards to assessed needs and information required to support and understand the service user. FIRS - RAVENSWOOD H52-H01 S33978 The Firs V229137 300605 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, and 9 Service users are fully involved in making decisions and agreeing personal goals in their individual plans. Risk assessments support independence in daily life and activities. Key workers hold monthly care plan support meetings, one service user did not have this record up to date in their “key file”. EVIDENCE: Each service user has a “key file” and separate “daily log”. The key file contains all relevant information occurring in the past year including an individual plan, care plans and monthly support summaries. Three service users individual plans were observed and all contained detailed reports including day services, other professional reports and a “my life” document. The “my life” document was completed by service users with their key workers and clearly detailed their “needs and strengths” for the future year and were signed by the service user. The individual plans are completed annually and reviewed every six months. In addition key workers review care plans and support required each month. In one “key file” this process had not been recorded since February 2005. There are separate risk assessments for each service user, which detail a variety of lifestyle and domestic activities. The Registered Manager keeps FIRS - RAVENSWOOD H52-H01 S33978 The Firs V229137 300605 Stage 4.doc Version 1.30 Page 10 these separate for staff accessibility and awareness. Staffs spoken to were knowledgeable about these assessments and their contribution to independence and protection. Staff review these documents on a regular basis. One service users risk assessment clearly involved their participation and was signed by them. Service users were spoken to and observed going about their daily lives and routines. Some required staff support to make appropriate decisions. Observations confirmed respectful, supportive and positive interactions maintaining dignity at all times. Staff spoken to were very knowledgeable about service users needs and their support required as detailed in written records. FIRS - RAVENSWOOD H52-H01 S33978 The Firs V229137 300605 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Standards 11 to 17 were not assessed during this inspection. EVIDENCE: FIRS - RAVENSWOOD H52-H01 S33978 The Firs V229137 300605 Stage 4.doc Version 1.30 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20 Service users receive flexible care to ensure personal and healthcare needs are fully met. EVIDENCE: Four service users spoken to confirmed that their personal care needs were met and they were happy with the staff assistance provided. There was clear evidence through observation that service users had control over personal support and appearance reflected their personality. One service user discussed a specialist report seen in their key file in regards to bathroom facilities and future plans to better assist personal care. Daily logs were inspected which detailed support and personal care required, these were seen to be up to date. The health needs of 3 service users were focused on and were fully met. All had access of local NHS health care facilities and these appointments were clearly documented in the “key files”. More specialist support included dietician and psychologist input. Such support was seen to contribute in this year’s goals in their Individual Plans. The staff member who takes responsibility for the medication system was on duty and available to explain the system. The home uses the Nomad system and all records relating to this were clear and appeared correct. A weekly audit called the “medication weekly check” was seen to cover all points of the FIRS - RAVENSWOOD H52-H01 S33978 The Firs V229137 300605 Stage 4.doc Version 1.30 Page 13 medication policy and the staff member was clearly competent in performing this task. A copy of this audit is given to the Registered Manager and several weeks were inspected confirming the medication policies are followed correctly. Training records provided by the Manager showed that all staff have medication training and regular updates. FIRS - RAVENSWOOD H52-H01 S33978 The Firs V229137 300605 Stage 4.doc Version 1.30 Page 14 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) 22 and 23 Service users are listened to and their views acted upon. Service users are carefully protected from abuse by the staff team and homes policies. EVIDENCE: There is a comprehensive complaints policy within the home and a further policy in pictorial form within the service users guide. The complaints register was seen and one complaint was recorded since the last inspection. This was dealt with as per policy. A complaints officer within the village reviews all complaints. A service user spoken to was clear about how to complain should the need arise. The Registered Manager has a detailed knowledge about the abuse policy and documentation seen demonstrates this policy is followed carefully to fully protect all service users. The Registered Manager assists in delivering this training within the village. The staffs at the home all have received training in protection of adults as evidenced in training records. Training to assist dealing with challenging behaviour including SCIP procedures was also evidenced. Staffs spoken to are clear and confident dealing with behaviour that may challenge and records demonstrate guidelines are in place where needed. One minor incident involving such behaviour was observed and the situation was diffused before escalation occurred and without intrusion on other service users. FIRS - RAVENSWOOD H52-H01 S33978 The Firs V229137 300605 Stage 4.doc Version 1.30 Page 15 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) 24 and 30 The home is very clean, homely and well decorated. A permanent repair to the crack by a doorframe in the flat is recommended. EVIDENCE: A tour was given by the manager, which covered the home and gardens. During this tour service users and staff were introduced and some discussions took place. The communal living space was seen to be very homely. The activity room had a pool table and stereo. Service users artwork and pictures were on the wall. The lounge was comfortable with leather sofas that had been chosen by services users. This was evidenced in a signed record seen after the tour and during general discussion. The dining room and kitchen were clean and tidy although the wooden dining room floor is worn and will require some maintenance in due course. Service users bedrooms seen were personalised and clean. Bathrooms were also very clean although the Manager identified the seal in the downstairs shower will be replaced. The firs also have a semi independent flat for two service users. This was clean and tidy. Occupants later confirmed that they had chosen the colours in the FIRS - RAVENSWOOD H52-H01 S33978 The Firs V229137 300605 Stage 4.doc Version 1.30 Page 16 communal areas. There was a deep crack running parallel with the bathroom doorframe, which is unsightly and requires a permanent repair. The gardens were well maintained with a recently renovated fishpond with surrounding planting. Service users and a staff member confirmed that they were involved in this project. FIRS - RAVENSWOOD H52-H01 S33978 The Firs V229137 300605 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) 36 Service users benefit from a staff team that receive regular supervision and support from senior team members. EVIDENCE: A previous recommendation was inspected to determine progress made in relation to the frequency of staff supervision. Records were seen to indicate supervisor training has occurred for a recently appointed deputy and the staff team are now being supervised regularly. Staff spoken to on duty confirmed this. FIRS - RAVENSWOOD H52-H01 S33978 The Firs V229137 300605 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) Standards 47 to 43 were not assessed during this inspection EVIDENCE: FIRS - RAVENSWOOD H52-H01 S33978 The Firs V229137 300605 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 4 x 3 x Standard No 22 23 ENVIRONMENT Score 3 4 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score x x x x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 FIRS - RAVENSWOOD Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x H52-H01 S33978 The Firs V229137 300605 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 24 Good Practice Recommendations A permanent repair should be made to the large crack in the wall by the bathroom doorframe in the flat. FIRS - RAVENSWOOD H52-H01 S33978 The Firs V229137 300605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 2nd Floor 1015 Arlington Business Park Theale RG7 4SA 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 FIRS - RAVENSWOOD H52-H01 S33978 The Firs V229137 300605 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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