Inspection on 14/12/05 for The Ranch

This inspection was carried out on 14th December 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 found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Ranch 18/02/08

The Ranch 23/02/07

The Ranch 24/01/06

The Ranch 28/02/05

The Ranch 06/01/05

Similar services:

Southfields

Thorndene

Insight - Eastchurch

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

1 Marten Road

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

CARE HOME ADULTS 18-65 The Ranch Well Path, Well Lane Horsell Woking Surrey GU21 4PJ Lead Inspector Cathy Clarke Unannounced Inspection 14th December 2005 12:30 The Ranch DS0000059190.V273963.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 The Ranch DS0000059190.V273963.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. The Ranch DS0000059190.V273963.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Ranch Address Well Path, Well Lane Horsell Woking Surrey GU21 4PJ 01424 438813 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) Quest Haven Ltd Mr Isaac Tagoe Care Home 3 Category(ies) of Learning disability (3) registration, with number of places The Ranch DS0000059190.V273963.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th February 2005 Brief Description of the Service: The Ranch is a detached Bungalow situated within a quiet residential area of Woking. The home provides 3 single bedrooms, bathroom, lounge, and conservatory, dining area, kitchen, office, utility room and a small rear garden. There is ample parking space to the front of the property. Local transport links provide access to Woking and surrounding areas. The Ranch DS0000059190.V273963.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 3 hours and was the first inspection to be undertaken by the Commission for Social Care Inspection year April 2005 to March 2006. Cathy Clarke, Lead Inspector for the service, carried out this inspection and Mr Isaac Tagoe was present as the representative for the establishment. A full tour of the premises took place; documents inspected included care plans, staff records, and policies and procedures. There was one service user in the home at the time of inspection. This was a positive inspection. The inspector would like to thank the management and staff for their time, assistance and hospitality during this inspection. What the service does well: What has improved since the last inspection? What they could do better: The statement of purpose must be reviewed and updated to include Mental Disorder in the registered category for the home. The Ranch DS0000059190.V273963.R01.S.doc Version 5.0 Page 6 It is recommended that discussion be held with the care management and advocacy service regarding the service users ongoing satisfaction and happiness within the home. Medication instructions recorded on medication administration records must accurately reflect the current dosage and prescription. The signatures of staff trained to administer medication should be listed in the front of the medication file. A current photograph of each service user must be inserted into medication file. It is recommended that the service provide a bound and numbered controlled drugs register. Flour must be stored in a sealed container once opened and eggs must be stored in a refrigerator. 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 Ranch DS0000059190.V273963.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 The Ranch DS0000059190.V273963.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): 1,2 Comprehensive information regarding the home is available for prospective service users and planned assessments are undertaken prior to moving into the home. EVIDENCE: The statement of purpose must be reviewed and updated to include mental disorder as a category of registration for the home. Planned assessments are conducted prior to admission to the home and the service user who was placed in the home in May 2005 has settled in well. A new service user is to move into the home shortly and staff have gradually introduced her to the service user living in the home on her own at present. During the inspection the current service user wrote on a message pad that she liked the home for the time being. The registered manager felt that she had become used to having the home completely to herself. The registered manager has agreed to discuss her ongoing satisfaction with her placement with her care manager and advocate. The Ranch DS0000059190.V273963.R01.S.doc Version 5.0 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 the following standard(s): 6,7, Care plans and risk assessments are clear and set out the achievements made by service users. EVIDENCE: Care plans sampled were comprehensive with protocols, which include a description of the short and long-term goals that service users are working towards achieving. Care plan reviews have been conducted between the local authority care management service and the provider on the 23rd August 2005. The service user has stated at her review that she was happy with the placement and felt the service was meeting her needs. The Ranch DS0000059190.V273963.R01.S.doc Version 5.0 Page 10 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): 11,12,15,17 The Service user takes part in age and peer appropriate activities. A varied menu is planned with the service user and alternative options are available. EVIDENCE: The service user was watching her favourite music channel on the television during the inspection. She also likes to listen to popular music on the radio. Her sister visits her fortnightly and her brother also visits regularly. The service user will be spending Christmas with her family. The service is trying to find a local advocate for the service user. The registered manager informed the inspector that they have tried to encourage the service user to attend college but she needs to build up her confidence further before fully committing to this. It was lunchtime when the inspector arrived and the service user was sitting in front of the television with her meal. There is a menu in the kitchen and a range of balanced and varied meals are available with alternatives choices if preferred. The Ranch DS0000059190.V273963.R01.S.doc Version 5.0 Page 11 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, 19, 20 The assessed healthcare needs of service users are met and the service has a good relationship with local healthcare professionals. The process for identification of service users and staff for the purposes of administration of medication must be improved. Medication records must reflect the current medication dose and prescription. EVIDENCE: The registered manager informed the inspector that the service user is independent in some aspects of personal care but needs assistance to wash her hair and help is needed to get in and out of the bath. Within the house the service user uses a trolley to get about and is assisted in a wheelchair when outdoors. A chiropody assessment was conducted on the 10th June 2005 and her next appointment has been booked. The service user had attended an Opticians appointment on the morning of the inspection but had become very nervous and was brought home. Medication records must reflect the current dosage and prescription. During the inspection the inspector found that medication, which was being given on an as required basis was written on medication administration chart to be The Ranch DS0000059190.V273963.R01.S.doc Version 5.0 Page 12 given once or twice per day. At present there are no controlled medicines being used. As a good practice measure it is recommended that the service provide a bound and numbered controlled drugs register. Current photographs of service users are to be added to the medication folder and staff signatures must be listed and kept within the file. The Ranch DS0000059190.V273963.R01.S.doc Version 5.0 Page 13 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): 22,23 Staff have received training in the protection of vulnerable adults using the Surrey Multi Agency Approach procedures therefore ensuring that staff are aware of any potential signs of abuse. A complaints policy and procedure is in place. EVIDENCE: There have been no complaints or vulnerable adult investigations since the last inspection. The Ranch DS0000059190.V273963.R01.S.doc Version 5.0 Page 14 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, 29,30 The layout of the home is suitable for it’s stated purpose. It is accessible, safe and well maintained. The home was found to meet the service users individual needs in a comfortable and homely way. EVIDENCE: The service provides a homely environment, which is comfortable and well furnished. Flour stored must be stored in a sealed container once opened and eggs must be stored in a refrigerator. The service user has a bath aid and wheelchair to assist her to maintain her independence. She uses a trolley to get about within the home. The home is clean and tidy and free from any mal odours. The Ranch DS0000059190.V273963.R01.S.doc Version 5.0 Page 15 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): These standards were not assessed during this inspection. EVIDENCE: The Ranch DS0000059190.V273963.R01.S.doc Version 5.0 Page 16 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): 42 There is an open and inclusive management style and staff work well as a team. The health, safety and welfare of service users is promoted and protected by the policies and procedures, which underpin the care provided. EVIDENCE: The registered manager has completed his NVQ Level 4 Registered Managers award. Staff respond well to the manager and work well as a team. Since the last inspection a sprinkler system has been installed to meet the recommendations of the fire service. There is a call bell system in each of the bedrooms. A bath aid has been installed in the main bathroom. Electrical equipment has been tested and found to be satisfactory on the 14/7/05. The Ranch DS0000059190.V273963.R01.S.doc Version 5.0 Page 17 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 2 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 X 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Ranch Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score X X X X X 3 X DS0000059190.V273963.R01.S.doc Version 5.0 Page 18 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 YA1 Regulation 4 (1) (a) (b) (c) Requirement The statement of purpose must be reviewed and updated to include Mental Disorder in the registered category for the home. Medication instructions recorded on medication administration records must accurately reflect the current dosage and prescription. The signatures of staff trained to administer medication should be listed in the front of the medication file. A current photograph of each service user must be inserted into medication file. Flour must be stored in a sealed container once opened and eggs must be stored in a refrigerator. Timescale for action 31/01/06 2 YA20 12 (1) (a) 31/01/06 3 YA20 12 (1) (a) 31/01/06 4 5 YA20 YA24 12 (1) (a) 16 (2) (g) 31/01/06 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. The Ranch Refer to Good Practice Recommendations DS0000059190.V273963.R01.S.doc Version 5.0 Page 19 1 2 Standard YA2 YA20 It is recommended that discussion be held with the care management and advocacy service regarding the service users ongoing satisfaction and happiness within the home. It is recommended that the service provide a bound and numbered controlled drugs register. The Ranch DS0000059190.V273963.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 The Ranch DS0000059190.V273963.R01.S.doc Version 5.0 Page 21 - 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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