Care Home: 25 Raynton Close

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What the care home does well During the feedback session the expert informed that Raynton Close is a nice home and he could live there. Care plans are of very good standard and are regularly updated and reviewed. The home is nicely decorated and provides a comfortable homely environment. People using the service informed me that they had no complaints and are happy to live in Raynton Close. What has improved since the last inspection? The home has met all of the five requirements and five of the six good practice recommendations made during the previous key inspection. The extension to the back of the building has been completed and a new kitchen has been built. The two ground floor bedrooms have been refurbished and en-suite facilities have been added.Carpets have been replaced, communal areas and bedrooms have been repainted. What the care home could do better: I have made two requirements during this key inspection. Due to the increase of falls of one people using the service, the home must provide falls assessments. The registered manager must provide a lock on peoples rooms to ensure privacy. CARE HOME ADULTS 18-65 25 Raynton Close 25 Raynton Close Rayners Lane Middlesex HA2 9TD Lead Inspector Andreas Schwarz Key Unannounced Inspection 15th November 2007 09:00 DS0000017556.V351477.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000017556.V351477.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000017556.V351477.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 25 Raynton Close Address 25 Raynton Close Rayners Lane Middlesex HA2 9TD 0208 868 3174 01895 638 974 info@santacarehomes.co.uk 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) Santa Bapoo Santa Bapoo Care Home 4 Category(ies) of Learning disability (4) registration, with number of places DS0000017556.V351477.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th November 2006 Brief Description of the Service: 25 Raynton Close is a registered care home providing personal care and accommodation for a maximum of 4 adults who have learning disabilities. All service users at the time of the inspection were male. There were no vacancies at the time of the inspection. The Registered Provider/Manager is Ms Santa Bapoo who is similarly registered in respect of the two other care homes in her organization The home is located in a quiet residential cul-de-sac in Rayners Lane, close to shops, pubs and other community amenities. Parking is available on the road outside the home. All the home’s bedrooms are single, and none have en-suite facilities. Two are upstairs along with the sleepover room for staff, whilst two are downstairs. Access upstairs is by stairs only. The home also has a spacious lounge, a dining room, and toilet & bathing facilities. The home has a garden to the rear that is reasonably maintained. It is accessible via some steps from the house. Fees and charges can be obtained from the registered manager. DS0000017556.V351477.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place during November 2007. I invited an Expert by Experience who was accompanied by a support worker to assist me during this key inspection. The expert spoke to all people using the service, one member of staff and toured the premises. The registered manager and deputy manager were available during this key inspection. I spoke to all people using the service and viewed two care plan files and other relevant documents to assess the outcomes for people using the service. The home forwarded a completed Annual Quality Assurance Assessment within the given timescale. I would like to take the opportunity thanking everybody assisting me during this key inspection. What the service does well: What has improved since the last inspection? The home has met all of the five requirements and five of the six good practice recommendations made during the previous key inspection. The extension to the back of the building has been completed and a new kitchen has been built. The two ground floor bedrooms have been refurbished and en-suite facilities have been added. DS0000017556.V351477.R01.S.doc Version 5.2 Page 6 Carpets have been replaced, communal areas and bedrooms have been repainted. 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. The summary of this inspection report can be made available in other formats on request. DS0000017556.V351477.R01.S.doc Version 5.2 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 DS0000017556.V351477.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Prior to being assessed appropriately, to establish if the home is able to meet the needs of new prospective residents. New prospective service users receive detailed information about the home. EVIDENCE: The home did not receive any new referrals and the current group of people has been living in the home since it was registered. The home does not have any vacancies. Original assessment documents have been archived. The registered manager informed me that she has undertaken the needs assessment of the people using the service living at the home. DS0000017556.V351477.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The care plans are person centred and are agreed with the individual. Each care plan includes a comprehensive risk assessment, which is reviewed regularly. The home ensures that people using the service are consulted on a regular basis to gather information about their satisfaction. EVIDENCE: I have viewed and assessed two care plans during this key inspection. Both care plans were of very good standard and have been reviewed within the last six months. People using the service, family and/or advocates have been involved in the reviewing process. People using the service told me that they know about their care plan. Care plans are person centred and cover the person’s needs holistically. Service users guide, contract, personal profile and statement of purpose are available in individual care plan folders. DS0000017556.V351477.R01.S.doc Version 5.2 Page 10 People using the service informed the expert that they can decide when to get up, what to wear, etc. The expert noted that people using the service do not hold a key, which has been assessed in care plans. People using the service financial records are correct, people using the service informed me that they receive pocket money and go to the bank weekly. The registered manager and/or deputy manager regularly audits people’s finances. One person told me that he could choose what he wanted to do for his birthday. All people using the service have a range of risk assessments in place, which have been reviewed within the last six months. One of the people living in the home had an increase in falls. This was discussed with the registered manager and a falls risk assessment must be provided for this person. DS0000017556.V351477.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The service has a strong commitment to enabling people who use services to develop their skills, including social, emotional, communication, and independent living skills. Individuals are supported to identify their goals, and work to achieve them. People who use the service have the opportunity to develop and maintain important personal and family relationships; The meals are balanced and nutritional and cater for the varying cultural and dietary needs of the individuals using the service. EVIDENCE: I was told by people using the service that they go to daycentres during the week. One person informed me that he is working one day per week at a garden centre. The deputy manager told me that due to the age of two people DS0000017556.V351477.R01.S.doc Version 5.2 Page 12 using the service social services is planning to change access to day centres, and instead of five days can only go for three days per week. Records showed that people using the service go to the pub, café’s, libraries or shopping centres. People using the service told me that they go regularly to church on Sundays. I observed staff discussing a trip to the West End with people using the service to do Christmas shopping. People using the service told me that they go swimming, play badminton and football. Families and advocates are involved in care planning and people using the services are visited regularly. Records show that people using the service go to social clubs during evenings to make friends and built relationships with other people. One person told me about his girlfriend. People using the service informed the expert that they planned their birthday party, and invited friends. The expert noted that people using the service don’t have a key and that bedrooms cannot be locked for privacy from the inside. I have discussed this with the registered manager and viewed risk assessments in people’s files, which demonstrated that people using the service choose not to have a key. It is however required to provide a lock on bedrooms to ensure privacy. Staff however must be able to override the lock from the outside in case of an emergency. People using the service informed me that they help to wash and tidy up after meals. If people using the service choose to smoke this can be done in the garden, which can be accessed through the lounge. The home is providing a healthy diet; people using the service have a cooked meal at the day centre and a light dinner in the home. Menus are discussed in weekly house meetings and service users choices are taken into account, on weekends people using the service have cooked breakfast, roast dinner and go to restaurants and café’s. The home is providing appropriate cultural meals for religious festivals such as Diwali, Christmas, etc. Fridge and freezer temperature is taken daily and was within the legal limits. DS0000017556.V351477.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Personal healthcare needs including specialist health, nursing and dietary requirements are clearly recorded in each resident’s plan. The delivery of personal care is individual and is flexible, consistent, reliable, and person centred. People who use services have access to healthcare and remedial services. The home has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. EVIDENCE: Personal care support is documented in peoples care plan files. A person using the service told me that staff helps him to wash his back. The home is monitoring people’s mobility and is supporting people using the service to access physiotherapist, wheelchair services, etc. People using the service informed me that they can get up or go to bed when they want provided they have no appointments. Records of these visits are well documented. All people using the service are registered with their General Practitioner and staff supports people using the service to visit the doctors surgery. The home DS0000017556.V351477.R01.S.doc Version 5.2 Page 14 is monitoring people’s health and is acting promptly to deal with changes. The General Practitioner undertakes annual health checks. People using the service are supported to access chiropodists, dentist and opticians. Medication is dispensed by a local chemist and safely stored in a lockable cupboard. A signatory list of staff authorised to administer medication is in the medication file. Medication Administration Sheets had no gaps and a separate sheet to record medication returned to the chemist is in place. The home has a medication policy in place. DS0000017556.V351477.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has an open culture that allows people using the service to express their views, and concerns in a safe and understanding environment. The policies and procedures for Safeguarding Adults are available and give clear specific guidance to those using them. EVIDENCE: The homes complaints procedure is available in the service users guide and is judged as compliant with National Minimum Standards. The home did not receive any complaints since the last inspection. People using the service informed me that they would complain to the manager if they were not happy. I found in one file a very positive comment a family member made about the home and care provided, “ I don’t think I’ve ever seen XXX look that smart”. The home has a Protection of Vulnerable Adults policy in place and staff have received training and demonstrated good understanding of reporting and recording Protection of Vulnerable Adults allegations. I noted that the home does not have the funding/ hosting borough Protection of Vulnerable Adults procedure, which should be obtained. There was no adult protection referral since the last inspection. DS0000017556.V351477.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home provides a physical environment that is appropriate to the specific needs of the people who live there. The home is a very pleasant, safe place to live the bedrooms and communal rooms meet the National Minimum Standards, most bedrooms have en-suite facilities. EVIDENCE: The registered provider showed me and people using the service showed the expert around the home. The home has finished the new extension and extra space has been created. People using the service rooms on the ground floor have now en-suite facilities. Carpets in communal areas have been replaced and the home has been repainted, people using the service told me that they could choose the colour of the paint. The expert told me that he likes the home and could live at Raynton Close. I noted that the boiler was very noisy and asked the registered manager to investigate this and find ways resolving DS0000017556.V351477.R01.S.doc Version 5.2 Page 17 this problem. The shower hose could not be fixed on the wall, which could, make it difficult for people having a shower. The laundry room was clean and the home is providing a washing machine and dryer for people using the service to use. The home was clean and free of any offensive odours and I observed staff cleaning during this visit. DS0000017556.V351477.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff members undertake external qualifications beyond the basic requirements. The staffing structure and training is based around delivering outcomes for the people using the service, and is not led by staff requirements. The service has a good recruitment procedure that clearly defines the process to be followed. EVIDENCE: During this inspection one member of staff was on duty and a second staff member arrived to accompany people using the service to go to the day centre. During the day no staff is on duty due to people using the service going to day centre, the day centres have a number which they cam call in case of an emergency. I observed very good interactions between staff and people using the service. Four of the five staff employed have or are working towards their National Vocational Qualification in Care; this exceeds requirements of 50 . I have viewed two staff files during this key inspection, all required documents such as Criminal Records Bureau checks, references, application forms, DS0000017556.V351477.R01.S.doc Version 5.2 Page 19 passport copy, and etc. was in place. Staff informed me of having had an interview before being offered their post. New staff have received an induction, staff have attended a wide range of training, e.g. manual handling, Food hygiene, Protection of Vulnerable Adults, Fire, Epilepsy, Autism, First Aid, etc. A training and development plan is on file. Staff have received 5 supervisions per year and a annual appraisal on the anniversary of their commencement date. This meets minimum requirements. DS0000017556.V351477.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The Manager has the required qualifications and experience and is competent to run the home. The manager has a clear understanding of the key principles and focus of the service, based on organisational values and priorities. The home works to a clear health and safety policy, all staff is fully aware of the policy and is trained to put theory into practice. EVIDENCE: The registered manager/ provider has not changed since the last inspection. Mrs Bapoo is experienced and qualified to manage a registered care home. Mrs Bapoo achieved her Registered Managers Award and informed me that she attended different training sessions with staff since the last inspection. Staff spoke very positive about the registered manager. DS0000017556.V351477.R01.S.doc Version 5.2 Page 21 The home has send out surveys to people using the service and stakeholders, information received from these surveys have been incorporated in the annual development plan. People using the service can attend regular meetings; records of these meetings have been viewed during this inspection. I have viewed fire records, which are all of good standards and regular checks are undertaken. The Portable Appliances Test Certificate and Landlords Gas Safety Certificate is in place and up to date. Staff have received Health and Safety training and policies are in place. DS0000017556.V351477.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X DS0000017556.V351477.R01.S.doc Version 5.2 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. 1. Standard YA9 Regulation 13(4)(c) Requirement The home must provide falls assessments if people using the service have had an increase in falls. The registered manager must provide a lock on peoples rooms to ensure privacy. Timescale for action 01/01/08 2. YA16 23(2)(g) 01/02/08 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 YA23 Good Practice Recommendations The home should obtain Protection of Vulnerable Adults guidelines from the hosting/funding borough. (Previously recommended) The home should investigate the noise of the boiler. The shower hose should be fixed and an appropriate fitting should be provided. 2. 3. YA24 YA24 DS0000017556.V351477.R01.S.doc Version 5.2 Page 24 DS0000017556.V351477.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000017556.V351477.R01.S.doc Version 5.2 Page 26 - 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. 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