Care Home: Gladstone House

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What the care home does well The home provides an excellent standard of care and support to residents in a sensitive and caring manner. Good risk assessments are in place which promotes independence and do not restrict the residents from leading an active and fulfilling lifestyle. Strengths and needs are outlined in well- maintained care plans as agreed with individual residents. The service provides a comfortable, well -decorated and safe environment for residents to live taking into account need, choice, and age. The home is well managed in the best interests of the residents and residents are encouraged to air their views and comments. What has improved since the last inspection? Since the last inspection the garden to the rear of the home has been made safe and residents can now access this via a garden path. Raised flowerbeds are also in place. Systems are now in place to monitor quality assurance. The RNIB College closed in July 2007, and a resource centre retained on the old college site. All the residents access some of the activities at this centre known as "the hub". This has created more stability for the residents, as there was a feeling of anxiety and uncertainty at the last inspection. Residents stated that they enjoy attending individual sessions there. What the care home could do better: There are no requirements as an outcome of this inspection. CARE HOME ADULTS 18-65 24-26 St John`s Road 24/26 St John`s Road Redhill Surrey RH1 6HX Lead Inspector Mary Williamson Unannounced Inspection 07th December 2007 11:00 24-26 St John`s Road DS0000052048.V353867.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 24-26 St John`s Road DS0000052048.V353867.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. 24-26 St John`s Road DS0000052048.V353867.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 24-26 St John`s Road Address 24/26 St John`s Road Redhill Surrey RH1 6HX 020 73 881266 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) RNIB Mark Eckersley Care Home 6 Category(ies) of Learning disability (6), Physical disability (6), registration, with number Sensory impairment (6) of places 24-26 St John`s Road DS0000052048.V353867.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd October 2006 Brief Description of the Service: 24/26 St Johns Road is a home for people with Sensory Impairment and Learning Disabilities owned by the Royal National Institute for the Blind. The home is in a residential area of Redhill. All of the Service Users attend the RNIB resource Hub. Each service user has an individual bedroom. The property is close to all local amenities and transport. There is a small garden to the rear of the premises. The fees charged at this service are a basic £60,936 per year. 24-26 St John`s Road DS0000052048.V353867.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first site visit of a key inspection and was unannounced. Mary Williamson Regulation Inspector undertook the inspection. The deputy manager was present for the duration of the inspection and the registered home manager was present for the evaluation and feedback. Five of the six residents were in the home and it was possible for the inspector to spend a significant part of the inspection talking to them and gaining feedback about the home. A tour of the premises was undertaken and residents invited the inspector to view their bedrooms. Records relating to the care of the residents and the management of the home were seen, including care plans, needs assessments, risk assessments, staff training and employment files, and health and safety legislation. Equality and diversity is observed and outlined in care plans and in house routine. The manager completed an AQAA (Annual Quality Assurance Assessment) prior to the inspection. The home has a complaints procedure in place, which is available in Braille, audio CD, large print and picture format. There have been no complaints since the last inspection. The Commission for Social care Inspection would like to thank the residents and staff for their help in the inspection process. What the service does well: The home provides an excellent standard of care and support to residents in a sensitive and caring manner. Good risk assessments are in place which promotes independence and do not restrict the residents from leading an active and fulfilling lifestyle. Strengths and needs are outlined in well- maintained care plans as agreed with individual residents. The service provides a comfortable, well -decorated and safe environment for residents to live taking into account need, choice, and age. The home is well managed in the best interests of the residents and residents are encouraged to air their views and comments. 24-26 St John`s Road DS0000052048.V353867.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. 24-26 St John`s Road DS0000052048.V353867.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 24-26 St John`s Road DS0000052048.V353867.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): 1, 2, and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The statement of purpose and service user guide provides residents with appropriate information regarding the home. Needs assessments are undertaken on all prospective residents and contracts of occupancy are in place. EVIDENCE: The home has a statement of purpose and service user guide in place. All the residents have access to a copy of this, which is also available in Braille, and audio CD format. The group of residents living in the home have been living there for a long time and the last person to be admitted was over three years ago. Individual needs assessments are in place. These were undertaken prior to admission to establish if individual needs could be met. These have been reviewed and updated regularly with a view to some residents being given the option of progressing to more independent living. The needs assessments are detailed and informative and involve the multidisciplinary team. Contracts of occupancy are in place and outline the support provided, the accommodation offered and the method and frequency of fees paid. 24-26 St John`s Road DS0000052048.V353867.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): 6, 7, and 9. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Individual needs and goals are reflected in individual care plans. Residents make decisions on all aspects of daily living, which are not restricted by the risk assessments in place. EVIDENCE: Individual care plans are in place, which have been written with the residents. Strengths and needs are discussed, which are then reflected in care plans outlining preference and choice. Residents are aware of their care plans and contents and sign these following each review. The residents stated that they are able to make decisions about the home and their leisure time. They stated that they have a house meeting every week where they decide on activities for the week, group menus, whose turn it is to do the shopping, individual house chores, and in house leisure activities. During group discussion it was evident that residents are very supportive of each others feelings and aspirations. Risk assessments are in place for both in house, and community activities. These assessments do not restrict residents and help promote independence 24-26 St John`s Road DS0000052048.V353867.R01.S.doc Version 5.2 Page 10 and choice. Some risk assessments include general household tasks such as cooking and doing laundry, going out independently, using public transport and walking without a sighted guide. 24-26 St John`s Road DS0000052048.V353867.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): 12, 13, 15, 16, and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to take part in appropriate activities. Community and family links are maintained and friendship groups supported. Residents are encouraged to follow a healthy eating plan. EVIDENCE: All the residents have an individual activities programme, which includes planned activities in house and at the local RNIB Resource Hub. This was the former RNIB College, which closed in July 2007. Residents stated that they use the gym, drama club, computer skills, and music facilities at the hub. One resident is a member of a band and explained how they entertain people at various venues for example day resource centres and older peoples homes. Another resident stated that he enjoys horse riding. On the day of the inspection five of the residents were involved in a cookery class facilitated by the resource centre in the home. The residents were icing their Christmas cake, which they had made the previous week. This was a 24-26 St John`s Road DS0000052048.V353867.R01.S.doc Version 5.2 Page 12 well- structured session, which included the participation of all the residents. They plan to eat this at the house Christmas dinner next week prior to all the residents going home for their Christmas break. The activity programme incorporates an individual day at home for residents to promote life skills. This included planning an individual meal, shopping for the ingredients, preparing the meal, and clearing up. It also included supporting residents with personal laundry, and budgeting. The residents spoke of their holiday in Devon during the summer, and their experiences in sharing caravans. It has been unanimously decided that a caravan holiday will not be repeated, but will consider alternative accommodation. Family links and friendship groups are maintained, and relatives are welcome in the home. Relatives were spoken during the inspection as they collected the residents to go home for the weekend. Residents stated that they can invite friends to the home and can visit friends and girlfriends in other homes. Spiritual needs are supported and two residents attend local churches with staff. One resident attends church when he goes home. Diverse needs are recorded and observed through diet and choice. The residents are encouraged to follow a healthy eating plan. All the residents meet on Sunday to plan the meals for the following week. The menu will include cultural and special needs. The residents stated that they plan a weekly meal relating to a specific country and had recently included spaghetti and meat- balls from Italy, and curry from India. Residents are included in the preparation of meals, and also prepare packed lunches if they spend all day at the “hub”. 24-26 St John`s Road DS0000052048.V353867.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): 18, 19, and 21. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents receive personal support in a way they prefer. Physical, and emotional health needs are being met. The medication procedure in place protects the residents living in the home. EVIDENCE: The agreed level of personal support is outlined in individual care plans and delivered in a way the residents prefer. The arrangements in place to meet the health care needs of the residents are excellent. All the residents are registered with a local GP of their choice. They can visit the surgery when necessary and have an annual health check. Health action plans are in place and these are discussed and reviewed regularly with care workers. Residents also access the dental and chiropody treatment in the community. They also attend an optician in Redhill with specific skills to meet the needs of people with a visual impairment. There is a medication administration policy in place and all staff are aware of this policy. Medication is stored correctly and regular audits of medication take 24-26 St John`s Road DS0000052048.V353867.R01.S.doc Version 5.2 Page 14 place. Residents are encouraged to be as independent as possible and risk assessments are in place for the self -administration of medication. 24-26 St John`s Road DS0000052048.V353867.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): 22, and 23. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents felt that their views are listened to and acted upon. The abuse awareness policy protects residents living in the home. EVIDENCE: There is a complaints procedure in place, which is also available in large print, Braille, and tape format. The deputy manager explained that this procedure is explained to residents regularly to support them to voice their opinions and concerns if they are not satisfied with a situation in the home. Residents stated that they could voice their feelings by confiding in their key worker, in residents meetings, in writing, or through their relatives. They are all confident about this procedure and felt that any concern or niggles would be resolved quickly and professionally. The home has an abuse awareness policy in place and all staff have training in this policy during induction training. There is also a copy on Surreys Multi Agency Policies and Procedures on Safeguarding Vulnerable Adults in place, and the manager has attended local authority training in these procedures. The organisation has a named person responsible for making Vulnerable Adult referrals. Safeguarding contact telephone numbers are available in the office and the general notice board if required. 24-26 St John`s Road DS0000052048.V353867.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): 24, 25, 27, 28, and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a homely, well maintained, and safe environment, that is suitable for its stated purpose. EVIDENCE: The home provides a comfortable, well-maintained and clean environment for residents live in. There is an ongoing programme of redecorating and maintenance in place and several areas of the home have been redecorated and fitted with new carpets since the last inspection. Residents have a choice of décor. The lounge is bright and airy and provided residents with a communal space to socialise play music and games. Residents were planning to buy the Christmas tree the following day for the lounge. Individual bedrooms have been personalised to reflect personality and includes music centres, televisions, play stations, videos, and personal effects. One bedroom has en-suite facilities. 24-26 St John`s Road DS0000052048.V353867.R01.S.doc Version 5.2 Page 17 There are sufficient bathroom and toilets situated within the home and there are plans in place to convert an existing bathroom into a walk in shower room at the request of the residents. There is a small laundry/utility room located on the ground floor where residents are supported to do their own laundry. There is a control of infection policy in place. Since the last inspection the rear garden has been developed into a sensory garden with raised flower- beds and garden path. Residents stated that the BBQ’s in the summer were good. 24-26 St John`s Road DS0000052048.V353867.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): 32, 34, and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by a competent and qualified staff team, in sufficient numbers to meet their individual and collective needs. Recruitment procedures protect residents. EVIDENCE: The duty rota was seen and indicted that sufficient staff are employed in the home to meet the assessed needs of the residents. There are an average of three staff on duty throughout the day and additional staff are flexible to support residents with their activities and recreational needs, including evening activities. Relatives commented that staff are very supportive of residents needs. The RNIB has a staff training coordinator in post. All new staff undertake induction training and mandatory training, which is overseen by the trainer. Examples of training include food hygiene, fire safety, health and safety, first aid, manual handling, abuse awareness, equality and diversity; activities risk assessment, visual awareness and sighted guide. Bank staff also undertake this training. 24-26 St John`s Road DS0000052048.V353867.R01.S.doc Version 5.2 Page 19 NVQ training is ongoing and all new staff are expected to enrol on NVQ training after six months employment. The home currently has a 100 achievement rate. The home has a staff recruitment procedure in place. This is robust and protects the residents living in the home. All staff have a face- to- face interview, undertaken by the manager and includes the residents whenever possible. Staff employment files were seen and are well maintained. They contained all the required documentation for employment legislation, including two written references, an employment history, and a CRB (Criminal Records Bureau) disclosure. Staff confirmed that they have contracts of employment and job descriptions. 24-26 St John`s Road DS0000052048.V353867.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): 37, 39, and 42. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well run home, which is managed in their best interests. The home promotes the health, safety, and welfare of the residents and staff. EVIDENCE: The home is well managed by a competent manager with the experience necessary to meet the needs of the residents in his care. He has almost completed his RMA (Registered Managers Award), which he anticipates will be achieved by December 2007. The deputy manager also has considerable experience and has achieved her NVQ level 4 in management. The RNIB has undergone major changes in the past year with the closure of the college provision and the redeployment of staff within the organisation. It 24-26 St John`s Road DS0000052048.V353867.R01.S.doc Version 5.2 Page 21 was pleasing to note that 24/26 St. Johns Road was consistently managed throughout this change with minimum disruption to the residents. The home is managed in the best interests of the residents. The service manager undertakes regular regulation 26 visits, and reports are retained in the home for inspection. Residents stated that they have regular house meetings and are supported to air their views. Residents also stated that one of them actively attend staff meetings to represent the residents and feedback their views and ideas. Reviews of care are undertaken. The health and safety policy has been updated since the last inspection. All the staff have received training and updating regarding this procedure, which promoted the health, safety and welfare of the staff and residents. Risk assessments are in place for all identified risks and safe working practice. Residents are aware of the fire safety procedures and were able to give an account of a fire drill. There is a contract in place for the maintenance of the fire fighting equipment. 24-26 St John`s Road DS0000052048.V353867.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 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 X 3 4 X 3 X X 3 X 24-26 St John`s Road DS0000052048.V353867.R01.S.doc Version 5.2 Page 23 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 24-26 St John`s Road DS0000052048.V353867.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 24-26 St John`s Road DS0000052048.V353867.R01.S.doc Version 5.2 Page 25 - 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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