Care Home: Rainbow Lodge

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Rainbow Lodge 15 Trinity Road Scarborough North Yorkshire YO11 2TD three star excellent service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Karen Ritson Date: 1 9 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Rainbow Lodge 15 Trinity Road Scarborough North Yorkshire YO11 2TD 01723375255 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ms Catherine Sleightholm Name of registered manager (if applicable) Ms Catherine Sleightholm Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 4 0 care home 4 learning disability Additional conditions: Date of last inspection A bit about the care home Rainbow Lodge is a large semi-detached property occupying three floors. It provides accommodation for four service users with a learning disability. Each has a single room with bathroom and toilet facilities nearby. Communal space is provided on the ground floor. The home is owned and managed by Mrs Kath Sleightholm. Mrs Sleightholm and members of her family provide personal care, meals, laundry and a domestic service. The home employs no staff. A large private garden is used for outdoor activities. Residents have easy access to the towns facilities and amenities, which are within walking distance. The home also has a car, which is used for outings and day-to-day transport. The home charges fees of £300 per week. Taxi fares and sundry personal expenses are not included in these fees. The latest CSCI report is available at the home. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home This is an overview of what the inspector found during the inspection. The quality rating for this service is three star. This means the people who use this service experience excellent quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at risk of significant harm. In future if a requirement is repeated, it is likely that enforcement action will be taken. The inspection for this service took fourteen hours. This includes time spent gathering information and examining documentation before and after an unannounced site visit and in writing the report. The site visit took place on 18.09.2008, between 09:30 and 16:00. Information for the inspection was gathered from: A tour of the premises. Observations of care throughout the day of the site visit. Speaking with people living at the home. Speaking with the Manager and her daughter. Case tracking all people living at the home. Notifications sent to the commission from the home since the last inspection. Examining policies. procedures and records kept at the home. Examining information kept on file by the commission about the home. Considering comments made by relatives, health and social care professionals. All key standards were looked at during this inspection. The manager was available throughout the day and she and was present for feedback following the inspection. What the care home does well People live in a comfortable and nicely decorated home. The manager, Cath, gets to know all about what people need before they come to live at Rainbow Lodge and writes it down. She talks to people often about what they need to make their lives happy at the home and changes things if they are not quite right. If someone wants to go on holiday for example she helps then to choose where they want to go. Cath makes sure that people dont do things which are dangerous, but she also helps them to do things that might be a bit difficult if that is what they what to do. She makes sure that the house is safe for people to live in. Cath makes good meals, and the people who live at the home help to makes the meals, do the gardening and to clear away and wash up. One person said about Sunday dinners: Its a wonderful spread. another said: I really like our meals. The manager does employ have any staff, but she and her daughter have had checks to make sure they are safe people to work with people living at the home. They have also been on courses to help them look after people well. The home listens to what people want and puts things right if someone says there is a problem, What has got better from the last inspection What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Karen Ritson St Pauls House 23 Park Square (South) Leeds LS1 2ND 011 3220 4600 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The needs of people are properly assessed prior to admission which ensures their care needs may be met. Evidence: The home has not admitted any new people since the last inspection. The assessment for each person living at the home is thorough and covers all areas required. The manager has used the information in the assessment as the basis of a care plan for each person. This ensures that she is offering care based on a detailed knowledge of individual care needs. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Care plans are written in detail to reflect the care and support needed to meet peoples needs. People are supported in making decisions about how they choose to live. Evidence: Care plans for all the people living at the home were looked at. They are detailed and based on the assessment. Each is regularly reviewed to ensure that it is up to date. Reviews take place with the person and anyone acting on that persons behalf e.g. family or professionals. This ensures that the manager has as much information as possible to make the care plan right. Specialists are consulted whenever necessary and their advice is written into the plan. The manager showed photographs of flip charts completed during person centred reviews at the home, where goals and wishes were recorded, and used to write an updated plan. The plan sets out how people are supported to make their own decisions about how they live their lives and any changes to the plans are recorded with reasons. For example if one person prefers not to attend a club for a while or if someone wants to go on holiday to a particular place this is written into the plan and every effort made to make this happen. Risks are assessed and reasons for any restrictions are recorded. One person said: I can go into town on my own. Trust is a big thing. Cath trusts me and I trust Cath. Another person said: I decided I didnt like going to the gym any more so I said to Cath and I stopped going, but I do other things I like now. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People are enabled to choose their lifestyle, social activity and keep in contact with family and friends. They receive a healthy varied diet they enjoy. Evidence: People have weekly activity plans which have been drawn up in consultation with each person. Each plan is individual. One person enjoys independant trips out to local shops, another has a week packed with different clubs, voluntary work, and day centre attendence, another spends alot of time drawing. People were very enthusiastic in their descriptions of what they did with their lives and were keen to talk about their goals for the future. Throughout conversation, each person referred to discussions theyd had with the manager about what they wanted to do and clearly showed they felt encouraged to fulfill their potential. Carers also indicated that people had the opportunity to lead fulfilling lives. One wrote: Since she moved in she is a different person and appears to be much happier. Cath takes an interest in all (her) varied daily routines. A health care professional wrote: My patients preference would be to stay in (the) room or bed all the time and not enjoy anyone or anything, so the fact that this carer does not support him to live the life he choses (ie isolated in his room) is a good thing. She ensure he is able to spend some of his time as he wishes. A social care professional said: My client benefits from having a structured day and Cath provides this very well. Care plans and discussion with people showed that they are supported to be as independant as possible. Some become involved in household chores and all have Evidence: stepped goals towards independence which receive recognition. People were obviously proud of their achievements. All people said they are involved in planning and chosing meals. The manager has a healthy eating approach towards food but people also enjoy treats and have meals out and take-aways occassionally too. Since the last inspection, the manager has developed a vegetable garden for the home. During the inspection, relatives were helping with weeding and some of the people living at the home said they helped with picking the vegetables for meals. They had plans to add more vegetables as they learned about how to grow them. None of the people living at the home have specialist dietary needs. A relative said: People have a real sense of family, particularly at meal times. Another said: You should come here at Christmas time or on a Sunday, what a fantastic spread, the food is wonderful and its such an occassion. Another said: My (relative) gets a really balanced healthy diet. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People receive sensitive care in the way they prefer, their physical and emotional needs are met and their medical welfare is protected by the safe handling of medication. Evidence: Evidence from speaking with people living at the home, their relatives, the manager, her daughter, health and social care professionals suggests that the people who live at Rainbow Lodge receive care that is sensitive to individual needs and how these might change , takes into consideration individual preferences and respects privacy and dignity. One person said: Her approach is just right for my relative, she is quite firm when she needs to be but knows exactly when to be adopt a more gentle approach. It works very well. A social care professional said: The balance is excellent. Cath respects that (one of the people) likes to be private in her room, but knows this would be unhelpful for (another person). One person said. I go out with Cath to get things. I might have a change of hair but Ill talk to Cath about it before I made up my mind. Cath helps me understand things. Daily notes show that any specialist advice is quickly sought when needed and all professionals contacted spoke highly of the professionalism of the manager in dealing with health care issues. People are supported to attend any outpatient or other health care appointments and any areas of concern are talked about with people to increase understanding and reduce anxiety. Medication is well handled according to policy and procedure. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People have access to an effective complaints procedure, their complaints are listened to and acted on. people are protected from abuse. Evidence: The home has a complaints policy which contains information about how to complain. Everyone spoken to said that the manager and Rachel her daughter were very approachable and that they responded immediately to any concerns. One person said: I can tell Cath anything and she sorts things out. Both the manager and her daughter have had abuse awareness training but this needs to be updated. The home has policies on safeguarding people in all areas of potential abuse. Peope living at the home are not isolated and all have other external contacts with people who could advocate if there was a problem or if there was any suspicion of abuse. People are also protected by the way the home manages personal allowances. Each person has an individual book in which a running total is kept and each person signs when ever money is handed out to make sure records remain accurate. Records were checked and there were no discrepancies. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People live in a well maintained and comfortable environment. Their safety may be compromised by the lack of an up to date fire risk assessment. The laundry facilities meet their needs. Evidence: The home is well maintained with improvements being carried out on a rolling programme. External work has been carried out to the roof in the last year, renewal of windows and general redecoration. The home is well placed in a quiet street but close to the centre of town, allowing easy access to day care centres and shops. One person said: I can walk to the shops from here no problem. Another said: I can easily get to Brook Leigh tea time club as it is just round the corner. The home has a policy on infection control, the premises is clean and hygienic. The manager has a risk assessment template for fire safety but has not yet completed this. The home met the needs of the last fire inspection but this was some time ago and it would be advised to request a visit to ensure compliance with current legislation. People said they knew what to do in the event of a fire. The alarm had gone off recently by mistake and all the people assembled in the correct area outside the house as they have been shown during the regular fire drills. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Staff are trained, skilled and in sufficient numbers to fulfil the aims of the home and meet the changing needs of people living there. Evidence: The manager and her daughter have the experience necessary to run the care home well. They both have CRB checks in place.The home does not employ any staff and does not intend to do so. Rachel has undertaken medication, conflict management, food hygiene, challenging behaviour, first aid, moving and handling and fire safety training. She is in the process of completing NVQ level 4 in care. The manager has also undetaken all foundation training. People said they felt confident the manager had a solid understanding of the principles of good care. One social care professional said: Cath has a great deal of skill in dealing with the people here. She understands current best practice, and Rachel has alot of experience working for another organisation caring for people with a learning disability. One relative said of the manager: What matters most to me is that she always knows the right thing to do. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People benefit from an open style of management based on respect, and from the experience of the manager. The views of people inform practice. Welfare is protected by robust health and safety practices. Evidence: The manager has undertaken all foundation training and is well qualified by experience to run the home. Her daughter is in the process of gaining qualifications in order to take over management of the home at some time in the future. The manager has developed a quality assurance system, and carries out her own internal audits to ensure the service she offers meets peoples expectations and potential improvements are identified. Health and safety is a priority and several maintenance documents were looked at. These were up to date and in order. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 23 People working at the home should gain updated abuse awareness training, to protect the welfare of those living at the home. The home could request a visit from the local fire authority to ensure compliance with current updated legislation. The home should complete an up to date fire risk assessment. 2 3 24 24 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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