Care Home: Randell House Care Home

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What the care home does well Care plans were derived from the original care need assessment detailing the residents` social and healthcare needs. The home provided residents with activities of their choice, relevant to their care need and promoting opportunity, equality and diversity. Relationships between family, friends and advocates were supported to ensure continuity of care. Residents` spiritual needs were respected and the opportunity for multi-faith practice was available. Residents enjoyed food of their choice and the home provided a menu to each resident that was easy to read and contained to alternatives everyday. If residents didn`t want what was on the menu they could have an alternative of their choice. Residents consulted commented; lovely food plenty of choice. Residents and families were confident that the home would listen and act upon any complaints. The residents at the home benefited from the homes commitment to providing a safe and homely environment that was both relaxing and stimulating. A friend of a resident said about the home; I would like to come here myself if I ever needed residential care. The home`s AQAA stated; we have a varied programme including visits to film shows, the canal, garden centres, meals out, the pub, and in-house entertainment, recitals, quizzes, bingo, indoor golf, crafts and demonstrations. Residents benefited from the homes commitment to provide staff with continuous professional development and training. Recruitment and induction training promoted good practice and helped to ensured residents and care staff were protected. A volunteer at the home said; I have been coming to the home for over 9 years and continued to be impressed by the high standards of care given to residents. What has improved since the last inspection? Fire precautions, drills, risk assessment and staff training had been implemented to ensure the safety of residents. What the care home could do better: There were four good practice recommendation made. These related to the homes `Statement of Purpose` being updated, the recording of old medicines/drugs to be returned to pharmacy, the control of unpleasant odours on the upper floor of the home and the last recommendation was relating to the reviewing and updating of personnel files. CARE HOMES FOR OLDER PEOPLE Randell House Care Home Fernhill Road Blackwater Camberley Surrey GU17 9HR Lead Inspector Damian Griffiths Unannounced Inspection 21st August 2008 10:30 X10015.doc Version 1.40 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 Randell House Care Home DS0000036975.V369493.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 Older People. 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. Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Randell House Care Home Address Fernhill Road Blackwater Camberley Surrey GU17 9HR 0127631840 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) janet.young@independentage.org.uk david.lockley@independentage.org.uk The Royal United Kingdom Beneficent Association Mrs Janet May Young Care Home 39 Category(ies) of Dementia - over 65 years of age (39), Old age, registration, with number not falling within any other category (39), of places Sensory Impairment over 65 years of age (39) Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd August 2006 Brief Description of the Service: Randell House is a registered care home providing personal care to 39 service users in the older person category. The Royal United Kingdom Beneficent Association (RUKBA) owns the service and has another service across the road from Randell House. RUKBA is a registered charity foundered 1863 and obtained a Royal Charter in 1911. The Victorian accommodation is provided on two floors with a passenger lift that allows access to all parts of the building. the Victorian premises does not offer accommodation to people who are reliant on motorised or self-propelled wheelchairs due to narrow corridors or people with wandering behaviour due to problems with security. Residents are accommodated in single rooms and there are two lounges, a large conservatory and a library that are accessible to all. There are a variety of equipment and adaptations available to maintain and promote service users independence and the home is registered to provide service to people with visual impairment. The service also benefits from a well-maintained garden, parts of which are accessible to wheelchair users. The home is situated in a residential area of Blackwater, on the outskirts of Camberley. Some local amenities including shops are close by. The registered manager confirmed that, dependent on care needs, residency fees began at £442 90 and £467 a week. The RUKBA will also consider charitable support if appropriate. Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. The inspection of Randell House Care Home took 7 hours beginning at 10:30 a.m. and ending at 5:30 p.m. The Inspector spent time with the residents, care staff and conducted a tour of the premises. Mr. Damian Griffiths Regulation Inspector completed the visit and the homes Registered Manager Mrs Janet May Young was available to assist throughout the day and represented the establishment. This key inspection report takes into account information from the Annual Quality Assurance Assessment (AQAA) provided by the registered manager and samples from a number of service users and staff personnel files. Feedback from residents and care staff has also been included. The Inspector would like to thank the residents, care staff and the registered manager of Randell House for their assistance and hospitality. Comments and CSCI surveys received during the inspection and statements from the ‘AQAA’ are written in italics. Some words have been changed in respect of confidentiality and are featured within (brackets). What the service does well: Care plans were derived from the original care need assessment detailing the residents’ social and healthcare needs. The home provided residents with activities of their choice, relevant to their care need and promoting opportunity, equality and diversity. Relationships between family, friends and advocates were supported to ensure continuity of care. Residents’ spiritual needs were respected and the opportunity for multi-faith practice was available. Residents enjoyed food of their choice and the home provided a menu to each resident that was easy to read and contained to alternatives everyday. If residents didnt want what was on the menu they could have an alternative of their choice. Residents consulted commented; lovely food plenty of choice. Residents and families were confident that the home would listen and act upon any complaints. Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 6 The residents at the home benefited from the homes commitment to providing a safe and homely environment that was both relaxing and stimulating. A friend of a resident said about the home; I would like to come here myself if I ever needed residential care. The homes AQAA stated; we have a varied programme including visits to film shows, the canal, garden centres, meals out, the pub, and in-house entertainment, recitals, quizzes, bingo, indoor golf, crafts and demonstrations. Residents benefited from the homes commitment to provide staff with continuous professional development and training. Recruitment and induction training promoted good practice and helped to ensured residents and care staff were protected. A volunteer at the home said; I have been coming to the home for over 9 years and continued to be impressed by the high standards of care given to residents. 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. Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3. Quality in this outcome area is good. New residents had received a pre-admission assessment to establish whether the home could meet their care needs and to formulate a care plan if support was possible. Randell House does not offer intermediate care support. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four care plans were inspected for evidence of pre-admittance assessment for prospective residents wishing to enter into Randell House. The home was unable to offer accommodation to residents with a tendency to wander or dependent on motorised wheelchairs due to limitations of the Victorian premises. Documentation had been completed and showed a comprehensive description of the residents care needs. Potential new residents were able to visit at their convenience, received information about the home and received Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 9 support to adjust when moving in. A volunteer visitor to the home confirmed the homes practice; residents are seen by the head of homes and conducted around Randell house following a full explanation of the care home. The AQAA completed by the home commented: each resident has their own plan of care which is initially based on the pre- admission information. The home is registered with The Royal National Institute for the Blind (RNIB) and works closely with this charity to ensure that residents received consistent assessment of health care need. The homes Statement of Purpose contained lots of useful information about the home. Sections of the document contained details of when it was last reviewed such as the; Summary of Quality Assurance Questionnaires, dated 2003 and the page titled Rules of Randell House dated 2000. It is recommended that the home ensures that all information contained in this document is up-to-date. . Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 7, 8, 9, and 10. Quality in this outcome area is good. Care plans were derived from the original assessment detailing social healthcare needs ensuring appropriate care and support was provided to residents. Medication administration was good but some attention to recording practices was needed to ensure an accurate record existed at all times. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans inspected had been developed from the assessment of care needs and contained full details relevant to supporting the residents’ daily life. The social care needs of the residents were recorded to ensure that the former lifestyle was maintained as much as possible within the residential environment. A detailed account of risks associated with care need to care staff and residents had been completed. Care plans were situated in the staff room where confidentiality could be guaranteed. Residents consulted did not find this problematic and were involved throughout the care plan review process. The care plans were Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 11 conveniently sited for maximum ease of use and were easy to read benefiting new and existing care staff. Health care plans detailing individual healthcare needs included records to monitor a wide range of healthcare needs such as; skin breakdown, to ensure pressure sores did not develop, accidental falls, hospital and GP visits. Residents assessed as needing help to maintain good mental health received support that demanded good observational techniques. An understanding of the behaviour exhibited by residents living with dementia helped reduced risk and increased the resident’s self-esteem. A volunteer visitor to the home who had observed staff practice commented in the CSCI survey in the section titled: What do you feel the care home does well; Involving residents in various forms of activity with particular emphasis on diversion therapy. Observations of care staff administering prescribed daily medication indicated that the staff member was aware of the potential risk of distraction and the need for accurate recording. Serving one resident at a time the staff member locked the medication trolley each time she left to administer the medication and on her return recorded the prescribed dosage accurately. The medication returns book used to record any medication that was spoilt, out of date or to be returned to pharmacy, was not an accurate record of medication stored at the home. Care staff had recently recorded a batch of medication in the medication returns book that was to be returned to the pharmacy. The medication could be found amongst other medication that had not been recorded. The manager stated that the recording of medication to be returned was usually done prior to pharmacy collection thereby remaining unrecorded until collection. The manager acknowledged that there was an inconsistency in policy and practice that would be addressed. The area where medication was stored was secure and posed no threat to residents’ health and safety. The home had made an accurate record of all Controlled Drugs (CD) and secure storage was in place and CD drug returns in order. Residents consulted had no concerns relating to their relationship with care staff or about the home in general. Care staff were observed taking time to talk to the residents and ensuring that care practice was safe, for instance, when helping a resident to get out of his chair, the care workers declined to assist the resident in the way that he was asking because it was unsafe, but with sensitivity, managed to help him out of his chair using a safe manual handling method. Residents with dementia care needs were treated with sensitivity and understanding. One resident was observed freely expressing their feelings; singing happily, within a safe environment and away from other residents who were watching a film that they had selected. Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 12 The homes AQAA commented; we had had one or two more loving relationships develop and these have been treated sensitively by staff and privacy given. Care staff completing the CSCI survey during the inspection commented in the section titled; What Does Service Do Well? all aspects of caring and special needs. A very good liaison with families of persons using the service. Please see the recommendation section of this report. Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 12, 14 and 15. Quality in this outcome area is excellent. The home provided residents with opportunity to partake in activities of their choice, relevant to their care need that promoted respect and understanding. Friends’ family and advocates were actively supported to ensure the continuity of relationships. Residents enjoyed a varied daily menu offering a choice of wholesome and nutritious food ensuring residents health and strength was maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans recording individual residents’ social histories enabled care staff to have a better understanding of the resident’s general interests. A new activities co-ordinator was in-post and the home had obtained training from a well-known national organisation that provided a positive understanding of the care needs of people living with dementia. The spiritual care needs of the residents were assured by the detailed assessment of this aspect of their life. Church services were available on a regular basis and featured in the Statement of Purpose. The home was committed to embracing all faiths and the AQAA commented; ministers or priests of other churches all faiths are welcome. Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 14 A Sand and Shells feature, evoking seaside memories, indicated the confident use of reminiscence therapy. Other such features were available throughout the home and were conveniently assessable. The home AQAA stated that it; had on average 10 activities a week available to residents. Residents confirmed this and listed further activities that they enjoyed including; sing-along, doing puzzles and going shopping. Residents settled down after dinner to watch a film featuring Carey Grant that they had selected earlier. The homes AQAA stated; we have a varied programme including visits to film shows, the canal, garden centres, teas out, the pub, meals out, and in-house entertainment, recitals, quizzes, bingo, indoor golf, crafts and demonstrations. The result of resident’s craftwork had been displayed throughout the home creating an interesting feature and a sense of belonging. The home had ensured that residents stayed in touch with the local community and had arranged for the local community to come to the residents. The homes AQAA confirmed that links were maintained with local colleges and primary schools whose students had visited. Family and friends visited residents throughout the day and could visit at any reasonable time. Residents could entertain their friends and family in their own room or anywhere throughout the home. The AQAA stated; if a resident refuses to see a visitor the staff respect this and handle the situation sensitively. The home promoted an open door policy and supported advocacy services, details were available in the entrance hall and accessible to residents. The kitchens were non-operational due to planned renovation of this area. The Statement of Purpose stated that; meals are prepared by contract caterers at (the sister home close by) and served by Randell house staff. Residents had an excellent choice of food and care plans showed evidence of nutritional monitoring to ensure that residents received a balanced diet and meals of special nutritional value. The homes AQAA indicated how this was advantageous to some residents with special needs; Puréed meals are presented attractively the food been pre-formed in moulds rather than puréed together. There has been a greater take-up of food particularly in residents with dementia because the shapes are recognisable. Easy to read menus in large print were made available to each resident for their convenience. The menus included two different choices of food and seasonal fruit and vegetables. Choices included a range of different types of food such as couscous and butternut squash. The dining area was clean airy and spacious providing a comfortable place to eat. Residents were observed enjoying their meal. A resident confirmed that she had not wanted anything on the menu that day and so the chef had prepared and agreeable alternative. Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 16 and 18. Quality in this outcome area is good. Residents and families were confident that the home would listen and act upon any complaints that they may have. The home promoted safeguarding of residents by ensuring care staff had access to training and policies and procedures relevant to their role. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The homes AQAA stated that; all complaints had been dealt with within 28 days. My deputy and I maintain an open door policy by which we encourage residents and their families to come into the office or approach us at any time to voice concerns or just pass the time of day. The homes complaints policy was prominently positioned within the hallway entrance and featured in the homes Statement of Purpose. Details of how to contact CSCI and RUKBA, including time scales of the complaints process was available. Complaints records indicated that the home practised a thorough complaints process including a record of the complaint outcome demonstrating how the home residents and their relatives complaints. There were no outstanding complaints at the time of the inspection. Residents consulted were confident that the manager would explore any complaints or concerns that they may have. A letter in the complaint folder indicated how successful the homes complaints procedure was. Following the Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 16 conclusion of a particular complaint where the home had agreed in favour of the family the letter stated that the family was still; confident of the care their (relative had) received. Care staff were aware of the homes safeguarding procedures due to regular training courses and could discuss any concerns with the registered manager. Whistle-blowing procedures featured in the homes policies and Hampshire County Councils procedure for the protection of vulnerable adults was available for reference. There had been no record of any cause of concern relating to the homes capacity to safeguard residents. Staff completing the CSCI survey on the day the inspection confirmed that they had received training which was relevant to their role and helped them to understand and meet individual care needs and supported equality and diversity. One of the comments received said; we can go and talk to our head of home or deputy about anything that concerns us, they never turn us away. Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. Residents benefited from the homes commitment to providing a safe and homely environment that was both relaxing and stimulating. There was a problem of malodour in some areas of the home that diminished the best efforts of care staff trying to providing a good environment for residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises was conducted. Residents had access to a pleasant lawned garden with well-kept flowerbeds, garden chairs and tables where residents could relax or entertain families and friends. Paint was peeling from the fire escape that led into the garden detracting from the overall quality of Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 18 this area. The manager stated that the home had a program of maintenance in place. A security camera, featured at the front door, ensured that staff could observe visitors to the home before allowing entry. There were ample bathroom facilities for visitors and residents who did not have en-suite facilities within their private rooms. Visitors to the home were required to record their visit by signing in the visitors’ book. Accommodation was provided on two levels that could be accessed by lift. The Victorian premises were clean and tidy and showed signs of everyday wear and tear. Corridors were rather narrow in places and limited availability to people with particular disability needs. The homes AQAA stated; we admit no residents who are dependent on motorised or self-propelled wheelchairs. An unusual feature of the home consisted of a corridor glazed with frosted glass, surrounding one of the communal living areas, currently being used as a storage area. The manager stated that the home planned to restore this area for residents use as it had been enjoyed by residents in the past. The home featured a well-stocked library containing books in a variety of written formats that were relative to residents’ care needs. A spacious conservatory with access to the garden area contained two wellstocked fish- tanks providing an interesting distraction for all visitors to this area. The conservatory was light and airy and with comfortable chairs and tables provided a peaceful haven for residents and their visitors. Residents confirmed that this was a favourite place to relax and read a newspaper or appreciate the garden from within on a wet day. The home had ensured that air-conditioning equipment was in place in the event of hot weather. The private accommodation and corridors on the upper level of the home was slightly malodorous. The home regularly assessed residents’ continence needs. The home had considering the most appropriate flooring to promote homeliness this had resulted in residents having a mix of carpets and wooden flooring. The manager confirmed that there was a risk of malodour from time to time. The rooms were in the process of being cleaned and that there was evidence to show that the home had found this to be an ongoing problem. The large kitchen area was not in general use and the manager stated that it was to be refurbished the AQAA stated that; quotes for the task had already been obtained. Please see the recommendations section of this report. Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 19 Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30. Quality in this outcome area is good. Residents and care staff benefited from the homes commitment to provide continuous professional development and training. Recruitment and induction training promoted good practice and helped to ensure residents and care staff were protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The files of four care staff that were on duty were inspected for details of the skill mix available to residents over a 24-hour period. Details of care staff training included and induction programme that ensured care staff had the appropriate background information about the home and its policies and practice, health safety and hygiene, safeguarding of vulnerable adults, first aid and training relating to the overall needs of residents at Randell house. Comments from care staff completing CSCI survey of the day the inspection were; had a week induction which was very good. Care staff were enthusiastic about obtaining continued professional development, qualifications and training. The AQAA stated; we are just under Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 21 the 50 of NVQ level 2. 12 staff working to-wards level 2, 3 (care staff) awarded level 3, others working towards level 3. Care staff completing the CSCI survey stated in the section titled; What Does the Service Do Well: provide relevant training such as NVQ and any other mandatory training. The recruitment history of the four care staff that were on duty indicated that the home was committed to promoting good recruitment practice. Personnel files showed that the Criminal Records Bureau (CRB) had been involved with regard to providing CRB disclosures and PoVA first checks. Staff had provided employment history but not all of the care staff files showed that two references had been obtained. The care staff involved had been working at the home for some time therefore there was no cause for concern. The manager agreed to ensure that all personnel files would be updated to ensure that the necessary documentation was place. It is recommended that personnel files are regularly reviewed to ensure documentation is correct and up to date. The homes AQAA stated; there is a rolling programme of the mandatory training. The home had ensured that care staff received training from a recognised source of excellence in areas of; age, hearing and vision awareness including the RNIB and offered training in areas such as; dementia awareness/activities training, Parkinson disease and adult protection. Five CSCI surveys were completed by care staff on the day of the of inspection comments included; if there is any training that we wish to do (the manager) gets us that training, these courses are extra to the mandatory ones. Our head of the home always makes sure that we have up-to-date training with new ways of working. Get lots of training, courses always available. Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 33, 35 and 37. Quality in this outcome area is excellent. Residents and care staff benefited from an accessible and supportive management team. Residents were listened to and they were encouraged to contribute to the running of the home. The home consistently supported and promoted positive health, safety and welfare practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Comments from care staff completing the CSCI survey on the day of the inspection indicated that staff were well supported and enjoyed working at the home; the line managers door is always open to discuss any problems you might be having. Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 23 In this home we are like a family. We support each other. We are a very good team and we all work well together. The registered manager, Mrs Janet May Young has managed the home for a number of years and has consistently shown an understanding of the needs of the residents and care staff at Randell house. The board of trustees (RUKBA) regularly meets with the manager and ensures that the home is regularly monitored for good practice, health and safety and lends its overall support to the home and its residents. The manager accepted that the storage of medication waiting to be returned to pharmacy/pharmaceutical collection needed to be tightened up, a recommendation was made that the home reviews its policy and practice. The home was aware of the problem of malodour and had mentioned this in its regulation 26 reports that had been sent to CSCI in April and May of this year; it is recommended that the home review and improve its current procedure for eliminating malodour. Care staff without the requisite number of character references indicated that there was a need to review personnel files. Recommendations were made for the home to address these areas of practice. The manager stated that the home was implementing a maintenance programme but there remained more work to do on some of the sluice rooms, the fire escape and the room used for storage on the ground floor. Overall this inspection shows the homes commitment to improving all aspects of its residents care, its understanding of dementia care needs; it’s commitment to further training and the provision of relevant activities for all residents while maintaining a comfortable, clean, stimulating but homely environment. This was a real achievement for the management and care staff teams. Residents confirmed that they were regularly consulted and could pop-in and see the manager. The AQAA stated; the residents helped to choose our new activities organiser and one of them sat and chatted to a young girl who wishes to volunteer here. The management and board of trustees were planning to develop a system of assessment for measuring successful outcomes for residents at the home focusing on independence and choice. The home met on a regular basis to discuss quality assurance and a committee had been formed for this purpose. A summary of Quality Assurance questionnaires was available in the homes Statement of Purpose dated 2003. A recommendation was made for the home to review and update this document. A volunteer visitor to the home commented that; I have been coming to the home for over 9 years and continued to be impressed by the high standards of care given to the residents. Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 24 The home was not responsible for managing residents’ monies and would bill the residents or family/advocates directly for such things not included within the residential contract for example; hairdressing, newspapers chiropody. Attention to Health and safety practice was apparent throughout the home. Hand cleaning dispensers were dotted around various localities where needed and care staff had been observed using safe manual handling practices. The home displayed the appropriate insurance details prominently within the entrance hall. Fire precautions were in place and fire escape details were displayed and a risk assessment of the home had recently been completed. Fire evacuation was detailed and records were maintained ensuring that the requirement made at the previous inspection had been met. The home had a certificate from “Visibility Better awarded by the RNIB and the environmental health department had visited within the last 12 months. There were no serious health and safety concerns to report. Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 4 3 X X X 4 X Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No 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. 1. 2. 3. 4. Refer to Standard OP1 OP9 OP26 OP29 Good Practice Recommendations The Statement of Purpose should be kept up-to-date. That the registered manager reviews the homes policy and practice relating to storage and recording of medication to be returned to the pharmacy. That the home reviews their current practice relating to the elimination of offensive odours. Personnel files should be regularly reviewed to ensure documentation is correct and up to date. Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 27 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 Randell House Care Home DS0000036975.V369493.R01.S.doc Version 5.2 Page 28 - 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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