Latest Inspection
This is the latest available inspection report for this service, carried out on 8th June 2010. CQC found this care home to be providing an Good service.
The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.
For extracts, read the latest CQC inspection for Ravenswood.
What the care home does well The service provides well planned care for people with a learning disability recording their preferences and how their care needs are met. There are detailed risk assessments providing information that helps to ensure people are safe. The staff ensure that people have appropriate support from healthcare professionals and clear records are kept to monitor progress. Behaviours that may challenge are managed well by experienced and well trained staff. The environment was well maintained and clean throughout, and there has been several improvements since the last inspection. What the care home could do better: Generally medication was well managed, however, we recommend that there are some changes to the way medication is administered. The method of medication administration should be reviewed to ensure that the administration record is with the staff member at the point of administration to reduce the risk of medication errors. Random inspection report
Care homes for adults (18-65 years)
Name: Address: Ravenswood Lansdown Road Westal Green Cheltenham Glos GL50 2JA two star good service 06/07/2009 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Kathryn Silvey Date: 0 8 0 6 2 0 1 0 Information about the care home
Name of care home: Address: Ravenswood Lansdown Road Westal Green Cheltenham Glos GL50 2JA 01242256900 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Gloucestershire Community Care Group Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 9 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 9 Manager to attend a Health & Safety for Managers course Manager to complete NVQ level 4 Registered Managers Award by 2005. Date of last inspection Brief description of the care home Ravenswood House provides residential care for adults with learning disabilities who may present with behaviour that challenges. The home is a large detached house situated on a main road close to Cheltenham town centre. The location enables service users to access a range of local amenities. Accommodation is provided on the ground and first floor. On the ground floor there are three bedrooms, a large lounge, a
Care Homes for Adults (18-65 years) Page 2 of 9 3 0 0 9 2 0 0 9 Brief description of the care home separate dining room, kitchen, laundry, toilet and bathroom. On the first floor there are six bedrooms, one of which has en-suite facilities, a shower room, bathroom, office and sleeping in room. To the rear there is an attractive secure garden. To the front of the property there is a car parking area. The home has its own people carrier. Ravenswood is one of three homes owned by Gloucestershire Community Care Group. The homes Statement of Purpose and Service User Guide provides information about the home. The current fee range for the home was not available at the time of the inspection. Care Homes for Adults (18-65 years) Page 3 of 9 What we found:
This random inspection took place on 8th June 2010 and included a visit to the home by one inspector. The new manager, Mr Andrew Turner, was unavailable on the day of the inspection. The acting manager sent us a completed Annual Quality Assurance Assessment (AQAA), in March 2010, as part of the inspection, providing considerable information about the service and plans for further improvement. The AQAA also included numerical information about the service (Dataset). We spoke to two staff and the eight people living in the home during the inspection. We also spoke to the provider briefly on the telephone. This random inspection focused on looking at two care plans in detail, speaking to people living in the home, medication, management, the environment and any trends of concern. We were unable to look at recruitment practices this time as the manager was unavailable. however, the AQAA told us that a new interview format had been introduced in November 2009, which included people living in the home being actively involved and that is was a tremendous success. We found comprehensive care plans and risk assessments, that included peoples individual choices, which helps to ensure that their personal needs are well met. The person centred care plans were excellent, and individual actions were detailed and specific. The plans had recorded strengths, needs and actions, which were clearly typed for staff to read and included lots of pictures to help people understand their own plan. Recent additions to the plans were highlighted in blue and important information to alert staff was recorded in red. The detailed and informative daily records were completed by the day and night staff. Communication information for one person included assessing mood throughout the day, as this person is unable to read, but can understand simple mood faces that are pointed to, and understands the spoken word. We spoke to this person and he agreed he liked the food and his bedroom. The home had created a list of people important to each person living in the home and this included their respective birthdays and home address. The list enables the care staff to help people remain in touch with friends and relatives, and send a card if they wish. Risk assessments were well recorded and one person had ten to include; money, keys, highway code, bathing, holidays, bowels, eating and drinking, Cardiff arena and electrical equipment. Health care plans were informative and covered all aspects of a persons health. One record described how a person was supported with dental care. There was detailed information about a persons referral to a consultant neurologist. The care staff had recorded the seizures in detail and what the person was likely to do to alert the staff that a seizure may occur. There was also a body chart to record any injuries sustained during a seizure. The person had a sensor mat by the bed and a plug in monitor that staff listen to during the night. This year the consultant had written a letter saying that the staffs seizure record was excellent. We looked at the six monthly reviews and the monthly summaries completed by a persons key worker, which included activities completed during the month, health issues, diet information and any chores completed by the person.
Care Homes for Adults (18-65 years) Page 4 of 9 There was detailed information in one care plan about managing challenging behaviours. The staff were aware of body language and judged situations using the recorded anger triggers information. Guidelines were recorded for staff to manage situations and this included that there was always staff in the communal areas to protect other people living in the home, when required. A reward programme was initiated for good behaviour involving stars for this person. The stars were recorded in the daily record. In March 2010 the psychologist had recommended more tangible rewards to help with behaviours and there had been significant improvements since this had been implemented, so that behaviour charts were no longer required. There was also an improved relationship with another person living in the home. Health assessment by the staff were comprehensive and health action plans were detailed and included medication information. The action plans had by when dates and review dates recorded. All relevant health professional support and medical information was clear, to include the record of all all visits. The care plans had detailed information about dental, chiropody and optical appointments and each person was regularly weighed. The medication administration records were correct, and all homely remedies given were recorded. The care plans we looked at included a signed agreement for staff to administer medication. The staff see the prescriptions before the pharmacy dispense the medication to reduce the risk of errots occuring. A new medication started for one person was clearly recorded, as there were varying doses. The information sheets for all medication administered were there for staff to refer to. The local dispensing pharmacist completes a comprehensive monthly audit of all medication. We recommended that medication not in the medidose containers are counted when audited to help ensure good practice. Currently there were no controlled drugs in the home, however we recommend that the manager ensures that the cupboard is bolted to the wall to comply with Misuse of Drugs (Safe Custody) Regulations 1973. The staff were carrying medication from the upstairs office in named pots around the home We recommend that a carry case is used for administration around the home and that medication is not put in pots in advance as the record should be with the medication, to include any liquid medication, when administering. All care staff have an annual refresher course for the administration of medication. The home was well maintained and clean. The AQAA told us that the maintenance plan has continued and included the following completed items; a new cooker, tiling completed in both bathrooms, second hall, stairs, landing and kitchen decorated, and repairs/decoration to the ground floor bathroom. The kitchen worktops had also been renewed and a new gas hob installed. We were concerned with the storage in the laundry, as food items were stored there, and we subsequently asked the manager to consult the Environmental Health Officer (EHO). We spoke to two people living in the home to include a person that had recently moved in. The new person liked his bedroom, and told us the food was good and that he liked the staff. He was more independent than most of the people living in the home. This person knew many of the staff as they had moved with him from the home that had recently closed.
Care Homes for Adults (18-65 years) Page 5 of 9 The new manager has applied to become the registered manager of the home, he previously held the registerd manager position at another home within the Gloucesterhire Community Care Group. We also spoke generally to everyone in the communal areas when they had returned home. We observed that people had a friendly relationship with the staff and there was a positive response from people about living in the home. One person seemed a little concerned that we were a stranger in the home, however, by the end of our visit she was relaxed and enjoying the company of people returning home. What the care home does well: What they could do better: 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 2. Care Homes for Adults (18-65 years) Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes R 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 37 8 The home must appoint and submit a managers application for registration with the Commission. The service has had a considerable period with a registered manager and this must be addressed without delay 15/09/2009 Care Homes for Adults (18-65 years) Page 7 of 9 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 Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement 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 2 20 30 We recommend that the staff review the administration of medication to reduce the risk of errors. We recommend that the manager seeks advice from the EHO regarding storage of food in the laundry. Care Homes for Adults (18-65 years) Page 8 of 9 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 9 of 9 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
