Care Home: Redclyffe

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What the care home does well What has improved since the last inspection? The staff files have been updated to include more detailed information about the agency workers that are deployed to make up the staff numbers. Following consultations with the residents, the home has built an aviary. Residents enjoy watching and feeding the exotic birds. What the care home could do better: The provider has reorganised the management structure for the service and as a result the home has two vacant positions for team co-ordinators. These vacant positions have been advertised. Agency workers are deployed to make up staff numbers. CARE HOME ADULTS 18-65 Redclyffe 21 Salisbury Avenue Harpenden Hertfordshire AL5 2QF Lead Inspector Yoke-Lan Jackson Unannounced Inspection 12th September 2008 10:30 Redclyffe DS0000019506.V371896.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 Redclyffe DS0000019506.V371896.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. Redclyffe DS0000019506.V371896.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Redclyffe Address 21 Salisbury Avenue Harpenden Hertfordshire AL5 2QF 01582 620000 01582 620001 barney.ng@scope.org.uk www.scope.org.uk SCOPE 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) Mr Hon Ching Ng (Barney) Care Home 20 Category(ies) of Learning disability (20), Physical disability (20), registration, with number Physical disability over 65 years of age (20) of places Redclyffe DS0000019506.V371896.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th June 2008 Brief Description of the Service: Redclyffe is a residential care home provided by Scope, a charitable organisation. It is registered for 20 people with learning disabilities and some of them may have physical disabilities and may be over the age of 65. The home has the use of three specially adapted vehicles to help with the transport needs of residents. The building is a large period house situated in Harpenden, close to the town centre. The administrative office, the lounges, dining room, laundry room and kitchen are all on the ground floor. There are bedrooms on all floors which are served by a lift. The assisted bathrooms and toilet facilities are nearby. To the front of the building is a large garage used for storage and recharging electric wheelchairs and the home also has a single storey annexe, which can be used for training, meetings and as a quiet area for the residents. There is an aviary with exotic birds in the patio area facing one of the communal lounges. The fees range from £ 23,000 - £ 65,000 per annum. Information about the home and the service it offers is contained in the Statement of Purpose and the Service User Guide. A copy of these and the most recent CSCI inspection report are available in the home. Redclyffe DS0000019506.V371896.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 two star. This means the people who use the service experience good quality outcomes. The unannounced inspection was carried out on 12/09/08. The registered manager and the assistant manager were present. The home has 19 people in residence. The inspection included a tour of the premises. Time was spent observing how the staff interacted with the residents. Staff and residents were spoken with and key documents were examined. There were some relatives present during this site visit and they were also interviewed. Information received by us (The Commission for Social Care Inspection) since the last inspection was reviewed. This included the written survey questionnaires and the Annual Quality and Assurance Assessment (AQAA) which providers of registered services are required to complete. The AQAA focuses on how the outcomes are being met for people using the service. What the service does well: All the residents appeared content and well cared for. They have access to a range of social and leisure activities that meet their needs. Some of the residents have learning and physical disabilities and staff are trained to assist and support them to lead a reasonably independent lifestyle. The members of staff present during the visit interacted well with the residents in their care and were readily available to assist them. Some residents are actively involved in the recruitment and selection process for new staff. A resident interviewed said, “I sit on the interview panel and attend Scope (provider) meetings.” In a recent questionnaire survey by us, those residents and relatives who responded gave very positive feedback about the care and service provided. Comments from residents include: “I am very happy living here.” “I am involved in recruiting new staff and decision making.” “I go home at weekends to my family.” “I think it is the right place for me because I am not too far away from my family.” Redclyffe DS0000019506.V371896.R01.S.doc Version 5.2 Page 6 Relatives’ comments include: “More like a family than a care service.” “Supportive staff who go out of their way to help.” “The staff I have met are unfailingly helpful.” “They are excellent carers.” “Caring environment – staff always ready to hep.” “Exceed expectations.” “They take great care that (service user) is able to lead a full and happy life. (Service User) has lots of outside activities.” 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. Redclyffe DS0000019506.V371896.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 Redclyffe DS0000019506.V371896.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): Standard 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective clients can be assured that a pre-admission assessment will be completed before they are admitted to ensure that the home can meet all their care needs. EVIDENCE: The home has not had an admission for a number of years but the home manager said that the management team would carry out a thorough assessment of care needs before a client is admitted. The pre-admission documents of existing clients were kept in their respective care plan folder. Redclyffe DS0000019506.V371896.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): Standards 6, 7, 8 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that they will have written care plans so that staff are able to identify their goals and care needs appropriately. This gives the people an opportunity to make everyday choices with staff respecting their preferences and requests, enabling them to achieve independent lifestyles. EVIDENCE: Each resident has a written care plan which is not in person-centred format. However, the management is in the process of reviewing the care plan to reflect person-centred planning. The deputy manager has attended two–day sessions on person-centred planning and is cascading the information down to key workers. The management hopes to update all care plans to personcentred format within the next few months. The written care plans are updated accordingly to ensure staff are aware of people’s latest care needs and objectives. Risk assessments and changing needs were reflected in the care plans examined, including six monthly reviews Redclyffe DS0000019506.V371896.R01.S.doc Version 5.2 Page 10 and the yearly review that involves the resident, their relatives, the social worker and other healthcare professionals. The home has a key-working system to ensure that each resident is consulted on all aspects of life in the home. The residents are given the opportunity to make everyday choices and their preferences and requests are respected. Staff encourage and support them to achieve independent lifestyles. Some residents have the assistance of an advocate from PohWer who visits regularly to ensure that residents are properly represented. On the day of the site visit, some residents were seen leaving the premises as and when they preferred. Some residents interviewed said that they have been to the local shops to do their own shopping or to the local bank to sort out their finances. The management assist others with their personal allowances which are kept securely in the administrative office. The accounting records examined were kept up to date. Redclyffe DS0000019506.V371896.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): Standards 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. People who use the service can expect that their rights will be respected and that they will be encouraged to lead an independent lifestyle, engage in communal activities, and maintain contact with their friends and family. A healthy diet is promoted which meets people’s needs and expectations. EVIDENCE: The daily routine promotes independence and individual choice. With the residents’ approval, the home has built an aviary in the patio area facing one of the lounges for all residents to enjoy watching exotic birds. The residents are encouraged to help feed the birds and some assist in cleaning the cages. Redclyffe DS0000019506.V371896.R01.S.doc Version 5.2 Page 12 The activity programme is planned to suit individual needs and interests. Residents are encouraged to integrate into the community through a range of outdoor activity programmes. During the week most residents attend the day centre, where they are encouraged to get involved in activities that are stimulating and educational. Some residents will shortly be attending the local colleges when the new term starts in September. Two of the residents interviewed said that they like the drama and cookery classes. Some of the residents do their own shopping in the local shops where they can buy whatever they want. Day trips and annual holiday breaks are arranged for the residents, who decide on the venue themselves. Each day a member of staff assists with the transportation, which is provided by the home. Equality and diversity are promoted. Residents are supported in their religious practice and celebrations. Some residents attend the local church and group social events at the local social clubs. Relatives are encouraged to visit the residents. The manager said that relatives are in constant contact and some residents return to their own home regularly. A resident interviewed said “I am going home for the weekend. My (family member) and I will be going to the funfair.” Relatives who responded to our (the Commission) written surveys gave very positive comments about the activities provided and the support given by all members of staff. Staff take turns to cook the meals. They encourage the residents in healthy eating. The meals provided are varied, nutritious and balanced so that residents maintain a healthy diet. Residents are actively involved in planning the menus, which were on display and are also available in picture format. On the day of the site visit, some residents were observed making their own drinks. A member of staff was present to ensure that the residents were safe and to offer help when necessary. Members of staff were observed to interact well with the residents who seemed happy and content. Redclyffe DS0000019506.V371896.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): Standards 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are treated with dignity and receive individual care and support in the way they prefer and require, including a full range of healthcare facilities. They can be assured that their medicines will be administered safely since they are not able to administer the medicines themselves. EVIDENCE: Staff have a good working knowledge of residents’ conditions, and their likes and dislikes, and deliver care and support in the way residents prefer and require. During the site visit it was noted that staff understood each resident’s limited verbal communication and gestures and assisted them accordingly. Residents seemed happy and they were treated with respect. On the day of the site visit one of the residents was accompanied by a relative to the follow-up specialist’s clinic following a recent surgery. The relative said that they are very happy with the service and care provided. Redclyffe DS0000019506.V371896.R01.S.doc Version 5.2 Page 14 The home has the support of healthcare professionals such as the General Practitioner and the Community Learning Disability Team. Behavioural concerns are referred to them for immediate assessment. The support plans regarding each resident’s physical and emotional healthcare are assessed regularly. During the site visit the management confirmed that two members of staff will assist a resident when a manual hoist is being used to ensure safety for the resident. However, risk assessments are carried out in the case of individuals who have an overhead hoist in their bedroom and if necessary, two members of staff will assist the resident to ensure safety. A trained member of staff administers the medication in accordance with the home’s medication policy and procedures for the receiving, recording, storage, handling and administration of medicines. Since the last inspection there have been no medication errors. The manager said that the deputy manager will continue to audit medication and the Medication Administration Record charts regularly to ensure that the standards of administration and recording are well maintained. Medicines are currently stored in a storage cupboard but work is in progress to transfer all medicines that are in use into a secured drug trolley which will be kept in the administrative office. The drug trolley will be attached to the wall. There are no controlled drugs in use at the present time. In accordance with the Misuse of Drugs Regulation 2007, the manager has made arrangements to install a Controlled Drug Cupboard as soon as possible. Redclyffe DS0000019506.V371896.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): Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that they will be listened to and that they will be protected from self-harm and abuse. EVIDENCE: The manager said that all members of staff have had training on issues regarding abuse and safeguarding adults (the protection of vulnerable adults) as well as whistle-blowing policy. Refresher courses are held when necessary to remind staff of the importance of safeguarding residents and following the safeguarding procedure. All staff are aware of the joint agency Safeguarding Adults (Adult Protection) procedures of Hertfordshire County Council Adult Care Services. Since the last inspection there have been no safeguarding incidents. Redclyffe DS0000019506.V371896.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): Standards 24, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that the home is well maintained and the environment is homely, safe and comfortable to live in. EVIDENCE: On the day of the site visit, the premises seemed well maintained and the environment appeared clean and tidy. The bedrooms have personal items on display. Some residents have their own computer and television in their bedroom. The residents interviewed said that they are quite happy with the facilities provided. Since the last inspection the kitchenette has been refurbished with new kitchen units and it is now in full use by residents and their visitors who wish to make drinks or snacks. There are some wheelchairs users in the home and the manager confirmed that wheelchairs, hoists and other equipment are serviced regularly and servicing records are readily available for inspection. Redclyffe DS0000019506.V371896.R01.S.doc Version 5.2 Page 17 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): Standards 32, 33, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that the home has an effective staff team who will support them and can be confident that they are safeguarded by the home’s robust recruitment policy and procedures. EVIDENCE: On the day of the site visit, the skill mix and the staffing level were well maintained with the help of regular agency workers. The members of staff present on the day were interacting well with the residents and seemed to understand residents’ verbal communication and gestures and responded to them accordingly. New staff have a period of induction including mandatory training that includes Moving and Handling, Fire Safety, First Aid and Food and Hygiene. Each member of staff has an annual appraisal and a monthly supervision. There is a rolling training programme, including refresher courses on medication, learning disability, safeguarding and equality and diversity. The majority of the support workers have NVQ 2 and above. Redclyffe DS0000019506.V371896.R01.S.doc Version 5.2 Page 18 The assistant manager (or team co-ordinator) has attended two days of training on person-centred planning, organised by Hertfordshire Adult Care Services. She hopes to cascade the information down to all key workers and update the care plans to person-centred format for all the residents. During a random inspection by us in June 2008, it was noted that the home’s recruitment policy and procedures have been followed and the new workers only commenced work after the Criminal Bureau Record (CRB) checks and the Protection of Vulnerable Adult (POVA) Register checks had been cleared. The staff files examined included training certificates, supervision notes and a cover note with the reference number of the CRB certificate. All recruitment records are kept at the head office. Since the random inspection, the records for the agency workers have been updated. The provider has reorganised the management structure for the service and as a result the home has two vacant positions for team co-ordinators. These posts have been advertised. The home no longer has designated ‘senior support workers’, only support workers. The manager said that the team co-ordinator will deputise as deputy manager when required and the more experienced support workers can serve as a shift leader when required. Redclyffe DS0000019506.V371896.R01.S.doc Version 5.2 Page 19 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): Standards 37, 38, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that the care and service provided will continue to be well maintained. They can be assured that their health and safety are promoted and protected. EVIDENCE: The standards of management and administration of the service have been well maintained, although the management team is currently short of two team leaders since the provider, Scope, reorganised the management structure. Any shortfalls in the service have been addressed since the last inspection. In a recent survey by us (the Commission) all the respondents gave very positive comments about the home manager and staff. A relative commented, Redclyffe DS0000019506.V371896.R01.S.doc Version 5.2 Page 20 “This is a caring service and a safe environment. Individual needs are being met.” The provider carries out an annual quality assurance and monitoring survey. This includes written questionnaire feedback from residents, relatives and others. The audit documents were readily available for inspection. There is a monthly proprietor’s report in compliance with regulations. The home is not involved in the residents’ finances but the home manager oversees the personal allowances for some residents and has authorised authority to access these residents’ bank accounts in order to assist them. Proper accounting records have been kept. The area manager carries out regular accounting audits. All records for the protection of the residents are kept secure and are handled in accordance with the Data Protection Act 1998. The servicing records have been well maintained. The Annual Quality Assurance Assessment (AQAA) forms issued by the Commission were received on time for this inspection. The information provided was detailed and has been included in this report. Redclyffe DS0000019506.V371896.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 x 3 3 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 3 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 x x 3 x Redclyffe DS0000019506.V371896.R01.S.doc Version 5.2 Page 22 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. Refer to Standard Good Practice Recommendations Redclyffe DS0000019506.V371896.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Redclyffe DS0000019506.V371896.R01.S.doc Version 5.2 Page 24 - 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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