Care Home: Richmond House

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What the care home does well People`s needs are properly assessed, so that their care can be planned appropriately. They have the chance to visit the home and see what the service offers, to help them make a choice about whether or not it can meet their needs. Staff know the people in their care well and understand their support needs. They treat them in a friendly way, and with respect. They make particular efforts to ensure that people are consulted, and encourage them to be part of the community they live in, and to keep in touch with the people who are important to them. Residents say that they enjoy their food. They can choose what they want, so that they are able to have the things they like to eat. The house is kept clean and tidy, and people say they are comfortable in their home. Proper checks are carried out on staff before they start work at the home. This is to ensure that they are fit for the job. Staff are well trained and supervised, so that they have the knowledge and skills and get the support they need to do their jobs well. The service is generally well managed, and residents and staff say they feel comfortable speaking to the Manager about any issues. Checks on essential equipment are carried out regularly, to help make sure that everyone in the house stays safe. What has improved since the last inspection? (This is the home`s first inspection under its new registration, so this section is not strictly applicable. However, the efforts of the new Manager (in the short time since she came into post) and the staff team to develop the service for the benefit of the residents should be acknowledged. Of particular note are the changes made to administration and management of medication, and the work done to improve the comfort and safety of the home environment.) What the care home could do better: Some work needs to be done to make individual care plans more "personcentred". People`s goals need to be developed so that they have outcomes that can be clearly measured. This means that everyone can see whether or not they have been met. This will help to ensure that each person gets the support they need. These will help them achieve the things that are important to them in ways that suit them best. Health Action Plans should also be further developed for each resident. Doing this will help to make sure that people get all the support they need to stay healthy and well. Some of the residents` bedrooms are now in need of redecoration and refurbishment. The home`s maintenance plan should be reviewed to make sure that resources are made available to complete this work. It is also recommended that a new combination lock be fitted to the home`s secondary front entrance. This will enhance levels of security and safety in the house. CARE HOME ADULTS 18-65 Richmond House 20-22 Richmond Road Hockley Birmingham West Midlands B18 5NH Lead Inspector Gerard Hammond Unannounced Inspection 19th March 2009 09:30 Richmond House DS0000072800.V374771.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 Richmond House DS0000072800.V374771.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. Richmond House DS0000072800.V374771.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Richmond House Address 20-22 Richmond Road Hockley Birmingham West Midlands B18 5NH 0121 554 5509 0121 515 3094 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) Midland Heart Limited Care Home 9 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (9) of places Richmond House DS0000072800.V374771.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only - Code PC To service users of either gender. Whose primary care needs on admission to the home are within the following category: 2. Mental Disorder - Code MD maximum number of places 9. The maximum number of service users to be accommodated is 9. Date of last inspection New registration Brief Description of the Service: Richmond House is a well-established facility for 9 adults who have mental health support needs. The registered service provider is now Midland Heart. The house is situated in a residential area close to local amenities, in the Hockley area of the city of Birmingham. It is well served by public transport. The home’s stated aim is to provide a service that enables residents, following a detailed assessment, to develop themselves personally through a supportive rehabilitation programme based on their perceived and expressed needs. The service provides individual key and co-workers to assist residents in their personal development. There are eight rooms with en-suite facilities on the first floor of the building. One bedroom is currently for shared use. On the ground floor there is a lounge area, large dining area adjoining the kitchen, and small kitchenette area where residents can prepare drinks/snacks. There is off road parking at the front of the house and a private enclosed garden to the rear of the property. The home would not be able to cater for wheelchair users or people with significant mobility support needs. The service should be contacted directly for the most up to date information on fees and charges. Richmond House DS0000072800.V374771.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 2 stars. This means the people who use this service experience good quality outcomes. This is the home’s first key inspection since the service was re-registered under the Midland Heart name. We gathered information from a number of places to inform the judgements made in this report. These included reports received from the home, a completed Annual Quality Assurance Assessment (AQAA) and inspection reports of the service under its previous registration. We looked around the home and were able to meet all of the residents. We spoke with the Manager and other members of the care team. We read records including personal files, surveys, care plans, staff files and safety records. Thanks are due to the residents, Manager and staff team for their help and cooperation throughout the inspection process. What the service does well: People’s needs are properly assessed, so that their care can be planned appropriately. They have the chance to visit the home and see what the service offers, to help them make a choice about whether or not it can meet their needs. Staff know the people in their care well and understand their support needs. They treat them in a friendly way, and with respect. They make particular efforts to ensure that people are consulted, and encourage them to be part of the community they live in, and to keep in touch with the people who are important to them. Residents say that they enjoy their food. They can choose what they want, so that they are able to have the things they like to eat. The house is kept clean and tidy, and people say they are comfortable in their home. Proper checks are carried out on staff before they start work at the home. This is to ensure that they are fit for the job. Staff are well trained and supervised, so that they have the knowledge and skills and get the support they need to do their jobs well. The service is generally well managed, and residents and staff say they feel comfortable speaking to the Manager about any issues. Checks on essential equipment are carried out regularly, to help make sure that everyone in the house stays safe. Richmond House DS0000072800.V374771.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Richmond House DS0000072800.V374771.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 Richmond House DS0000072800.V374771.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): 2&4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs are assessed, so that their care and support can be properly planned. EVIDENCE: There have been no admissions to the home since the last key inspection, (carried out under the previous registration) and there are currently no vacancies. We looked at people’s personal files to see if their strengths and needs had been properly assessed. The records we saw contained current assessments, which had been kept under review, as required. This means that information needed to guide people’s care planning was available and has been kept up to date. Records show that people have been given opportunities to visit the home before they came to live there. This means that they were able to come and see what the service offers, to help them decide if it is what they were looking for. Richmond House DS0000072800.V374771.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s care plans give staff clear guidance about how to support them in ways they like. Some improvement is needed to help people develop their goals. This will help to ensure that people get all the support they need to achieve the things that are important to them. EVIDENCE: We looked at people’s personal records to see how their care and support is planned and managed. The format for this is uniform, and there are clear links between the different parts. This helps to promote consistency and makes it easier to find important information. Each person has a detailed needs and risk assessment, which is used to inform their personal support plans (signed by the residents). Each person has a designated key worker. Every month the key worker has to complete a report covering the resident’s mental health, personal care, maintenance of the room, money, social activities, issues from the residents’ group, food, and physical health. This represents good practice, Richmond House DS0000072800.V374771.R01.S.doc Version 5.2 Page 10 providing an excellent opportunity of ensuring that plans are kept under constant review, and up to date. People’s records also contained copies of minutes from multi-disciplinary team review and Care Programme Approach meetings. The support plan format includes places to record people’s personal goals. These should show what is to be done, who is responsible for doing things, when things should be done by, and how they should be done. Some development is needed in this area, and this was discussed with the Manager. Goals should have outcomes that can be clearly measured. These should be evaluated regularly. This is so that judgements can be made about what is working and what might need to be changed. It was suggested that the key workers’ monthly report presents an ideal opportunity to do this. The report should review what was agreed at the previous month’s meeting, and comment on what was actually achieved. Doing this regularly will help to ensure that people get the support they need to achieve the things they say are important to them. As previously reported, the use of person-centred approaches in agreeing individuals care plans and goals could enhance this further. It should be acknowledged that the Manager demonstrated her understanding of the issues involved and willingness to take this forward. The relatively short time she has been in post means that this should be seen as a work in progress. The Annual Quality Assurance Assessment (AQAA) shows that people are supported to make decisions about daily activities, leisure, their diet, and future plans. As shown above, they meet regularly with their key workers so that they can discuss any matters of concern. They also take part in resident group meetings, which they chair. The cook told us that residents have the opportunity to be actively involved in the food shopping, if they wish. One of the residents confirmed that this is the case. Richmond House DS0000072800.V374771.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are able to do things they value and go to places they like. Planning of activities could be improved by linking the things they do to their personal goals. This will help people achieve the things they say are important to them. Residents get the support they need so that they can keep in touch with their friends and families. They have a balanced and nutritious diet, and enjoy their food. EVIDENCE: We looked at people’s records and spoke to residents to find out about the opportunities they have to do things that they value. Some people access local day centres and colleges regularly. Records show that people use local amenities including shops, cafes, restaurants and pubs, the cinema, and go on day trips to places of interest. Staff also organise in-house activities. On the day of the inspection visit, some residents took part in an arts and crafts session in the morning, and a cookery exercise in the afternoon. Residents are Richmond House DS0000072800.V374771.R01.S.doc Version 5.2 Page 12 also supported to go away on holiday if they choose. They also work with staff to keep their rooms clean and tidy, do jobs around the house and try to learn / develop skills to help them be as independent as they can be. Some people’s regular schedules include visits to families and relatives or friends. Residents told us that they are able to keep in touch with the people that are important to them. It is suggested that some improvements could be made to activity planning by making clearer links between activity opportunities and individuals’ personal goals. These could then be evaluated as part of the regular monthly report completed by key workers. Staff have already done some good work in encouraging residents to see their care plans as an agreement or a “two-way process”. It has to be acknowledged that motivating people with mental health support needs to take part in activities can present particular challenges. Linking scheduled activities to their agreed goals should ensure that people get the support they need to achieve the things they say are important to them. As reported above, the development of the use of person-centred approaches should enhance this process further. We looked at the stocks of food in the home and saw that these were plentiful. Fresh produce was available including fruit, vegetables and salad items. The home operates a rolling menu that has been drawn up with the residents. Some of them are actively involved in ordering and buying groceries. Alternatives are always available. Records show that people have access to a balanced and varied diet. The cook also regularly does “themed days” with a cultural / ethnic / international menu, and these are very popular. She also provides cookery sessions for residents to get involved in: on the day of the visit they made some cookies. Baking and cake-making also remain very popular. Residents told us that they like the food they get and that they can have what they want. Richmond House DS0000072800.V374771.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are generally well supported to stay healthy and well. Developing Health Action Plans would help to manage people’s healthcare more effectively. People get the help they need to make sure they get their medicines when they should, and in the right amounts. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) shows that “Customers are supported sensitively by staff to manage personal care needs.” Most people are generally self-sufficient in this area: support is mainly provided in the form of supervision and prompts. We saw that residents were generally dressed in good clothing and had clearly received the support they needed. We saw that residents and staff appeared to get on with each other very well, and were comfortable in each other’s company. Staff knocked on people’s doors and asked permission before going in to their rooms. We saw them give support with warmth and friendliness, and treat residents respectfully. People have detailed care plans, so that staff have good guidance about how to give them Richmond House DS0000072800.V374771.R01.S.doc Version 5.2 Page 14 support in the ways they like. As reported above, this should be developed, by extending the use of person-centred approaches. We looked at people’s records to see how their health care is planned and managed. Records showed that other health professionals are regularly involved in their care. These include their GP, Consultant Psychiatrist, Community Nurse, Dentist, Optician and Chiropodist. We met with one of the resident’s social worker and community nurse, who were visiting on the day of the inspection. They said they were very happy with the support that he is getting. Regular reviews required under the Care Programme Approach (CPA) take place as necessary. This helps to ensure that people’s mental health support needs can be met. We saw the minutes of these meetings on people’s personal files. Health Action Plans are being developed, and these should be seen as a work in progress. These should be based on a detailed assessment of individuals’ strengths and needs. The shift in focus is away from strategies that are reactive (i.e. only do something when a problem arises) to ones that are positive or proactive (i.e. plan to promote good health, so as to prevent problems arising where possible, and reduce risks). Another primary focus of Health Action Planning should be to encourage individuals to take as much responsibility for their own health and wellbeing as possible. Doing this helps people to value the efforts they make and the time they invest in trying to stay healthy and well. As with general care plans, Health Action Plans should include clear goals with measurable outcomes. The Manager told us that she has overhauled the systems in place for administering medication. Ordering prescriptions has been simplified and is now more regular and systematic. Blister packs are colour coded. Two staff complete a stock audit of all medication at each handover. The Annual Quality Assurance assessment shows that all staff have done medication training. We looked at the Medication Administration Record: this was complete, and all medicines had been given as recorded. The staff said that they are much happier with the new system, as it helps to minimise the risk of any errors. Written protocols are in place for PRN (“as required”) medication, so that staff have clear guidance about the circumstances in which this should be given. We saw that the medication store was clean, tidy and secure. Richmond House DS0000072800.V374771.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are confident that their concerns are listened to, taken seriously and acted upon. They are generally well supported to stay safe from abuse, neglect and self-harm. EVIDENCE: Appropriate policies and procedures are in place covering complaints and safeguarding (adult protection). We looked at the complaints record in the home: none have been received, and we have not received any complaints in respect of this service either. Copies of the complaints procedure are displayed in the home, and residents also have copies. Dedicated time is included in the monthly meetings they have with key worker to raise any concerns. Group concerns can also be raised in the residents’ group meetings. People told us that they understand they have a right to make complaints, and could say to whom they would speak. The Manager said that all staff have now done adult protection training. The organisation’s policy is linked to local multi-agency guidelines, and this is displayed in the office. Staff “sign up” to this annually, including Midland Heart’s code of conduct and whistle-blowing procedures. This is good practice, ensuring that all staff are aware of their responsibilities, what to do and how to get support when necessary. The Manager has to complete a safeguarding log every month. No safeguarding referrals have been received. The Annual Quality Assurance Assessment (AQAA) shows that all staff undergo checks with Richmond House DS0000072800.V374771.R01.S.doc Version 5.2 Page 16 the Criminal Records Bureau (CRB) before starting work at the home. These are renewed every three years. Each resident requiring support to manage personal finances has an agreement in place as part of the care plan. We looked at the records of these, to see how they work in practice. We saw that there were receipts to cover any expenditure. The balance of cash held in the safe tallied with the written account. Richmond House DS0000072800.V374771.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff try hard to ensure that the house is comfortable and homely, but some redecoration and refurbishment is now needed in residents’ bedrooms. EVIDENCE: We looked around the building, both inside and out. There are eight bedrooms: all of them have en-suite facilities. One of the rooms is shared, but this is a longstanding arrangement and by mutual consent. The bathroom in this room has been refitted as previously recommended. The upstairs bathroom has also been refitted. We were able to see all of the bedrooms: some of them are now badly in need of redecoration and refurbishment. New flame retardant bedding has already been bought. Each room is now fitted with a “fire bin” to help minimise any risks associated with smoking. Some easy chairs are very worn and in need of replacement. The support needs of this particular group of residents mean that wear and tear on the fixtures and fittings in the building is very heavy. This needs to be Richmond House DS0000072800.V374771.R01.S.doc Version 5.2 Page 18 recognised and taken account of in the home’s cyclical decoration, maintenance and renewal plan. It is recommended that arrangements for this be reviewed as a matter of some priority. However, it should be acknowledged that the Manager has already started this process, and taking positive steps to address the issues. The Registered Provider should make sure that sufficient resources are allocated to ensure that this can be completed at an early date. New flooring has been put down in the hallway, lounge and in three residents’ bedrooms. The lounge has recently been redecorated and new furniture purchased in the last twelve months. It was recommended at a previous inspection that the kitchen be refurbished. Some of the units have been replaced since then, and it is recommended that the job now be completed. The dining room is adjacent to the kitchen at the rear of the house. A number of small tables provide people with flexible options about where they take their meals. The garden can be accessed through this room and the kitchen. It has a summerhouse, patio areas, and is enclosed and private, providing residents with a pleasant outside space. The internal design and layout of the building makes it unsuitable for wheelchair users or people with significant mobility problems. The home is generally well maintained, with good standards of cleanliness and hygiene maintained throughout. Richmond House DS0000072800.V374771.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from being supported by a consistent team of familiar staff. People working in the home get regular training and supervision. This ensures that they have the knowledge, skills and support they need to do their jobs well. EVIDENCE: The Annual Quality Assurance Assessment shows that there is low “turnover” among the staff group. Most have worked at the home for a number of years, promoting continuity of care for the residents. Recruitment is dealt with centrally within the organisation. We looked at staff files. These have been reorganised and a checklist put in place for all essential documents. Records show that staff have had checks with the Criminal Records Bureau (CRB) before they started work. Records also show that references, medical clearance and induction (including a probationary period) have been duly completed. Richmond House DS0000072800.V374771.R01.S.doc Version 5.2 Page 20 There are sufficient staff working in the home to meet the assessed needs of the residents. The service also offers placements for student nurses and social workers. This is positive practice, providing learning opportunities for the students, staff as well as the residents. Records show that most of the staff team hold qualifications at NVQ level 2 or above, or are working towards gaining these. Records provided evidence of recent training, and staff confirmed that they have regular training opportunities and updates. Midland Heart is in the process of re-organising staff training, which is also dealt with centrally. The first priority has been training relating to health and safety. A spreadsheet showing what training individuals have done and identifying dates for “refreshers” is now in place. This should be extended to cover all other training in due course. Staff meetings take place each month, and staff have 1:1 supervision every six-eight weeks. They also receive an annual appraisal of their performance and development. The Manager said she is looking to delegate some of the responsibility for supervision to senior staff. This should provide them with further opportunities for learning and personal development. Richmond House DS0000072800.V374771.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is generally well run for the benefit of the people who live there. Residents say that managers and staff are approachable, so that they feel happy raising any issues with them. Positive action is taken to find out what people think, so that planning the service can be properly informed. Checks of essential equipment are done regularly, so that people’s health and safety can be protected. EVIDENCE: We talked with the Manager and staff to help us make a judgement about how well the home is run. The Manager is appropriately qualified and has several years experience running another service for the same organisation. Staff told us that she is very approachable and they are comfortable raising any issues Richmond House DS0000072800.V374771.R01.S.doc Version 5.2 Page 22 of concern with her. They were very positive about things that she has introduced during the short time she has been in post. She demonstrates a similarly positive attitude towards developing the service for the benefit of the people who use it. Midland Heart operates a well-established system for monitoring and quality assurance of the service. Visits and reports on behalf of the Registered provider are completed regularly. Records show that the annual audit was carried out in September 2008: we saw copies of the questionnaires completed by the residents. The organisation has a good track record of consulting and seeking to involve its customers. The challenge in completing this process is to show specifically how their views have been used to guide the review and development of the service. Midland Heart now has a dedicated Health and Safety Team to monitor and support practice across all its services. An audit of Richmond House was completed in December 2008 and an action plan produced. All issues identified have been addressed subsequently. We also sampled some safety records in the home. Regular checks and servicing have been carried out on the fire alarm and emergency lighting systems, and fire evacuation drills completed. Temperature checks have been done regularly on the fridge / freezer and also water supply around the home. We saw that cleaning materials and other potentially hazardous substances were securely stored. It is recommended that a combination lock (as installed at the main entrance) be fitted to the secondary front entrance to the house, to enhance the levels of security in the home. This is in recognition of the support needs of the residents and local neighbourhood issues. All these things reported above help to show that due care and attention is paid to making sure that people in the home stay safe. Richmond House DS0000072800.V374771.R01.S.doc Version 5.2 Page 23 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 3 3 X 4 3 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 2 25 X 26 2 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 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 Richmond House DS0000072800.V374771.R01.S.doc Version 5.2 Page 24 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. Refer to Standard YA6 Good Practice Recommendations Develop individual care plans so that goals are specific and have outcomes that can be clearly measured. Use regular key worker meetings to review and evaluate goals. This will help to ensure that people get the support they need to do the things they want. Promote the use of person-centred approaches, to help people achieve the things that are important to them. Ensure that there are clear links between people’s activity opportunities and their agreed goals. This will help to ensure they are able to do the things they want and achieve their goals. Develop Health Action Plans for each resident. This will help to positively promote a healthier lifestyle, and ensure that people get the support they need to stay healthy and well. Review the home’s maintenance plan to make sure that sufficient resources are available to support cyclical redecoration and refurbishment. DS0000072800.V374771.R01.S.doc Version 5.2 Page 25 2. 3. YA6 YA12 4. YA19 5. YA24 Richmond House 6. 7. YA26 YA42 Ensure that residents’ bedrooms are redecorated and worn furniture replaced, to keep the accommodation homely and comfortable. Fit a combination lock to the secondary front entrance, to enhance residents’ security and safety. Richmond House DS0000072800.V374771.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Richmond House DS0000072800.V374771.R01.S.doc Version 5.2 Page 27 - 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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