Care Home: Russell House

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What the care home does well Russell House is suitable for individuals with a physical impairment. There is level access and adequate adaptations to ensure the safety of the individuals. There is a strong commitment to provide individuals with a personalised package of care in a homely environment. Individuals are supported to actively engage in the community. Individuals appeared comfortable and well cared for. There is a commitment from the Trust and the manager to ensure that competent and trained staff support the individuals. What has improved since the last inspection? Individuals have benefited from the health and safety risk assessments being kept under review. Much work has been undertaken to improve the communication systems in the home for the benefit of the individuals. It was evident that the staff team have been fully involved and are actively supporting individuals to communicate. CARE HOME ADULTS 18-65 Russell House Hortham Lane Almondsbury South Glos BS32 4JH Lead Inspector Paula Cordell Unannounced Inspection 13th November 2007 09:30 Russell House DS0000020286.V351800.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 Russell House DS0000020286.V351800.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. Russell House DS0000020286.V351800.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Russell House Address Hortham Lane Almondsbury South Glos BS32 4JH 01454 619131 NONE 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) admin@aspectsandmilestones.org.uk Aspects and Milestones Trust Mrs Sousan Asef-Evans Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Russell House DS0000020286.V351800.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. May accommodate up to 6 persons with learning disabilities and physical disabilities who are receiving nursing care. Staffing Notice dated 13/10/1997 applies Manager must be a RN on Parts 5 or 14 of the NMC register Date of last inspection 18th September 2006 Brief Description of the Service: Russell House is a care home registered to provide personal care and nursing care to six people with a physical and a learning disability. The home is situated in a rural location off the A38 in Almondsbury and has its own mini bus, which, is essential to provide access to the local social and community venues. The home is set in its own grounds. There is an extensive garden with a patio area, which provides level access for residents. Car parking is available. The home is a converted property and all accommodation is provided on the ground floor. This comprises of two single rooms and two double rooms. Whilst none of the rooms have ensuite facilities all rooms have a washbasin. Communal rooms include a lounge, dining room and a multi-sensory area. The bathroom and toilet areas have been fitted with adaptations to meet the care needs of the people in the home. Appropriate equipment is provided for individual use based on the assessed identified need. The fees at the time of compiling this report were in the region of £1,1101,400. Russell House DS0000020286.V351800.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit as part of a key inspection. The purpose of the site visit was to review the progress to the requirements and recommendations made at the last visit in September 2006 and review the quality of the care provided to the people who live at Russell House. The focus of the site visit was on the general care of a sample group of people who live at Russell House. This included a review of the records that are held in the home in accordance with the National Minimum Standards and the Care Home Regulations and a tour of the home. This provided a good opportunity to observe the people living at Russell House as well as allowing for informal conversations with the staff supporting them. Three members of staff were spoken with during the inspection, which included the registered manager and a registered nurse on duty at the time of the visit. The home has been sending information in respect of regulation 37 notices of events affecting the well being of the residents. These were used as a focus for the site visit along with the annual quality assurance assessment, which was completed by the home and the monthly provider reports. The site visit was conducted over a period of five hours. Please note that due to the profound and multiple disabilities, people living at Russell House are unable to verbally communicate their views about their home. However, opportunities were taken to observe individuals and it was evident that staff have developed effective ways of communicating with people which has been built over a period of time. What the service does well: Russell House is suitable for individuals with a physical impairment. There is level access and adequate adaptations to ensure the safety of the individuals. There is a strong commitment to provide individuals with a personalised package of care in a homely environment. Individuals are supported to actively engage in the community. Individuals appeared comfortable and well cared for. There is a commitment from the Trust and the manager to ensure that competent and trained staff support the individuals. Russell House DS0000020286.V351800.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. Russell House DS0000020286.V351800.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 Russell House DS0000020286.V351800.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): 1,2,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individuals have clear information about the service provided at Russell House. This would be enhanced if the contract of care clearly detailed the fees and any additional extras that the individuals contribute too. Individuals assessed care needs are being met. EVIDENCE: The home has a statement of purpose and a service user guide. This has recently been reviewed and clearly describes the service provided to individuals living at Russell House. The service user guide is written in plain English and includes photographs making it more accessible to the individuals that the home intends to support. Each person has a contract. The contract states what the individuals contribute, but does not include the full fees and who is responsible for paying this. In addition it was noted that the individuals contribute to the home’s vehicle but it did not state the amount and the frequency of the contribution. Russell House DS0000020286.V351800.R01.S.doc Version 5.2 Page 9 The home has an established group of people living in Russell House. Many of the individuals have lived there for many years since it first opened sixteen years ago with the last admission six years ago. Each person had an assessment of need, which was kept under review. This included an assessment and a care plan drawn up by the placing authority and other professionals involved in the individual’s care. The statement of purpose clearly described the admission process and the people that Russell House could support. Russell House DS0000020286.V351800.R01.S.doc Version 5.2 Page 10 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. Individuals can be confident that their assessed care needs are being met. Individuals are encouraged to participate and make decisions on a day-to-day basis. Staff are striving to find ways to increase the individuals involvement including improving communications between staff and the people living in Russell House. EVIDENCE: Three person’s care plans were chosen at random out of the six people that lived at Russell House. These were informative and tailored to the individual giving clear instruction for staff to follow. Photographs had been used to assist with manual handling equipment and passive exercise. This is commendable. Care plans had been kept under review demonstrating that the home was meeting the individual’s changing needs. Russell House DS0000020286.V351800.R01.S.doc Version 5.2 Page 11 A member of staff described how the staff team were exploring how to improve communication with the individuals in the home. The staff had recently attended training on “intensive interaction”, a means to communicate with individuals that communicate using non-verbal communication. It was evident that this was being used in every day activities with the individuals as observed during the visit. A member of staff described how this was building and enhancing the relationships between staff and the people living in the home. Care records included a communication dictionary for each person detailing how the person uses non-verbal communication to effectively get their needs across. Staff were observed supporting individuals to communicate effectively and responding appropriately to the needs of the individuals. Risk assessments were in place covering a range of activities both in the home and the community. These had been kept under review. Individuals are involved in day-to-day decisions for example what to wear, what to eat and where to spend time in the home. More complex decisions were made by staff due to the individual’s complex and physical disability and their dependence on staff for all areas of their care. However, it was evident from reading care records that the care was tailored to the individual and this was frequently checked and reviewed to ensure appropriate. Care records included whether the individuals had enjoyed particular activities both in the home and the community. Staff described positive relationships with the individuals and how individuals expressed whether they were happy, in pain or upset. An independent advocate has been used in the past to ascertain the wishes of one individual in relation to day care. It was evident that this service would be used again if the need arose. Russell House DS0000020286.V351800.R01.S.doc Version 5.2 Page 12 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): 12,13,16,17, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individuals are supported to access the community and have opportunities for personal development. Individuals have a varied and healthy menu available to them. EVIDENCE: Care plans included information on how the person likes to spend their time both in the home and the community. Individuals had a combination of structured activities including attendance at a day centre and support from day care workers. Other activities included hydrotherapy, reflexology and aromatherapy. Individuals are supported to go on an annual holiday and it was evident that this was tailored to the individual based on their likes and dislikes. From talking with staff it was evident that individuals are supported to go out in the community and their physical disability does not hinder the options available to Russell House DS0000020286.V351800.R01.S.doc Version 5.2 Page 13 them. Records and conversations with staff evidenced that individuals had been supported to go ice-skating, to the theatre and places of interest, shopping and out for meals. Staff maintain a record of the activity so that this can be used to plan future trips. Two individuals in the past have attended an activity centre enabling them to experience a wide range of outdoor pursuits as part of their annual holiday. Some of the individuals attend a local church. It was evident that individuals would be supported to attend a place of worship of their choice to ensure their spiritual needs are being met. Since the last visit the home has been donated a second vehicle to enable the individuals to actively go out into the community. Staff stated that this has increased the opportunities for people to go out more. From talking with staff it was evident that the manager tries to ensure that there is a driver on each shift. Since the last visit, a new post has been created, with a member of staff having the specific role of being a “carer/driver”. Information on the funding of the vehicle could be made clearer by including in the contract the amount and frequency of the contributions. The home has a local policy on the funding of the vehicle, but there was no organisational policy to guide the home. The manager stated that agreements on funding of the vehicle are kept centrally at the office for Aspects and Milestones. Good practice would be for a copy to be maintained in the home. The manager stated that no vehicle could be purchased on behalf of the people living in the home without authorisation from the financial director. The cost of the vehicle is particularly high. This has been assessed as a necessity due to the rural location of the home and the specialist equipment to enable the individuals to access the community. The individuals equally contribute to the cost of one vehicle and contribute to the running costs of both vehicles including petrol. Clear accountable records are maintained of the petrol contributions, which are based on usage. An area of the home has been set-aside as a relaxation area and includes specialist equipment. Individuals were observed listening to music in this area. It was noted that bedrooms have some sensory and relaxation equipment. Staff described some of the activities that take place in the home, which includes hand massage, listening to music, gentle exercises, relaxation and observation in the kitchen when staff are cooking. Individuals were seen relaxing in their bedrooms as well as the lounge area listening to music or watching television. Menus were seen and provided evidence that individuals have available to them a wholesome and varied diet. The cook has completed a National Vocational Award in catering. Care plans included information on how individuals would like to be supported during meal times. Staff were observed Russell House DS0000020286.V351800.R01.S.doc Version 5.2 Page 14 supporting individuals in a sensitive and discreet manner. The meal was unrushed and the atmosphere relaxed. From conversations with staff it was evident that they were knowledgeable about specialist diets and the likes and dislikes of the individuals. Russell House DS0000020286.V351800.R01.S.doc Version 5.2 Page 15 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. Individual’s personal and health care needs are being met. Individuals are protected by the home’s policies and practices in relation to the safe administration of medication. EVIDENCE: Records provided evidence that individuals personal and healthcare needs were being met. Clear guidelines were in place describing how individuals prefer to be supported. Individuals are supported to attend appointments with the GP, optician, dentist and hospital. Other professionals are involved in the planning of the care, including speech and language, occupational therapists and a dietician complimenting the skills of the staff team. Russell House is a care home providing nursing. Registered nurses support individuals at all times and lead each shift. The home has good management on the prevention of pressure sores. This includes guidance for staff in the form of training, a local policy and individual Russell House DS0000020286.V351800.R01.S.doc Version 5.2 Page 16 risk assessments and equipment to prevent skin breakdown including specialist seating, pressure relieving mattresses and evidently good personal care. Each person had clear plans relating to manual handling. Photographs were included in the plan of the care, which made them clearer and pertinent to the individual. Staff attend manual handling training annually. The manager is a manual-handling assessor. Staff stated that new hoists have recently been purchased to support the individuals living in the home. An external contractor completes checks on the hoists and staff routinely check the equipment both on a day-to-day basis and weekly with records maintained. From observations and discussions with staff it was evident that individuals privacy is maintained. Curtains are provided in shared rooms. Individuals are supported with all their personal care needs. Individuals on the day of the visit had an appearance of being well care for. Medication was stored in accordance with the Royal Pharmaceutical Guidelines. Records were being maintained of all medication entering and leaving the home including administraton. The home has developed medication risk assessments and protocols for each person involving the prescribing doctor. This included a homely remedy protocol. The information was informative and detailed to enable new staff to support individuals. However, it was noted that the “medication administration record” (MAR sheet) for some of the prescribed medication lacked sufficient information and stated, “As directed”. The manager stated that she is liaising with the prescribing doctor and the pharmacist to expand on this information. The registered nurses are responsible for the administration of medication and their competence is checked annually as evidenced in the records seen. In addition staff have attended training from the pharmacist responsible for the system in place as seen at the last visit. Russell House DS0000020286.V351800.R01.S.doc Version 5.2 Page 17 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. Individuals living at Russell House can be confident that their concerns would be listened to and acted upon. Individuals are protected from abuse and neglect. This would be enhanced if staff were refreshed in the area of the protection. EVIDENCE: Individuals living at Russell House as already mentioned in this report use nonverbal communication to express their needs. What was very evident was that staff have built good relationships with the individuals and work very much as a team to ensure that individuals well being is maintained. Staff evidently have good observation skills and document in the individuals diaries any concerns or changes to the person’s well being. Concerns are discussed at team meetings and during handovers ensuring a responsive service is provided. The home has a complaints procedure, which meets with the National Minimum Standards. The home maintains a record of complaints, which includes the action taken to alleviate the concern and the outcome. There have been no complaints since the last visit. However one of the complaints noted from the last visit remains outstanding. This relates to four of the individuals having to share a bedroom. Staff were advocating that the individuals have a right to have their own personal space, which would afford them privacy. The manager stated that the organisation is still in discussion with the social landlord who rents the property. However, the proposed plan is for the home to be extended to provide additional bedrooms to enable the people to have a bedroom of Russell House DS0000020286.V351800.R01.S.doc Version 5.2 Page 18 their own. This followed up at the next visit. The manager has agreed to keep the Commission for Social Care Inspection informed of progress. Training records provided evidence that all staff have undertaken training in protection of vulnerable adults. However, it was noted that one staff has not had a refresher course since 2002, and the majority of the staff completed the initial training in 2004. Good practice would be for staff to attend a refresher course. The home has a policy of Safeguarding Adults from Abuse along with the local authorities as seen at previous visits to the service. Staff spoken with during this visit were knowledgeable about what constitutes abuse and the procedure to follow. A random selection of finances were checked and found to correspond with the records held in the home. All money coming into the home and expenditure was clearly documented and two staff had signed for each financial transaction. The finances are checked on every shift. This is good practice. The home has robust financial procedures on the finances of the home and that belonging to the individuals living in the home. These procedures were translated into practice. Russell House DS0000020286.V351800.R01.S.doc Version 5.2 Page 19 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): 24-30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Individuals live in a safe, homely environment. Individuals would benefit from having a bedroom of their own. EVIDENCE: Russell House is in a rural location. There are two single bedrooms and two double bedrooms. The Trust is in the process of liaising with the social landlord to refurbish the home to enable people who use the service to have a single bedroom and increase the numbers of beds from 6 to 8. The manager stated that the plans are still being discussed and the home is awaiting the outcome as noted at the last visit in September 2006. It was evident that providing single bedrooms is the way forward giving individuals more privacy and ensuring the home meets the National Minimum Standards. It is strongly advisable that where a vacancy occurs in a double Russell House DS0000020286.V351800.R01.S.doc Version 5.2 Page 20 room that a new person is not admitted into a shared space unless for married couples or individuals expressing a clear wish to share and this would need to be demonstrated. Maintenance was being responded to appropriately ensuring a safe place for people living at Russell House. Staff maintain monthly audit reports on the environment including equipment and the general upkeep. It was evident that any deficit would be reported to the Trust. The Trust has a property manager who has ultimate responsibility for the major expenditure. All areas of the home were clean and free from odour. All areas seen were homely and furnished to a good standard. It was noted that the hallways have taking some knocking with chipped paint. Staff stated that the hoist has caused this, and it has been identified for redecoration but as yet a date has not been confirmed. New flooring has been purchased throughout the communal areas and the hallways. Staff stated that this is more practical and easier to ensure that it is clean. Individuals have one useable bathroom available to them. This area was lockable and there was a safety device if necessary to gain access in an emergency. The home has level access with handrails situated in the home. Door widths are suitable for people who use a wheelchair. All of the people living at Russell House use wheelchairs to access their home. The individuals have a large garden with a patio and raised garden, which has established planting. The staff have recently completed a fund raising exercise and from the proceeds purchased a wheelchair swing for the garden for the benefit of the people living in Russell House. The home has policies and procedures on infection control and individual guidelines in care plans. There was a supply of plastic gloves, aprons, liquid soap and paper towels in toilets and in bedrooms. There is a separate laundry facility, which is suitable to meet the needs of the people living in the home. All the individuals require assistance with their mobility and personal care. There are a number of aids and adaptations including hoists, high low bath and beds that could be raised to assist an individual with a physical disability. Records seen confirmed that an external contractor maintained these periodically. Records seen confirmed that staff had attended training in manual handling. There were clear instructions in care files tailored to the individual on the equipment in use. This is good practice. Russell House DS0000020286.V351800.R01.S.doc Version 5.2 Page 21 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient and competent staff support the individuals living in Russell House. There are good support mechanisms in place ensuring good communication between the staff members. EVIDENCE: The home has an established team of staff made up of registered nurses and home support workers. The home is a care home that provides nursing and a registered nurse is on duty at all times. As confirmed in conversations with staff and the home’s duty rota. The duty rota provided sufficient evidence that the home was staffed in appropriately to meet the assessed care needs of the individuals in accordance with the home’s statement of purpose. There was four staff working during the day with two staff providing waking night cover. Recruitment information was not seen on this occasion. This is locked and restricted to the home’s manager. The manager was on a day off but wanted to be present for the part of the visit. It was noted at the last visit that staff Russell House DS0000020286.V351800.R01.S.doc Version 5.2 Page 22 were only employed once a thorough recruitment process had been undertaken. Staff inductions were seen with comprehensive documentation in place demonstrating that this had been undertaken within a timely manner. Staff complete the Learning Disability Award Framework as part of their induction. The home has three National Vocational Award Assessors, which includes the manager. The home has exceeded the target of 50 of the workforce having a National Vocational Award. Presently 75 of the team have completed an NVQ 2 in care. Records confirmed that the registered nurses are maintaining their qualification with the Nursing Midwifery Council (NMC). It was evident from records and conversations with staff that there were good support mechanisms in place including regular staff meetings, daily handovers and supervision for individual members of staff. Staff training was in place and covered a wide range of topics relevant to the care of the individuals living at Russell House. There was a good rolling programme of health and safety training for all staff. Russell House DS0000020286.V351800.R01.S.doc Version 5.2 Page 23 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. Individuals benefit from a well-managed service. The manager and the staff are proactive in developing and improving the quality of the service for the benefit of the individuals living in Russell House Individuals can be assured their safety. EVIDENCE: Mrs Asef-Evans manages the home. She is passionate about her role as manager and the rights of the individuals living in the home to an individual tailored lifestyle. Ms Asef Evans has completed the Registered Manager’s Award and is an NVQ Assessor. Russell House DS0000020286.V351800.R01.S.doc Version 5.2 Page 24 Staff spoken with spoke positively about the support and the open approach of the manager. This included the positive changes that have occurred since the manager has been in post. The home has a quality assurance tool to assist in developing the service and ensure compliance to the Care Home Regulations and the National Minimum Standards. This included audits on the environment, care planning processes, social activities, supervisions, team meetings, finances and medication. An external assessor (another home manager working for the organisation) in addition has completed an assessment based on the National Minimum Standards. An opportunity was taken to review the documentation it was both thorough and comprehensive. The home has developed an action plan as part of these quality assurance exercises. This demonstrated that the home, the manager and the team are dedicated to improve the service for the benefit of the people who live there. There was evidence of regular staff meetings covering a wide range of topics relevant to the running of a care home and the needs of the people living in Russell House. The provider is visiting the home on a monthly basis in respect of regulation 26 and copies of the report are being forwarded to the Commission for Social Care Inspection. In addition the named Trustee for the home is visiting every three months and compiles a report as part of a quality assurance initiative. This is good practice. Regulation 37 notifications are being received in the event of any incident occurring in the home that might adversely affect the people receiving a service. The home is maintaining accident records in accordance with the legislation. Records were held securely and found to be current and up to date. There was a current certificate of insurance and the home’s registration certificate both were clearly displayed. Fire records, risk assessments and policies and procedures relating to health and safety were all found to be in order. The home has had a visit in August 2007 from the Environmental Health Officer, when the home was awarded a possible four out of five stars. Risk assessments had been reviewed in response to a requirement from the last visit. Risk assessments and conversations with staff on duty demonstrated that there were safe working practices being adopted in the home to protect both the individuals and the staff. Russell House DS0000020286.V351800.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 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 3 2 3 3 X 4 X 5 2 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 2 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 X 36 3 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 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 X 3 X X 3 X Russell House DS0000020286.V351800.R01.S.doc Version 5.2 Page 26 No Are there any outstanding requirements from the last inspection? 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. 1. Standard YA5 Regulation 5a Requirement Expand contracts for people who use the service to include information relating to Regulation 5a, which includes a full breakdown of fees and who is responsible for paying them. For people who use the service to have a copy of their contract and this to be signed by the individual where possible and other appropriate persons. The contract must include what is included in the fees and any additional costs for example contribution towards the home’s vehicle. Timescale for action 13/01/08 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 YA25 Good Practice Recommendations Double rooms where a bed becomes vacant that the DS0000020286.V351800.R01.S.doc Version 5.2 Page 27 Russell House vacancy is not filled to provide the remaining occupant with his or her own private space. 2. YA23 For staff to attend a refresher course in safeguarding adults from abuse Russell House DS0000020286.V351800.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection South West Regional Office 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA 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. 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