Care Home: Rutland Gardens 79

What the care home does well As the home is not accommodating service users currently it has not been possible to make judgements about direct outcomes for service users at this inspection. The physical environment has been extended and improved to provide an improved and comfortable environment for prospective service users when they are accommodated. The home has a range of good quality policies and procedures that will contribute to providing a responsive service to new service users when they are accommodated. The registered manager and other managers from the provider organisation have a range of knowledge and skills that will assist meet the needs of service users with mental health needs. What has improved since the last inspection? Three requirements were made at the last inspection and these had all been complied with. The requirements were in the following areas: reviewing care plans, safe administration of medication training for staff and health and safety. CARE HOME ADULTS 18-65 Rutland Gardens 79 London N4 1JW Lead Inspector Peter Illes Key Unannounced Inspection 19th December 2006 09:30 Rutland Gardens 79 DS0000010786.V319135.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 Rutland Gardens 79 DS0000010786.V319135.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. Rutland Gardens 79 DS0000010786.V319135.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rutland Gardens 79 Address London N4 1JW 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) 020 8245 2024 020 8800 0429 Mr Phivos Joannides Mr Phivos Joannides Care Home 4 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (4) of places Rutland Gardens 79 DS0000010786.V319135.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th October 2005 Brief Description of the Service: 79 Rutland Gardens is a care home currently registered to provide personal care for four younger adults with mental health needs. The home is run by St Raphael’s Integrity Care Homes, a family owned and managed private company that operate a number of care homes for people with mental health needs or people with a learning disability in Haringey. The registered manager is also the registered provider. The home consists of a converted two-storey terrace house with four single bedrooms. On the ground floor, there is a kitchen, dining room/ lounge, two single bedrooms with en-suite facilities and the homes laundry facilities. On the first floor, there are two other single bedrooms, a toilet, a bathroom/ toilet, and the manager’s office/sleeping in room. There is a pleasant paved area at the front of the building. The back garden is partly paved, accessible to service users and contains a variety of fruit trees. The home is situated in a residential area of Haringey and close to a large selection of multi cultural restaurants, shops and community facilities located along the busy Green Lanes. Wood Green Shopping Centre and Manor House are within walking distance. The registered manager stated that the home charges from £600 per week depending on the service user’s assessed needs. The registered manager also stated that that CSCI inspection reports would be made available, including to prospective service users and their representatives on request. The stated aims of the home include: to provide a service that promotes the social care of adults with mental health needs by enabling them to access the wider community facilities, bringing them into mainstream leisure facilities, shops, parks and in participating in community events and activities. Rutland Gardens 79 DS0000010786.V319135.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was previously registered to accommodate three service users with a learning disability who may also have been over 65 years of age. The previous three service users all moved on and the home has not accommodated any service users since March 2006. At that stage the provider organisation applied to the Commission to accommodate service users with mental health needs and the category of service user was amended accordingly. The provider organisation has experience of running other registered care homes for this service user group. Since the last inspection the provider organisation has also built an extension to the home to include a fourth service user bedroom. The home is now seeking referrals for prospective service users with mental health needs. This key inspection took approximately two hours. The registered manager and two other managers from the provider organisation attended the home to contribute to the inspection. One of the visiting managers is effectively the provider organisation’s service manager and takes an overview regarding care issues. The other manager takes an overview regarding training for the provider organisation. No staff were employed at the home at the time. The inspection consisted of discussion with the registered manager and the other managers from the provider organisation, inspecting a range of documentation including key policies and procedures kept at the home and a tour of the premises. What the service does well: As the home is not accommodating service users currently it has not been possible to make judgements about direct outcomes for service users at this inspection. The physical environment has been extended and improved to provide an improved and comfortable environment for prospective service users when they are accommodated. The home has a range of good quality policies and procedures that will contribute to providing a responsive service to new service users when they are accommodated. The registered manager and other managers from the provider organisation have a range of knowledge and skills that will assist meet the needs of service users with mental health needs. Rutland Gardens 79 DS0000010786.V319135.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. Rutland Gardens 79 DS0000010786.V319135.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 Rutland Gardens 79 DS0000010786.V319135.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users have up to date information available to them to allow them to make appropriate decisions about living in the home. The home has clear policies and procedures that require service users needs and aspirations to be assessed to make sure that the home can effectively address these. EVIDENCE: The home has updated and amended its statement of purpose and service user guide to show that the home now accommodates adults with mental health needs. A copy of the statement of purpose was given to the inspector. No service users were accommodated at the time of this inspection although the registered manager stated that the home was actively seeking referrals. The home had a clear referrals and admissions policy that was seen. This stated that the home would need a comprehensive assessment of need as part of the referral process. The policy also specified that initial visits and a trial period would be offered to all prospective service users before a placement is confirmed. The registered manager and the provider organisation’s service manager are aware of the need for the home to be sure it can effectively address new service users assessed needs before they are offered a long term placement. Rutland Gardens 79 DS0000010786.V319135.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. The home has clear policies and procedures regarding care planning, service users rights and responsibilities and risk management that prospective service users will benefit from. EVIDENCE: No service users were accommodated at the home at the time of this inspection. The inspector was shown the provider organisation’s care planning documentation, a residents charter and a risk management policy and procedure that were all clear and relevant. The inspector was informed that these would be used when service users were admitted to the home. A requirement had been made at the last inspection that all service users care plans must be reviewed at least six-monthly and that had been complied with following that inspection. Rutland Gardens 79 DS0000010786.V319135.R01.S.doc Version 5.2 Page 10 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, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has clear policies and procedures to assist prospective service users maximise their lifestyle options in ways that they wish. The home has a domestic scale kitchen to assist new service users prepare healthful meals of their choice. EVIDENCE: No service users were accommodated at the home at the time of this inspection. Information about how the home will support and encourage new service users to engage in worthwhile occupation, social activities, religious and cultural activities, hobbies and leisure opportunities of their choice are outlined in the home’s statement of purpose. The inspector’s view from discussion with the registered manager and other managers spoken to was that the home would work sensitively with new service users to enhance their quality of life. The Rutland Gardens 79 DS0000010786.V319135.R01.S.doc Version 5.2 Page 11 provider organisation has experience of assisting service user’s meet their cultural and religious needs. The home’s statement of purpose also outlines how new service users will be assisted to develop and maintain relationships with relatives, friends and representatives in ways that they wish. The home has a suitably equipped domestic style kitchen for the size of the home. The inspector was informed that menu’s would be developed with new service users to meet their specific needs and preferences. Rutland Gardens 79 DS0000010786.V319135.R01.S.doc Version 5.2 Page 12 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. The home has clear policies and procedures to assist meet prospective service users personal care and health care needs. The home also has a clear policy to assist protect service users with regard to any medication that they may require. EVIDENCE: No service users were accommodated at the home at the time of this inspection. The home has an appropriate section in its statement of purpose regarding how service users will be assisted to meet their personal care needs and healthcare needs. This includes ensuring these areas are covered in their assessment of need and any required support to be included in their care plan. The section of the statement of purpose also includes that that the home will arrange for appropriate professionals to meet the health needs of each resident. Rutland Gardens 79 DS0000010786.V319135.R01.S.doc Version 5.2 Page 13 The home had a satisfactory safe administration of medication policy that was seen. The provider organisation is currently in the process of negotiating with relevant healthcare professionals for medication to be supplied to the organisation’s homes using a monitored dosage system (blister packs) where appropriate. A requirement had been made at the last inspection that all staff that were working at the home at that time had received up to date training in safe administration of medication. That requirement had been complied with after that inspection. Rutland Gardens 79 DS0000010786.V319135.R01.S.doc Version 5.2 Page 14 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. The home has clear policies and procedures to assist prospective service users raise concerns and have these appropriately dealt with. The home also has clear policies to assist protect them from abuse. EVIDENCE: No service users were accommodated at the home at the time of this inspection. The home has clear policies relating to how to complain about the service and safeguarding adults (adult protection) that were seen. The registered manager and the other managers spoken to were clear about how to maximise protection to service users in an appropriate and sensitive way. Rutland Gardens 79 DS0000010786.V319135.R01.S.doc Version 5.2 Page 15 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 good. This judgement has been made using available evidence including a visit to this service. The home has recently been extended and redecorated to ensure that it can provide a suitable living environment for prospective service users. Further advice is needed to ensure that protection to prospective service users is maximised in relation to the home’s fire precaution arrangements. EVIDENCE: No service users were accommodated at the home at the time of this inspection. The provider organisation has recently completed a ground floor extension to the home to provide a fourth service user bedroom with en-suite facilities at the rear of the home. The home has also completed other improvements to the home. These include providing en-suite facilities to the ground floor bedroom at the front of the home and moving the home’s laundry facilities on the ground floor. The laundry facilities are now completely independent from the Rutland Gardens 79 DS0000010786.V319135.R01.S.doc Version 5.2 Page 16 kitchen and dining room. The home has been redecorated throughout since the last inspection with new furniture and fittings being provided in various areas of the home. The accommodation now comprises: kitchen, dining room, laundry facilities and two en-suite bedrooms on the ground floor and two bedrooms, bathroom/ toilet, an additional toilet and staff office on the first floor. At the last inspection a requirement was made regarding an identified fire door in the home that did not close properly and remain shut. This had been complied with and it was noted that all fire doors had new smoke seals fitted. However, it was noted that in one bedroom the fire door did not shut and stay shut when the windows in the room were closed despite a door closure mechanism being fitted. A requirement is made that the home seeks the advice of the fire officer and ensure that the fire door can close and remain shut when released. The home was clean, warm and comfortable at the time of the inspection. Rutland Gardens 79 DS0000010786.V319135.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): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a clear recruitment policy that will assist protect potential service users as new staff are recruited to the home. The home also has clear training, professional development, supervision and appraisal systems. These will all contribute to developing new staff’s knowledge and skills to assist them enhance their knowledge and skills to better address the needs of prospective service users. EVIDENCE: No service users were accommodated or care staff employed at the home at the time of this inspection. As the home had not been accommodating service users since early in 2006 no staff were currently employed at the home. The previous staff members had been re-deployed to work in other homes run by the provider organisation. The home had a clear staff training policy that was seen. This included the content of induction training that will be provided for new staff and foundation training that will be provided in new staff’s first six months of employment. The registered manager is aware of the need for 50 of the new staff group, Rutland Gardens 79 DS0000010786.V319135.R01.S.doc Version 5.2 Page 18 when employed, to have the national vocational qualification (NVQ), level 2 in care. The home had a clear staff recruitment policy that was seen. The policy stated that all prospective staff members needed to have a range of recruitment checks undertaken before they commenced employment. This included a new enhanced criminal records bureau (CRB) clearance and a protection of vulnerable adults (POVA) check. The inspector was shown a clear staff supervision recording format and was informed that this will be used on a 2 monthly basis for supervising staff at the home when they are recruited. Similarly, the inspector was shown a staff appraisal and annual development plan format that will be used when staff are recruited. Rutland Gardens 79 DS0000010786.V319135.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): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users will benefit from the home being managed by a suitably qualified registered manager. They will also benefit from a clear quality assurance policy and procedures and from health and safety being taken seriously for their protection and for the protection of others who work in or visit the home. EVIDENCE: The registered manager has six years experience managing the home and stated that he had a number of years management experience in catering management prior to that. He went on to say that he had now completed and passed his registered managers award and was awaiting the certification in relation to this. Rutland Gardens 79 DS0000010786.V319135.R01.S.doc Version 5.2 Page 20 The home has a quality assurance system and service user satisfaction forms that were seen. The inspector was informed that these will be introduced once service users are accommodated. Health and safety documentation was sampled and found to be satisfactory. The documentation sampled included a gas safety certificate and an electrical installation certificate. In addition evidence was seen that portable appliances, fire fighting equipment and the fire alarm system had all been satisfactorily tested. A requirement is made regarding ensuring that fire doors close effectively in the Environment section of this report. Rutland Gardens 79 DS0000010786.V319135.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 3 2 3 3 X 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X 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 X 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 Rutland Gardens 79 DS0000010786.V319135.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. 1 Standard YA24 Regulation 23(4) Requirement The registered person must ensure that the home seeks the advice of the fire officer and ensures that an identified fire door can close and remain shut when released. Timescale for action 31/01/07 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 Rutland Gardens 79 DS0000010786.V319135.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Rutland Gardens 79 DS0000010786.V319135.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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