Care Home: Rydal House

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What the care home does well General observations during the process of the inspection identified that people living at Rydal House had freedom of movement throughout their home. Staff members approach and practices promoted the rights, choice and independence of the individual. Staff were observed to encourage people to be actively involved in all activities within the home. Care plans and risk assessments provided sufficient information, to enable staff to have the knowledge of the level of support the individual required to enable them, to live a lifestyle in accordance to their assessed needs. What has improved since the last inspection? All requirements that were identified within the last inspection report had been addressed. What the care home could do better: During the tour of the property it was identified that the bathroom, shower area and the toilets and some bedrooms were in need of decorating, to provide a more pleasant and stimulating environment. It was noted that an en suite was used for staff and visitors of which, impinged on the privacy of the person whose bedroom was adjacent. With reference to the terms and conditions of the person`s contract of residency, the Registered Manager should determine, whether the identified bedroom, is provided with an en suite and the dual use of this facility should cease. Food and drinks provisions were stored within the laundry area. In the interest of health and safety, food hygiene and infection control, the Registered Manager should ensure that these items are removed and stored more appropriately. CARE HOME ADULTS 18-65 Rydal House 6 Spratslade Drive Dresden Stoke-on-Trent Staffordshire ST3 4DZ Lead Inspector Dawn Dillion Key Unannounced Inspection 7th November 2007 10:00 Rydal House DS0000029772.V354830.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 Rydal House DS0000029772.V354830.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. Rydal House DS0000029772.V354830.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rydal House Address 6 Spratslade Drive Dresden Stoke-on-Trent Staffordshire ST3 4DZ 01782 330854 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) emmahenson@aol.com Mr Alan John Bradshaw Mrs Joy Bradshaw Mrs Emma Karen Henson Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Rydal House DS0000029772.V354830.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide personal care and accommodation (without nursing) for service users of both sexes whose primary care needs on admission to the home are within the following categories: Learning Disability (LD) 8 The maximum number of service users to be accommodated is 8. 2. Date of last inspection 22nd February 2007 Brief Description of the Service: Rydal House is a residential home located in Stoke On Trent, Staffordshire, of which provides a service for eight adults who have a learning disability. The large mature semi detached property is situated in a residential area and is accessible via public transport and is in close proximity to local amenities. The exterior of the property is in keeping with the local community. The home provides eight single occupancy bedrooms, of which are located over three floors. There is no passenger lift, specialist aids or adaptations available and these are not currently required for the people living in the home. Five bedrooms are equipped with an en suite and three bedrooms on the ground floor have a washbasin. One toilet with bathing facilities is located on the ground floor and there is a shower room on the first floor. The property also provides a large lounge with dining facilities and a domestic style kitchen, the laundry is located in the basement. People living at the home have access to an enclosed garden located at the rear of the property. Parking is available on the road. Staffing is provided on a twenty-four basis, to provide continued support and supervision to people living in the home. The fees chargeable for the service provided at Rydal House is from £325.00 £335.00 per week. Rydal House DS0000029772.V354830.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced key inspection of Rydal House was undertaken within six hours. The inspection methodologies that were used, to establish the quality of care provided and the effectiveness of the management of the home, to promote equality, diversity and best practices entailed the examination of records, relating to the homes policies, procedures and general practices. A tour of the property was undertaken to ensure that the environment and systems in operation, were safe and suitable in meeting the needs of the people accessing the service. People living in the home were interviewed during the process of the inspection, to ascertain their views and opinions, in relation to the support and assistance provided to them, to enable them to live a lifestyle of their choice, reflecting their cultural and religious needs. The Registered Manager was present for most of the duration of the inspection. What the service does well: What has improved since the last inspection? Rydal House DS0000029772.V354830.R01.S.doc Version 5.2 Page 6 All requirements that were identified within the last inspection report had been addressed. 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. Rydal House DS0000029772.V354830.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 Rydal House DS0000029772.V354830.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, and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People wishing to access the service were provided with sufficient information, to enable them to establish whether the home would be suitable to meet their needs. The homes admission process ensured that people’s needs were assessed prior to a placement being offered. EVIDENCE: The homes Statement of Purpose provided comprehensive information relating to the service and provisions available at the home, the document should however be reviewed, to ensure that information relating to the management is up dated. People living in the home also had access to a Service User Guide of which was also in depth. The examination of three files pertaining to people living in the home and discussions with the Registered Manager, confirmed that people were subject Rydal House DS0000029772.V354830.R01.S.doc Version 5.2 Page 9 to a Care Management Assessment (Pre Admission Assessment), to ensure that the home would have the capacity to meet the persons needs, prior to a placement being offered. The homes admission process also incorporated a trial visit, of which, enabled the individual to visit the home prior to admission, having the opportunity to establish whether the placement would be appropriate for them. Rydal House DS0000029772.V354830.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, 8 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home were actively involved in decisions affecting their welfare. The homes practices and procedures promoted equality and diversity, to ensure that people live a normal and independent lifestyle. EVIDENCE: Information obtained from the Care Management Assessment (Pre Admission Assessment), provided the basis for the development of the care plan and risk assessment. Three care plans were randomly selected for examination, all of which provided detailed information relating to the care needs of the individual and the level of Rydal House DS0000029772.V354830.R01.S.doc Version 5.2 Page 11 support and assistance required, to ensure that the person would be able to live a lifestyle of their choice, and to promote their independence and welfare. It was pleasing to see that people were encouraged to be actively involved in the development and review of their care plan. Records evidenced that people had access to relevant healthcare services. Risk assessments were in place for the individual, providing relevant information relating to potential hazards within and outside the home. The assessment also provided information of the appropriate control measures, of which would enable and promote the individual to take a risk to live an independent lifestyle. Discussions with people who access the service and staff members, confirmed the undertaking of regular meetings, to ensure that people were actively involved in the management of the home and kept abreast of issues relating to the service delivery. The examination of minutes of meetings identified discussions relating to, the pet rabbit, holidays, social activities and meals. People who attended the meetings signed the minutes of the meetings to acknowledge the contents. Rydal House DS0000029772.V354830.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): 11, 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff’s approach and practices promoted the choice of the individual and there was a positive emphasis focused on ensuring that people had access to outside activities and to also to have a positive presence within their local community. EVIDENCE: The examination of records and general observations during the process of the inspection, confirmed that people living in the home were provided with the necessary support and assistance, to learn new skills and to live an independent lifestyle where possible. The Registered Manager informed the Inspector that there was no one in residence who were in paid employment, this was due to the lack of capacity. Rydal House DS0000029772.V354830.R01.S.doc Version 5.2 Page 13 Discussions with people living at the home confirmed that they had access to a variety of social activities to meet their needs. Activities consisted of shopping trips, accessing social clubs and pubs, some people attended day care services whereby, they also had access to the local colleges to learn new skills. A number of people at Rydal House informed the Inspector of their holidays this year, that consisted of visits to Wales, Blackpool, and Ibiza. One person living at Rydal House was able to continue to practice their religious faith with the support of their family. On the day of the inspection people living in the home were participating in decorating the home for a Birthday celebration on the night and were also heard discussing past Halloween and Birthday parties. There were no people in residence from the ethnic minority group, with reference to equality and diversity, the homes Statement of Purpose identified information in relation to providing a service, with regards to the individuals’ ethnic, cultural and religious practices. Discussions with people who live at Rydal House, confirmed that they were provided with the necessary support, to enable them to maintain contact with their family and friends. The homes Statement of Purpose stated that, “Residents are given every possible help to maintain the links they wish to retain with their families and friends outside the home, but can choose whom they see and when and where.” The daily routine within the home was observed to be relaxed, with people having freedom of movement throughout, with some restriction to promote the privacy of people living in the home. The examination of menus identified that a varied and well-balanced diet was provided; an alternative choice was also identified on the menus. During the process of the inspection a staff member was observed assisting a person to choose what they wanted for lunch, using pictorial cards and communicating in a mode suitable to individual. Rydal House DS0000029772.V354830.R01.S.doc Version 5.2 Page 14 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 and 19 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home were provided with the necessary support and assistance to maintain their general health, in a manner that promoted the individual’s privacy and dignity. EVIDENCE: Staffing was provided within the home on a 24-hour basis, to ensure that the individual received the necessary support and supervision, to promote their general health and welfare. Staff rotas were flexible to ensure that people were provided with the relevant support. Rydal House DS0000029772.V354830.R01.S.doc Version 5.2 Page 15 People using the service were encouraged to maintain their preference to style of dress to reflect their personality. The examination of care plans identified that people had access to relevant healthcare services to monitor their physical and mental health. Rydal House DS0000029772.V354830.R01.S.doc Version 5.2 Page 16 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns via the homes complaint procedure. The homes recruitment practices ensured that people are protected from abuse. EVIDENCE: The homes complaints procedure was accessible to all people living in the home, of which identified information, relating to the support that would be provided, whether it be the support of a friend, staff member or an advocate, to enable the individual to express their concerns. The home was in receipt of the Inter Agency Vulnerable Adults procedure, which had been signed by all staff to acknowledge the contents. The examination of a file pertaining to a person, who had recently been recruited, identified that the appropriate checks had been undertaken to ensure that people living in the home were protected from abuse. Staff training records evidenced that they had received training relating to adult abuse and aggression. Rydal House DS0000029772.V354830.R01.S.doc Version 5.2 Page 17 Rydal House DS0000029772.V354830.R01.S.doc Version 5.2 Page 18 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, 25, 27 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enabled people who use the service to live in a safe and comfortable environment. Some areas within the home were in need redecorating, more emphasis needed to be focused on preserving the privacy of one person living in the home. EVIDENCE: Rydal House is a large mature semi detached property located in Stoke On Trent, Staffordshire. The home is situated in a residential area and is accessible via public transport and is in close proximity to local amenities. The exterior of the property was in keeping with the local community. Rydal House DS0000029772.V354830.R01.S.doc Version 5.2 Page 19 The home consisted of eight single occupancy bedrooms, which were located on three floors. People living in the home were able to personalise their rooms to reflect their interests and personality. Some consideration should be given in redecorating bedrooms to provide a more stimulating environment. Five bedrooms were equipped with an en suite and three bedrooms on the ground floor had a washbasin. One toilet with bathing facilities was located on the ground floor and there was a shower room on the first floor. Bathrooms and toilet areas were very sparse and institutional in appearance, providing very little home comforts. The Inspector raised concerns that an en suite located on the ground floor was used for staff and visitors, which impinged on the privacy of the individual occupying the bedroom adjacent. With reference to the individuals contract of residency, the Registered Manager should determine whether this identified bedroom is equipped with an en suite facility or not and the practice of dual use should cease. There is no passenger lift, specialist aids or adaptations available, however these aids were not currently required for the people living in the home. The property also provided a large lounge with dining facilities and essential furnishings and fitments to provide a comfortable area for relaxation, or to socialise with other people. People living in the home had access to a domestic style kitchen. A compact laundry was provided in the basement, the inspector raised concerns that food provisions were stored in the laundry area. Discussions with the Registered Provider confirmed that these provisions would be removed and stored more appropriately. There was a garden at the rear of the property; limited parking was available on the road. The cleanliness and hygiene throughout the home was of good standard. Rydal House DS0000029772.V354830.R01.S.doc Version 5.2 Page 20 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 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A positive emphasis focused on staff training and development, ensured that people accessing the service benefited from a skilled workforce. EVIDENCE: The examination of staff training records identified that there was a positive emphasis focused on staff training and development. Training provided within the last twelve months consisted of First Aid, Mental Capacity Act, Infection Control, Adult Abuse and Aggression and Administration of Medicines. The staff working rotas were flexible to meet the needs of people living in home, providing additional staff during peak times of the day. One staff member was providing during the night. Discussions with the Registered Manager confirmed that one person had been recruitmented since the last inspection visit. The examination of the file Rydal House DS0000029772.V354830.R01.S.doc Version 5.2 Page 21 pertaining to this individual, identified that all the necessary checks, to ensure the protection of people living in the home were undertaken. The homes recruitment process included the involvement of people living in the home, of which one person was nominated to sit on the interview panel and they were also actively involved in the assessment during the probationary period. Files that were examined evidenced that staff were provided with regular supervision sessions. Rydal House DS0000029772.V354830.R01.S.doc Version 5.2 Page 22 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, 38, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management style was open and transparent promoting the rights and independence of the individual. EVIDENCE: The Registered Manager was experienced in social care and demonstrated a sound knowledge of the needs of people in her care. Rydal House DS0000029772.V354830.R01.S.doc Version 5.2 Page 23 Observations during the process of the inspection evidenced that she was proactive in promoting the rights of the individual and encouraged their participation in all activities within their home. The management approach created an open, positive and inclusive atmosphere, where staff were observed to interact with people in a respectful and professional manner. General observations during the process of the inspection identified, that the Registered Manager portrayed a clear leadership style and interacted well with the people using the service and her staff team. The examination of care plans and discussions with the Registered Manager evidenced her knowledge of the individual’s care needs and the strengths and weakness of the service. The homes quality assurance tool consisted of an audit check that reflected the ‘National Minimum Standards for Care Homes for Adults.’ A service user questionnaire that was published in a pictorial format was distributed to the individual; where necessary the individual would be provided with the relevant support to enable them to complete the questionnaire. The quality assurance questionnaire provided questions relating to daily routines, social activities and meals. Questionnaires were also distributed to staff and outside agencies. With regards to systems and practices that promote the health, safety and the welfare of people accessing the service, all safety records were up to date and well maintained. Rydal House DS0000029772.V354830.R01.S.doc Version 5.2 Page 24 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 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 3 25 3 26 X 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 3 3 X LIFESTYLES Standard No Score 11 3 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 X X 3 3 3 X X 3 X Rydal House DS0000029772.V354830.R01.S.doc Version 5.2 Page 25 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. 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. 2. 3. 4. Refer to Standard YA1 YA27 YA25 YA27 Good Practice Recommendations The homes Statement of Purpose should be reviewed to provide up date information relating to the management of the home. Consideration should be given in redecorating the bathrooms/shower and toilet areas to provide a more comfortable area. Bedrooms should be redecorated with the involvement of people living in the home, to choose the colour scheme to provide a more pleasant and comfortable environment. It has been identified, as a recommendation in this instance that the Registered Manager should determine whether the identified bedroom, is provided with an en suite facility and the dual use of this en suite should cease. It has been identified as a recommendation in this instance that food and drink provisions should not be stored in the DS0000029772.V354830.R01.S.doc Version 5.2 Page 26 5. YA30 Rydal House laundry. Rydal House DS0000029772.V354830.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection 1st Floor Chapter House South Abbey Lawn Abbey Foregate Shrewsbury SY2 5DE 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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