Inspection on 25/02/08 for Roseacre

This is the latest available inspection report for this service, carried out on 25th February 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Roseacre 23/09/05

Roseacre 03/05/05

Roseacre 06/09/04

Roseacre 11/05/04

Similar services:

2 Perhaver Park

The Vicarage

Fairfields Country Rest Home

St George`s

5 Seafield Road

Credence House

Poldhu

Queensmount

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Roseacre St Winnolls Polbathick Torpoint Cornwall PL11 3DX Lead Inspector Elaine Bruce Unannounced Inspection 25th February 2008 09:00 X10015.doc Version 1.40 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 Roseacre DS0000009219.V360233.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 Older People. 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. Roseacre DS0000009219.V360233.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Roseacre Address St Winnolls Polbathick Torpoint Cornwall PL11 3DX 01503 230256 01503 230854 roseacre333@aol.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Anthony Ivor Knight Mrs Pauline Knight Care Home 22 Category(ies) of Dementia - over 65 years of age (9), Learning registration, with number disability over 65 years of age (4), Mental of places Disorder, excluding learning disability or dementia - over 65 years of age (9), Old age, not falling within any other category (13) Roseacre DS0000009219.V360233.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Service users to include up to 9 adults aged over 65 with a mental illness (MD[E]) Service users to include up to 4 named adults aged over 65 with a learning disability (LD[E]) Service users to include up to 13 adults of old age (OP) Service users to include up to 9 adults aged over 65 with dementia DE(E) Total number of service users not to exceed a maximum of 22 Date of last inspection 15th December 2006 Brief Description of the Service: Roseacre is a family run home located in a rural situation, providing care for up to twenty-two service users. Of these service users there are four with a Learning Disability (LD), the home may also admit up to nine service users with mental health problems (MD). The majority of service users are people who have family in the locality and wish to retain their links with the local community. The main house is an older dwelling with an added extension. There is a pleasant conservatory used as a dining and sitting area to the rear of the property, with patio doors to the garden. From the rear of the property there are panoramic views looking across Plymouth, coastal towns and far out to sea. The home no longer has its own mini-bus. Instead transport is hired to take service users on trips and staff cars are used for service users wishing to visit the local village. The home also provides day care for a maximum of four people per day, which limits disruption to the present service users; and provides an introduction to those who may wish to be accommodated at a later date. The weekly cost of fees ranges from: £300:58 to £383:00. Roseacre DS0000009219.V360233.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The key unannounced inspection at Roseacre took place on the 25th February 2008 between the hours of 0900 and 1500. The Company Secretary was on duty at the time of the inspection. The registered provider and registered manager were on annual leave at the time of the inspection. People were spoken to during the course of the day and case tracking took place with four people. Some of the people in the home are not able to communicate due to their levels of dependency. Observations during the course of the day suggest that the people in the home are being attended to by the staff in a courteous and respectful manner. All the people spoken to suggest that they are very happy living at Roseacre. An inspection of the premises took place as did an inspection of the medication arrangements and the arrangements for the meals in the home. A random selection of staff files were inspected as were the policies and procedures for the home. Prior to the inspection a completed Annual Quality Assurance Document was received and surveys from the people and staff in the home. What the service does well: The home would appear to have good working relationships with the local general practitioners and community nursing service. Good medical information is given to the home from the local surgery and one community nurse commented on the day of the inspection that the home is delivering a good standard of care. Roseacre DS0000009219.V360233.R01.S.doc Version 5.2 Page 6 Senior staff to include the Company Secretary and Deputy Manger presented well on the day of the inspection. They each have their own responsibilities and that appears to work well to the benefit of the home. Staff survey forms indicate that the staff at the home enjoy working at Roseacre. They suggest that they receive good training and enjoy good relationships with relatives and the people in the home. What has improved since the last inspection? What they could do better: Improvements are required to the statement of purpose/service user guide to ensure that people are given the correct and full information about the services that Roseacre is providing. It is recognised that it is difficult to meet the social care needs of such a wide range of people in a care home. It is though important this area of daily life is reviewed to ensure that there are opportunities available to people to take part in stimulating and interesting activities in the home and the community. There are plans for improvements to take place to the environment and it is anticipated that when undertaken this will be of considerable benefit to the people in the home. Please contact the provider for advice of actions taken in response to this Roseacre DS0000009219.V360233.R01.S.doc Version 5.2 Page 7 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. Roseacre DS0000009219.V360233.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Roseacre DS0000009219.V360233.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who use this service have adequate information about the home in order to make an informed decision about whether the service is right for them. The personalised needs assessment means that people’s diverse needs are identified and planned for before they move to the home. EVIDENCE: A recent admission had taken place at Four Seasons with a senior staff member carrying out a full assessment of need prior to the admission. This person was spoken to during the course of the inspection. She expressed very positive comments as to how her admission had been handled and how happy she was at the home. Roseacre DS0000009219.V360233.R01.S.doc Version 5.2 Page 10 The senior staff member explained the admission procedure which includes gathering written information from funding agencies. The staff member was very clear that no admissions take place without this important information. The home ensures that they have gathered written assessment information prior to admission to enable them to meet the social, emotional and care needs of a new person. The home has plans to involve a care assistant in the pre admission assessment process as well as the senior staff member. The service user guide/statement of purpose requires updating to ensure that people have information on all the services that the home is able to provide. In addition to long stay care the home is also able to provide a respite care service. On the day of the inspection one person had been admitted for one week and visiting health and social care professionals were at the home to discuss the placement with the senior staff member. One health care professional was spoken to about the admission. She explained that the home had worked well with the health and social care professionals arranging the complex respite placement. Roseacre DS0000009219.V360233.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The good planning and delivery of care means that the people in the home can be sure that their health and personal care needs will be fully met. Medication arrangements are safe. EVIDENCE: Each person at the home has a plan of care in place with information currently evolving to include assessments on nutritional screening and a life history of the person in the home. The senior staff member who has responsibility for care planning explained the system and how it works. All the staff are involved in the daily recording and care plan reviews were found to be up to date. It is recommended that more evidence be provided that the people in the home are fully involved in the care planning process. Roseacre DS0000009219.V360233.R01.S.doc Version 5.2 Page 12 The home has good systems in place for medication administration and storage. Medication records were found to be completed correctly. Controlled drugs were safely stored and recorded correctly. Only senior staff have medication administration responsibilities and they have all received training to enable them to undertake this task safely. The people in the home who were spoken to felt their privacy was respected and that staff were sensitive and kind when they needed help with personal care. Staff have an overall understanding of the needs of the people with dementia and those of a learning disability. They were seen to be kind and patient when interacting with them. Care plans include health care requirements and the home appears to have good working relationships with the local general practitioners. Good medical information is provided in the care plans from the local surgery. A community nurse spoken to on the day of the inspection said: “they deliver good care at Roseacre, and always get in touch if they have any problems. A staff survey said: “knowing the standards of the home, I was happy for my Gran to spend the last months of her life in this home. She has been very happy” Roseacre DS0000009219.V360233.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A limited range of activities within the home and community mean the people do not have a range of opportunities to participate in stimulating and motivating activities. Meals and mealtimes are an enjoyable social occasion. EVIDENCE: On the afternoon of the inspection a staff member organised an activity for the people in the home (skittles) which appeared to be successful. Daily records indicate that there are some activities taking place in the home but this area of “home life” requires further development. The Company Secretary explained that a musician used to visit the home regularly as did a representative from the Church of England but both of these people have since retired. The home used to have it’s own transport for attending activities but this is no longer the case. The home is very rural and is isolated without this transport. It is important that people in the home are given the opportunity to take part in a variety of activities both within the home and community. The senior staff Roseacre DS0000009219.V360233.R01.S.doc Version 5.2 Page 14 spoken to did recognise the shortfalls in this area and has plans in place to improve outcomes to the people in the home. Throughout the morning of this visit the people in the home were occupying themselves by watching TV or enjoying their own company in their bedrooms. The two people who were spending their day in their bedroom said that they were very happy with this arrangement and in particular looked forward to their visitors coming. It was noted in the afternoon that one staff member was spending one to one time with one of the people in their room. One “person” survey indicated that they are happy with the activities arranged by the home. Visiting arrangements for the home are open and encouraged. People are given a warm drink, encouraged to stay for meals and welcomed into the home. All visitors are asked to sign the “visitors book” on arrival at the home. Menus for the meals in the home are varied and planned by the cook at the beginning of the week. The dining area for the home is comfortable with a pleasant outlook over the fields but the carpet and chairs are shabby in presentation. The Company Secretary explained the plans for improvement to this area. The people spoken to about the meals in the home said they were very good with a choice of meal always provided. The main meal on the day of the inspection was sweet and sour pork with rice and corned beef, potatoes and coleslaw as an alternative. This was to be followed by banoffi pie. The evening meal was to be pate and toast and home made cakes. Two roast dinners are provided every week. One “person” survey stated that they are happy with the standard of the meals in the home. The cook is experienced, has undertaken training and presented as capable and fully involved in establishing the likes and dislikes of the people in the home as well as auditing the weight records of everyone. The requirements of the District Council Environmental Health Officer inspection (25/04/07) have been fully complied with. Roseacre DS0000009219.V360233.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have received training and policies are in place to ensure that the people in the home are safe and their concerns are listened to EVIDENCE: A complaints procedure is available to all the people in the home and this is included in the service user guide. The complaints procedure is also on display in the entrance area of the home. All the people spoken to at the inspection felt safe, listened to, and able to speak to the staff and senior managers if they were not happy about anything to do with their care. Staff surveys indicate that they know what to do if a person has concerns about the service. The home has in place a safeguarding adults policy. It is recommended that this is updated along with recent changes in procedures at the local Adult Social Care Department. All the staff have undertaken safeguarding adults training and the senior staff are due to attend a mangers training course in this important area Roseacre DS0000009219.V360233.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The lack of maintenance in some areas of the home spoils the overall feel of the home which in other areas is very pleasant and comfortable. EVIDENCE: The home was found to be very clean on the day of the inspection and free from any offensive odours. People spoken to during the course of the day commented on the high standard of the cleaning. Staff are provided with disposable gloves and aprons and satisfactory hand washing facilities. Some areas of the home are presenting as “shabby” at this time. In particular this is around a recent problem with a leaking roof at the home. On the day of Roseacre DS0000009219.V360233.R01.S.doc Version 5.2 Page 17 the inspection maintenance work was taking place following this problem. Some bedrooms have recently been painted and updated and the Company Secretary explained all the plans that are in place for a refurbishment that she agreed was long overdue. Work is also to commence on an expensive rewiring programme. Individuals spoken to said that they liked their bedrooms and were happy with the facilities in the home. Bedrooms were noted to be very homely and personalised. The first floor of the home has varying levels that could cause difficulty for some people with mobility problems. Grab rails are provided to help and steps are clearly marked. Externally the home is looking very shabby with essential painting required and a tidy up to the gardens. The laundry was found to be clean, well organised with commercial machines and suitable flooring. Night staff have responsibility for these duties. Roseacre DS0000009219.V360233.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people in the home have a diverse range of needs. They benefit from being cared for by suitable, competent and trained staff in appropriate numbers. EVIDENCE: Many people in the home had high praise for the carers saying “they are very good here at their job and they are very kind”. The rota showed that there were sufficient staff on duty but a senior staff member was not on the rota which should be addressed. Staff surveys clearly indicate that the staff are very happy working at the home, they feel they are delivering a very good standard of care and receive regular training to allow them to do this. On the day of the inspection two care staff were on duty with two senior care staff. There are two waking night staff members employed. The home provides new staff members with a “Skills for Care” Induction programme that ensures new staff members are given the right information to Roseacre DS0000009219.V360233.R01.S.doc Version 5.2 Page 19 be able to do their jobs well. A training plan is in place to ensure that training is provided to staff throughout the year. Mandatory training such as moving and handling, fire safety and health and safety was found to be up to date. Training in the past has included dementia care, which is now to be updated. The Company Secretary also explained that the home is accessing a training course for learning disability. Senior care staff members have obtained an NVQ level 4 in care. 50 of staff have obtained an NVQ level 2 qualification in care and 3 more staff are working towards this qualification. Recruitment procedures are fully in place to protect the people in the home and staff files were found to be well organised. It is recommended that criminal records bureau checks be updated for those staff who have not had a protection of vulnerable adults check Roseacre DS0000009219.V360233.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management team of Roseacre are fully aware of where improvements to the home are required and plans are in hand to improve outcomes where required. EVIDENCE: People spoken to knew the senior members of staff and felt that they were very competent. The owner visits the home regularly. He was on annual leave at the time of the inspection as was the registered manager. The Company Secretary works in the home Monday to Friday. She has Roseacre DS0000009219.V360233.R01.S.doc Version 5.2 Page 21 responsibility for all administration duties. A senior staff member (deputy manager) has responsibility for overseeing care delivery. Both these staff members presented as knowledgeable and capable on the day of the inspection. They have also both obtained the registered manager qualification. Roseacre is running as a Limited Company. Further clarification of this to ensure that the certificate of registration is correct is presently taking place with the CSCI. The quality assurance systems are effective and the Company Secretary proactive in addressing quality issues within the home. The views of people, staff members, relatives and professionals are sought via a questionnaire. A recent questionnaire has taken place to establish the views of people in the home about the standards of the meals. The registered person acts for a small number of people in the home in managing their finances. Records of all transactions are maintained and individual accounts held for money that is accumulated. It is important that the funding authority is fully aware of this arrangement. The Company Secretary has responsibility for health and safety. She has undertaken training in this area and is aware that some policies and procedures require updating. Maintenance of equipment is up to date and compliance will be met for electric hard wiring when the planned work is undertaken. Roseacre DS0000009219.V360233.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Roseacre DS0000009219.V360233.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard OP1 OP12 OP19 OP29 Good Practice Recommendations To update the service user guide/statement of purpose to ensure that information is fully available on the services that the home is providing. To provide more opportunities for people to be involved in stimulating and motivating activities in the home and community. To continue to improve the environment at the home internally and externally. To update the criminal records bureau checks as required and to ensure that all staff working at the home are identified on the rota Roseacre DS0000009219.V360233.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection 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. Extracts may not be used or reproduced without the express permission of CSCI Roseacre DS0000009219.V360233.R01.S.doc Version 5.2 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!