Inspection on 11/05/09 for Roseacre

This is the latest available inspection report for this service, carried out on 11th May 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Roseacre 09/01/06

Roseacre 20/01/05

Roseacre 12/09/04

Extracts from inspection reports are licensed from CQC, this page was updated on 20/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Roseacre Roseacre Holly Hill Drive Banstead Surrey SM7 2BD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kenneth Dunn     Date: 1 1 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Roseacre Holly Hill Drive Roseacre Banstead Surrey SM7 2BD 01737356685 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Banstead, Carshalton & District Housing Society Limited The registered provider is responsible for running the service care home 40 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 0 40 0 dementia old age, not falling within any other category physical disability Additional conditions: 40 0 40 The maximum number of service users to be accommodated is 40 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Dementia (DE) Physical disability (PD) Old age, not falling within any other category(OP) Date of last inspection Brief description of the care home Roseacre was purpose built to accommodate older people in the early 1960s. Since that time the home has been subjected to modernisation and development, now Care Homes for Older People Page 4 of 28 Brief description of the care home providing a good standard of accommodation. The home is sited in its own grounds with good sized and well-maintained gardens accessible to residents. There is limited car-parking facilities to the front of the home. The home is well presented providing accommodation for up to 40 older people. The home has one bedroom, which can be used as a double, for occupancy by a couple if required. All the other bedrooms are for single occupancy; eleven of which have ensuit facilities, two with full bathrooms. The home has four-day rooms and a separate dining room with a private alcove, which service users can use when they entertain their visitors to a meal. Stairs or a passenger lift accesses the upstairs accommodation. The weekly fees for the home are 466.00 to 567.00 pounds. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection of this Care Home for Older People was an unannounced Key Inspection. Regulation Inspectors Mr Kenneth Dunn undertook the site visit. The registered manager was present during the site visit. The registered manager requested that the people living at the home prefer to be known as residents, therefore this term of reference is used throughout his report. The inspector looked at how well the service is doing in respect to the National Minimum Standards for Care Home for Older People. The site visit took into account detailed information provided by the registered provider/manager, and any information that the Care Quality Commission has received about the service since the last inspection. In addition the service has submitted the Annual Quality Assurance Care Homes for Older People Page 6 of 28 Assessment prior to the inspection, some details of which have been added to the report. Documents sampled during the inspection included the home policies and procedures and certificates from professional organisations or contractors. The inspector would like to thank the registered provider and registered manager for their time, assistance and hospitality during this inspection. The quality rating Roseacre is two star. This means the people who use this service experience good quality outcomes. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 Care Homes for Older People Page 8 of 28 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with information,which they need to know to make an informed choice about the suitability of the home as a place to live. Peoples needs are assessed prior to admission to the home. Evidence: The home provides a statement of purpose and service user guide. However these documents have not been reviewed or update since May 2005. The registered provider stated that regular reviews have been undertaken but the documents have not been updated to reflect this. Therefore a good practices recommendation was made to ensure that where areas for change have been highlighted the documents should be updated and reproduced. Information supplied in the AQAA states that people referred to the service receive an assessment prior to admission to the home. This was confirmed by information seen Care Homes for Older People Page 11 of 28 Evidence: on the file of the most recent person admitted to the home,which covered their health, personal, emotional, emotional, social, participation and cultural needs. Other information had also been obtained from the care manager, health care professionals and family. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive support from staff in they way they prefer and want and their physical and emotional needs are met. People are protected by the homes medication policies and practices. Evidence: Each person has a plan of care in place. During this visit we looked at four peoples care plans,which were detailed and comprehensive and provided clear information and guidelines to staff about peoples health , personal, emotional, and social needs and how their needs are to be supported. Information supplied in the AQAA states that care plans are reviewed six monthly and that a weekly meeting takes place between people and their key worker. Daily diaries are maintained,which reflect peoples goals. It was seen that some of the information in peoples files would benefit from being reorganized to make the information easier to read. It was clear that peoples likes, dislikes, choices and preferred routines are recorded Care Homes for Older People Page 13 of 28 Evidence: and respected such their preferred times of going to bed and getting up. During this visit staff were observed to be caring and respectful to people and a health care professional stated that , The home is very aware and proactive in ensuring peoples privacy and dignity. Each persons care plan contained risk assessments ensuring that they are are kept safe. A member of staff spoken with was clear about the procedure for safe handling and using the hoist, which was documented in their care plan. People are supported by a range of health professionals including, General Practitioner, district nurse, chiropody, dentist, occupational therapist, physiotherapist and a person diagnosed with dementia is supported by the community learning disability team. Records were maintained of all health consultation visits. During this visit we looked at the homes medication administration practices. Medication was stored appropriately and systems are in place for the receipt and auditing. Medication is dispensed using the monitored dose system (MDS) and the local pharmacy carries out audits. Each person has a medication profile and medication administration records included a photograph of the person for identification and they were all signed. The medication policy was dated March 2006. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The activity programme meets the recreational needs of the residents. Spiritual needs are observrd and promoted. The systems for autonomy and choice are good enabling residents to exercise choice and control over their lives. The standard of catering is excellent and offers residents a wholesome, and varied diet. Evidence: The home has an activity programme in place that reflects individual needs and choice. Garden activities are organised weather permitting and special events and birthdays are celebrated. Family contact is maintained and relatives and visitors are welcome in the home at any reasonable time. Relatives are encouraged to contribute to the care planning process and to attend care reviews. They are also encouraged to participate in home events and functions. Spiritual needs are supported and a monthly church service is organised in the home. Visits from various clergy or lay persons are also arranged. Care Homes for Older People Page 15 of 28 Evidence: Residents are given the opportunity to to make choice regarding all aspects of their daily lives. The can choose when they get up and go to bed, when they wish to bath or shower, what clothing they wear, how they wish to spend their day, what activities if any they wish to take part in. They can choose to spend time alone or in the company of others, and choose to take meals in the dining room or in their bedroom. Menus are planned by the cook with input from and evaluated by a diatician. Everyone is offered a choice of food for all three main meals. Drinks and snacks are served throughout the day, and homemade cakes are available with afternoon tea. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure and safeguarding procedures in place have protect the residents however they require to be updated and kept under consistent review. Evidence: The home has a complaints procedure in place date June 1990 and this forms part of the residents information guide.. The registered person stated that the policy has been reviewed but unfortunately this was not evidenced during the site visit. The policy audited during the site visit contained very limited contact details of external agencies and some of the were no longer relevant or had been superseded. Therefore a requirement has been made. However staff spoken to were aware of this document and felt that any issues or concerns raised are managed before they get to the formal complaints process. Records confirmed that there has been complaint since the last inspection and that it was investigated with the stated time frames of the policy and was resolved to the satisfaction of the resident and her family. The home also receives many thank you cards and letters. There is a safeguarding procedure in place and staff confirmed that they receive training in this procedure, and would know what to do if they felt abuse was taking place. The home also has a copy of Surreys Multi Agencies policies and procedures on Safeguarding Vulnerable Adults in place. The senior staff have attended external local Care Homes for Older People Page 17 of 28 Evidence: authority training in these procedures and have cascaded this to the staff team. In addition the home has recently purchased a new set of training tools to reinforce the concept of safeguarding among the staff team. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is suitable for its stated purpose. The residents live in a comfortable, homely and well maintained environment, which meets their individual and collective needs . The standard of cleanliness is good and procedures are in place minimise the spread of infection. Evidence: A tour of the premises was undertaken as part of the site visit. The home is comfortable, homely and decorated to a good standard. The providers have an ongoing programme of refurbishment and is well maintained. The dining room is spacious and multifunction initially residents were observed using the room for crafting and then having lunch in comfortable and unhurried surroundings. The area of damp on the ceiling of the lounge identified in the previous inspection report 15 May 2007 had been repaired, however because of ongoing issues with the flat roof directly above the damaged area it has reappeared. The manager stated that the flat roof has had all the moss removed and has been resealed in order to stop future leeks. Bedrooms are single occupancy some with en-suite facilities. Residents can bring items of furniture and personal possessions with them on admission to help personalise their rooms and make it feel homely. Feed back received from one family member stated Care Homes for Older People Page 19 of 28 Evidence: that they were satisfied with the facilities provided for their relative and they thought that they were very comfortable. Toilets and bathrooms have been adapted to meet the mobility needs of the residents. There is a lift to access the first floor and ramp access to the garden. The standard of cleanliness is good. The laundry is small and well equipped. There is an infection control policy in place and all staff undertake training in this policy. Disposable aprons and gloves are provided, and staff were observed to wash their hands frequently. Arrangements are in place for the collection of clinical waste. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing arrangements are sufficient ensuring that residents needs are being met. Staff training and development is ongoing providing a competent staff team to care for the residents living in the home. The recruitment and vetting of staff is good promoting the welfare and safety of the residents. Evidence: The staff duty rota was seen and there is sufficient staff on duty at all times to meet the needs of the residents. Feedback received from a family member of a residents stated that the standard of care was very good and that the residents are well cared for. One member of staff stated that there are times when the home is busy but that there was always enough people on duty to support the residents and other staff members. Staff training is ongoing and evidence of this was seen in individual files. All staff undertake induction process. Mandatory training is in place and includes fire safety, manual handling, food hygiene, health and safety, and medication safety awareness. National Vocational Qualification (NVQ) records evidenced that the home has a strong commitment to staff going a NVQ in care in order to improve the support offered to the residents. Staff also confirmed that formal supervision is in place. Care Homes for Older People Page 21 of 28 Evidence: There is a recruitment procedure in place. Four staff employment files were randomly sampled during the site visit. The files have been reviewed since the last CSCI site visit in May 2007 in compliance to a requirement. However in two files gaps were highlighted in the employment histories of staff members this was discussed with the registered manager and provider who stated that they would undertake a further review of all staff files to ensure that all staff members have a fully detailed employment history on file. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for the day to day management of the home are good ensuring that the home is well managed. The systems in place for monitoring quality assurance should be reviewed to ensure that they fully represent the best interests of the residents. Policies and procedures are in place but are in need for review. The health, safety and welfare of the residents and the staff are promoted and protected Evidence: The home is well managed by the registered manager who is fully qualified to undertake this role. The registered manager has several years experience in the provision of care for older people and strong leadership skills. The registered manager is supported on a daily basis by the registered provider who has a sound knowledge of administration and home management. Between them they operate on open and inclusive style of management and make themselves available to see residents and Care Homes for Older People Page 23 of 28 Evidence: relatives as much as possible. Family members of residents spoken to stated that the home was well run and I can always talk to the manager. The home has a comprehensive set of policies and procedures to ensure that the residents and staff are safeguarded. However the policies and procedures are in need for a full review and update to ensure that they are accurate and relevant. Systems are in place to manage random focused quality assurance. Questionnaires are distributed to residents, on a variety of topics and their feedback is analysed and acted upon. The most recent questionnaire was undertaken during April 2009 and focused on the meals and the quality of food provided by the home. The analysis of the April questionnaire was not available at the time of the site visit. Care plans are reviewed monthly, and audits of medication are also undertaken monthly. Health and safety audits are undertaken and maintenance checks weekly. The health, safety and welfare of the residents and the staff are observed and promoted. All staff are familiar with the health and safety policy in place and undertake training in this policy during their induction period. This was fully discussed with the registered manger and the registered provider and a requirement has been made. Risk assessments are in place for all identified risks and to promote safe working practise. However it is recommended that the registered manger undertakes risk assessments on the continual use water boilers in the tea making areas of the home to ensure that residents are safeguarded from possible burns or scolds The inspector observed that COSHH (Control of Substances Hazardous to Health) procedures are adhered to. Fire safety is observed and there is a contract in place for the maintenance of fire fighting equipment. All staff have regular training in fire safety awareness. The AQAA indicated that all the required safety certificates are in place and renewed as required. The inspector noted the home kept records of all accidents and incidents and these are reported accordingly. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 16 22 The complaints policy must 11/06/2009 be reviewed and updated on a regular bases to ensure that the residents have access to the correct information in the event that they want to make a complaint To safeguard the residents from possible harm or abuse. 2 37 17 The registered provider 26/06/2009 must undertake a full review of all policies and procedures to ensure that they accurately reflect the current working practises of the home and external agencies. To safeguard the residents and staff. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. Care Homes for Older People Page 26 of 28 No. Refer to Standard Good Practice Recommendations 1 3 The registered provider should ensure that the statement of purpose and service users guide are regularly reviewed and updated, to ensure that the residents have access to relevant and accurate information. The registered provider should open the quality assurance process to family, friends and external professional involved in the care of the residents. Risk assessments should be completed on residents use of the hot water boilers available to the residents. 2 34 3 38 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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