Inspection on 09/12/05 for 4 Romulus Close

This inspection was carried out on 9th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

4 Romulus Close 26/07/06

4 Romulus Close 19/05/05

4 Romulus Close 15/02/05

4 Romulus Close 03/08/04

4 Romulus Close 23/12/03

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 Romulus Close (4) Dorchester Dorset DT1 2TH Lead Inspector Marion Hurley Unannounced Inspection 9th December 2005 09:00 Romulus Close (4) DS0000026749.V266675.R01.S.doc Version 5.0 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 Romulus Close (4) DS0000026749.V266675.R01.S.doc Version 5.0 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. Romulus Close (4) DS0000026749.V266675.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Romulus Close (4) Address Dorchester Dorset DT1 2TH 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) 01305 263479 Leonard Cheshire Care Home 3 Category(ies) of Learning disability (3), Physical disability (3) registration, with number of places Romulus Close (4) DS0000026749.V266675.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th May 2005 Brief Description of the Service: Romulus Close is a registered care home accommodating three adults who have a learning disability, and additional physical disabilities. The home is one of seven similar services in Dorchester that are owned by the Leonard Cheshire Foundation, a not for profit organisation providing services to people with disabilities. The bungalow is located in a popular residential area of Dorchester, within walking distance of the town centre and local facilities. The physical environment has been adapted and equipped to meet the needs of service users who have significant physical disabilities. However, the house retains a domestic and homely appearance and feel. Both the property and gardens are totally accessible for all the residents. Service users living at Romulus Close are supported by staff on a 24-hour basis. Each person has an individually tailored plan of support to assist them to live as independently as possible, and to take full advantage of social, educational and work opportunities available to them. The service provided includes the provision of accommodation, day services, personal care, meals and laundry services. Service users are expected to pay for personal items such as clothing and toiletries, and also make contributions to certain activities that are provided outside of the day service programme. Romulus Close (4) DS0000026749.V266675.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection has been undertaken as part of the statutory inspection process in accordance with the Care Standards Act, 2000. Romulus Close was assessed according to the Care Home for Adults (18-65) National Minimum Standards. The overall time spent to complete the inspection process was a total of five hours; one and half were spent at the home. This unannounced inspection took place on a morning of a house/staff meeting and all staff and the three residents were present. What the service does well: What has improved since the last inspection? What they could do better: The home must continue to develop the Individual Service Plans in a format, which is more accessible and reflects the person centred approach to writing individual plans. Risk assessments, should reflect each resident’s abilities and needs and the associated hazards and specific risks to each individual. The risk assessments should not only be used to justify limiting certain actions but demonstrate how positive use of the risk assessments residents can enable the residents to expand their horizons and lifestyles even further. Romulus Close (4) DS0000026749.V266675.R01.S.doc Version 5.0 Page 6 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. Romulus Close (4) DS0000026749.V266675.R01.S.doc Version 5.0 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 Romulus Close (4) DS0000026749.V266675.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 • Service Users would only be admitted based on an assessment of their needs, ensuring the home would be able to meet the service user’s identified needs and have the appropriate staffing levels and facilities. EVIDENCE: Since the last inspection no new services users have been considered for Romulus Close. The group of people living at this small family style home have done so for many years and a vacancy is not anticipated. In view of this the inspector discussed the principles of a prospective service user being considered for a placement with staff. It was clear from these discussions that their knowledge and understanding of good working practices would ensure any prospective resident and or their representative would be involved in a comprehensive assessment to identify their specific needs. Many of the prospective service users considered for the Cheshire Home Service have complex needs and very individual methods of communicating and in reality it might take months to complete a full assessment of the persons needs, preferences and wishes. Records relating to the resident’s needs indicated the staff’s ability to seek advice and work as part of a multi agency network obtaining specialist assessments where appropriate. It is anticipated any prospective service user would benefit from this comprehensive approach. Prospective service users would always be involved and the admission process would be based on the individual’s ability to cope with the transition of moving into a new situation. Romulus Close (4) DS0000026749.V266675.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The key standards were not assessed having been met at the previous inspection. Please note a good practice recommendation from the previous report remains outstanding. Staff have yet to complete the work in writing individual service plans in a more accessible format reflecting a person centred approach which would then mirror their practice. EVIDENCE: Romulus Close (4) DS0000026749.V266675.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15, 16 & 17 • Staff ensure residents are supported in maintaining contact with family members and in developing appropriate friendships. • Resident’s rights are respected and where possible independence and choice and freedom of movement are promoted within the home. • Meals are healthy and mealtimes flexible to suit residents lives. EVIDENCE: The evidence for these standards was obtained from discussion with staff and from reading relevant records. Residents are helped to visit their family and friends, which for some include overnight stays. In addition visitors are always welcomed at Romulus Close. All contacts with family and friends are recorded in the resident’s diary or in their service records. Residents are friends with other service users supported though the Cheshire Home Services and often meet up for activities. Two people from different homes enjoy walking and going to the hydro therapy session together another two like sharing their days out and going to dances and discos. Other residents benefit from regularly meeting with their peers at Social and Education Centres. Romulus Close (4) DS0000026749.V266675.R01.S.doc Version 5.0 Page 11 The menu is planned a month in advance and whilst it does not show specific choices there is always an alternative available. Staff know the resident’s like and dislikes and adjust the menu accordingly. Staff are keen to encourage healthy living and the menu appeared balanced and with a good variety of meals. Ample fresh fruit and juices are consumed daily. A record of all meals/food consumed whether at home or whilst out is recorded in each resident’s diary. Further records were noted of the temperatures of appliances, cleaning rota, and cooked food temperatures. Romulus Close (4) DS0000026749.V266675.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The key standards were not assessed having been met at the previous inspection. EVIDENCE: Romulus Close (4) DS0000026749.V266675.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 • • Adult Protection is appropriately and well addressed in staff training. There are both policies and good practice in place to help safe guard service users from potential abuse and harm. EVIDENCE: Cheshire Homes, Dorchester, has clear policies and procedures and staff have a working understanding of the issues concerning the Protection of Vulnerable Adults. Staff are provided with information in their induction programme about the key issues surrounding Adult Protection, and Whistle blowing and two recently recruited staff confirmed this aspect of their induction training. Other staff are currently being nominated for a series of POVA training events. The staff spoken with during the course of this inspection demonstrated a good understanding of the issues and were alert to ensure the residents are safeguarded at all times from potential abuse and harm. Romulus Close (4) DS0000026749.V266675.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The key standards were assessed and met at the previous inspection. EVIDENCE: Romulus Close (4) DS0000026749.V266675.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 & 35 • Residents are protected by the employment procedures and the staff training programme, which is comprehensive and covers all aspects of the statutory training. EVIDENCE: Members of the staff team each talked confidently about the needs and preferences and wishes of the different residents. They each had clear insight into the different styles each resident uses for communicating their needs and preferences. Brief observations made on the day of the inspection indicated how well staff and residents get on and there appeared to be a positive and open relationship. Residents were unable to verbally confirm these indications but there is no question that through their individual communication and specific behaviour each would clearly indicate any negative feelings they might have towards staff - none were observed. All staff files are retained at Cheshire Homes main Dorchester Office and three files were checked when visiting these administrative offices. Each file contained the required statutory checks and references. Both POVA first and Enhanced CRBs check had been received plus two references. Identification and a photograph were found in each file along with completed interview notes, “letter of offer of employment”, terms and conditions/contract. Romulus Close (4) DS0000026749.V266675.R01.S.doc Version 5.0 Page 16 A useful checklist was at the front of each file and had been completed in each case. An induction/training checklist was found completed in two out of the three files and those completed confirmed which policies and procedures had been provided to the new recruit. Staff confirmed their induction training, which linked with the LDAF induction, and foundation training. Romulus Close (4) DS0000026749.V266675.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 • Health & safety checks are adequate and these contribute to safe working practices to protect residents and staff living and working at the home EVIDENCE: The responsibility for checking the health and safety equipment and servicing records is with the maintenance employee who is based at the Cheshire Homes Administrative Offices, Dorchester. Each home has a generic work base file containing risk assessment and these are reviewed. Other documents relating to individual staff fire prevention training are collated at the Administrative offices and kept with other training records in staff training files. The “responsible individual” representative for Cheshire Homes completes the monthly monitoring visits, Regulation 26 and these reports are comprehensive and extremely useful and practical in providing on going information. Romulus Close (4) DS0000026749.V266675.R01.S.doc Version 5.0 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 Score x 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x x 2 x Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x x x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Romulus Close (4) Score x x x x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x DS0000026749.V266675.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? YES 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. Refer to Standard YA5 Good Practice Recommendations Each resident should have an individual costed contract/statement of terms and conditions between themselves and the home. This recommendation is carried forward from the inspection in February 2005 as this standard was not fully assessed at this inspection. This standard was not assessed at this inspection and therefore this good practice recommendation is carried forward. The individual care/service user plans need to be written based on the principles of Person Centred Planning and should include a record of the residents short and long term goals and achievements. This standard was not assessed at this inspection and therefore this good practice recommendation is carried forward. DS0000026749.V266675.R01.S.doc Version 5.0 Page 20 2. YA6 Romulus Close (4) 3. YA9 4. YA20 Risk assessments should be reviewed regularly and provide details of who has been involved /consulted with during the assessment process. Risk assessments must reflect the individual residents abilities/needs and the hazards applicable to them and the plan of action to minimize the hazards and risks. This standard was not assessed at this inspection and therefore this good practice recommendation is carried forward. The medication recording system should allow for an audit to be undertaken of the medicines received into the home. This recommendation is carried forward from the previous inspection undertaken in February 2005 as this standard was not fully assessed at this inspection. This standard was not assessed at this inspection and therefore this good practice recommendation is carried forward. Romulus Close (4) DS0000026749.V266675.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 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 Romulus Close (4) DS0000026749.V266675.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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