Inspection on 25/08/05 for 9 Roseland Avenue

This inspection was carried out on 25th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

9 Roseland Avenue 10/10/08

9 Roseland Avenue 05/10/06

9 Roseland Avenue 05/12/05

9 Roseland Avenue 28/09/04

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 Roseland Avenue (9) 9 Roseland Avenue Devizes Wiltshire SN10 3AR Lead Inspector Jacqui Burvill Unannounced 25 August 2005 th 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 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 Stationary 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. Roseland Avenue (9) D51_D01_S235118_ROSELANDAVE(9)_V235118_200705Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Roseland Avenue (9) Address 9 Roseland Avenue Devizes Wiltshire SN10 3AR 01380 728507 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Cornerstones (UI) Ltd Lisa Cheryl Harridine Care Home 6 Category(ies) of LD Learning Disability (6) registration, with number LD(E) Learning Disability (1) of places PD Physical Disability (1) Roseland Avenue (9) D51_D01_S235118_ROSELANDAVE(9)_V235118_200705Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of service users who may be accommodated in the home at any one time is 6 2.Only the one, named, female service user between the ages of 18 and 64 years with a physical disability referred to in the application dated 5 October 2003 may be accommodated in the home and this person must be accommodated on the ground floor. 3. The home may only accommodate one person with a learning disability aged 65 years and over. 4. Any placement for short -term care or for an emergency placement must be agreed with the Commision before the placement commences. For the purpose of this condition, short - term is defined as a placement that is expected to last not longer than 3 months. An emergency admission is defined as an admission whereby someone is likely to be placed at short notice without an up -to - date asessment of needs having been carried out and the person has not had the opportunity to visit the home prior to the placement. Date of last inspection 7th February 2005 Brief Description of the Service: 9 Roseland Avenue is a home for 6 adults who have a learning disability. This home is one of five homes owned by Cornerstones UK Ltd. The needs of the service users are wide ranging, including physical disability and age range. The home is located on the edge of Devizes town centre and is within easy reach of shops, leisure centre and open spaces. Each service user has their own bedroom, sharing a communal lounge, and a dining area in a conservatory. One bedroom has an ensuite bathroom. There is a communal bathroom on the ground floor, which is used primarily by one service user. There is a separate ground floor toilet and a first floor bathroom with a separate toilet. There is a small rear garden, which is overlooked and close to neighbouring properties. There is a mimum of two staff on duty during the day, with one staff member sleeping in at night. Roseland Avenue (9) D51_D01_S235118_ROSELANDAVE(9)_V235118_200705Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one morning on 25th August 2005. The inspector spoke to four service users who were at home. Service users were unable to give a view of the home, but the inspector observed that there was a calm atmosphere in the home, despite there being a staff shortage that morning. As a result, the staff member on duty had used the on – call system to ask another staff member to support a service user going to day care. Two of the other service users had been able to go to day care independently. This meant that the plans for the morning had to be re-arranged. Service users seemed to take this change in their routine very well. The second staff member came in later that morning and then took the service users out for lunch. The following records were seen: care plans, risk assessments, medication records, complaints, staff training records, menus and fire safety records. Two service users were case tracked. What the service does well: What has improved since the last inspection? Since the last inspection, the service has made progress in meeting eight of the ten requirements and six of the eight recommendations have been met since the last inspection. This is a positive achievement, especially as the manager was absent during a large proportion of this time and an acting manager was in charge. There have been changes to the management structure, with a new deputy appointed in the home. Roseland Avenue (9) D51_D01_S235118_ROSELANDAVE(9)_V235118_200705Stage4.doc Version 1.40 Page 6 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. Roseland Avenue (9) D51_D01_S235118_ROSELANDAVE(9)_V235118_200705Stage4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Roseland Avenue (9) D51_D01_S235118_ROSELANDAVE(9)_V235118_200705Stage4.doc Version 1.40 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 standard(s) 2 This standard was not assessed on this occasion, as there have been no new service users admitted to the home. EVIDENCE: Roseland Avenue (9) D51_D01_S235118_ROSELANDAVE(9)_V235118_200705Stage4.doc Version 1.40 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 standard(s) 6, 9 Lack of care plan reviews could lead to service users care needs not being met or changes not being addressed. Service users are supported to take appropriate risks and documentation supports this. EVIDENCE: There are different types of care plans in the home. One is an in depth care plan that has not been fully completed yet for all the service users in the home. This in depth record is designed to include all of the details for service users care needs. It runs to some 80 pages. There is a document at the front of the file, which appears to be a reviewing sheet, identifying goals and how they have been met. Neither of these forms had been signed by the person completing them and only one had been dated. There is a shorter, more concise support plan. It was possible to case track the records across the three files that are in place for service users. There was evidence of follow up records on medical and healthcare sheets, which showed that a range of professionals are involved in the care of service users. Service users with communication needs did not have clear procedures in place so that staff could support them in line with professional guidance. Roseland Avenue (9) D51_D01_S235118_ROSELANDAVE(9)_V235118_200705Stage4.doc Version 1.40 Page 10 However, it was not possible to determine how involved service users are in the delivery of their care. Service users are unable to comment on this. Many of the comments in care plans show that some of the service users need a high level of staff support both within the home and in the community. Risk assessments are kept in a separate file. These were related to the risks that may affect service users and had all been reviewed in recent months. Guidelines are in place for any specific behavioural need. Roseland Avenue (9) D51_D01_S235118_ROSELANDAVE(9)_V235118_200705Stage4.doc Version 1.40 Page 11 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 standard(s) 17 Service users have a variety and choice with the meals that are provided. EVIDENCE: Menu records are up to date and in order. They show what choices service users make over meals, as well as a structured menu plan. On the day of inspection, one service user was eating breakfast and service users were offered a drink mid morning. Staff took service users out for lunch and such events are recorded on the menu record. Roseland Avenue (9) D51_D01_S235118_ROSELANDAVE(9)_V235118_200705Stage4.doc Version 1.40 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 standard(s) 18,19, 20 Service users receive personal support in the way they prefer. Service users have their healthcare needs met and anticipated. Service users safety is compromised by poor medication record keeping. EVIDENCE: Care plans describe in great detail the way in which personal care is to be provided. This shows that staff have observed the way in which residents need support. There are clear objective records showing the involvement of healthcare professionals. This standard has been consistently met over previous inspections. Staff have recorded the appointments and any action needing to be taken. When staff hand write new medication onto the medication administration sheet, this must be checked and signed by two staff members. Codes must be used on every occasion when medication is not administered. There are clear guidelines in the medication file and information about medication. The home uses a dosette box system. This was inspected by the home’s pharmacy inspector on 17.3.05 with no problems or concerns detected. Roseland Avenue (9) D51_D01_S235118_ROSELANDAVE(9)_V235118_200705Stage4.doc Version 1.40 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 standard(s) 22, 23 There are procedures in place for complaints to be dealt with in the home. Service users are at risk from abuse due to the lack of staff training and awareness. EVIDENCE: There have been no complaints since the last inspection. New formats have been devised to record and respond to complaints. There is a formal complaints procedure in place and this is complemented by the Wiltshire County Council complaint procedure and a pictorial complaint procedure in the service user guide. Service users are acknowledged to be unlikely to make complaints themselves there is no evidence that families are aware of this procedure to be able to do this on their behalf. The previous requirement has not been met for staff to receive training in adult protection. The deputy manager stated that training was going to happen, but could not provide a date. In house training is acceptable. This requirement has been carried forward for the fifth time at this inspection. Failure to meet this requirement may result in enforcement action. There are copies of the Wiltshire and Swindon ‘No Secrets’ guidance in the staff office, as well as copies of the General Social Care Council’s code of conduct. Staff do not appear to have been given their own copies. The policy and procedure has been amended to include the vulnerable adult policies in place in Wiltshire and Swindon. There are separate copies of these policies in the home. There is insufficient evidence to suggest that staff are familiar and competent in understanding signs and symptoms of abuse, or that they are aware of the procedures to follow. Roseland Avenue (9) D51_D01_S235118_ROSELANDAVE(9)_V235118_200705Stage4.doc Version 1.40 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 standard(s) 24 The home is well maintained and homely. EVIDENCE: The home was clean and tidy on the day of inspection. Parts of the home have been redecorated since the last inspection. This includes one service users’ bedroom, who was involved in the choices of colours. The kitchen was being redecorated during the inspection; there is to be a planned refurbishment of the laundry area, including new machines and flooring; new carpet in the lounge and some items of lounge furniture are to be replaced. Service users were observed sat in the lounge and moving around the home, going to their rooms and walking about the home in a relaxed way. Roseland Avenue (9) D51_D01_S235118_ROSELANDAVE(9)_V235118_200705Stage4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Staff do not have a full range of skills to meet the needs of service users. EVIDENCE: One member of staff is doing LDAF training, despite having worked at the home for some time. Two other staff are doing NVQ level 2. The deputy manager has NVQ level 3. The registered manager is doing the registered managers’ award. There has been some considerable work into devising a training plan within the organisation. Staff training records did not reflect this. The records were in pencil and do not detail the actual date of the training session, just the month and the year. The certificates in the home were not in order, although it was possible to verify some of the courses attended. Staff can also sign the training record as evidence that they have attended a session. The deputy manager was advised that where training issues are part of team meetings, that this can also be counted as in house training and can be recorded on the staff training record. Staff would benefit from communication and autism training. Roseland Avenue (9) D51_D01_S235118_ROSELANDAVE(9)_V235118_200705Stage4.doc Version 1.40 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 Service users are protected by good fire safety checks. EVIDENCE: Fire safety records show that the systems are checked regularly. Staff are named when they attend fire drills. Staff fire safety training records do not detail the actual date of the training in that quarter. The manager has obtained the distance learning pack. Evidence of this training can be kept to show staff ‘s competence. This was the only element of this standard that was inspected. Roseland Avenue (9) D51_D01_S235118_ROSELANDAVE(9)_V235118_200705Stage4.doc Version 1.40 Page 17 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 N/A x x x Standard No 22 23 ENVIRONMENT Score 2 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x Standard No 11 12 13 14 15 16 17 x x x x x x 3 Standard No 31 32 33 34 35 36 Score x x x x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Roseland Avenue (9) Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x D51_D01_S235118_ROSELANDAVE(9)_V235118_200705Stage4.doc Version 1.40 Page 18 Yes 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. 1. 2. Standard 20 20 Regulation 13(2) 13(2) Requirement Two staff must check and double sign any handwritten entries on medication administration sheet. All staff must receive medication training. This had been met in part. Staff are now booked to take part in Protocol medication training. This requirement has been carried forward for the second time. When staff administer medication, codes must be used every time medication is not given. The registered person must ensure staff working in the home receive training in the protection of vulnerable adults. This was a requirement from the inspection dated 17th June 2003. This is fifth time it has been carried forward. Training has been planned, but no date has been set. The manager must ensure that staff receive in house training in the interim. Timescale for action 30th August 2005 31st December 2005 3. 20 13(2) 30th August 2005 30th November 2005 4. 23 13(6) 5. 6. Roseland Avenue (9) D51_D01_S235118_ROSELANDAVE(9)_V235118_200705Stage4.doc Version 1.40 Page 19 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. Refer to Standard 22 22 23 Good Practice Recommendations All staff should attend continence promotion training. This has been carried forward from the last inspection. Relatives or significant others should be informed of the homes complaint procedure and evidence that this has been discussed and shared, should be kept. Discussions about the General Social Care Councils code of conduct should be discussed in the staff team meetings, to ensure that all staff are familiar with the code and that they have their own copy. Staff should discuss and be familiar with the reporting procedures for alerting professionals to adult abuse in the Wiltshire and Swindon No Secrets guidance and have their own copy. Staff should receive training and awareness in autism and communication difficulties that enables them to better meet the needs of service users in the home. The actual date that fire safety training took place should be recorded. (This was a recommendation at the last inspection that was not met.) 4. 23 5. 6. 35 42 Roseland Avenue (9) D51_D01_S235118_ROSELANDAVE(9)_V235118_200705Stage4.doc Version 1.40 Page 20 Commission for Social Care Inspection for Avonbridge House Bath Road Chippenham SN15 2BB 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 Roseland Avenue (9) D51_D01_S235118_ROSELANDAVE(9)_V235118_200705Stage4.doc Version 1.40 Page 21 - 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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