Inspection on 05/12/05 for 9 Roseland Avenue

This inspection was carried out on 5th December 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

9 Roseland Avenue 10/10/08

9 Roseland Avenue 05/10/06

9 Roseland Avenue 25/08/05

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 Mrs Jacqui Burvill Unannounced Inspection 5th December 2005 09.45 Roseland Avenue (9) DS0000060339.V269735.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 Roseland Avenue (9) DS0000060339.V269735.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. Roseland Avenue (9) DS0000060339.V269735.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Roseland Avenue (9) Address 9 Roseland Avenue Devizes Wiltshire SN10 3AR 01380 728507 01672 569477 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) Cornerstones (UK) Ltd Mrs Lisa Cheryl Harridine Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (1), Physical disability (1) of places Roseland Avenue (9) DS0000060339.V269735.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users who may be accommodated in the home at any one time is 6. 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. The home may only accommodate one person with a learning disability aged 65 years and over. Any placement for short-term care or for an emergency placement must be agreed with the Commission 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 assessment of needs having been carried out and the person has not had the opportunity to visit the home prior to placement. 25th August 2005 3. 4. Date of last inspection 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 minimum of two staff on duty during the day, with one staff member sleeping in at night. Roseland Avenue (9) DS0000060339.V269735.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on 5th December 2005 and lasted for 5 hours. Two staff members and the manager were met with and two service users were spoken with during the inspection. Neither of the service users are able to comment directly about the home, or the care they receive. Observations were made of the interactions between staff and service users. The following documents were looked at; care plans, daily notes, medication and medication records, service user meeting notes, team meeting notes, COSHH records and the fire log book. There was a partial tour of the premises. No bedrooms were seen on this occasion. An immediate requirement was set as the fire alarm had not been tested weekly. What the service does well: What has improved since the last inspection? There has been a tremendous improvement to the staff training since the last inspection. This includes the record keeping, the range of courses staff have taken part in and the effects this has had on the staff team and how this has benefited service users. Staff spoke about how they saw training having an impact on the way care is being provided. There are plans for staff to talk to other members of the team about training courses they have taken part in. Roseland Avenue (9) DS0000060339.V269735.R01.S.doc Version 5.0 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) DS0000060339.V269735.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 Roseland Avenue (9) DS0000060339.V269735.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 Standard not assessed as no new service users have been admitted since the last inspection. EVIDENCE: Roseland Avenue (9) DS0000060339.V269735.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): 7 Standard 6 was almost met at the last inspection and standard 9 was met. Service users are partly supported by staff to make decisions about their own choices. EVIDENCE: Service users have care plans, which are being revised at this time. Two service users’ care plans were looked at. One was in the new format and the other was in the old format. There are separate notes with a daily record sheet and other health related documents. There is a new style daily note record, which has been used in the last week. This involves staff using a checklist for personal care and whether the service users have had an epileptic seizure, or completed physiotherapy exercises, as well as comments on their behaviour. There is space for staff to write in additional comments. The inspector noted that on occasion, staff were repeating comments entered in one section of the same sheet in another section. Service users have a weekly opportunity sheet, which lists activities in the community throughout the week. This includes day care in resource centres as well as swimming, Gateway Club and other social activities. The inspector looked at how service users who are unable to verbalise choices are offered activities or other choices. Roseland Avenue (9) DS0000060339.V269735.R01.S.doc Version 5.0 Page 10 The daily notes sometimes recorded ‘quiet day’ rather than what activities the service user may have done whilst at home. One care plan states that the service user is unable to make choices and is reliant on staff knowing his likes and dislikes and providing something he likes to do. The staff discussed their approach to this care need. An example regarding haircuts was discussed. Unless there is a behavioural reason, service users should be enabled to have their hair cut in the community, or at least have a choice over where and how they would like it cut. Two service users have their hair cut by staff in the home. The care plans and daily notes need to record the ways service users who have communication difficulties are enabled to make choices. One service user uses objects of reference, but there is no reference to this in the care plans. Service users are supported in managing their finances. They are expected to contribute towards the cost of petrol for the ‘house’ car. This is regardless of whether they use the home’s vehicle to go to day care or not, as on occasion, other homes within the organisation provide transport. Roseland Avenue (9) DS0000060339.V269735.R01.S.doc Version 5.0 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 the following standard(s): 12, 13, 15, 16 Standard 17 was met at the last inspection. Service users take part in a range of activities and clubs in the local community, which they seem to enjoy. There is positive involvement with families in the home. Service users would benefit from staff having more knowledge and awareness of their rights. EVIDENCE: Staff support service users in attending any day care opportunities they have. This includes day clubs, resource centres and voluntary jobs in the community. There is a wide range of needs in the service user group in this home and staff are aware of what other activities they can offer service users at the weekend and the evenings. There are two staff on duty throughout the day and evening. There is the possibility of an additional staff member being available for a few hours at weekends, although staff would have to book this time in advance. There is a section in the daily notes to record any family interactions, such as meetings, or phone calls. Many of the service users have close family relationships, which they enjoy. The manager spoke about creating a notice Roseland Avenue (9) DS0000060339.V269735.R01.S.doc Version 5.0 Page 12 board for the service users’ room with family pictures to try and develop communication further. A booklet has been developed so that staff in day care have access to relevant information about service users’ needs. This includes ‘things you must know’, ‘things that are important’ and ‘likes and dislikes’. How service users take part in the daily routines in the home is clear in the care plan. Not all service users are able to be involved at the same level. Some of the residents’ meeting notes highlighted areas where some service users need clarification about some of the tasks. Staff were observed to support service users and to try and keep them interested in some activities during the inspection. One service user was keen to show the inspector drawings that he was doing. A discussion took place about an incident where the police were involved. The manager and staff were not aware of the Police and Criminal Evidence Act, which describes the way in which service users with a learning disability must have appropriate adults present. Roseland Avenue (9) DS0000060339.V269735.R01.S.doc Version 5.0 Page 13 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): 20 Standards 18 and 19 were met at the last inspection. Standard 20 was looked again as there were requirements set. Service users benefit from a staff team who have been trained in medication administration. EVIDENCE: The home uses a NOMAD medication system. This is stored appropriately and records are made of medication received into the home. The records showed that two staff are signing the medication administration sheet when new medication is being entered. Apart from one occasion in the last month for one service user, all of the medication record sheets had been filled in correctly. The manager has provided staff with information about the policy and procedure for the way medication is to be administered in care homes. This has been combined with distance learning training in medication. Not all staff have completed this yet. When they have done so, the manager plans to assess their competency and record this. Roseland Avenue (9) DS0000060339.V269735.R01.S.doc Version 5.0 Page 14 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 Standard 22 was almost met at the last inspection. There were major shortfalls in standard 23, which was looked at in terms of the requirement set at the last inspection. Service users benefit from staff who are aware of adult protection procedures and the signs and symptoms of abuse. EVIDENCE: All staff have received adult protection training. This was provided by the Wiltshire Police in April 2005. No certificated evidence has been provided. Where certificates are not provided, staff should sign against the record to verify that they have attended the training session. An in house training session in adult protection was also provided in September 2005. The manager has simplified the procedure, so that staff can easily see which area they need to contact for which service user. Roseland Avenue (9) DS0000060339.V269735.R01.S.doc Version 5.0 Page 15 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): 30 Standard 24 was assessed as met at the last inspection. Some areas of the home would benefit from re- organising and renewal, which would make the home more hygienic for service users. EVIDENCE: A new washing machine with a sluice cycle has been installed in the small utility room. The flooring here must be replaced as it is not waterproof. The flooring extending out from the utility room into the small hallway also must be replaced. The home uses a red bag system to manage soiled linen. The tumble dryer is now situated in the garage at the end of the garden. The garage was full of furniture, mattresses, old carpets and assorted boxes in a state of disorder. Much of this furniture did not belong to the home, but came from other homes within the organisation. The garage door had been damaged in the process and does not close properly now. In the garden close to the garage was a collection of rusting paint cans and old bags of cement, which need to be removed. The ground floor toilet did not have a bin for used hand towels. The home was clean and tidy on the day of inspection. Roseland Avenue (9) DS0000060339.V269735.R01.S.doc Version 5.0 Page 16 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): 32, 34 Standard 35 was almost met at the last inspection. Service users are benefiting from a staff team who have received a wide range of training. No new staff have been recruited since the last inspection. EVIDENCE: Staff records were checked and staff spoken to about their training since the last inspection. Two staff are enrolled onto NVQ level 2 and awaiting a start date. One other staff member has NVQ level 3. Staff have completed a range of training in the past year, which exceeds five days. The manager is keeping evidence of training requests and the response to the requests. Staff have completed training in infection control, moving and handling, medication and a course about the support needs of service users who may have difficulty in foods or eating. One staff member is doing an extended course in autism awareness and other staff have completed courses in communication. No new staff have been employed since the last inspection. Roseland Avenue (9) DS0000060339.V269735.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): 37, 39, 42 Service users benefit from a home that is well managed. Quality assurance systems are in place. A full audit is underway. A lack of regular checks on fire safety systems may put service users at risk. EVIDENCE: The manager has had to defer some of the NVQ level 4 units, due to an extended period of year. She will resume the course and hopes to have this completed by the end of the Summer in 2006. The staff spoke positively about having a manager in the home, that they feel this gives a sense of purpose and direction to the home. Quality assurance audits are in progress, with several units being checked each month. A report will be devised once the audit has been completed. None of the audits were seen on this occasion. All of the radiators in the home are covered, water temperatures are regulated and window restrictors are fitted to first floor windows. Roseland Avenue (9) DS0000060339.V269735.R01.S.doc Version 5.0 Page 18 COSHH records were in order. Cleaning products are safely locked away from harm. Fire safety records were in order in the main, except for the fire alarm tests. The alarm had not been tested since 20th November 2005. An immediate requirement was issued, as it was not felt appropriate to test the alarm during the inspection. Roseland Avenue (9) DS0000060339.V269735.R01.S.doc Version 5.0 Page 19 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 X X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 2 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X 2 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 2 17 Standard No 31 32 33 34 35 36 Score X 3 X X X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Roseland Avenue (9) Score X X 3 X Standard No 37 38 39 40 41 42 43 Score 2 X X X X 2 X DS0000060339.V269735.R01.S.doc Version 5.0 Page 20 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard YA24 YA24 Regulation 23(2) (b) 23 (2) (b) Requirement Timescale for action 31/01/06 3. YA30 23 (2) (b) The garage door must be repaired or replaced. The garage must be cleared and 31/01/06 tidied into a more orderly fashion if it is to be used as storage area. This includes clearing any items that must be removed or destroyed, such as old paint cans. A waterproof flooring must be 31/01/06 installed in the utility room and the hallway extending from the utility room. 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 YA22 Good Practice Recommendations All staff should attend continence promotion training. This has been carried forward from the last inspection. (Carried forward from the last inspection. The training manager is trying to find an appropriate course and information on how to do this was left in the home.) The manager should ensure that she is fully aware of the DS0000060339.V269735.R01.S.doc Version 5.0 Page 21 2. YA13 Roseland Avenue (9) 3. YA35 Police and Criminal Evidence Act and how to support service users should they be arrested. This is to support them in achieving their rights during an arrest and possible interview. Where certificates are not provided as part of a training course, staff should sign the training record to verify they have received the training. Roseland Avenue (9) DS0000060339.V269735.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Chippenham Area Office 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) DS0000060339.V269735.R01.S.doc Version 5.0 Page 23 - 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. 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