Inspection on 22/12/05 for Phoenix Lodge

This inspection was carried out on 22nd 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 no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Phoenix Lodge 18/10/07

Phoenix Lodge 22/05/07

Phoenix Lodge 05/09/06

Phoenix Lodge 17/05/05

Phoenix Lodge 20/12/04

Phoenix Lodge 02/06/04

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

CARE HOME ADULTS 18-65 Rosehill House 30 Rougemont Avenue Torquay Devon TQ2 7JP Lead Inspector Sam Sly Unannounced Inspection 02:00 22 December 2005 & 3 January 2006 nd rd Rosehill House DS0000018418.V252924.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 Rosehill House DS0000018418.V252924.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. Rosehill House DS0000018418.V252924.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Rosehill House Address 30 Rougemont Avenue Torquay Devon TQ2 7JP 01803 615538 01803 613430 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) info@craegmoor.co.uk Parkcare Homes Limited Vacancy Care Home 4 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (4), Physical disability (4) of places Rosehill House DS0000018418.V252924.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th May 2005 Brief Description of the Service: Rosehill House cares for 4 people with physical disabilities and/or mental disorder. It specialises in caring for people who have suffered a brain injury and is owned by a subsidary of Craegmoor Healthcare Limited. The house is in a residential area of Torquay and near to community amenities. Rosehill is wheelchair accessible with level access throughout and adapted shower rooms and a bathroom with an electric chair. There are four single bedrooms, an office/staff room, lounge, dinig room, kitchen and laundry room. The garden to the back of the house is ramped with a patio area. Rosehill House DS0000018418.V252924.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Due to important information being unavailable, and the acting manager not being present, this Inspection took place over two days. The first visit was unannounced, and took 3.5 hours a few days before Christmas, the second visit was announced and took 1 hour on a weekday in January 2006. Time was spent talking to all four residents, staff on duty, the acting manager Helen Tremlett and a representative of the registered provider Peter Cavanaugh. Observation of staff/resident interaction and staff, health & safety and care records also informed the judgements made in this report. What the service does well: What has improved since the last inspection? What they could do better: Rosehill House DS0000018418.V252924.R01.S.doc Version 5.0 Page 6 Prior to admission a resident’s needs must be thoroughly assessed, including any potential risks, and ideally involving the placing Local Authority Care Manager so that the resident can be sure Rosehill House can meet their needs. Once admitted the resident’s care plan must be detailed, and reviewed as their needs change. When employing staff any management decision-making, in relation to the fitness of a potential staff member must be recorded. The Commission must be informed of any event that adversely affects the welfare of a resident, and all health and safety records must be consistently recorded. 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. Rosehill House DS0000018418.V252924.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 Rosehill House DS0000018418.V252924.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 The most recently admitted resident’s needs had not been fully assessed prior to admission, causing problems for other residents at Rosehill House. EVIDENCE: A new resident had moved into Rosehill House since the last Inspection and their assessment and care planning information was examined. The information recorded was then judged against the observed behaviour of the resident, discussion with the resident, daily recording, the views of staff working with the resident, the views of other residents and discussion with the acting manager and Registered Provider’s representative. The most up to date Placing Authority review had taken place at his last care home in December 2003, and there had been no re-assessment before he had moved to Rosehill House. The information collected by the Home prior to the resident’s admission was not comprehensive, and did not contain information on needs that the resident was now presenting. Staff said that these needs were known by the previous care home, but had not been passed on. There was an assessment/ risk assessment and care plan produced by the acting manager on admission, for the resident however it did not fully reflect all the risks, needs and action required by staff to meet the resident’s needs, and had not been up dated as the residents needs had changed. Rosehill House DS0000018418.V252924.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): 6&9 The most recently admitted resident’s care plan and risk assessment did not reflect their changing needs and goals, and so staff did not have clear direction about working with and protecting the resident. EVIDENCE: As described in the previous section the most recently admitted resident’s care plan and risk assessment did not fully reflect the needs and staff action required to work with them. Rosehill House DS0000018418.V252924.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): None were Inspected. EVIDENCE: None of these standards were inspected as all were met at the last Inspection, and nothing was found to warrant further investigation. On the first day of Inspection the residents were going off to a Christmas Pantomime, and coming home afterwards with a Chinese takeaway. Records also showed that residents did a wide range of activities, and had tickets for football matches, music gigs and shows in the New Year. Rosehill House DS0000018418.V252924.R01.S.doc Version 5.0 Page 11 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 The medication procedures at Rosehill House protected residents. EVIDENCE: The medication procedures were examined. A new metal drugs cabinet was in use and medicines stored appropriately, however the medicines fridge was broken, and had not been replaced yet. None of the residents administered their own medication. Medicine administration records were being filled in properly, however it is recommended that written drug sheets are checked and signed by two staff for safety reasons. Drugs were being disposed of correctly too. All staff had undertaken a medicine management course since the last Inspection, and staff demonstrated that medication refusals were highlighted to a professional appropriately, or re-administered in a safe timescale. Rosehill House DS0000018418.V252924.R01.S.doc Version 5.0 Page 12 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): 22 & 23 Staff are able to protect residents from abuse, and concerns are dealt with swiftly. EVIDENCE: All staff have attended an adult protection course since the last Inspection, and those on duty were able to demonstrate an understanding of the abuse, and the correct procedure to follow when faced with an abusive situation. The Home had a clear complaints procedure, and on the unannounced visit it was found that a resident’s relative had recently made a complaint to the acting manager. This was discussed with the acting manager at the second visit who was carrying out an appropriate investigation. One resident expressed a concern about being woken at night and said they had told staff but did not know what staff were doing about it. This was discussed with the acting manager and Provider representative at the second visit, and appropriate action was being taken. Rosehill House DS0000018418.V252924.R01.S.doc Version 5.0 Page 13 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 Rosehill is clean with strategies in place to keep it hygienic. EVIDENCE: The laundry facilities were clean, hygienic and appropriate to the needs of residents. Staff said they had undertaken training on Infection Control, and this was confirmed on inspection of their training files. Rosehill House DS0000018418.V252924.R01.S.doc Version 5.0 Page 14 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, 33, 34 A fit, qualified, competent staff team supports residents, however a lack of some written documentation could potentially weaken the protection of residents. EVIDENCE: On the first unannounced visit staff files were inaccessible as they were locked away, due to the acting manager not being on duty. On the second visit two staff files were examined and found to contain references, evidence of Criminal Record Bureau checks, contracts, terms and conditions, and I.D. Although the acting manager said that a record of both staff interviews had been made, neither could be found. There was also a lack of written documentation to evidence that issues around staff fitness prior to appointment had been discussed, although the acting manager said this had been done. Three new staff had started and three staff had left since the last Inspection and a deputy manager had been very recently appointed. The two staff on duty at the first visit were friendly, interacting with residents at all times, approachable by residents, and committed to meeting their needs. Residents said they liked the staff, and that the new staff were OK. The staff said they had recently received fire, adult protection and medication training, and the more recently employed staff member said she had attended an Induction course, was undertaking Foundation training and had started NVQ Rosehill House DS0000018418.V252924.R01.S.doc Version 5.0 Page 15 3 with a previous employer. There was an overall staff training plan but no records of supervision. One staff member said they had received supervision, another said they had not. Minutes of regular staff meeting were recorded. The acting manager was now super-numery working Monday to Thursdays 7.30am-6.30pm and concentrating on managerial tasks. This then left two care staff working with four residents. On the Unannounced Inspection there was discussion with one staff member, who felt one particular resident required 1:1 staffing levels at certain times of the day and for certain behaviours, was requiring sleeping staff to wake up at night, and whose needs included increased laundry work which took care hours away from the other residents. The culmination of these factors had resulted in an unsettled atmosphere in the home, which one resident described as ‘it is not very relaxed here now’ and then went on to say it made them ‘want to move out’. These concerns were discussed with the acting manager and Provider’s representative on the second visit, who were actively reviewing the resident’s needs and monitoring staffing inputs. Rosehill House DS0000018418.V252924.R01.S.doc Version 5.0 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 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 and 42 The registered providers were introducing a system that would ensure resident’s views underpinned quality improvements at Rosehill House. On the whole residents health, safety and welfare was protected and promoted at Rosehill, however some deficits in checks and records could potentially put residents at risk. EVIDENCE: An application had been received by CSCI to register the acting manager, and the application was still being processed. The registered providers had also provided extra staffing hours so that the acting manager was super-numery, working on managerial tasks at all times. The Commission were aware that the registered provider was in the process of developing and implementing a comprehensive Quality Assurance system. Staff showed staff had attended a range of health and safety training fire safety. The fire book was up to date, however, when the staff member who did carried out most of the health and safety and financial checks, including Rosehill House DS0000018418.V252924.R01.S.doc Version 5.0 Page 17 the fire checks and resident’s expenditure records was away, there were gaps in the fire checks and fridge and freezer temperature checks and the money held for residents did not tally with that recorded as looked after. Other maintenance and serving checks were up to date. Records showed that an incident affecting the well-being of a resident had not been reported to the Commission as required. Rosehill House DS0000018418.V252924.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 2 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 2 X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Rosehill House Score X X 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 2 X DS0000018418.V252924.R01.S.doc Version 5.0 Page 19 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 YA2 YA6 Regulation 14 15 Requirement Each resident must have a thorough assessment prior to admission. Each resident must have a detailed care plan that reflects all his or her needs. This plan must be reviewed as needs change. Each resident must have a detailed risk assessment that is reviewed as risks change. Employment decision-making, in relation to the fitness of a potential staff member, must be recorded. The Commission must be informed of all incidents adversely affecting the welfare of residents. All the required health & safety records must be consistently recorded. Timescale for action 04/03/06 04/03/06 3 4 YA9 YA34 13(4) 19 04/03/06 04/03/06 5 YA42 37 (e) 04/03/06 6 YA42 Sch. 4 04/03/06 Rosehill House DS0000018418.V252924.R01.S.doc Version 5.0 Page 20 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 Refer to Standard YA20 YA34 Good Practice Recommendations A new medicines fridge should be purchased. Staff interviews should be recorded. Rosehill House DS0000018418.V252924.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. 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