Inspection on 30/05/06 for Roann House

This inspection was carried out on 30th May 2006.

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

Roann House 28/07/08

Roann House 19/02/08

Roann House 27/06/07

Roann House 11/10/05

Roann House 10/05/05

Roann House 15/11/04

Roann House 05/07/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Roann House 91 Bouverie Road West Folkestone Kent CT20 2PP Lead Inspector Lois Tozer Unannounced Inspection 30th May 2006 11:50 X10015.doc Version 1.40 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 Roann House DS0000057418.V294667.R01.S.doc Version 5.1 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 Older People. 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. Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Roann House Address 91 Bouverie Road West Folkestone Kent CT20 2PP 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) 01303 253705 Roann House Ltd Mrs Sursatie Sanicharie Pieries Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One (1) respite placement for Service User with DE who’s date of birth is 24/04/1951. 11th October 2005 Date of last inspection Brief Description of the Service: Roann House is situated in a residential area of Folkestone, close to The Leas promenade. It is approximately 1 mile from the town centre, which has a good range of amenities. There are good public transport links available nearby. The service is owned, managed and run by two experienced Registered Mental Health Nurses. It provides care and support for up to 18 older people. The home does not offer nursing care. A condition of registration allows one specific service user who has dementia care needs to have respite support. The home is set out over three floors with the majority of the resident’s rooms being on the ground and first floor. There is a good-sized passenger lift and a stair lift to enable access throughout the house. The home benefits from a large open lounge. It has a relatively small dining area and a quiet room with a private telephone. To the rear of the home is a good-sized conservatory. There is an accessible, enclosed courtyard garden at the back of the house. Fees are currently between £303.25 and £368.00 per week. Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 30th May 2006 between 11.50 and 17.45. The owner, Mr Pieries and staff on duty assisted with the process. Fifteen people were living at the home, and nine gave feedback. The inspection process consisted of information collected before, during and after the visit to the home. At the time of the site visit, an adult protection meeting was pending, and outcomes are reflected. Other information seen included pre-admission assessments and care plans, medication records, duty rota and staff employment and induction paperwork. Choice of Home Service user said the home was meeting their needs. They had contracts and knew what service was on offer. Health and Personal Care Service users were highly complementary about staff skills. One said ‘Its not much fun loosing your independence, but they make sure I don’t loose my dignity’. The care plans said what type of support each person needed. Medication management needed improvement in one area. Daily Life and Social Activities A service user said ‘It’s all right, but it’s mainly TV for entertainment. We have church singers and chair exercises, that’s fun, but I wish there was more going on’. Others were quite happy with life in the home. Meals got a big thumbs up ‘The meals are good, I don’t like mince or sausage, so always get something I do like’. ‘There is always plenty, if you want more, you can have it’. Complaints and Protection Service user confirmed that they could, and would, make problems known. But, one person was having real problems with their heater, and didn’t want to complain. Staff must be on the lookout for issues that need dealing with. Most service users felt happy and safe. Environment Service users like the house. ‘Its friendly here, but the heating is a real pain. It’s either too hot or too cold’. Another said ‘This room is always cold, I mentioned it once but its too cold again, it doesn’t get the sun’. Rooms are decorated and furnished to service user liking, but a couple had strong odours, that need to be banished. Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 6 Staffing Staff are really liked by service users. ‘Nothing is too much trouble. Don’t have to wait long if we buzz the call bell’. ‘Need help, or need something done differently, it’s not a problem’. The team are well qualified, but recruitment really needs improving. Management and Administration The home is well run. The management team are well liked. Quality assurance needs revision to show how much consultation with service users actually goes on. What the service does well: What has improved since the last inspection? All but one of the requirements have been met. Two bedrooms now have en-suite toilets, making a total of 4. The statement of purpose and contracts has been reviewed. All service users have a copy. Prospective service users can get a copy from the home on request. Care planning has been reviewed, and its now very good. The rota shows who is on duty at all times. 75 of staff hold a minimum NVQ 2 qualification. Every service user bedroom has been risk assessed. Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 7 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. Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2, 3, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The statement of purpose describes the service offered. Contracts are clear. Needs assessments make clear the support required. Intermediate care is not offered. EVIDENCE: The statement of purpose has recently been reviewed. This is available upon request from the home. Each service user has a contract. It clearly states the service purchased, and the rules of the home. Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 10 Each service user has had a needs assessment. Residency is only offered to service users who’s needs can be met. Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 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, 8, 9, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The service user plans clearly describe individual needs. Health care is well supported. Medication is generally very well managed, one aspect needs improvement. The majority of service users feel respected. EVIDENCE: Service user plans are very well documented and cover all aspects of care and support needed. Service users say that the home sorts out GP and other health care appointments quickly, they never have to wait long. Medication is generally very well managed, but pre-dispensing of paracetamol is taking place. This is dangerous and must stop. Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 12 The majority of service users feel they are treated well and with dignity. One service user has specific issues. A meeting with care management has been organised to resolve this. Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above 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, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Although activities are available, some service users say the type and frequency needs revision. Visitors are welcome and encouraged to visit. Service users generally feel in control of their lives. Meal type and quantity meet service users approval. EVIDENCE: There are some activities available, but two service users said that this was not enough. Some would like a greater choice. Visitors to the home are welcome. Service user said that staff always make their friends tea. Choice within the home is supported. Service users said they could request things to be done differently with no problem, staff were flexible. Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 14 All service users said the meals were good and that there was plenty of food. Choice, preferences and alternative meals are available. Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Most service users said the complaints process works. Service users generally feel well supported and protected. One adult protection alert has been opened and closed in the last month. EVIDENCE: The complaints procedure and management attitude to resolving issues is effective. All bar one service user said that they found staff and managers approachable and would not have issue raising problems. This said, one service user could not bring themselves to mention the heating failure in their room – they had not mentioned it, as they did not want to make a fuss. Staff must make sure that they do not rely on service users speaking up about environmental problems. Open and positive relationships between all staff and service users were seen. All bar one service user said they felt safe. Specific and personal issues surrounding the adult protection alert are currently being worked through with care management. Adult protection recommended that the owner review the manner in which risk management is conveyed to service users. The manager must be careful not to accidentally belittle service users when reiterating safe practices. Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24, 25,26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The home is safe and known maintenance issues are in hand. Service users enjoy shared facilities. Bedrooms are personalised, but greater effort to eliminate stale odours is needed. Heating and lighting need improvement. The home is generally clean and hygienic. EVIDENCE: The premises are generally in good order. The environment is safe. Redecoration and maintenance issues are scheduled to take place. Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 17 The shared space is well laid out, enabling privacy and social contact. Service user rooms are personalised. Service users have been encouraged to change the layout of bedrooms to aid safer mobility. There is a problem with heating in some parts of the house. One bedroom was very cold, and the service user said they were uncomfortable. The owner proceeded to take action to sort it out. Staff must be aware of the vulnerability of cold to older people and ensure action is taken to keep people comfortable. Two bedrooms had urine odour, efforts are needed to eliminate this. Continence pads were not discreetly stored in service users bedrooms. A very dark corner leading to top floor bedroom has no working lighting. This is a danger to staff and service user. The home is generally clean and tidy, sluice and laundry facilities are in good order. Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. The number of staff on duty is adequate, but the skill mix is good. Service users feel they are in safe hands. Recruitment processes need improvement. Some areas of training are well supported; others need improvement. Induction needs improvement. EVIDENCE: Unforeseen recent events have left the staff team short. Generally the numbers and skill mix of staff is good. Approximately 75 of staff working in direct contact with service users hold a minimum of an NVQ2 qualification. Service users said that their needs are met quickly. They feel that staff know how to support them, and are careful when using moving equipment. They feel they are treated with dignity when having personal care. Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 19 The recruitment process is not safe. Staff have been employed prior to written references and CRB / POVA checks being conducted. The manager must become familiar with Care Homes Regulations Schedule 2 and POVA process. Most of the staff have a wide range of service user specific training. The owner has identified that First Aid provision is poor and is seeking to rectify. Few staff have food hygiene and only one staff has received specific adult protection training (although this is covered in NVQ training). Previous inspection noted this shortfall; the timescale for improvement has been extended. It is now essential that this is met without delay. Staff induction needs improvement. There is no competency-based induction, and recently employed staff had not read care plans. The Skills for Care induction programme is recommended. Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The home is well run. Service users generally feel comfortable with the style of management. The quality assurance system needs to be revised and improved. Service users finances are handled safely. Health and safety measures need improvement. Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 21 EVIDENCE: Service users generally hold the owner, manager and deputy in high regard. A quality assurance process takes place occasionally. Service users surveys were last sent out 6 months ago, resulting in changes to the menu. Some service users say they want more activities. Regular revision of events in the home, to take account of changing interests and preferences, is a good idea. The changes to inspection were discussed. Quality assurance will be integral to the new process. Most service users handle their own finances. Accounts are maintained for those who do not. Any expenditure on behalf of service users is accounted. The health and safety of service users is generally well promoted. Each bedroom has an environmental risk assessment, but the communal areas have not. Issues, such as blown light bulbs and ensuring free fire exit access needs incorporating into the risk assessment. Regular checks will highlight issues as they arise. The heating issues should be incorporated into this plan to proactively prevent future occurrences. Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 2 2 3 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 23 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. 1 2 3 Standard OP9 OP24 OP25 Regulation 13 16 13, 23 Requirement All medication administration must be safe. Eradicate urine odour in bedrooms. Standards OP25 & OP38 Heating and lighting must meet service users needs and health and safety requirements. Review and make safe recruitment procedures. Previous requirement 10/05/05 – partially met. To ensure all staff receive all mandatory training and additional service specific training. Previous requirement 1/8/05 – partially met. To develop detailed environmental risk assessments subject to regular review. Timescale for action 01/06/06 23/06/06 01/06/06 4 5 OP29 OP30 19 (schedule 2) 12, 18 23/06/06 01/07/06 6 OP38 12, 13 01/07/06 Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 24 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 OP12 OP30 OP33 Good Practice Recommendations Consult with service users and review activities. Induction package be more comprehensive and service user focused. See Skills For Care package. Review quality assurance process to include service user input for home ongoing development. Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Roann House DS0000057418.V294667.R01.S.doc Version 5.1 Page 26 - 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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