Inspection on 21/08/07 for Roanu House

This inspection was carried out on 21st August 2007.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Roanu House 22/05/06

Roanu House 01/12/05

Roanu House 06/09/05

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Roanu House Roanu House 2 Grosvenor Avenue Carshalton Beeches Surrey SM5 3EW Lead Inspector Mohammad Peerbux Key Unannounced Inspection 21st August 2007 9:00am Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 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 Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 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. Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Roanu House Address Roanu House 2 Grosvenor Avenue Carshalton Beeches Surrey SM5 3EW 020 8647 6366 020 8669 1766 tordarrach@yahoo.com 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) Rashot Ltd Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Of the six service users, all six may have dual diagnosis of mental illness and learning disability. Of the six service users, two may also have a physical disability but must not be wheel chair bound. Of the six service users, two may also have a sensory impairment. Only one service user at any one time may have a high level of care needs. The bedroom that is less than twelve square meters and does not have en-suite facilities cannot be used. 22nd May 2006 Date of last inspection Brief Description of the Service: Roanu House provides a service to adults with a learning disability who may also have a dual diagnosis (of mental illness and learning disability). The home is currently registered with the Commission for Social Care and Inspection (CSCI) to provide personal care and accommodation for up to six adults between the ages of 18-65. Situated in a suburban area of Carshalton Beeches, the home is within easy walking distance of a variety of local amenities, including shops, cafes, pubs and public transport links. Wallington and Carshalton Beeches train stations with their links to central London and the surrounding areas are both within walking distance of the home. The house comprises of six single occupancy bedrooms, a dinning/living space, a kitchen, laundry room, and a small office. There is a pleasant garden at the rear of the property, which has a patio area. The range of weekly fees is between £1000 and £1800. Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit to the home was undertaken as a part of the inspection process for the year 2007/2008. In writing the report consideration has also been given to information received throughout the year such as comments from people who use the service, reports of incidents and complaints. This was the home’s first inspection for the year 2007/08. It took place over five hours. Some times were spent looking at the policies and procedures, records, talking to some residents, staff and the acting manager. A tour of the building was also carried out. They are all thanked for their time and all of those who provided feedback for their support in the inspection process. What the service does well: What has improved since the last inspection? What they could do better: All new residents need to have a full comprehensive needs assessment so that staff are aware of their needs. The assessment must be kept under review and revised at any time when it is necessary to do so having regard to any change of circumstances. Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 Page 6 Residents’ care plans should cover all aspects of their personal and social support and healthcare and their risk assessments must be comprehensive so that staff have good information on which to base decisions. The medication administration records must be accurately completed at all times. The home must ensure that all staff are aware of and understand the procedures for Safeguarding Adults. The home must be kept warm especially during the cold weather for the health and welfare of residents and staff. 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. The summary of this inspection report can be made available in other formats on request. Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 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 Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has its own assessment plan to ensure that any new resident’s needs are fully assessed prior to their admission however the assessment in not always completed fully. EVIDENCE: The home consults the assessment information to see if they can meet the prospective individual’s needs before they make the decision to accept the application for admission and offer a placement. Evidence suggests that prospective people who use services have a needs assessment carried out before they are admitted to the home. However it was noted that the assessments were not being completed fully. The home must ensure that all new residents receive a full comprehensive needs assessment so that staff are aware of their needs. Family carers’ interests and needs must also be taken into account, subject to the resident’s agreement. Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 Page 9 It was also noted that one resident who uses the service for respite care has not had his assessment updated since it was first completed. The registered person must ensure that the assessment of the residents needs is kept under review and revised at any time when it is necessary to do so having regard to any change of circumstances. Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Generally residents’ care plans include detailed information about their needs and personal goals. This helps staff to know the residents’ needs and how to meet them. EVIDENCE: Each individual has a care plan, which includes basic information necessary to deliver the resident’s care but is not detailed or person centred. One example is a resident suffers from epilepsy however his care plan did not set out in detail the action which needs to be taken by care staff to ensure that his need is being met. The home must ensure that care plans cover all aspects of personal and social support and healthcare needs of the residents. There is a key worker system that allows staff to work on a one to one basis and Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 Page 11 contribute to the care plan for the individual. Care plans are reviewed and updated as required. The acting manager stated that staff provide residents with the information, assistance and communication support they need to make decisions about their own lives. Risk assessments are completed but these are basic and mainly focus on keeping people who use the service safe. The home must ensure that residents’ risk assessments are comprehensive and staff have good information on which to base decisions, within the context of the resident’s individual plan and of the home’s risk assessment and risk management strategies. Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to explore opportunities to enhance their quality of life as well as maintain and participate with friends and the local community, with the aim of maximum integration. EVIDENCE: The home encourages all its residents to maintain their life skills and participate in activities appropriate to their abilities. The home also offers inhouse activities. It was agreed that the recording of activities could be further improved; as it was difficult at times to identify what activities the residents have been involved in. Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 Page 13 Staff support the residents to become part of, and participate in, the local community in accordance with their assessed needs and the individual Plans. People who use the service are actively encouraged to maintain links with their families and friends. The acting manager stated that the home has an ‘open’ visitor’s policy. Residents, who were at home at the time of this inspection, appeared to enjoy some level of independence. Routines can be flexible and are well observed to take into account all the residents’ individual needs. The home tries to be flexible and attempts to provide a service that is as individual as possible using its staff and resources effectively. Residents who were spoken to stated that they are happy with the way that the staff deliver their care. One resident stated, “I am happy here and the staff look after me well, they are kind to me”. The acting manager stated that the residents are involved in the planning of the menu. Residents are offered a choice of suitable menus, which meet their dietary needs, and which respect their individual preferences. Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall the arrangement for health care needs of the residents is good and they receive personal support in the way they prefer. However the system for administration of medications is not always consistent and could potentially place residents at risk. EVIDENCE: The delivery of personal care is individual and flexible. Staff respect the privacy and dignity of the residents and are sensitive to their changing needs. Where needed, guidance and support regarding personal hygiene (e.g. to wash, shave) is provided. Times for getting up/going to bed, baths, meals and other activities are flexible. Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 Page 15 People who use services have access to health care services both within the home and in the local community. Generally health needs are monitored and appropriate action and intervention taken. The medication administration records were audited. There were several instances where prescribed medication had been omitted or administered but not signed for. While it transpired that there were acceptable explanations for this, these explanations had not been recorded. In all cases where medication is not given as prescribed, staff must ensure that they record the reason. The registered person must ensure that medication administration records are accurately completed at all times. There have been ongoing concerns with regards to medication and the Commission will be taking enforcement action against the home to ensure that residents are not being put at risk. Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are generally managed well, which should ensure that residents’ and relatives’ concerns are listened to. However there is a lack of awareness of safeguarding procedures, which could put resident at risk. EVIDENCE: The home has a complaints procedure that is clearly written and easy to understand. The procedure explains how to make a complaint and that the complainant can expect a response about the outcome of any investigation to a complaint within 28 days. Policies and procedures for safeguarding people who use the service are in place however the staff are not familiar with the guidance. As part of the inspection process one staff was interviewed on her knowledge of reporting alleged abuse. She stated that she would investigate any incident of alleged abuse. This is very concerning to the Commission as this would contaminate any investigation that would be carried out by the Care Management Team. The home must ensure that all staff are aware of and understand the procedures for Safeguarding Adults. Staff working at the home must know when incidents need external input and who to refer the incident to. Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally clean and homely. However the temperature within the home needs to be kept at a comfortable level for the health and well- being of residents. EVIDENCE: The home is suitable for its stated purpose. It is accessible, meet residents’ individual and collective needs in a comfortable and homely way. Residents’ bedrooms are personalised to reflect their individual needs, and personalities. However there was little evidence that the heating was on in all parts of the home giving an air of coldness. The registered person must ensure that the home is kept warm especially during the cold weather for the health and welfare of residents and staff. Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 Page 18 The home is kept very clean and hygienic and free from offensive odours throughout. Systems are in place to control infection in accordance with relevant legislation and published professional guidance. Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Generally staff numbers are of sufficient quantity to meet the residents’ needs and provide consistency and to ensure their safety. EVIDENCE: There are consistently enough staff available to meet the needs of the people using the service. The staffing structure is based around delivering outcomes for the people using the service. The home has a good recruitment procedure that clearly defines the process to be followed. Two staff files were examined at random and found to contain the information required by the Care Homes Regulations 2001 including a completed job application, terms and conditions of employment, an enhanced CRB check and proof of their identity. Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 Page 20 The home recognises the importance of training, and tries to delivers a programme that meets any statutory requirements and the National Minimum Standards. The acting manager is aware that there are some gaps in the training programme however these are being addressed and further training sessions have been arranged. Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Generally the health, safety and welfare of the residents and staff were being promoted and protected. EVIDENCE: It was previously required that the homeowner must ensure a suitably qualified person applies to register with the Commission for Social Care Inspection as the home’s manager. The acting manager stated that she had started the process of applying to be the registered manager for the home and Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 Page 22 was waiting for her criminal record bureau check to come back. The Commission would then invite her for an interview. The home has an effective quality assurance and quality monitoring systems, based on seeking the views of service users, to measure success in achieving the aims, objectives and statement of purpose of the home. The home has developed a health and safety policy that generally meets health and safety requirements and legislation. Certificates relating to health and safety were up to date servicing certificates. Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 Page 23 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 Standard No Score 1 X 2 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 Page 24 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 Standard YA2 Regulation 14(1) Requirement All new residents must receive a full comprehensive needs assessment so that staff are aware of their needs. The assessment of residents’ needs must be kept under review and revised at any time when it is necessary to do so having regard to any change of circumstances. Residents’ care plans must cover all aspects of their personal and social support and healthcare. Residents’ risk assessments must be comprehensive so that staff have good information on which to base decisions, within the context of the resident’s individual plan and of the home’s risk assessment and risk management strategies. The medication administration records must be accurately completed at all times. (Previous timescale for action of 22/05/06, 09/11/06 not met). Timescale for action 21/10/07 2 YA2 14(2) 21/10/07 3 YA6 15(1) 21/10/07 4 YA9 13(4) 21/10/07 5 YA20 13(2) 21/08/07 Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 Page 25 6 YA23 13(6) The home must ensure that all staff are aware of and understand the procedures for Safeguarding Adults. The home must be kept warm especially during the cold weather for the health and welfare of residents and staff. 21/09/07 7 YA24 13(4) 21/08/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Roanu House DS0000063202.V348347.R01.S.doc Version 5.2 Page 27 - 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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