Inspection on 31/05/05 for Roberta House

This inspection was carried out on 31st May 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Roberta House 16/04/07

Roberta House 17/10/05

Roberta House 15/02/05

Roberta 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 Roberta House 99-103 Island Road Upstreet Canterbury CT3 4DE Lead Inspector Wendy Gabriel Announced 31/05/05 at 09:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Roberta House H56 - H05 S23527 Roberta House V222968 310505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Roberta House Address 99-103 Island Road, Upstreet, Canterbury, Kent, CT3 4DE 01227 860704 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr R Tarry & Mrs R Tarry Registered Care Home 17 Category(ies) of Older People x 17 registration, with number of places Roberta House H56 - H05 S23527 Roberta House V222968 310505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15/02/05 Brief Description of the Service: Roberta House is registered to provide care for up to seventeen Service Users, but the Registered Owners have discontinued the use of two double bedrooms and now provide one double bedroom. The Registered Owners have previously told the Inspector that they would not increase their numbers to more than fourteen Service Users. The Home is situated on the outskirts of the rural village of Upstreet and is adjacent to the main road between Canterbury and Ramsgate. Upstreet has shops within walking distance of the Home. There is limited parking to the front of the premises. The rear garden has some wheelchair access with support and the Registered Owners have plans to landscape the rear garden to increase usage for wheelchair users. There are views across the countryside from the rear of the premises. There is a mini bus provided for the benefit of the Service Users. Roberta House H56 - H05 S23527 Roberta House V222968 310505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was fully staffed at the time of the inspection and the rota indicated that all shifts were covered. Several comment cards were received from relatives and friends and whilst most commented favourably on the care give by the staff; some felt that there was not always enough staff on duty at times. Comments also ranged from enjoying the meals to stating that the weekend meals were not always so good. Several residents advised the Inspector about their life in the home and one resident said, when asked about the staff; ”I feel I am surrounded by love”. The Registered Owner discussed the forthcoming redecorating for the Home, which will include new soft furnishings. The kitchen is to be revamped with new hand washing sink, new wall tiles and flooring. The outside of the home is also to be repainted and ‘generally tidied up’. There are also plans for a new entrance to be made, to be more convenient for any resident who may require a wheelchair and to enhance the welcome area offered to residents and visitors. The Registered Owner has been reformatting the Statement of Purpose and service users guide and a requirement was made for this to be forwarded to the inspection office. The outside bin for clinical waste did not have a lid on at that time and a requirement was made for this as an infection control measure. The home was clean and tidy at the time of the inspection. Since a visit by the CSCI specialist pharmacy inspector who advised on medication administration, the Registered Owner has been proactive in setting up a completely new system to suit the needs of the home. Staff told the Inspector that Mr and Mrs Tarry, the Registered Owners were very approachable and friendly and they would have no hesitation in speaking with them to discuss any issues. This was reiterated by several residents who expressed their fondness for the Registered Owners and were observed communicating with them in a relaxed and friendly manner that was enhanced by much laughter and suitable interaction. What the service does well: Roberta House H56 - H05 S23527 Roberta House V222968 310505 Stage 4.doc Version 1.30 Page 6 Some residents were keen to talk about their life in the home and the kindness of the Registered Owners and staff. Written comments from residents and visitors and relatives indicated the support staff give to their relatives. One resident spoke at length about the proactive support given to him by the Registered Owners and staff in maintaining contact with his family. What has improved since the last inspection? 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 Roberta House H56 - H05 S23527 Roberta House V222968 310505 Stage 4.doc Version 1.30 Page 7 contacting your local CSCI office. Roberta House H56 - H05 S23527 Roberta House V222968 310505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Roberta House H56 - H05 S23527 Roberta House V222968 310505 Stage 4.doc Version 1.30 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 standard(s) 1-5 The statement of purpose does not contain, as yet, the complete package of information as indicated by the National Minimum Standards. EVIDENCE: The Registered Owner stated that the statement of purpose and the service users guide was in the process of being enhanced to meet the National Minimum Standards. This is a requirement and is to be forwarded to the Inspection office. The Registered Owner stated that each prospective resident is assessed by the home prior to being admitted. A completed assessment package was seen and this included information regarding the prospective residents lifestyle and abilities as understood at the first meeting. Care managers also provide an assessment. Contracts detailing terms and conditions are provided for residents. The home does not undertake intermediate care. Roberta House H56 - H05 S23527 Roberta House V222968 310505 Stage 4.doc Version 1.30 Page 10 Roberta House H56 - H05 S23527 Roberta House V222968 310505 Stage 4.doc Version 1.30 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 standard(s) 7-11 The health, social and personal needs of residents is identified and suitable health care professionals accessed when required. A suitable protocol has been provided for medication administration. Residents’ choice is promoted. EVIDENCE: Care plans are provided to enable all daily aspects of the residents’ health, personal and social care needs to be met. These are updated monthly. Key workers are involved with the care planning and a descriptive policy is in place detailing the purpose and status of care plans. There is written evidence of visits by and to Health care professionals. Medication administration is in the process of being changed to a procedure that is expected, by the Registered Owner and team leader, to provide a more satisfactory administration protocol. This is a positive response by the Registered Owner to a previous visit by the CSCI specialist Pharmacy Inspector who made some requirements and recommendations. This will be in place by the 1st June. Key staff receive ‘safe handling of medication’ training. Training for the new medication administration system commenced on the day of the inspection. Roberta House H56 - H05 S23527 Roberta House V222968 310505 Stage 4.doc Version 1.30 Page 12 Staff discussed with empathy the rights of the residents and this included individual choice of times to rise and go to bed. One resident explained, with genuine affection, the lengths the Registered Owners and staff go to, to enable residents to feel ‘at home’ and to participate in social opportunities. Palliative care training is undertaken and the policy of the home is to attempt to keep a terminally ill resident ‘at home’ with advice and support from suitable Health care professionals. There is written information for staff, detailing action to be taken in the event of death of a resident. Roberta House H56 - H05 S23527 Roberta House V222968 310505 Stage 4.doc Version 1.30 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 standard(s) 12-15 A balanced and varied diet is provided. Staff enable choice and direction in residents lifestyles. EVIDENCE: A resident described the input the Registered Owners had had in enabling his contact with his family and stated his joy at the support given to him by both the Registered Owners and the staff. Interaction between staff and residents was warm and understanding of different needs and levels of communication. Residents meetings are held and one resident has undertaken a twice-weekly session for other residents to speak to him about any issues they wish to be raised. He stated that the Registered Owners encouraged this and were prepared to act on suitable advice given by residents. Care plans detail social and religious needs and the church visits weekly. Subject to risk assessments, residents may leave the home independently to visit the local shops. One resident said she went out several times in the week to a day centre. Some residents spoke about their weekly trips out in the mini bus. However, the Registered Owner and staff said that it was becoming increasingly difficult to motivate the current residents. An aromatherapist was in the home and visits weekly. A resident said that there was usually a choice of two main meals plus there was a variety of frozen meals kept at the home if they preferred something different. There was evidence of this in the freezer. A recommendation was Roberta House H56 - H05 S23527 Roberta House V222968 310505 Stage 4.doc Version 1.30 Page 14 made for the freezer to be defrosted. Another resident said he preferred to eat his dinner in the evenings and indicated that a member of staff would organise this for him. As included in the summary, some written comments received from relatives/friends said that they thought the weekend meals were not always so good as in the week. Vegetables are prepared in the kitchen but the main part of the meal i.e. the meat; is cooked in the co-owned home nearby and delivered at lunchtime. This is checked for temperature and is transported in suitable containers. The distance is under a minutes drive away. Roberta House H56 - H05 S23527 Roberta House V222968 310505 Stage 4.doc Version 1.30 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 standard(s) 16-18 Staff receive training in understanding abuse and understand the importance of whistle blowing. EVIDENCE: A complaints register is kept. The Registered Owner undertakes a quality assurance questionnaire for residents and visitors. The written responses to these are collated and the Registered Owner said action would be taken where appropriate to review matters that had been raised. Training for staff to understand and deal with abuse is undertaken. A member of staff said that she would have no hesitation in speaking to the Registered Owner if she had cause for concern. The Registered Owners stated they do not undertake advocacy but would contact appropriate sources should a resident require such advice. A resident has created a role for himself to be formally available twice a week to other residents to listen to any problems or suggestions they may have. He said that the Registered Owners encouraged this and were always ready to listen to suggestions made by residents. Roberta House H56 - H05 S23527 Roberta House V222968 310505 Stage 4.doc Version 1.30 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 standard(s) 19-26 Residents live in a clean and comfortable environment that will be enhanced by the planned refurbishment and redecoration. EVIDENCE: The Registered Owner said that Roberta House is due to be redecorated in line with their co-owned home nearby that has just undergone redecoration and refurbishment. This will include painting and decorating, some new furniture, the kitchen having new wall tiles, new floor and hand basin. A bathroom is to be replaced by a shower as well as redecorating. A recommendation for the waste bins to have pedal operated lids was made. A pull cord for the call bell in the bathroom is to be made more secure. Dirty laundry is to be take from source to the laundry room in a covered container for to enhance infection control. The outside of the premises is to be painted and a recommendation was made for a disused extractor vent to be filled in. Some residents said that their rooms suited their lifestyles. Bedrooms were individual, containing possessions that reflected the interests of the occupier. Roberta House H56 - H05 S23527 Roberta House V222968 310505 Stage 4.doc Version 1.30 Page 17 A member of staff discussed the use of bedrails for one resident and said that this was at that residents’ own request to increase her feelings of security when in bed. Specialist equipment can be obtained following advice from Health care professionals. Although the rear garden is accessible to wheelchair users, it is on a slope and the Registered Owner said that plans for graduated access were being planned. Further sockets to bedrooms are to be one metre from the floor where there is mobility impairment. Opportunities for this should be taken when electrical work is being undertaken. There are homely touches in evidence in the home and the Registered Owner discussed the possible resiting of the front door to make the home more welcoming and provide better access for residents who may use a wheelchair at times. The hygienic waste bin outside is to have a lid on at all times. The home was clean and odour free at the time of the inspection. Roberta House H56 - H05 S23527 Roberta House V222968 310505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27.28.30. The National Minimum Standards mandatory training is undertaken and staff are encouraged to take NVQ training. There was sufficient staff on duty to meet the needs of the residents at the time of the inspection. EVIDENCE: The rota clearly indicates the hours allocated for care and for cleaning and administration. The handyman and night staff undertakes cleaning. Staff receive ongoing training and NVQs are promoted by the Registered Owners. Some comment cards received from relatives/friends said that they felt there was not always enough staff on duty at times. Senior staff have recently been reorganised to create a more stable staff group in both of the homes owned by the Registered Owners. Staff said residents who commented that it was good to see the ‘same face’ each day rather than once every few days appreciated this. Staff also said that having the senior member of staff fully aware of current events in the home; rather than having to repeat issues at handover improved communication between themselves. Formal appraisals take place and staff said that supervision is more informal as the Registered Owner is in the home almost daily and is accessible for supervisory issues. Roberta House H56 - H05 S23527 Roberta House V222968 310505 Stage 4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31.32.33.34.35.36. The Registered Owner is suitably qualified and experienced to run and manage the home. EVIDENCE: The Registered Owner has obtained the NVQ4 and management in care and has been running the home since 1990. Staff and residents commented on Mr and Mrs Tarry, the Registered Owners as being supportive and always available for discuss any matters. Communication by the Registered Owners was noted to be friendly and appropriate. Following the demise of certain Post Office Savings Bank accounts that had been used by residents, the Registered Owner has been seeking a suitable savings scheme. Some cash is held on residents’ behalf and this is recorded Roberta House H56 - H05 S23527 Roberta House V222968 310505 Stage 4.doc Version 1.30 Page 20 and receipts are kept. A recommendation was made that a suitable saving system be made for the residents who have lost their original savings scheme due to the Post Offices’ change in policy. Care plans and risk assessments for residents are reviewed monthly and changes recorded. Roberta House H56 - H05 S23527 Roberta House V222968 310505 Stage 4.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 3 x x Roberta House H56 - H05 S23527 Roberta House V222968 310505 Stage 4.doc Version 1.30 Page 22 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 1 26 Regulation 5 13 Requirement The statement of purpose and service users guide is to be completed. hygienic waste bin outside to have lid on at all times. Timescale for action 06/06/05 31/05/05 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. 4. 5. Refer to Standard 25 21 19 35 26 Good Practice Recommendations Further electrical sockets are to be put in bedrooms at one metre from the floor, and may be done when electrical work need to be done. A call bell cord is to be made secure. Disused extractor vent outside of kitchen to be filled in. Suitable savings accounts for residents to be sought. Dirty laundry to be trnsported in covered container. Roberta House H56 - H05 S23527 Roberta House V222968 310505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 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 Roberta House H56 - H05 S23527 Roberta House V222968 310505 Stage 4.doc Version 1.30 Page 24 - 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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