Inspection on 12/10/05 for Robleaze

This inspection was carried out on 12th October 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Robleaze 25/09/07

Robleaze 10/10/06

Robleaze 24/02/06

Robleaze 02/03/05

Robleaze 03/08/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Robleaze 537-539 Bath Road Brislington Bristol BS4 3LB Lead Inspector Sandra Jones Unannounced Inspection 09:30 12 & 17 October 2005 th th Robleaze DS0000026552.V255149.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 Robleaze DS0000026552.V255149.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. Robleaze DS0000026552.V255149.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Robleaze Address 537-539 Bath Road Brislington Bristol BS4 3LB 0117 9720813 NONE 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) Mrs Susan Mary Robinson Mrs Claire Louise Luton Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Robleaze DS0000026552.V255149.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 10 persons aged 18 - 64 years Date of last inspection 2nd March 2005 Brief Description of the Service: Robleaze is a care home operated by Sue Robinson and managed by Claire Luton. It is registered to accommodate up to ten adults of both sexes with learning disabilities. The property is situated on a busy main road close to shops, parks, amenities and bus routes. Two houses were converted to accommodate the registered numbers and maintain its appearance of a domestic dwelling, which blends with its local environment. Robleaze DS0000026552.V255149.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted over two days in October 2005 with the staff on duty and residents at the home. There were no additional visits conducted at the home since the last inspection. The home has not been assessed as requiring monitoring visits. Other forms of information used to support the findings included examination of the records and consultation with the residents and staff. Quality assurance and residents personal development will be the focus of the next inspection. What the service does well: What has improved since the last inspection? One member of staff that has returned to the home reported that there is more structure within the staff team and the service is more professional. Since the last inspection a person-centred approach to meeting needs has been used in developing the care planning process. Robleaze DS0000026552.V255149.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Robleaze DS0000026552.V255149.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 Robleaze DS0000026552.V255149.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): These standards were not inspected at this inspection. EVIDENCE: Robleaze DS0000026552.V255149.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&7 A person centred approach to meeting needs is incorporated into the care planning process. This evidences that residents have meaningful involvement in planning decisions about their lives. Documentation in place at the home confirmed that residents make decisions about their lives. EVIDENCE: Care plans reviews are organised by the staff at the home. From the review meetings, care plans are updated and monitored monthly by the staff at the home. The Valuing People philosophy has provided the manager with the guideline to develop a person centred approach to meeting resident’s needs. Past histories and personal profiles are to be added to care plans to provide the staff with additional information that may reflect behaviours. The responsibilities for reporting events, falls onto the member of staff that had the input. Reports of significant events describe outcomes of visits and separate sheets are used for health and associated issues. The manager does not currently monitor reports of significant events. Reports of significant Robleaze DS0000026552.V255149.R01.S.doc Version 5.0 Page 10 events should be part of individual staff supervision. This would ensure that staff’s attitudes are monitored and that an analysis of the person progress is conducted. Individual profiles include the person’s likes and dislikes, with care plans describing their preferred routines. Daily reports confirmed that residents make choices about their day-to-day lives. Robleaze DS0000026552.V255149.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 17 Daily routines undertaken by the residents promote their level of independence. The variety of the meals offered promotes residents wellbeing. EVIDENCE: Residents were consulted during the inspection on the standard of care at the home. It was reported that during their days at the home, key workers assist with household chores. The level of support provided by the staff is dependant on their abilities to complete household tasks. Care plans identify goals and the household chores undertaken by the person with the level of supervision to be provided. It was confirmed that bedrooms are lockable and keys are provided. During the discussion with residents one person said they locked their bedroom door and the other did not. Additional comments were made about the home’s knock and wait for an answer policy. Robleaze DS0000026552.V255149.R01.S.doc Version 5.0 Page 12 Residents reported that there is an expectation that residents participate in food preparation. A record of the food provided is maintained and from the range of provision at the home, residents have a varied and nutritious diet. Positive comments were made by the residents about the food. Robleaze DS0000026552.V255149.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 & 21 Through the introduction of policies and procedures, the manager has taken appropriate steps to guide staff in the event of an unexpected and expected death of a resident. Additional information should be added to ensure that the death of a resident is conducted with respect and sensitivity Safe systems of medication are in place, which protect residents. EVIDENCE: A procedure for the death of a resident was developed since the last inspection. It incorporates the procedure for expected and unexpected death, with additional guidance for registering the death. The manager may wish to add to the policy that for unexpected deaths the police will be contacted. Along with the arrangements for personal belongings in the event of an unexpected death should be outlined within the policy. It was understood from the manager that it’s the home’s policy to provide palliative care to existing residents diagnosed with a terminal illness. The Statement of Purpose must inform potential residents of the practice and Robleaze DS0000026552.V255149.R01.S.doc Version 5.0 Page 14 describe the commitment towards palliative care. For example, training offered to staff, aids and support from outside agencies. It is the intention of the manager to discuss resident wishes to initiate the policy. Medications prescribed by the GP, are administered by the staff through a monitored dosage system. For medications dispensed by the hospital, standard bottles are used to administer medication by the staff. Medications administration records evidenced that staff sign records immediately after administration. Homely remedies are administered from a stock supply when required by the residents. The running balances were found to reflect the medications held within the secure cabinet. A record of medication no longer required is maintained which, is countersigned by the pharmacist to indicate receipt of the medication for disposal. Medication profiles are being introduced for staff’s information and through the City of Bristol College six staff have complete distance training in medication. Medication profiles are being introduced for staff Robleaze DS0000026552.V255149.R01.S.doc Version 5.0 Page 15 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 Residents comments indicated that their views are sought and action taken by the staff. More adult protection training is needed to promote the protection of residents from abuse, neglect or self-harm. EVIDENCE: There were no complaints received at the home for investigation, since the last inspection. Residents giving feedback confirmed their confidence with the staff abilities to resolve their complaints. The service provider and manager have yet to attend specific POVA training to raise their awareness of the interagency approach to safeguarding residents from abuse. Robleaze DS0000026552.V255149.R01.S.doc Version 5.0 Page 16 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): These standards were not assessed at this inspection. They will form part of the focus for the next inspection. EVIDENCE: Robleaze DS0000026552.V255149.R01.S.doc Version 5.0 Page 17 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): 31, 32 & 36 Job descriptions define the purpose and responsibilities of the role providing a staff team with the qualities necessary to fulfil the aims of the home. The commitment towards training ensures that competent staff carry out the tasks that are required. Systems of support are in place for staff. EVIDENCE: Full job descriptions are in place for care assistants, senior care assistants and assistant managers’, which are the roles, performed at the home. GSCC Code of Conduct are provided to the staff and to evidence their awareness of the code, staff sign on receipt. New staff have in-house induction training which is within Avon Sector training guidelines and Health and Safety instructions. The home has recently subscribed to distance learning from a training provider. Members of staff have two weeks to complete units, which is then sent off for marking. Successful candidates receive a certificate of recognition that describes the Robleaze DS0000026552.V255149.R01.S.doc Version 5.0 Page 18 topics covered. Distance learning consists of statutory training, food hygiene, First aid, Health and Safety and fire. Manual Handling, infection control, aggression and medication can be completed through this provider. It is an expectation of that members of staff undertake NVQ training. The manager explained that is a clear commitment towards NVQ training at the home. As it develops a professional service and raises staff awareness on the tasks they undertake. Three members of staff are currently undertaking NVQ level 3 evidencing that the home operates above NMS. A system of individual supervision is in place at the home and currently the manager supervises the staff, with the service provider supervising the manager. Appraisals are annual from April-May, which the staff sign on completion. Supervision agreements based on the aim of supervision, the frequency and expectations are signed by the staff. The agenda for supervision follows a format of key residents, performance and personal development. Robleaze DS0000026552.V255149.R01.S.doc Version 5.0 Page 19 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): 38, 41 & 43 The culture of the home provides an inclusive atmosphere for the residents. Records of cash and fire safety promote residents and staff safety. The manager should incorporate within the budget, additional amounts for CRB’s, holidays and advertisements. The aim of the budget, the number of residents that must be accommodated for financial viability and the profits to be generated should be determined. The service provider must introduce a formal system for reporting on the conduct of the home to demonstrate their awareness of how the home is being managed. EVIDENCE: Members of staff and residents agreed to give feedback on the standards of care at the home. Members of staff confirmed that training is an expectation Robleaze DS0000026552.V255149.R01.S.doc Version 5.0 Page 20 of the role, which ensures they can carry out tasks competently. Staff reported that the manager was approachable and systems for continuity of care are in place. Staff meetings, supervision and handovers were used to maintain the standards of care. One member of staff, that had retuned to work at the home, stated that that the service was more structured and professional. Residents giving feedback confirmed that a key worker system was in operation and described the roles they perform. Additional positive comments were made about the service, residents stated their rights are respected and views are sought during meetings. Facilities for the safekeeping of cash and valuables exist at the home. During the inspection members of staff were observed checking the residents cash balances. Safe systems for checking of residents cash were witnessed during the inspection. The records of fire safety policies, procedures, checks and practices were examined. Records evidenced that checks and practices are conducted at the stipulated frequencies. Since the last inspection, the manager and the service provider have developed budgets for the home. Previous expenses were used to forecast cash budgets, with cash sums allocated for specific expenditures, including generated incomes. The cost of CRB’s, job advertisements and holidays were not included in the budgets. To fully establish the effectiveness of the budget specific amounts must be allocated for CRB’s, advertisement and holidays. For effective accounting the manager should determine the aim of the budget, establish the number that must be accommodated for financial viability and decide the profit margin. Copies of the visits by the service provider are not currently in place. While it is accepted that the service provider visits the home daily and maintains some responsibilities, a formal record must be maintained. The service provider must have formal discussions with the manager on the direction of the home, views of the staff and residents must be sought and records examined. The manager must receive a copy of the report, with a copy sent to the CSCI. Robleaze DS0000026552.V255149.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 x x x Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 x x x 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Robleaze Score x x 3 2 Standard No 37 38 39 40 41 42 43 Score x 3 x x 3 x 2 DS0000026552.V255149.R01.S.doc Version 5.0 Page 22 yes 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 3 Standard Standard 21 Standard 23 Standard 36 Regulation Reg. 4. Sch.1 Reg.13.6 Reg. 26 Requirement The Statement of Purpose must detail the arrangements for terminal care at the home. The service provider and manager must attend appropriate POVA training. The service provider must prepare a monthly report on the conduct of the home and copies must be sent to the manager and CSCI. Timescale for action 30/12/05 30/08/06 30/11/05 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 Refer to Standard Standard 21 Standard 43 Good Practice Recommendations The policy for unexpected death should include guidance for personal possessions and that the police must be contacted. The aim of the budget, the number of residents that must be accommodated for financial viability and the profits to be generated should be determined. Robleaze DS0000026552.V255149.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Robleaze DS0000026552.V255149.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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