Inspection on 07/12/05 for Roborough House

This inspection was carried out on 7th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Roborough House 01/12/09

Roborough House 04/06/09

Roborough House 09/04/08

Roborough House 18/06/07

Roborough House 14/08/06

Roborough House 05/07/05

Roborough House 24/01/05

Roborough House 07/07/04

Similar services:

The Vicarage

7 Hyde Road

5 Seafield Road

Trevaylor Manor

12 Orchard Mews

Stallcombe House

Stepping Stones

Cornerstones

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

CARE HOME ADULTS 18-65 Roborough House Roborough House Off Tamerton Lane Roborough Plymouth Devon PL6 7BQ Lead Inspector Rachel Proctor Unannounced Inspection 7th December 2005 11:00 Roborough House DS0000061085.V258397.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 Roborough House DS0000061085.V258397.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. Roborough House DS0000061085.V258397.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Roborough House Address 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) Roborough House Off Tamerton Lane Roborough Plymouth Devon PL6 7BQ 01752 700788 01752 721088 Roborough House Ltd Mrs Patricia Mary Norman Care Home 35 Category(ies) of Dementia (12), Physical disability (35), Physical registration, with number disability over 65 years of age (35), Terminally of places ill (4) Roborough House DS0000061085.V258397.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. This home is registered as a Care Home with Nursing for a maximum of 35 Service Users in the category of PD 35, PD(E) 35, TI 4 Maximum of 3 service users with mild learning disability needing to convalesce following surgery or other general health care needs, max of 6 weeks To include DE (12) categories of care One named service user under the age of 60 years with mild learning difficulties may reside at the home 5th July 2005 Date of last inspection Brief Description of the Service: Goldmax resources, trading as Roborough House Ltd, own Roborough house. It is a 35 bedded home for young physically disabled, terminally ill and elderly who require nursing care. It can also accommodate a maximum of 3 service users requiring personal care only. It is an old building that has a modern extension. The home is arranged on two floors with access to most areas via two passenger lifts and a step lift. There are two lounges, a dining room and a conservatory on the ground floor. The manager supports a team of Registered Nurses and Health Care Assistants who are able to deliver care to a wide variety of service users. The home has recently changed ownership and extensive refurbishments and building work is taking place to improve the environment. The grounds are extensive and suitable for use by wheelchair users with ample parking for service users, staff and visitors vehicles Roborough House DS0000061085.V258397.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The commission for social care inspection has introduced key standards to be inspected over each inspection year. Therefore, unless it is felt necessary by the inspector, some standards will not be inspected. To obtain a full picture of the home it is recommended that previous reports also be taken into consideration. The inspection took place on 8th December 2005 between 11 a.m. and 4 p.m. The inspector spoke to five residents, three staff and one relative during the inspection. A tour of the home was completed and some records were inspected. Two Complaints regarding the cleanliness of the home had been received since the last inspection this was reviewed during the inspection. What the service does well: What has improved since the last inspection? What they could do better: Roborough house is undergoing major refurbishments and the building of a new extension is almost ready for occupation. The overall appearance of the home in relation to the carpets in existing building could be improved. Some residents said they were disappointed that the staining created by the building work on carpets in both communal areas and some resident’s rooms had not been removed. Woodwork on doorframes within some corridors remains badly damaged. The lack of attention to maintaining the appearance of the homes environment during the building work has distracted from an otherwise pleasant environment for both residents and staff. Roborough House DS0000061085.V258397.R01.S.doc Version 5.0 Page 6 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. Roborough House DS0000061085.V258397.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 Roborough House DS0000061085.V258397.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The residents at Roborough house have access to a staff team who are skilled at assessing their care needs. EVIDENCE: The three residents plans of care viewed each had a comprehensive assessment of their individual care needs completed. Copies of the referral assessments from social service and health professionals were also provided with the resident’s information. How the home staff team were working with other health professionals through ongoing assessment was clearly recorded. The Community Psychiatric team had assessed one resident who had mental health issues. Advice they had given had been incorporated into the resident’s plan of care. The homes deputy manager is a first level registered nurse who specialises in mental health; she has developed a psychological assessment tool. This had been completed for the three residents whose plans of care were viewed. These assessments provided information regarding what was important to the resident and what helped them cope with their disease processes. Roborough House DS0000061085.V258397.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 The residents can have confidence that their individual changing needs and personal goals will be reflected in their plan of care. EVIDENCE: Each of the three residents plans of care had information contained in them that evidenced the residents had been involved in the development of their plan of care. These plans had been developed from their initial assessment. The plans set out personal goals for the resident’s to achieve. The manager advised that two residents were working towards being able to move on to sheltered more independent living. Examples of this were seen. The six monthly reviews provided information on the resident’s progress and how their plan of care was meeting their needs. Where changes had been recommended by the health professional’s attending the review these had been incorporated into the residents plan of care. The manager explained how one residents challenging behaviour was being managed. The restriction in place for this resident and the reason for this had been recorded. The resident had signed the risk assessment. The manager advised that the episodes of challenging behaviour had reduced since the implementation of the plan. Roborough House DS0000061085.V258397.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 The homes staff team endeavour to enable the residents to participate in the local community events and take part in activities of their choice. EVIDENCE: The manager advised that gym sessions have been organised for some residents since the last inspection. The local college was also providing courses in art, mechanics and other subjects the residents had expressed an interest in. The residents spoken to during inspection said they were satisfied with the level of activities provided at present. The quality assurance survey completed in June had indicated that the residents would like to see different activities provided. At this inspection more varied structured activities had been organised for the residents to take part in if they wished. The improvement building work is continuing. The manager confirmed that two bed-sit units would be created as part of the redevelopment. These would be intended for the residents who were working towards independent living. The manager also advised that as part of this a social club activities programme one evening a week would be organised. One resident had been facilitated to take part in an outdoor activity supported by a member of staff. Roborough House DS0000061085.V258397.R01.S.doc Version 5.0 Page 11 Contact with family and friends are encouraged by the staff at Roborough. Visitors were coming and going throughout the inspection. The manager explained how friendships between residents are supported in a risk-managed way to ensure that the residents entering into a new friendship are able to make informed choice. A comprehensive risk assessment process, which looks at physical and emotional and psychological needs of the residents, is completed. An example of this was seen during the inspection. How individual residents are encouraged to achieve their optimum function is clearly recorded in the plans of care. The staff observes speaking to residents were doing so in a respectful friendly manner. The residents were being addressed by their preferred name, which had been recorded in the plan of care. Residents were choosing to spend time in one of the communal areas or were in their own rooms during the inspection. The majority of the home and grounds are easily accessible. However some corridors and doorways in the older part have the building and narrow making it difficult to manoeuvre wheelchairs in this area. Major refurbishment and upgrades are in progress to improve the environment for the residents. Residents spoken to during the inspection said the manager had kept them informed about the progress of the building work. They also said they were looking forward to using the new lounge. The manager advised that several of the residents like to smoke. Risk assessments have been recorded for these residents, which enabled them to make informed choice and get the assistance they required to continue to smoke. A smoking policy was seen to be available for the residents and staff. The activities organised outside the home enabled the residents to mix with people who do not have disabilities. This includes visiting local attractions. One resident told the inspector that staff regularly took them to local shops to do shopping. Roborough House DS0000061085.V258397.R01.S.doc Version 5.0 Page 12 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): 19,20, The staff team at Roborough house endeavour to provide care for the resident’s physical, emotional and health care needs in a way that they would do themselves if they were able. EVIDENCE: The residents at Roborough house continue to have key workers allocated to them. The manager confirmed that the allocation of the key worker is discussed with the resident. The residents spoken to said the staff are friendly and supportive towards them and unable them to have choice when planning their day. The home has been adapted to provide equipment to assist residents with their mobility. Several hoists had been provided; these were in use during the inspection. The manager confirmed that staff had received manual handling training. The manager has introduced new care planning documentation since last inspection. Oral hygiene assessments are completed for residents; this has been implemented since the last inspection. During the tour of the home two resident’s rooms contained prescribed creams, which had been prescribed for them. The manager confirmed that she Roborough House DS0000061085.V258397.R01.S.doc Version 5.0 Page 13 regular checks this to ensure that staff continue to use only prescribed treatment creams prescribed for the residents. The controlled drug record book was checked against the stock for one resident as correct. Roborough House DS0000061085.V258397.R01.S.doc Version 5.0 Page 14 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 Although several complaints had been received by the commission. The manager has dealt with these in a timely professional way. The residents can have confidence than any concerns they raise will be dealt with sensitively. EVIDENCE: The commission has received five complaints since the last inspection. Elements of four of these were regarding the cleanliness and the presentation of the environment. One complaint was referred to adult protection. This complaint was unsubstantiated. The professional handling (including a thorough and mature approach to investigation and response to complaints, using clinical governance / best practice processes) of the difficult issues raised by the complaint impressed the inspector. A senior social worker involved in the investigation also praised the managers handling of the complaint. The home is undergoing major refurbishments. Building work to provide a purpose build extension has been going on for several months. This work has affected the overall appear of the older part of the home. Carpets in communal corridors have become stained with water and building dust. The cleanliness and presentation of the home is affecting the resident’s enjoyment of the homes environment. Two residents spoken to said they were looking forward to the completion of the building work. Roborough House DS0000061085.V258397.R01.S.doc Version 5.0 Page 15 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): 24, 30 The lack of attention to cleaning carpets and maintaining the overall look of the older part of the home during the building work detracts from an otherwise pleasant environment for the residents. EVIDENCE: During a tour of the home it was noticed that many of the carpets in the residents rooms and communal corridors were stained. The manager advised that the building work was making it difficult to keep the carpets clean. The manager was also aware four complaints had been received regarding the cleanliness of the carpets within the home. Building work is continuing, the new laundry space has been completed and awaiting fitting of the washing machines and other equipment. A large activities room had almost been completed. The manager advised that computers were due to be fitted at one end of the room, which would enable the residents to have easier access. Another part of the room had a pool table. The manager advised that it was intended they would be a drinks preparation area within the activities room, although this hadnt been completed at the time of the inspection. Roborough House DS0000061085.V258397.R01.S.doc Version 5.0 Page 16 New extension had almost been completed and the manager advised that she would be ordering furniture for this shortly. The residents spoken to during an inspection tour told the inspector they were looking forward to using the new space. During the inspection and tour of the home cleaners were seen working. The home smelt fresh and clean. The carpets in corridors and three of the resident’s rooms entered were stained. The manager confirmed that when the extension had been completed the older part of the home was due to be refurbished; this would include replacing carpets. Three of the staff spoken to during the inspection advised that they had received infection control training. Information relating to the training was available for inspection. The manager advised that all staff have access to infection control training and she was in the process of ensuring this had been completed. Links with the Health Protection Agency were evident from the reference material available for staff in the office. Roborough House DS0000061085.V258397.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): 32, The residents are cared for by a staff team who care for them in a way that maintains respect and values their individuality. EVIDENCE: The manager advised that a new quality assurance questionnaire is due to be sent out to the residents and their representatives. The returned questionnaires from last June were available for inspection. However these had not been analysed to provide a report that was easily accessible for the residents. However the manager confirmed that the findings of the quality assurance questionnaires had been discussed at residents meetings. Minutes of the residents meetings were available to support this. The manager advised that she is in the process of developing a dependencyrating tool, which will enable her to accurately plan the staff rota. The residents spoken to during the inspection said that the staff are friendly and supportive towards them. The residents care plans reflected their personal choices enabling them to maintain an element of control over their daily lives. The manager confirmed that the organisation is committed to training the workforce. The records of training planned and received by staff supported this. The manager had built up reference material in the office, which related to disease processes and research relevant to the residents care needs. Two members and staff and the manager told the inspector a recent training events for managing challenging behaviour had been beneficial. Roborough House DS0000061085.V258397.R01.S.doc Version 5.0 Page 18 Roborough House DS0000061085.V258397.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): 37, 39, 41, 42 The residents at Roborough house continue to have their views taken into account by the management team. The improvements the manager has introduced in care planning should enhance the resident’s experience of care at Roborough house. EVIDENCE: The key standards in this section were assessed at the announced inspection in July. The standards not fully met at the last inspection were reviewed both were found to have been meet on this occasion. The manager advised that she had started the registered managers award. She also gave information about the courses that she had undertaken since the last inspection and had planned. These included wound care management and NAPPI (None Abusive Physical and Psychological Intervention). The inspector spoke to one staff member who had attended this course as well as the manager both said they had found this useful. A quality assurance system is in place. Quality assurance questionnaires completed in June has still to be analysed. However the results of these were Roborough House DS0000061085.V258397.R01.S.doc Version 5.0 Page 20 discussed at residents meetings and some suggestions have already been implemented. Minutes of residents meetings were available. The inspector was told that another quality assurance questionnaire was due to be circulated. The residents spoken to during the inspection said the manager had kept them informed about the progress with the extension and had discussed activities options with them. The records reviewed during this inspection had been completed as required. Residents care plans had been further developed and each of those seen had been reviewed and at least six monthly. The manager advised that the reviews enabled the residents and staff to agree goals and plan for the next six months. During the inspection inspector saw COSHH information easily available for the staff use. The manager confirmed that a copy of the COSHH information was also kept in the office. Roborough House DS0000061085.V258397.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 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 1 X X X X X 2 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X X X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Roborough House Score X 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X 3 3 X DS0000061085.V258397.R01.S.doc Version 5.0 Page 22 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 Standard YA24 Regulation 23 (2)(d) Requirement All parts of the care home must be kept clean and reasonably decorated. Timescale for action 31/03/06 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 Refer to Standard YA24 Good Practice Recommendations The providers should continue the refurbishments in order that it meets the service users individual and collective needs in a comfortable and homely way (carried forward from the last inspection) The carpets in areas the residents have access to should be cleaned. 2 YA30 Roborough House DS0000061085.V258397.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Roborough House DS0000061085.V258397.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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