CARE HOME ADULTS 18-65
Rockfield House Rocky Lane Liverpool Merseyside L6 4BA Lead Inspector
Christopher Bond Unannounced Inspection 25th February 2006 11:00 Rockfield House DS0000025368.V284595.R01.S.doc Version 5.1 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 Rockfield House DS0000025368.V284595.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Rockfield House DS0000025368.V284595.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Rockfield House Address Rocky Lane Liverpool Merseyside L6 4BA 0151 260 4414 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) Mental Health Care (Rockfield) Limited Ms Lisa Bessal Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Rockfield House DS0000025368.V284595.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The number of persons for whom residential accommodation (with personal care) is provided at any one time shall not exceed ten (10) Only adults (aged 18 - 64 years) whose primary disability is learning disability maybe accommodated. 17th December 2005 Date of last inspection Brief Description of the Service: Rockfield House is a specialised service for adults who have a primary diagnosis of a learning disability. It is specifically for those people who have challenged other services and it provides a safe and secure environment for 10 residents of both sexes. The service is located in a converted school building in the Anfield Area of Liverpool. All of the bedrooms are en-suite and the home also has two separate bathrooms with specialist facilities for those with a physical disability. There are lots of local shops close by and other amenities, such as churches, cinemas parks and GP surgeries are also situated close to the home. Bus services run from close by to other parts of the city. This is a unique service and as such provides a valuable resource. Rockfield House DS0000025368.V284595.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over three and a half hours. The manager gave the inspector a tour of the home. Care staff and residents records were looked at. The inspector spoke to two of the residents and two visitors. Three of the staff were also spoken to. The inspector also spoke to the Clinical Nurse Specialist, the manager and the assistant manager. What the service does well: What has improved since the last inspection?
The home was moving towards a system where photographs and illustration were to be used to help demonstrate how people have progressed and developed whilst living at the home. This will make the information more accessible to the residents within the home and help residents to achieve goals that have been set to learn new skills in small, well -planned steps. The manager confirmed that the company had developed their own induction for new staff. This was very similar to the Learning Disability Award Framework (LDAF), which helps to prepare care staff for working specifically with adults
Rockfield House DS0000025368.V284595.R01.S.doc Version 5.1 Page 6 who have a learning disability. Good training adds to people’s skills to help them work more effectively. It was good to see that a complaints procedure had been developed that would help the residents to voice their concerns, should they wish to do so. This had photographs and illustrations so that people could understand it more. 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. Rockfield House DS0000025368.V284595.R01.S.doc Version 5.1 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 Rockfield House DS0000025368.V284595.R01.S.doc Version 5.1 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): EVIDENCE: This section was not assessed during this inspection. Rockfield House DS0000025368.V284595.R01.S.doc Version 5.1 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, 8 and 10. An ‘Individual Plan’ is developed with the service users, which ensures that their wishes, goals and aspirations are well planned and constantly reviewed to support positive outcomes. Service users are respected and treated as individuals, which helps to ensure a good quality of life. EVIDENCE: All of the residents who lived at the home had lots of information written down about them regarding their particular needs and how they should be addressed. This information was very thorough and clear. The home was moving towards a system where photographs and illustration were to be used to help demonstrate how people have progressed and developed whilst living at the home. This will make the information more accessible to the residents within the home and help residents to achieve goals that have been set to learn skills in small, well -planned steps. These ‘care plans’ were reviewed every month. The Clinical Nurse Specialist explained how the plans helped to build a clinical profile for each person. This information would help to provide a strong assessment should a resident develop the correct skills to live in the community in a less structured
Rockfield House DS0000025368.V284595.R01.S.doc Version 5.1 Page 10 environment. All of the staff that were spoken to were fully aware that the information on each person had to be handled sensitively and confidentially. The inspector spoke to two visitors. Both said that they were always welcomed and made to feel valued. One lady said that she could arrive at the home at any time and always be confident that her relative would be cared for properly. Rockfield House DS0000025368.V284595.R01.S.doc Version 5.1 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): 11, 12, 13, 14, 15 and 16. Good staffing means that residents are helped to have a full and active life both inside the home and in the local community. EVIDENCE: The high staff to resident ratio had been maintained and residents were able to go out and enjoy life in the community with appropriate support. Many of the residents had quite complex needs and it was good to see that there were enough staff around to ensure that they could go out and enjoy the things that most others take for granted. One of the visitors said,” my brother needs twoto –one support and I am delighted to see that the home always sticks to this. He can go out and enjoy things like going to restaurants or more specialist things, like hydrotherapy. His behaviour has improved because he is being stimulated.” Rockfield House DS0000025368.V284595.R01.S.doc Version 5.1 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): EVIDENCE: This section was not assessed during this inspection. Rockfield House DS0000025368.V284595.R01.S.doc Version 5.1 Page 13 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 and 23 Safety is promoted for service users and support workers. People are protected from harm by good training and robust procedures. EVIDENCE: It was good to see that a complaints procedure had been developed that would help the residents to voice their concerns, should they wish to do so. This had photographs and illustrations so that people could understand it more. The training available to staff to help them to be more aware of abuse issues was ongoing. The manager had a good knowledge of the correct procedures to follow should abuse be suspected. Criminal Records Bureau checks and Protection of Vulnerable Adult checks were evident within the care staff files. There were good procedures in place to help protect residents from harm. One of the support staff had been trained in specific techniques with regard to de-escalation. This meant that potentially threatening situations could sometimes be dealt with effectively before problems became unmanageable. There was also training given in breakaway techniques to help protect staff when faced with difficult situations. Rockfield House DS0000025368.V284595.R01.S.doc Version 5.1 Page 14 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, 25, 26 and 30. Residents live in a homely, safe, comfortable environment. EVIDENCE: Once again, it was highly evident that the home was kept clean and free from any unpleasant odours. One visitor said, “The place is always lovely and clean every time I come.” The home was relaxed, comfortable and safe. There were lots of personal possessions around in the residents’ rooms that reflected their personalities and to make them feel at home. Some of the rooms were a little sparse but it is necessary to take into account that this is a specialist and unique home for those who have challenged other services. One of the residents showed the inspector his room. This was very well decorated and furnished. It was clear that this person was very proud of his room and that it was his own very personal and private environment. This was a specialised service that centred on the support of people who may have challenged other services. Because of this there were measures taken to ensure that people were not harmed by the environment that they lived in.
Rockfield House DS0000025368.V284595.R01.S.doc Version 5.1 Page 15 Some of the glass windows had been covered up by Perspex and some of the bedroom furniture had to be fixed to walls or the floor. Rockfield House DS0000025368.V284595.R01.S.doc Version 5.1 Page 16 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, 33 and 35. Training is considered a priority so that a competent and well- trained staff team assist the residents. EVIDENCE: Training was still seen as a priority by the company. A list was available of all the training that had taken place over a period of time and each of the care staff had certificates within their personal files to show what training that they had taken part in. The manager was able to confirm that over 50 of the staff had a National Vocational Qualification level 2 or 3 in care. This is a nationally recognised qualification, which helps staff to do their jobs well. The manager confirmed that the company had developed their own induction for new staff. This was very similar to the Learning Disability Award Framework (LDAF), which helps to prepare care staff for working specifically with adults who have a learning disability. Good training adds to people’s skills to help them work more effectively. One of the visitors was very pleased that her relative was always supported appropriately and according to his assessment. She commented, “Staffing wise this place is brilliant. There’s always two- to- one support available.” Rockfield House DS0000025368.V284595.R01.S.doc Version 5.1 Page 17 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, 38, 39, 40, 42 and 43. The home was well managed and this helped to ensure that people received a good consistent service. EVIDENCE: The manager had many years experience in caring for and supporting vulnerable adults and managing a staff group. The manager currently holds the City and Guilds 3253, which is a management qualification. The manager also gave in-house training and was continuing to work towards obtaining the Diploma in Social Work. It was clear that the home was managed strongly, professionally and competently. The care staff benefited from being given specific responsibilities, such as ensuring that the medication procedures were being handled properly, or ensuring that the finance systems were being used properly and safely. Staff were supported individually and staff meetings were held on a regular basis to ensure that everyone had the correct information about how the service ran.
Rockfield House DS0000025368.V284595.R01.S.doc Version 5.1 Page 18 Financial procedures were found to be clear and properly used by the staff. This helped to protect the residents from any financial abuse. Visitors were asked to fill in questionnaires regarding their views about the home. The results of these were used to improve the service. Training had taken place in health and safety issues. This included ensuring that staff knew how to move residents safely and correctly. Staff were also shown how prepare food hygienically and safely. A fire risk assessment had been done for the building and care staff were instructed in what to do if fire broke out. Certificates were seen to show that proper safety inspections were done regularly on the electrics, gas equipment, fire equipment and fire alarm system. It would be beneficial if copies of these could be kept at the home for regular inspection at all times. Rockfield House DS0000025368.V284595.R01.S.doc Version 5.1 Page 19 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 X 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 4 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 4 32 3 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X 4 3 3 3 X 3 3 Rockfield House DS0000025368.V284595.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 Rockfield House DS0000025368.V284595.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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