Inspection on 07/03/07 for Rockfield House

This inspection was carried out on 7th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Rockfield House 25/02/06

Rockfield House 17/12/05

Rockfield House 24/01/05

Rockfield House 18/08/04

Rockfield House 11/02/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Rockfield House Rocky Lane Liverpool Merseyside L6 4BA Lead Inspector Peter Cresswell Key Unannounced Inspection 7 March 2007 09:10 Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 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.V315490.R01.S.doc Version 5.2 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. 25th February 2006 Date of last inspection Brief Description of the Service: Rockfield House is a specialised service for up to ten adults with a learning disability. It provides care for people who have challenged other services and is a safe, secure environment for its residents. The service is located in a converted school building in the Anfield area of Liverpool. All of the bedrooms are spacious with en-suite facilities 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 there are other amenities close to the home, such as churches, cinemas, parks and GP surgeries. Bus services run from close by to other parts of the city including the city centre and both football grounds. Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included an unannounced site visit which lasted seven hours. The inspector spoke to the deputy manager, the Registered Manager, three other members of staff and a number of residents. He toured the whole home and examined medication and records including care plans, staffing, fire safety, staff training and food hygiene. The Registered Manager had completed and returned a Pre Inspection Questionnaire before the site visit and included with it a wide range of information about the home. Three residents returned survey forms to the inspector before the visit. What the service does well: What has improved since the last inspection? What they could do better: Rockfield House meets all of the National Minimum Standards and provides an excellent, specialised service. The gas safety certificate was a few days out of date and the renewal of safety certificates should be properly monitored. Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 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. Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is excellent. Residents are properly and expertly assessed before being admitted, ensuring that the service is able to meet their needs. The Statement of Purpose and service user guide are excellent, ensuring that prospective residents and, where appropriate, their relatives have satisfactory information about the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users who are considered for admission to Rockfield House have very particular needs and require specialised, tailor made care. They are thoroughly assessed before admission and the home receives assessment documents from all relevant professionals. The Registered Person (the owner) employs specialist staff including consultant psychiatrists who contribute to the assessment. We examined the file of the most recently admitted resident and it included appropriate assessment documents. Other files contained copies of the residents’ contracts. The home has a Statement of Purpose and an excellent, easy to read, service users’ guide. The fees for Rockfield House reflect the fact that it provides a very specialised and demanding service. They are negotiated individually with contracting authorities and start at £2,220 a week. Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 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, 9. Quality in this outcome area is excellent. Detailed care planning and risk assessment help to ensure that the residents’ needs are central to the life of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a detailed care plan for each resident. They include detailed social histories and separate care plans for different elements such as activities, food and personal care. Staff complete twice daily monitoring reports for each element of the care plans, thus ensuring that there is a detailed record of every aspect of the resident’s life at Rockfield to inform continuing reviews and assessments. There are also detailed assessments for risks such as self harm, aggression, absconding , sexual behaviour and alcohol misuse, as appropriate for each resident. The care plans and risk assessments are reviewed by the Registered Manager and key workers every month, with full reviews once a year. The annual reviews are attended by staff from the home, social workers from the commissioning authority, other relevant professionals, relatives and – when they so wish – the resident. The individual files also Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 Page 10 contain a wealth of other information such as psychiatric and psychological reports and details of medical care and appointments. This ensures that staff and management consulting the files have access to a wide range of information that underpins the care plans and risk assessments. Residents are encouraged to make decisions about their own life style as far as they are able, though the capacity for this varies enormously. They are then given the support to enable them to pursue this life style and their chosen activities. Regular residents’ meetings are held to discuss all aspects of life at Rockfield House and a record is kept of the meetings. Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 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, 16 and 17. Quality in this outcome area is good. Rockfield has personalised activity plans to enable the residents to take part in activities of their choice in the local community and elsewhere. Residents enjoy healthy, personalised diets. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each resident has a personalised and detailed activities schedule. In one of the files we looked at this included going to the shops, visiting the pub, playing golf and going to college. One resident has his own vehicle and enjoys going out in it – accompanied by staff, who drive the vehicle. The home has the use of two other vehicles for other residents to use. Each resident goes on holiday at least once a year, accompanied by enough staff to ensure their safety. Residents’ rooms reflected the wide range of interests that some of them have, including football, record collecting and pets. The home has five cats and a rabbit and some individual residents keep tropical fish and budgerigars. Most residents like to help with some of the shopping, when they also help to choose their own food. In a service user survey form one resident said that s/he likes “to go out in one of the three buses we have here in Rockfield”. Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 Page 12 There is a central menu that includes a Sunday roast dinner and a chippie meal on Fridays, but each resident chooses his or her own food and many like to help the staff to prepare their meals. Staff take into account the individual dietary needs of the residents as well as their likes and dislikes. Some residents were enjoying their breakfast, supported by staff, when the site visit started. Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 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): 18. 19, 20. Quality in this outcome area is excellent. Care staff give personal care appropriately and considerately. Well trained care staff administer medication safely, ensuring that residents are not put at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are good facilities to help ensure that personal care, where needed, is given appropriately. One resident has a built in ceiling hoist and tracking in his bedroom. The detailed care plans described earlier contained information showing that physical and psychological health needs are dealt with appropriately and are closely monitored. Individual bedrooms are very spacious and include en suite facilities so personal care can be given in the privacy of the resident’s own room. All of the residents receive community and specialist health care as required and full records are kept of this. Two senior care staff showed the inspector the medication records and procedures during the site visit and all of the records were found to be accurate and very well organised. There is a spacious, dedicated medications room which includes a special cabinet for controlled drugs, though at the time of the site visit no such medication was in the home. The CD cupboard and Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 Page 14 register were in fact used for drugs which the Registered Manager felt needed extra care, so if any controlled drugs are prescribed, care will be needed to make sure that there is no confusion. Rockfield uses a NOMAD type of system whereby medication is dispensed by the pharmacist in individual cassettes every week. All of the tablets to be taken by each individual at any given time are in one blister. Where medication is to be taken ‘as required’ (PRN) there is guidance on the precise circumstances in which it is to be administered. Medicines that need to be refrigerated are kept in a small, dedicated, lockable fridge in the medication room. Its temperature is checked and recorded twice a day. No residents retain their own medication. Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 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. Quality in this outcome area is good. There are procedures in place to protect the residents from the risk of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a satisfactory complaints procedure which is also referred to in the service user guide. Care staff are trained in the recognition and prevention of abuse which helps to ensure that residents are safe and not at risk. The manager has a clear understanding of the correct procedures to follow should abuse be suspected. She described one incident which had been referred to Social Services in line with the adult protection procedures. No abuse had taken place and the referral was by way of a precaution. Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 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): 24, 25, 26, 27, 28, 29, 30. Quality in this outcome area is good. Rooms and facilities meet the particular needs of the residents at Rockfield in a homely, relaxed way. Special equipment is provided where necessary to meet residents’ needs and protect their privacy and dignity. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Rockfield House is very close to one of the major routes in to Liverpool city centre and there are frequent bus routes to all parts of the city nearby, such as both of the football grounds. All of the residents have individual rooms. These rooms are spacious, some of them exceptionally so, and all have en suite facilities, including showers or baths. The rooms are furnished according to the tastes and needs of the individual residents and are strikingly different. The contents of the rooms reflected the tastes and personalities of the occupants. Some of the rooms are quite sparsely furnished or have specially designed furniture to meet the specific needs of the residents. There is a large central lounge/dining room which looks out on to the pleasant enclosed garden. The home’s cats were wandering round the main lounge, adding to the homely atmosphere, and the rabbit is kept in a run in the garden, Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 Page 17 protected from the attention of the cats. There is a small smoking lounge for the residents; staff will be completely banned from smoking as from July. The home was clean and reasonably well maintained on the day of the inspection. Rockfield receives very hard wear and employs a full time handyman to keep on top of running repairs and redecoration. In a survey form one resident confirmed that “the home is kept clean by a cleaner every day”. Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 Page 18 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, 34, 35, 36. Quality in this outcome area is good. Rockfield’s high staffing levels ensure that the residents receive the support they need. Staff are enthusiastic, well trained and highly motivated, helping to meet the residents’ needs effectively. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Rockfield House employs 34 care staff, reflecting the high level of staffing required to meet the needs of the residents. Staffing for individual residents is negotiated with commissioning authorities. The owners have a comprehensive training programme and recent courses have included Adult Abuse, Infection Control, Psychosis and Epilepsy Awareness. Staff receive regular updates in areas such as Manual Handling. 18 care staff have NVQ2 or above (four have NVQ3) so the home exceeds the national standard of 50 of care staff with this qualification. Six further staff are working towards NVQ2. Staff who spoke to the inspector during the site visit were extremely enthusiastic, knowledgeable and committed to the welfare of the residents. Staff receive regular one to one supervision which is recorded. The owners have an effective and well established staff recruitment process and the records for staff recruited since the last inspection showed that the necessary checks had been carried out. However, original copies of Criminal Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 Page 19 Records Bureau certificates were not available as they are held at the owners’ head office in North Wales. Copies were on file but these did not include the section which lists any criminal record. It was therefore not possible to check that staff had clear records or that appropriate action had been taken if any offences were revealed. The Registered Manager said that if there was anything on the CRB certificate, staff at head office would inform her so that an informed judgement as to their suitability could be taken. We have no reason to doubt this but the full CRB checks should be retained until the next inspection (in line with national guidance) so that the CSCI can check them. It is not practical for inspectors to travel to the owner’s head office to do this. Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 Page 20 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, 42. Quality in this outcome area is good. The home is well run by an enthusiastic and committed management team, providing a well run, efficient and safe home for the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has many years experience in caring for and supporting vulnerable adults and managing staff. She has managed Rockfield House since it was opened. She has the City and Guilds 325/3 - a recognised care management qualification - and is part way through a course for the Diploma in Social Work. She provides clear and decisive leadership in a very individual way. Financial procedures are clear and properly used, helping to protect the residents from any financial abuse. Various stakeholders (residents, relatives, visiting professionals) are asked to complete a ‘Service Evaluation Form’ to Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 Page 21 record their experience of the home. These are used as the basis of Rockfield’s quality assurance process. One relative said “I am extremely happy with (my son’s) progress. From a ‘concerned mother’s perspective this is the first home to offer him a choice and ensure he interacts with the community”. A representative of the owners visits the home every month and completes a report in line with regulation 26. Fire safety records were up to date. An electrical safety certificate was available but the gas safety certificate had run out a few days before the site visit. A certificate was obtained two days after the site visit and forwarded to the Commission for Social Care Inspection. Care should be taken to ensure that safety certificates are renewed on time. The Registered Manager should approach the Environmental Health Officer with a view to implementing the Food Standards Agency food safety programme Safer Food, Better Business. Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 Page 22 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 4 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 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 4 x 3 3 3 X X 3 x Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 Page 23 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. 1 Refer to Standard YA34 Good Practice Recommendations The home should retain completed CRB certificates on staff until they have been checked by the Commission for Social Care Inspection at the subsequent inspection. Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 Page 24 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 © 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 Rockfield House DS0000025368.V315490.R01.S.doc Version 5.2 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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