CARE HOME ADULTS 18-65
Rockfield Residential 22-24 New Queen Street Scarborough North Yorkshire YO12 7HJ Lead Inspector
David Blackburn Unannounced Inspection 8th March 2006 11:00 Rockfield Residential DS0000063726.V283980.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 Residential DS0000063726.V283980.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 Residential DS0000063726.V283980.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Rockfield Residential Address 22-24 New Queen Street Scarborough North Yorkshire YO12 7HJ 01723 361019 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) Comfy Care Homes Ltd Mrs Christine McDonnell Care Home 17 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (17) of places Rockfield Residential DS0000063726.V283980.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 13th April 2005 Brief Description of the Service: Rockfield comprises two terraced houses, adapted as one and situated on the north side of the town. An enclosed private corridor links the two properties. No.22 occupies four floors and provides single flatlet type accommodation, all with kitchenette, sitting room, bedroom and en-suite facilities. No. 24 has five floors, the upper three providing single accommodation with adjacent toilets and bath or shower facilities. There are communal sitting and dining rooms for all service users on the two lower floors. Neither property has a garden to the front but small, enclosed rear gardens are provided with suitable seating. The staff offer care and services to persons who have had or who are experiencing mental health problems. They seek to provide a holistic regime offering personal care, advice and guidance on daily living skills and activities, a catering service, a laundry service and domestic and cleaning services. All services are offered in conjunction with input from residents. Leisure and recreational activities are offered in-house and at external centres and day care placements. Many residents can leave the premises unaided and take advantage of the attractions available in the town. All residents are registered with local general medical practitioners who will make arrangements for the provision of more specialised health services when needed. Residents have direct access to community psychiatric nursing services. Rockfield Residential DS0000063726.V283980.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection upon which this report is based was the second to be carried out in the inspection year April 2005 to March 2006. It was carried out over five hours including preparation time. The focus was on those key standards not assessed at the first inspection in April 2005 together with those parts of standards subject to a requirement or recommendation. A small number of other standards were re-assessed. An inspection of some parts of the premises including a small number of bedrooms was undertaken. Documents including policies and procedures were examined. Discussions were held with the registered manager and one support worker. Some staff were off site undertaking updated first aid training. A number of residents were spoken with either singularly or in a group communal setting. Their comments are recorded in this report. What the service does well:
Good and consistent care planning systems were in place that ensured residents’ needs were recorded and acted upon. Residents said they “were well looked after.” Risk assessments were in place and showed evidence of updating. Proper procedures were in place to eliminate or minimise known risks to ensure the overall safety and welfare of residents. The routines in the home enhanced residents’ right to choice, freedom of movement and independence. Residents said they were free to come and go, to decide on their own activities and attendance at day care placements. Food was provided in sufficient quantities and of good quality to ensure residents’ dietary needs were met. Residents said the food “was good.” Proper procedures and systems were in place for the promotion and maintenance of residents’ personal and health care. Adult protection procedures gave residents the confidence they would be protected from harm. The premises were well maintained giving residents a comfortable place in which to live. Residents said they “were happy with their rooms.” The staff team provided a consistency of care that meant residents’ needs were met. Residents were complimentary towards the registered manager and staff team. Residents were relaxed and at ease. They enjoyed a positive and
Rockfield Residential DS0000063726.V283980.R01.S.doc Version 5.1 Page 6 good relationship with staff and obviously appreciated the level of care and services on offer. Everything done within the home was for the benefit of the residents. They were the primary focus of staff attention and their needs were of prime importance. One resident said “There are few rules and regulations. Routines are for my benefit not theirs (staff).” Another commented “I value my independence and they realise this.” All the standards inspected and reported on reflected this philosophy giving the residents an independent lifestyle but with the knowledge that help and assistance were readily available if and when required. Any restrictions or limitations were clearly recorded. The home was well managed with attention paid to matters of health and safety to ensure a safe and secure environment for the residents. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rockfield Residential DS0000063726.V283980.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 Residential DS0000063726.V283980.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): 0 None of these standards was addressed. EVIDENCE: Rockfield Residential DS0000063726.V283980.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 and 9. There was a clear and consistent care planning system in place that adequately provided staff with the information they needed to satisfactorily meet residents’ needs. EVIDENCE: A number of case files were examined. They were in two separate binders. One was seen as the working file and contained information needed on a dayto-day basis and the other stored general and historical information. All files had a care plan that had recently been reviewed, revised and updated as necessary. The registered manager said all care plans were reviewed at a maximum of six monthly intervals, though sooner if required. Both files were indexed enabling information to be quickly located and retrieved. The care plans were seen as user friendly. The updated plans had been signed by the residents. Residents said they were free to determine their own lives and how to live them. They were given the freedom to make choices, decisions and to exercise their rights. These freedoms were only limited or restricted where there was firm evidence that the resident could come to harm. Any such
Rockfield Residential DS0000063726.V283980.R01.S.doc Version 5.1 Page 10 limitations or restrictions were clearly recorded in the care plans and on the personal risk assessments. Information on local advocacy services was on display. One case file contained letters from the local service. The registered manager held money for seven residents. The reasons for these decisions were detailed in the individual care plans and these were seen. The financial records were checked and found to be correct. Rockfield Residential DS0000063726.V283980.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): 15, 16 and 17. Residents’ contact with family and friends was promoted enabling them to maintain good relations with relatives and peers. Residents’ rights were respected enabling them to enjoy the same privileges as other people. Dietary needs of residents were well met with meals that offered choice and variety and catered for residents’ tastes and preferences. EVIDENCE: The number and frequency of visitors received by residents varied. Some received regular visitors, often weekly or more frequently, while others only called at birthdays and Christmas. Other residents were able to enjoy periods of home leave. Two residents had no family contact either because of a refusal on their part or that of their family. Residents were subject to few rules and regulations. Those in place were seen as a benefit and protection for the majority. Residents had keys to their bedrooms doors and were given the entrance door keypad number. Some
Rockfield Residential DS0000063726.V283980.R01.S.doc Version 5.1 Page 12 were able to undertake light duties in the home, for example helping with cleaning or catering. Residents said they enjoyed three meals a day together with a light supper. A hot option was available at all meals. Lunch was usually a light snack with the main meal taken at teatime. This ensured residents out for the day, either taking part in an activity or at a day care placement, received a hot and substantial meal. A weekly menu was published showing the available choices. Residents were asked to indicate their preference. Meals were taken in the dining room though some residents preferred to eat in the sitting room or their bedroom. Some bedrooms had a kitchenette that included a cooker and refrigerator. Rockfield Residential DS0000063726.V283980.R01.S.doc Version 5.1 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 and 19. The personal and health care needs of residents were well met with evidence of multi agency working taking place on a regular basis. EVIDENCE: All residents were said to be able to self-care. Staff offered the necessary support, guidance, advice and encouragement as necessary. Care plans detailed any particular needs with regard to the maintenance of personal care. Residents said they decided on times of rising and retiring. They also confirmed they bought their own clothing and personal items or these were purchased on their behalf by staff. A key working system whereby one staff member takes particular responsibility for one or more residents was in operation. Residents’ healthcare needs were clearly shown in their care plans. All appointments with and interventions by health care professionals were fully recorded. All residents were registered with a local general medical practitioner. Staff would generally accompany residents to the surgery but would only enter the consulting room if so requested by the resident. All had direct access to community psychiatric health services. Dental and optical services were provided locally in the town.
Rockfield Residential DS0000063726.V283980.R01.S.doc Version 5.1 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): 23. Arrangements for protecting residents were satisfactory ensuring they were not placed at risk of harm or abuse. EVIDENCE: A policy on the protection of vulnerable adults revised in January this year was seen. This succinctly but clearly detailed the actions to be taken should abuse be alleged or suspected. The registered manager had obtained a copy of the revised multi agency agreement on adult protection. This documentation was supported by a number of other policies and procedures including whistle blowing, dealing with aggression, residents’ finances and the receiving of gifts. Staff confirmed they were made aware of these policies and procedures at induction. They said that one mandatory unit in their National Vocational Qualification work concerned protection of vulnerable adults. An anonymous complaint had been received in October 2005 regarding a resident’s inability to access their money held in the home. The matter was fully and thoroughly investigated under Adult Protection procedures by members of the local authority social services department. It was found the complaint had no substance in any part and was not upheld. Rockfield Residential DS0000063726.V283980.R01.S.doc Version 5.1 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 and 30. The standard of the environment was good providing residents with a clean and homely place in which to live. EVIDENCE: Only the communal areas were seen on this visit. They were in good decorative order, clean, tidy, warm and odour free. These areas were furnished in a domestic style reflecting the registered provider’s and registered manager’s wish to create a non-institutionalised environment. Regular checks and necessary maintenance were carried out as required. The laundry walls had been improved to provide a readily cleansable surface. The floor had a sealed covering. New machines had been installed. Rockfield Residential DS0000063726.V283980.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): 32 and 34. Sufficient numbers of staff were deployed to meet residents’ needs and offered consistency of care. The recruitment and selection procedures must be improved to ensure residents have continued protection from harm. EVIDENCE: The home had a full complement of staff. The staff rota was examined. This showed an adequate level of staff deployed throughout the day. There was one waking night staff with one sleeping-in support. The rota showed one support worker (floater) employed at various times according to the daily needs of residents for example to attend appointments or activities. Resident and staff interaction was noted as relaxed, friendly and warm. Residents said staff “were nice and kind.” Of the 14 support staff, 2 had a National Vocational Qualification in care to level 2. The registered manager said that all staff were enrolled on National Vocational Qualification in care courses. Staff were also undertaking a number of distance learning courses including Healthy Eating and Diversity and Equality. All but one had completed an external medication course. A number
Rockfield Residential DS0000063726.V283980.R01.S.doc Version 5.1 Page 17 of staff were undertaking a first aid refresher on the day of the inspection. New arrangements were in place for the induction of staff. The file of the last staff member to be appointed was examined. It contained an application form, two written references and interview forms including one completed by the residents. The file also detailed supervision, appraisal and training. The enhanced disclosure from the Criminal Records Bureau related to a former employer. The registered manager was reminded of the need for the home to obtain a current disclosure, as they cannot be transferred between employers. Rockfield Residential DS0000063726.V283980.R01.S.doc Version 5.1 Page 18 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 and 42. The home is well managed providing a safe and secure environment for residents. EVIDENCE: The registered manager had recently achieved the Registered Managers Award (Adults) NVQ4. She was working towards a National Vocational Qualification in care to level 4. The registered manager carried out a six monthly audit of procedures, practices and services provided in the home. These included care planning, medication, food, staff training and health and safety. These audits were forwarded to the responsible individual with whom she then met to discuss the findings. A plan of action was drawn up to address the issues raised and this was then actioned as appropriate. Rockfield Residential DS0000063726.V283980.R01.S.doc Version 5.1 Page 19 House meetings were undertaken on a monthly basis. Copies of the minutes were seen. A number of issues had been raised by residents and the appropriate action taken by staff to address them. Proper attention was given to matters of health and safety. An external company provided a thorough health and safety assessment every two months. Copies of their reports were seen. A number of safety certificates and reports related to the premises were examined. All were relevant and in date. Rockfield Residential DS0000063726.V283980.R01.S.doc Version 5.1 Page 20 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 X 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 1 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 3 X 3 X X 3 X Rockfield Residential DS0000063726.V283980.R01.S.doc Version 5.1 Page 21 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. 1. Standard YA34 Regulation 19 Requirement A current enhanced disclosure from the Criminal Records Bureau must be obtained by the present registered provider for all staff. Timescale for action 22/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Rockfield Residential DS0000063726.V283980.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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