Inspection on 01/08/06 for Rockleaze

This inspection was carried out on 1st August 2006.

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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rockleaze 21/04/09

Rockleaze 06/05/08

Rockleaze 03/07/07

Rockleaze 12/12/05

Rockleaze 27/06/05

Rockleaze 07/01/05

Rockleaze 13/07/04

Rockleaze 09/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Rockleaze 56 Lower Hanham Road Kingswood South Glos BS15 8QP Lead Inspector Paula Cordell Key Unannounced Inspection 1st August 2006 09:30 Rockleaze DS0000003352.V304536.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 Rockleaze DS0000003352.V304536.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. Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rockleaze Address 56 Lower Hanham Road Kingswood South Glos BS15 8QP 0117 9673395 NONE Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Jonathan Short Mr Jonathan Short Care Home 13 Category(ies) of Learning disability (13), Mental disorder, registration, with number excluding learning disability or dementia (13), of places Old age, not falling within any other category (13) Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 13 persons aged 25 years and over who may have learning disability and/or mental disorder 12th December 2005 Date of last inspection Brief Description of the Service: Rockleaze is a large double fronted Victorian property, which has been significantly extended. It is in an elevated corner position on the Lower Hanham Road and provides excellent views over Bristol from first floor rooms. The buildings and gardens are well kept and the front garden provides seating for residents. Considerable work has been undertaken internally over the last two years. The rooms are furnished to a high standard and the home is pleasant and comfortable for the residents. Local shopping and other amenities in Hanham are within walking distance and the Kingswood shopping area is a short drive away and enjoyed by residents. The home is on a bus route accessing both places and the centre of Bristol. The home also has its own transport with an easy access vehicle, enabling either small or larger groups to go on trips from the home. The fees at the time of publishing this report were from £415 to £453. Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection. The purpose of the visit was to monitor the progress to meet the requirements and recommendations from the last unannounced site visit in January 2006 and review the standard of care provided to the residents at Rockleaze. There has been no inspection activity between January 2006 and this site visit. The focus of the site visit was on the general care of a sample group of residents and the environment, including an extensive tour of the premises. This provided a good opportunity to observe residents as well as allowing for informal conversations with individuals and the staff supporting them. Two members of staff were spoken with during the inspection, in addition to the registered manager. The home has been sending information in respect of regulation 37 notices of events affecting the well being of the residents. This was used as a focus for the site visit along with the pre-inspection questionnaire completed by the home and survey forms received from relatives (4), residents (8) and visiting professionals. The site visit was conducted over a period of 5 hours. What the service does well: What has improved since the last inspection? Residents can be assured that they have sufficient information to make a choice about the home. This is in an accessible format. This requires more information to ensure that it meets with the Care Home Regulations 2001. Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 6 Residents are assured that staff have the knowledge and competence to deal with an allegation of abuse. This will be enhanced when staff attend further training with the local placing authority, but interim measures have been taken. Residents can be assured that the home’s risk assessments have been reviewed and updated ensuring the safety of the individuals living in the home and the staff. Residents have contracts of care detailing their terms and conditions. These must be updated to reflect the recent change in the legislation. Residents are benefiting from the introduction of a new care planning system which is evidently person centred with more resident involvement in initiating what is important to them. 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. Rockleaze DS0000003352.V304536.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 Rockleaze DS0000003352.V304536.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): 1,2,3,4,5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents have adequate information to make a decision to move to Rockleaze, however this must be expanded to include all information as required by the Care Homes Regulations to enable individuals to be fully informed about their care. Residents can be assured that the home will meet their assessed care needs. EVIDENCE: Since the last inspection the manager has updated the statement of purpose and the service user guide. These were in an accessible format, written in plain English and contained photographs. Resident involvement was evident; consent was sought for the photographs. The documentation must be expanded to include information about the day to day staffing, the assessment process and the home’s complaint procedure. Whilst this is an outstanding requirement the manager has demonstrated that there is a commitment to meeting the Care Homes Regulations and National Minimum Standards. The manager was able to verbally demonstrate how prospective residents would be supported to move to the home including completing an assessment of need, offering a trial period and arranging visits. It was evident that the Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 9 needs and compatibility of the existing residents would be taken into consideration. The home is registered for 13 residents. The manager believes that three of the bedrooms do not meet the National Minimum Standard and are no longer used. Presently there are two vacancies. The National Minimum Standards were amended and all rooms in the home could be used as the home was registered before April 2001. The manager stated that therefore the home would only support 10 residents. From discussions with the manager it was evident that the home will only accommodate an individual whose needs they could meet. Rockleaze has provided a home for many of the residents in excess of fifteen years. Residents are very able and were the first individuals to move from long-term institutions. The manager has noticed that the referrals the home is receiving are for residents that require more support or exhibit varying levels of challenges not seen in the other residents. Discussions were had with the provider on how the vacancies could be filled and consideration to broadening the client group to ensure that the home remains viable. A relative commended the home relating to the process of admission stating “their relative is much happier since moving to Rockleaze” and put this down to the “wonderful care and support that they receive from all the staff.” Contracts were seen; the manager has updated these in response to a requirement from the last site visit. However, the information did not include a break down of the fees, who was responsible, and what was and not included or the room that the person was to occupy. This is a recent change in the legislation and only came in to effect from July 2006. Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 10 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): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are benefiting from a review of the care documentation and the introduction of a new system. Residents are involved in making decisions about their care. Residents are supported within a risk assessment framework ensuring their safety without compromising the individual’s independence. EVIDENCE: Care plans were in the process of being updated. The home was introducing a more person centred planning system. This was still in the early stages of implementation. From discussions with the manager, residents were being consulted and fully involved in the planning of their care. Residents were evidently happy living in the home and with the support from staff and the manager. This was evidenced via discussions with residents on the day of the site visit and all questionnaires that were received. All residents spoken with confirmed that they had a plan of care and that they could access this on request. Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 11 Relative questionnaires confirmed that where relevant they were informed of changes to the care provision for individuals. One questionnaire commended the manager for keeping them informed. Risk assessments were seen for three individuals. Risk assessments had recently been updated, however the manager acknowledged for one individual that these still required updating to fully demonstrate how the home was meeting the individual’s changing needs. The home was liaising with the community learning disability team in respect of a reassessment, which has included purchasing of equipment to assist with meeting the changing care needs of an individual. The manager was describing how these changes would be fully documented in the care plan but this was only a recent change. Whilst the care plans did not fully document these changes it was evident that the outcome for the individual was in place. The home has a policy on confidentiality. Staff and the manager were observed maintaining the confidentiality of residents information this was stored in a lockable cabinet and conversations of a confidential nature were discussed in the privacy of the office. Resident questionnaires confirmed that the home maintained their privacy in relation to information. Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 12 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Resident’s participate in activities within the community and in the home. Resident’s rights are respected and there is a good level of user involvement. Residents have a well balanced diet. EVIDENCE: Completed resident questionnaires confirmed that residents had access to a variety of activities. Residents on the day of the site visit stated that they could access the community independently and with staff support and all they need to do was ask. Residents stated that the home organises external social entertainers to visit the home. It was evident that they were seen as enjoyable and fun. Residents spoken with were keen to share that they were planning an annual holiday to Burnham on Sea for a week’s caravan holiday in addition to day trips. Trips included Longleat, fish and chips at the seaside and a visit to a garden centre. Further trips were planned for August and September. Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 13 Several of the residents attended a luncheon club locally and day centres. Residents were observed to have a variety of activities in the home including board games, puzzles and art and craft material. As well as television and music centre in the communal areas this was available in residents bedrooms. Daily records confirmed that residents had a wide range of leisure and social opportunities open to them. The home has a smoking area, which is separate from communal areas. Care documentation demonstrated that the home supported residents to maintain contact with friends and family. One of the residents was entertaining a friend on the day of the inspection. It was evident that the individual was made welcome from conversation with both parties and observation of the staff on duty. Residents confirmed that they could entertain their friends or relatives in private should they wish. A resident stated that they go to church which is only a short walk from the home and are made to feel welcome by the congregation. Menus were viewed prior to the site visit, as part of the information sent by the provider. These provided evidence that residents had available to them a varied and nutritious diet. Residents spoken with confirmed that the food was good and sufficient in quantity. Drinks were available to residents throughout the inspection Residents were asked at appropriate times what they wanted to drink which included juice, tea, coffee and squash and biscuits were available along with fruit. Resident’s rights are respected and responsibilities recognised in their daily lives. It was evident that individuals were encouraged to attend resident meetings, some of the residents attend people first meetings, and one of the residents had access to an independent advocate. Residents were supported with their finances based on the individual’s ability. One resident is responsible for all their finances and the manager was concerned that this could have implications re an annual holiday due to lack of funds, this was still being explored by the individual and the manager. Clear documentation was in place regarding what amounts individuals had and how they wanted to spend their money, where residents were able records had been signed. The manager stated that all residents have their own bank account and where this is not possible relatives take on this responsibility. Documentation was in place supporting this. The manager stated that they were the appointee in respect of benefits but not in relation to their personal finances where residents were unable to make decisions a nominated relative was responsible. Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 14 The home has access to a mini bus, for which the residents make a small contribution to the running costs. Residents confirmed that they were supported to use the bus, which was usually driven by the provider. Residents contribute £5 per week for transport. Documentation was seen confirming the resident and/or their relative was happy with this arrangement. Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 15 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 good. This judgement has been made using available evidence including a visit to the service. Residents’ personal and health care needs were being met. Residents are protected by robust medication systems, which would be enhanced if the policy included guidance for staff to follow in the event of an error. EVIDENCE: Care documentation included how the individual wanted to be supported with personal care, the home maintained a clear record of when and who supported individuals. Residents confirmed that they had access to a doctor, chiropodist and dentist and attended annual eye appointments. This was confirmed in care documentation. Feedback from professionals was positive. Professionals confirmed that they could see individuals in private and that staff demonstrate a clear understanding of the resident’s care needs. Residents have access to the community learning disability team complimenting the skills of the staff team. This was confirmed by the manager, staff and in care documentation. Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 16 Residents stated that they could get up and go to bed when they wanted. One resident stated that they could no longer go out independently for their own toiletries, however staff would either support him to go out or they would purchase on his behalf. Medication was stored and administered appropriately with clear documentation in place. The home has a policy, which requires guidance for staff to follow in the event of an error. All staff are presently completing a distance learning pack on the administration of medication. Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 17 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 adequate. This judgement has been made using available evidence including a visit to the service. Residents can be confident that they concerns would be listened to and acted upon. Residents must be confident that the home’s policy on protection is clear on the role of staff and the manager in reporting all incidents of abuse to the appropriate local authority. Residents evidently felt safe and supported in their home. EVIDENCE: The home has a complaints policy. This was displayed in the main hallway. Residents confirmed they were aware of the procedure both in conversation and through the completed questionnaires. Residents spoken with stated that the manager or staff would “sort it out”. The complaint log was viewed. It was found that the manager had dealt with incidents effectively. There has been one complaint since the last inspection and this has been resolved and discussed with all relevant parties. Two staff were interviewed to discuss the term “Protection of Vulnerable Adults”, both had a good understanding and stated that the manager has recently purchased a questionnaire and video for all staff and further training was planned with an external provider. This was in response to a previous requirement. It was noted that many of the staff had attended a training course in 2003 and the manager stated that they were trying to arrange an update for all staff. Staff were aware of the term “whistle blowing”. An opportunity was taken to view the policy on protection. This stated that the home would investigate and made no reference to the local authorities adult Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 18 protection procedures. This must be reviewed and updated to reflect current legislation. The home has copies of the South Gloucestershire’s Guidance on No Secrets and this should be used to inform the home’s policy. The manager was clear that they had a duty to report all incidents of abuse to the local authority. The residents’ questionnaires confirmed that residents felt safe in their own home. Residents spoken with stated that they were happy living in Rockleaze and with the staff support. Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 19 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. This judgement has been made using available evidence including a visit to the service. Residents are provided with a homely and comfortable place to live, which is meeting their needs and lifestyle. This would be enhanced if a risk assessment on the environment were completed on radiators and window restrictors and action taken where there is an identifiable risk. EVIDENCE: Rockleaze is a large extended double fronted Victorian property, which is positioned, in an elevated corner of the Lower Hanham Road. The home is in keeping with the local area. Furniture, fittings and décor of the rooms were of a good standard, which were clean, comfortable and created a homely environment. All residents have a single bedroom. The home has two vacant rooms and three bedrooms, which are no longer, used for residents and is now private accommodation for the manager and a training suite for staff. The manager believes that these bedrooms do not meet with the National Minimum Care standards and have been deemed too small. The manager at this present time does not wish to deregister this area. Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 20 Residents confirmed that they had a key to their bedroom door. Two residents had chosen to lock their bedroom doors and this was respected by the staff on duty. However, in the case of an emergency staff said that they could gain access. Toilets and bathrooms were all furnished to a high standard of finish, with clean baths, shower areas, modern tiling and functional flooring. All bathrooms and toilets had locks and offered privacy to residents. Communal areas and the kitchen were clean and homely. Residents were observed moving freely around their home. The home has separate laundry facilities sited to the end of the building. Again this was well organised and clean. The manager stated that he completes the majority of the repairs and décor, unless this is electrical, plumbing or involved major building works. Evidence was seen of routine electrical tests and the home’s gas certificate, which had been completed by an external contractor. The home has had an environmental health visit. There was a recommendation for the home to review the recording of the fridge temperatures and new thermometers were purchased. Handrails were seen in appropriate places, there was a stair lift but this did not access the bedrooms on the third floor. The home has two ground floor bedrooms. Evidence was provided that the home takes and acts upon the advice of professionals including the purchase of aids and adaptations. The home has two office type spaces. One of these offices is at the end of the communal lounge. Consideration should be taken to whether this detracts from the homely feel of the home and could be used more to the residents benefit. It was noted that only one of the upstairs windows had a restrictor and none of the radiators have protective covers. This must be risk assessed and where there is a potential or high-risk area appropriate action must be taken. The manager stated that the one window restrictor had been installed to minimise the risks to that individual. Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 21 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 adequate. This judgement has been made using available evidence including a visit to the service. An effective well-trained staff team, who receive regular supervision from their manager, supports residents. Less apparent was an effective recruitment process ensuring that residents are safeguarded. EVIDENCE: The home is staffed adequately to meet the care needs of the residents. There are usually three staff working in the home including the manager during the day with one staff providing night waking cover. Two nights per week there was an additional member of staff working at night in the absence of the manager who lives on site. This is commendable and it was evident that the manager was committed to meeting the individual needs of the residents without compromising their safety. There was a commitment for staff to complete their NVQ 2 in care; two staff confirmed that they were now in the process of enrolling to complete an NVQ 3 in care. Whilst there was an absence of regular team meetings staff stated that the manager is very supportive and gives clear direction on expectations. Staff had attended training in first aid, manual handling, food hygiene and health Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 22 and safety. Two recently employed staff had completed a TOPPS induction now known as the Skills for Care Induction. The manager stated that training would be arranged if resident’s needs changed or where a resident was admitted to the home and had complex care needs, for example epilepsy. It was evident from discussions that this would be completed prior to offering an individual a placement. Staff confirmed that they have regular supervisions with the manager at least every two months. Clear records were maintained. Job descriptions were in place but not viewed in full on this occasion. It was evident from talking with staff that they enjoyed working for the provider/manager and echoed his commitment to providing a “home from home” service to the individuals. Through discussions it was evident that many of the staff had worked in the home for a long time and that the team worked well together. Staff spoke with residents in a professional and respectful manner. Residents confirmed that they were treated with respect and staff listened and acted upon what was being said. Recruitment information was seen for two staff, both had been working in the home in excess of two years. It was noted that one individuals criminal record bureau check related to previous employment and another had been received 3 months after they had started working in the home. The manager stated that this would be rectified and he was planning to update all staff’s criminal record bureau checks. Whilst the provider has no legal obligation to complete this, it would be good practice. The home has equal opportunity policies in place. Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 23 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): 37,38,39,40,41,42,43 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents can be confident that the home is well managed with resident’s interests at the forefront. Rockleaze provides a safe place to live however; residents must be assured their safety in the event of a fire by being supported by competent staff. The manager needs to evaluate the service to ensure it remains a viable concern, exploring alternatives to ensure it is meeting the present trends in the care industry. EVIDENCE: Mr Jonathon Short is the registered provider and manager for the home. Mr Short has been in the care business for the last eleven years. Previously his parents ran the home. Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 24 Mr Short has recently completed an NVQ 4 in management and is now in the process of completing an NVQ 4 in care. It was evident throughout the inspection that this has been a valuable qualification and has been instrumental in updating many of the home’s systems. Staff spoken with during this inspection stated that Mr Short has an open door policy and is always available to offer support and guidance. It was evident that Mr Short is a “hands on manager”. Four residents spoken with during the site visit all commented on how well the home was managed and that they liked it at Rockleaze. Residents confirmed that the manager and the staff team were approachable and they could talk to “Jon” and he would “get thinks sorted”. The home is in the process of developing a quality assurance tool, which includes seeking the views of the residents, their relatives and the staff. In addition audits were being completed on care planning, staffing, menu planning and the environment. This is good practice and in the early stages. This will be followed up at the next inspection. The focus of health and safety was fire records. There were good records in relation to the routine testing of the fire equipment less apparent was regular fire drills (all staff must attend a fire drill once in a six month period) and fire training (three monthly for night staff and six monthly for day staff). External contractors were involved as already stated in checking electrical appliances and gas appliances. The home has a certificate of insurance clearly displayed in the hallway. Discussions were held with the provider on the long-term viability of the home. The manager stated that he was exploring a number of options and one being the conversion of the middle floor in to a self contained flat, which would have a separate entrance. This would enable an individual with learning disabilities to live independently. It was evident for the home to continue to be viable the home must fill the two vacancies and Mr Short was in consultation with the local placing authorities raising the profile of his business. This will be followed up at the next inspection. For the home to move forward the home needs to develop in order to appeal to a broader resident group. Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 25 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 2 2 2 3 3 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 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 3 3 2 X 3 3 3 3 3 2 2 Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 26 No 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 YA1 Regulation 4(1c) Requirement Ensure that information contained in the homes statement of purpose is up to date and corresponds with the details listed in Regulation 4 (1)(c) Schedule 1 and detailed in standard 1. (Outstanding since 30/10/05,31/3/06) To expand on the written terms and conditions of residency between the home and residents which must be updated to correspond with specifications required in National Minimum Standard 5 including a breakdown of the fees and what is and is not included. To update home’s policy on abuse to ensure reflects local authority guidance. A copy to be sent to the Commission for Social Care Inspection. Ensure that a risk assessment of the premises is undertaken in relation to window restrictors and radiator covers and appropriate action to taken DS0000003352.V304536.R01.S.doc Timescale for action 02/11/06 2. YA5 5(b) 02/11/06 3. YA23 13 (6) 02/11/06 4. YA24 13(4a) 02/09/06 Rockleaze Version 5.2 Page 27 where a high risk identified. 5. YA34 17 (2) Sch 4.6 The home must obtain a satisfactory POVA first and criminal record bureau check prior to offering employment to staff. Ensure all staff attend fire drills and fire training in accordance with the fire brigades recommendations. 02/08/06 6. YA42 23 (4) (d) (e) 02/09/06 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. 2. 3. Refer to Standard YA1 YA20 YA1 Good Practice Recommendations For the home to develop an assessment policy and procedure. For the home to expand on the medication policy to include the procedure in the event of an error. For the home to develop a criteria for prospective residents to enable the home to continue to be viable and meet current market trends. Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rockleaze DS0000003352.V304536.R01.S.doc Version 5.2 Page 29 - 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. 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