Inspection on 21/04/09 for Rockleaze

This inspection was carried out on 21st April 2009.

CQC found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rockleaze 06/05/08

Rockleaze 03/07/07

Rockleaze 01/08/06

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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Rockleaze 56 Lower Hanham Road Kingswood South Glos BS15 8QP     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Paula Cordell     Date: 2 1 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Rockleaze 56 Lower Hanham Road Kingswood South Glos BS15 8QP 01179673395 01179619515 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Jonathan Short care home 10 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 10 The maximum number of service users who can be accommodated is 10. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) Date of last inspection Brief description of the care home Rockleaze is registered with the Commission for Social Care to support 10 people with a learning disability. Mr Jonathon Short privately owns the home and is the registered manager. 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 the individuals living in the home. 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. Local shopping and other amenities in Hanham are within walking distance and the Kingswood shopping area is a short drive away and enjoyed by people who use the service. 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 Care Homes for Adults (18-65 years) Page 4 of 31 Brief description of the care home or larger groups to go on trips from the home. The home is staffed 24 hours a day with the provider/manager living at the premises. The service aims to provide a comfortable place to live and for the individuals to have opportunities to lead the life they chose as independently as possible. The fees at the time of publishing this report were from 462 to 662 per week. Care Homes for Adults (18-65 years) Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced visit as part of the key inspection process. The purpose of the visit was to review the requirements and the recommendations from the visit in May 2008 and to monitor the quality of the service provided to the people living in Rockleaze. There have been no visits to the service since May 2008. The Care Quality Commission has not received any complaints in the last 12 months. The visit was planned using the surveys received from people who use the service, staff and visiting professionals along with correspondence received between may 2008 and this visit. The provider completed an Annual Quality Assurance Assessment this Care Homes for Adults (18-65 years) Page 6 of 31 provided evidence of where the service is now, what improvements have been proposed for the next twelve months and some statistical data. This information assisted in assessing the service. The inspection methods used during this visit included record checks, case tracking, observations and discussions with the people who use the service, the staff and the manager. The visit was conducted over a period of 6.5 hours. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 31 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals can be confident that there is sufficient information available to them to make a decision on whether to move to the home and that an assessment is completed ensuring the home is suitable. Evidence: The home has a statement of purpose and a service user guide. These met with the Care Homes Regulations and the National Minimum Standards. All completed surveys from people who use the service confirmed that they had information about the home and that they had been involved in the decision process. The home has an established group of people living in the home. Some of the people have lived in the home for twenty years. Since the last visit one person has recently moved to a supported living service and one new person has recently moved to the home. The individual said they had settled in well. It was evident that a comprehensive assessment had been completed with the manager completing an Care Homes for Adults (18-65 years) Page 10 of 31 Evidence: assessment to ensure that the home was suitable for the individual. In addition the home had obtained the placing authoritys assessment and care plan and information from the individuals previous placement. Care Homes for Adults (18-65 years) Page 11 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals care needs are being met and they are involved in decisions about how they want to live. The home is in the process of developing a new care planning system which is more person centred, however some of the documentation that is in place has not been reviewed which could lead to confusion for staff and inconsistent approach. Evidence: Three peoples care needs were case tracked as a means to determine the quality of the care provided to the individuals living at Rockleaze. Care plans detailed the support needs of the individuals focusing on life skills and personal care. It was evident for two of the individuals that these had been based on the assessment and care plan drawn up by the placing authority and the homes assessment process. One person had a copy of the placing authority assessment and care plan and but no care plan drawn up by the home to demonstrate how the staff were supporting the individual with their personal, health, emotional and psychological wellbeing. The lack of documentation Care Homes for Adults (18-65 years) Page 12 of 31 Evidence: and the knowledge of staff in respect of the individuals health care needs could potentially put the individual at risk. However it was evident from the social workers review that the person had settled in well and has made significant progress. The individual said that they liked living in the home and the staff support. The manager/provider said that the reason the person did not have a formal care plan was that the system for recording was being changed to a more person centred approach. The manager has been attending Person Centred Planning workshops with the local Council to assist with the development of a new system. However this person has been in the home for six months with no clear documentation in place. The manager and the staff said in their defense that there is good communication and they continually discuss what we are doing with all the individuals. From looking at the reviews conducted for individuals it was evident that these were happening on an annual basis involving the individual, staff and other professionals where relevant. Less apparent was a six monthly review in accordance with the National Minimum Standards or where needs change significantly then this would be more frequent. It was noted that some of the information had changed for individuals for example changes in day services, or the death of a next of kin these require amending to ensure that it reflects the currents needs of the person. Individuals spoken with said they liked living in the home and the staff support. The home operates a key worker system where by each person has a nominated person to support them with the purchasing of clothes, supporting the individual to write letters, attending reviews and supporting the person to go out on a regular basis. Risk assessments are in place and cover activities both in the home and the community. It was noted that these were similar in content for all the individuals. From reading daily care records it was noted that two of the individuals could be verbally aggressive to staff and other service users. There was no documentation detailing the triggers, the support or how staff should support the individuals. From reading daily records and speaking with staff it was evident that these were managed in a positive manner. Staff said that it was part of the settling in process for one of the individuals and the home was liaising with the placing authority and appropriate professionals. From talking with staff, the manager and the individuals it is evident that they are more involved in the running of the home. The home organises two monthly meetings with the individuals seeking their views on activities, holidays, menu planning and the decor of the home. Minutes were maintained of the meetings. Individuals said they could make hot drinks and snacks when they were wanted. It was evident that all the Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: individuals were consulted about activities that they want to do. The manager said that as part of the new care planning system individuals will be involved and their views sought in what is written and how. Care Homes for Adults (18-65 years) Page 14 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are encouraged to lead active lifestyles both in the home and the community, which includes maintaining contact with friends and family. A healthy diet is made available to individuals. Evidence: Individuals spoken with during this visit indicated that there had been an increase in activities offered to them. Individuals said that they are supported to go out most days with staff either shopping or to the local coffee shop. The manager said that there was more one to one opportunities for people to go out in the afternoon due to an increase of staffing. On the day of the visit it was noted there were five staff on duty in the afternoon. Individuals expressed a high satisfaction in what they did both in the home and the Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: local community. Surveys from all the individuals said they could do what they want during the day, in the evenings and at the weekends. Some of the individuals have structured day care which is tailored to the individual, including attendance at day centres, college courses and activities organised by the home. The home has recently been given additional funds to provide meaningful activities for three of the individuals as the resource and activity centre where they attended had closed. It was evident the home has discussed this with the individuals and drawn up a plan of activities throughout the week based on the interests of the person. Some of the individuals have retired and enjoy a more relaxed and less structured plan of activities. The home has recently employed an activity coordinator to assist with the planning of the activities with the individuals. Staff stated that activities are organised in the home including arts and crafts, games evenings and fortnightly entertainers visit the home. Individuals confirmed this in conversations. Individuals are supported to attend the local church if they wish. From conversations with individuals it was evident that it was an important aspect of their week. The statement of purpose stated that individuals would be supported to attend a church of their faith should their wish. From talking with staff and the provider it was evident that they were aware of the diverse needs of the people living in the home and that each person was an individual with different interests and needs. Staff had a good understanding of equal opportunities and the rights of people with a learning disability. Individuals confirmed that they were planning a holiday and options were being explored. The manager said that this year individuals would be supported in smaller groups as previously the whole house had gone on holiday together. The manager said that this would enable individuals to have more choice. The home has a mini bus to enable the individuals to access places of interest both locally and further a field. Individuals confirmed that trips are organised to places of interest including the seaside and places further a field. Individuals confirmed that they were supported to visit friends and family and had access to a telephone to enable them to maintain contact. This was confirmed in care records. Individuals have a varied and nutritious diet. From discussions it was evident that the Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: individuals were happy with the catering arrangements. There was a clear record of the food that was available and it was evident that individuals preferences are met with alternatives given to the planned menu. Staff said that the aim of the home is to offer a healthy diet which includes plenty of fresh vegetables and fruit. This was clearly documented. Care Homes for Adults (18-65 years) Page 17 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In the main individuals personal and health care needs are being met. However, this could be compromised for one individual, where staff do not have sufficient information to support individuals with specific health care needs and not following through the advice of a professional. Evidence: Each person had clear information relating to their personal care needs and the support that is required. The home maintains a daily record of the care that is given and who supported them. Systems for monitoring an individuals wellbeing were in place and concerns about health were quickly addressed. However, it was noted that one person had been advised to see the GP last August by the psychiatrist requesting a prescription for a particular medication and a scan. This had not been followed up by the home. The manager said that they expected the psychiatrist to follow this up with the GP. The psychiatrist had reviewed this person had not noted that this had not been addressed. Although it was noted that the condition was still mentioned in correspondence relating Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: to follow up visits. The manager has agreed to follow this up as a matter of priority. Individuals are supported to attend regular health care check ups with the GP, dentist, optician and chiropodist. Clear records were maintained in respect of the visit and the outcome. It was noted that the most recent person to move to the home had a some health care needs. There was no care plan to guide staff and in addition staff were unaware of the specific need or any action that they need to take to reduce the risks. However, what was clear from reading the social work review was that the persons general wellbeing had improved due to a good diet and the support from the staff team in relation to personal care. Good practice would be for the home to have some information relating to the condition so that they can be better informed to enable them to monitor any changes enabling them to liaise with the appropriate professional. Staff have attended training in first aid and manual handling. The home maintains a record of accidents and incidents. These are kept under review and detail the action taken to address the incident and further prevention. From conversations with the individuals it was evident that they liked the staff that supported them. There was evidently good communication between the team in planning the day to day routine in the form of a handover. The home has robust procedures and practices on the administration of medication, including medication training with the local pharmacist. The manager said that he regularly reviews staff competence in respect of the administration of medication both formally and informally. The competence checklist was kept in staff files. Clear Medication records were maintained of medication entering the home, administration and disposal. It was noted that all topical creams and liquid medication is returned after one month. Consideration should be taken to review this practice as this could be deemed as wasteful. Care Homes for Adults (18-65 years) Page 19 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals can be confident that their views are sought on the service being provided and that concerns are addressed. Individuals can be confident that the home would respond appropriately to allegations of abuse. Evidence: The home has a complaint procedure. This met with the National Minimum Standards. Individuals spoken with said they knew how to complain and would speak to the owner or staff on duty if they were unhappy. This was confirmed in the surveys from individuals. The home maintains a record of complaints. There has been one complaint in the last twelve months it was evident that this had been discussed with the individuals concerned with a satisfactory outcome. Individuals spoken with said they felt safe and well supported living at Rockleaze. The completed surveys received prior to the visit said the staff treat them with respect and listen and act upon what is being said with seven saying always and one person saying sometimes. This was further evidenced in conversations with five of the individuals during the visit. It was evident that the provider spent a considerable time chatting with the individuals about the care their receive and ensuring that they are happy. Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: Training records seen provided evidence that staff have attended training in safeguarding and this forms part of the homes induction. Staff spoken with said they had watched a video on abuse and attend a training course with the local council. The provider in response to a requirement from the last visit has attended both an alerters course and a course for managers on safeguarding. It was evident from conversations that staff were aware of the procedures relating to safeguarding and what constitutes abuse. There were records of individual financial transactions and receipts. People who live in the home had a financial care plan, which detailed how the individual liked their money and when. All the individuals had some degree of responsibility for their finances and their own bank account. This is good practice. The home has responded to a recommendation that individuals consistently where able are encouraged to sign for all financial transactions. Good systems are in place to safeguard money belonging to the individuals. In addition individuals have an inventory of their belongings. Care Homes for Adults (18-65 years) Page 21 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Rockleaze provides individuals with a comfortable, clean and homely environment that is meeting their needs. 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 decor of the home were of a good standard, which were clean and comfortable and created a homely environment. All individuals have a single bedroom. There is one vacant room. Bedrooms were not viewed on this occasion. Individuals confirmed that they had a key to their bedroom door. One individual said they had been supported to personalise their bedroom with pictures and posters. Individuals have a lockable storage in their bedrooms for items they want to keep safe. Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: Communal areas and the kitchen were clean and homely. Cleaning schedules were in place. Individuals are supported to assist with the cleaning of their bedrooms. Handrails were seen throughout the building and a stair lift assists individuals to the first but not the second floor of the building. Evidence was provided that the home takes and acts upon the advice of professionals including the purchase of aids and adaptations. The home has separate laundry facilities sited away from the kitchen area. Staff have completed training in infection control as evidenced in training files and through the completed annual quality assurance assessment completed by the provider. The annual quality assurance assessment identified an area for improvement as the garden. The provider said that this is to be landscaped and decked. It was evident that individuals had been consulted in this, from conversations and the minutes of the monthly house meetings. Care Homes for Adults (18-65 years) Page 23 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient and competent staff support the individuals living in the home. Good support mechanisms are place for staff ensuring a consistent and open approach is adopted. Evidence: Rockleaze is sufficiently staffed in accordance with the statement of purpose taking into account the needs of the people living in the home. There are three staff working in the morning, two staff working in the evening, with one waking and one sleep in member of staff covering the home at night. The provider/manager lives on the premises and covers five of the seven sleep ins. Two nights a week there are two waking nights. In the afternoon there are five members of staff and this enables individuals to go out either in small groups or on a one to one basis. THis enables individuals to be supported to make choices on how they spend their time. The manager said that staffing is regularly reviewed to ensure that it meets the needs of the individuals and recently an activity coordinator has been appointed. Staff described a good cohesive team with good support mechanisms in place including Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: regular supervisions, meetings and management support. Staff described clearly their roles in supporting the individuals living in the home. This was further evidenced in completed staff surveys sent prior to the visit and the records held in the home. Recruitment information was viewed for three staff. All relevant documentation was in place including a completed application, two references, a criminal record bureau check and a copy of the interview notes. Gaps in employment were explored and documented. Once staff commence in employment an induction is completed. This was confirmed in records and in discussions with the staff during the visit. Newly appointed staff link with more experienced staff as part of the induction acting as a mentor. Staff confirmed in the surveys that they have sufficient information to enable them to fulfill their roles and support the individuals. The home presently has 8 staff working in the home with a National Vocational Award at level 2. The home has exceeded the target to ensure that 50 of the workforce have an NVQ. The manager said that he has been concentrating on this area which has meant that progress for staff completing the Learning Disability Qualification has been slow. There was a good rolling programme of statutory training which was being closely monitored by the manager. Other training was in place including supporting people with a learning disability, the mental capacity act, supporting people with dementia and infection control. The home accesses training from the local council. Further training was planned including health and safety and the Deprivation of Liberty. Each member of staff had a professional development file which included training, supervision records and an annual appraisal of their performance. The home has good communication systems in place including daily handovers, two monthly one to one supervisions and two monthly team meetings. This was confirmed in records held in the home. Staff described good support networks and commitment to working in the home and for the provider/manager. Care Homes for Adults (18-65 years) Page 25 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals benefit from a well managed service that takes into account their views. Individuals can be assured that they live in a safe environment with good procedures in relation to health and safety being in place. Evidence: Mr Jonathon Short is the registered manager and the owner of Rockleaze. Mr Short has completed his Registered Managers Award. It was evident from conversations with Mr Short and the staff team that there was a commitment to develop the service to the benefit of the people living in the home. Staff and people who use the service spoke very highly of the management of the home. Staff said that Mr Short has an open door approach to the management of the home. From talking with staff and the people who live in the home it is evident that Mr Short is very much part of the day to day running of the home and has a hands on approach in supporting the individuals. Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: The home has recently implemented a quality assurance tool with audits being completed on a weekly, monthly and three monthly basis. This included audits on the environment, water temperatures, menu planning, checking the fire system, training, care planning and medication to name a few. The views of the individuals are sought regularly through house meetings. The manager said that they were looking to develop a questionnaire for relatives and individuals using the service at the last visit however this was not explored during this visit. The manager forwarded the annual quality assurance when requested. This documented where the home is now, what improvements are planned over the next twelve months and some statistical data. It was evident that there was a plan to further develop the home to the benefit of the people living at Rockleaze. Good systems were in place to ensure that the home was a safe place to live and work. The gas and electric appliances were routinely being checked including checking the stair lift by external contractors. In addition there was information relating to the control of substances hazardous to health and risk assessments relating to tasks and the environment. This was being kept under review. Fire Records clearly evidenced staff training in fire, participation in fire drills and routine checks on the fire fighting equipment. A fire risk assessment was in place. Care Homes for Adults (18-65 years) Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 15 Ensure there is a comprehensive care plan detailing the needs of the new person to move to the home This will ensure that there is an open and transparent service being provided and give staff clear guidance. 21/05/2009 2 6 15 Keep care plans under review. This will ensure that individuals changing needs are being met. 21/05/2009 3 9 12 Where individuals can be 21/05/2009 challenging ensure there is a clear plan of care to support them detailing the triggers and the support the individual requires. To enable the home to monitor the effectiveness of the approach. Care Homes for Adults (18-65 years) Page 29 of 31 4 19 12 Ensure that individuals 22/05/2009 health care needs are clearly documented. Ensuring that staff have an increased awareness of the individual. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 6 19 Review care plans at least every six months or more frequent where needs change. Information relating to specific medical conditions should be made available to staff working in the home. Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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