Inspection on 13/09/05 for Rockny House

This inspection was carried out on 13th September 2005.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Rockny House 16/01/07

Rockny House 16/03/06

Rockny House 22/03/05

Rockny House 01/07/04

Rockny House 30/01/04

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Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

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10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Rockny House 25 Birmingham Road Kidderminster Worcestershire DY10 2BX Lead Inspector Rachel McGorman Unannounced 13 September 2005 10:00 hours 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 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 Stationary 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. Rockny House E52 S44977 Rockny House V248598 130905.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Rockny House Address 25 Birmingham Road, Kidderminster, Worcestershire DY10 1BX Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01562 864067 Mrs Anna Giannini Caterina Giannini Caterina Giannini Care home 10 Category(ies) of LD Learning disability (10) registration, with number LD(E) Learning disability over 65 (2) of places Rockny House E52 S44977 Rockny House V248598 130905.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The following conditions of registration apply in addition to those mentioned on the previous page: The home may also accommodate people with an associated physical disabilty. The home may also accommodate a maximum of two people with an associated mental disorder Date of last inspection 22 March 2005 Brief Description of the Service: Rockny House is registered to provide residential care for up to 10 adults who have a learning disability. Two of the service users are over 65 years of age, although they remain active. The premises is a large, detached, Victorian house, which has been extended and upgraded to provide a high standard of accommodation. Situated in a residential area, it is within walking distance of Kidderminster town centre, and is also on a bus route to the town. The stated aim of the home is to provide 24 hour support for service users, who are encouraged to be as independent as possible and achieve their maximum potential. Mrs Anna Giannini & her daughter Ms Caterina Giannini are the registered providers, and Caterina is the registered care manager. Rockny House E52 S44977 Rockny House V248598 130905.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of this routine, unannounced inspection was to check on previous requirements and recommendations, and to monitor the care provision at the home in relation to the stated aims and objectives. The inspection took approximately 3 hours. Time was spent with service users, and talking to staff, to ascertain their views on living and working at the home, and with the care manager, checking documentation and discussing the organisational arrangements at the home. Several areas of the home were inspected, including some bedrooms, bathing and toilet facilities, and the gardens. Documentation was seen, including the service user care plans and Health Action Plans, staff files, the accident books, the fire log book, and the records kept in respect of the maintenance of equipment and safe working practices. What the service does well: Rockny House is a happy home, and there is evidence of mutual respect and consideration amongst both service users and staff, which is also extended to visitors. A warm welcome is given, and the atmosphere throughout the home is calm and relaxed. The commitment of the management and staff to the provision of person centred care is commendable. ‘We focus on the clients and everything else follows’, is how it is described. Residents are involved in making decisions about their lives, both within and outside the home, and their independence is promoted at all times, and supported appropriately with risk assessment. Relevant information about the home, and what can be provided, is available to service users, and their family, and is produced in an appropriate format. ‘The food is great’, and ‘I like living here’, were two of the many comments made by service users. Rockny House E52 S44977 Rockny House V248598 130905.doc Version 1.40 Page 6 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. Rockny House E52 S44977 Rockny House V248598 130905.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Rockny House E52 S44977 Rockny House V248598 130905.doc Version 1.40 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 standard(s) 1,2,4 & 5 The information provided by the home ensures that service users and their families are able to make an informed choice about their future care needs. A detailed assessment is undertaken, and all proposed admissions to the home are planned very thoroughly, over several weeks, to ensure an appropriate decision is made, both by the home and the service user. Rockny House E52 S44977 Rockny House V248598 130905.doc Version 1.40 Page 9 EVIDENCE: A statement of purpose and a service users guide have been produced, and are available in a suitable format for service users. A copy of the last inspection report was displayed in the front hall. The Care Manager is able to demonstrate an awareness of the importance of the initial assessment, prior to the admission of a service user, although there have been no recent changes in the resident group at Rockny House. An extensive assessment is made following the initial referral, and the introduction to the home includes tea visits, overnight stays and detailed consultation with all the relevant people. A statement of the terms and conditions of residence is provided for each service user, and a contract is also produced by the Social Services Department. Rockny House E52 S44977 Rockny House V248598 130905.doc Version 1.40 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 standard(s) 6,8,9 & 10 The service users plan of care is based on the initial assessment, which clearly identifies their assessed needs, and how these will be met. Service users at Rockny House are encouraged to achieve as much independence as possible, and are supported in making choices in all areas of their lives. Risk management strategies enable a responsible approach to the risks associated with the various activities of daily living. Rockny House E52 S44977 Rockny House V248598 130905.doc Version 1.40 Page 11 EVIDENCE: A plan of care, using the Standex system, has been developed for each service user, with their involvement, and these are reviewed regularly. The frequency is determined by the needs of the individual service user, although they are updated at least every month. A memory folder has been developed for a service user whose short-term memory is becoming increasingly limited. A record is maintained of immediate family and friends, and other contacts made, or places visited. Photographs are used as a constant reminder of each person and their relationship, and the various holidays that have been taken, or places of interest visited. The involvement of service users in making decisions about their daily lives, is clearly evident, and was confirmed during conversations with both residents and staff. Monthly residents meetings are held, which are recorded, and appropriate action is then taken. Risk assessments for each service user are included in their individual plan of care, and cover all areas of their lives. The home has a policy on confidentiality, which is reviewed regularly, and is explained to residents, and understood by staff. A copy has been circulated to the relevant people. Rockny House E52 S44977 Rockny House V248598 130905.doc Version 1.40 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 standard(s) 11,12,13,16,& 17 Rockny House is run on the basis of mutual consideration, and the positive relationships between staff and service users demonstrate their obvious respect for each other. The opportunities made available to service users enable them to live as fulfilling a life as possible. The well-documented views of service users are central to the delivery of the high standard of care that is provided at the home. The food is enjoyed by service users, and they are able to choose from a selection of nutritious and well-balanced meals. Rockny House E52 S44977 Rockny House V248598 130905.doc Version 1.40 Page 13 EVIDENCE: A policy on personal development is implemented with all service users, and independence is promoted depending on each individual’s assessed ability. Service users are constantly encouraged and supported by staff to be as independent as possible, to achieve individual goals, and to develop and maintain various life skills, by helping with food preparation, washing up and doing general household chores. Service users are assisted and encouraged to be involved in various activities, which include day placements, voluntary work, and college courses at Kidderminster and Stourbridge Colleges. Several residents confirmed how much they enjoy going to college, and various items of pottery and pictures were proudly presented to demonstrate their work. Varied activities are made available both within and outside the Home, for individuals and/or group participation. They include shopping, knitting, doing jigsaw puzzles, swimming, playing skittles, bingo, board games or cards, going to the pub, or going out for a meal, attending church, train spotting, browsing around markets or visiting family and friends. The individual wishes of service users are considered and decisions not to be involved are respected and recorded. Two service users are over retirement age, and will not be looking for employment. Concerns are being expressed in regard to a day placement where three service users have dropped out, and two others have indicated they are not happy. The reasons are to be further explored by the care manager. There was evidence, during conversations with service users, of the mutual respect and consideration amongst the group, which created the positive and stimulating environment that everyone appeared to be enjoying. The home is able to cater for individual dietary needs, and drinks and snacks are available throughout the day, with some service users making their own. The main meal of the day is usually taken in the evening, although meal times are dependant on the movements of service users, and at weekends there is a much more relaxed approach. Several service users said how much they enjoyed the food. Rockny House E52 S44977 Rockny House V248598 130905.doc Version 1.40 Page 14 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 standard(s) 18,19 & 20 Support and encouragement is provided to each service user in order to promote their independence. The health of each service user is consistently monitored, to ensure that their individual personal and healthcare needs are appropriately met. Arrangements for the safe administration of medication are in place at the home. Rockny House E52 S44977 Rockny House V248598 130905.doc Version 1.40 Page 15 EVIDENCE: The personal care needs of service users are recorded in the individual plan of care. The majority of service users need only prompting or minimal supervision with their personal care, but for those needing more assistance, this is provided discreetly and in private. Appropriate advice and guidance on health care matters is provided to service users, and a well person check is undertaken every 3 years. When service users are unwell, appropriate interventions are provided by staff, who are able to give the required support. A Health Action Plan has been produced for each service user, and this is taken whenever they attend a medical appointment. A satisfactory medication policy is in place, and appropriate procedures are followed by staff at the home. The Nomad System for the administration of medication is in place at the home, and the Medication Administration Record charts are completed to a good standard. Rockny House E52 S44977 Rockny House V248598 130905.doc Version 1.40 Page 16 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 standard(s) 22 & 23 A satisfactory complaints procedure is followed at the home, and service users are encouraged and enabled to express their views and opinions. The management and staff understand the issues relating to abuse, which ensures the protection of service users, although the need for further training is identified. EVIDENCE: A complaints procedure has been developed in a suitable format for service users, and a record is maintained of comments, compliments and complaints, although there has been no recent complaint made to the management. A suggestion box has been produced by a service user, and everyone is encouraged to make use of it. Policies and procedures for protecting service users have been produced, and have been reviewed by the manager recently. Service users have all been encouraged to become more independent with handling their own financial affairs, and an individual bank account has been opened. The home is only involved with the personal monies of one service user, and a suitable record is maintained. Training for staff on the Protection of Vulnerable Adults (POVA), remains outstanding, although a module is included in the NVQ Level 2 in Care training. Rockny House E52 S44977 Rockny House V248598 130905.doc Version 1.40 Page 17 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 standard(s) 24,25,27,28 & 30 The premises is maintained to a high standard, and is suitable for its purpose, being safe, comfortable, and warm. The décor and furnishings are in good condition, and the standard of cleanliness is excellent, providing a homely environment for residents. The communal and individual facilities have been designed to meet the needs of service users and to enhance their quality of life. Rockny House E52 S44977 Rockny House V248598 130905.doc Version 1.40 Page 18 EVIDENCE: Rockny House is a large, imposing, Victorian style property, which has been upgraded, and is being maintained to a high standard. The house has been completely redecorated, during the last 2 years and new hot water and central heating systems installed. In addition a new laundry has been developed recently, where the office was previously located, and this has further improved facilities at the home. The office has been transferred to the staff sleeping-in room, and consideration is now being given to the further development of this part of the home, to create additional communal space for service users and dedicated facilities for staff. There are a total of 8 single bedrooms and a double room, which two service users have made a positive choice to share. Three of the single rooms have en suite facilities, and the possibility of creating additional en suite facilities is being considered. Each bedroom is tastefully decorated and furnished to a high standard, and reflects the individuality of the service users, who are each encouraged to personalise their rooms. The communal areas of the home include a good sized lounge/dining room for the use of service users. There is also a large garden to the rear of the property, with a patio and appropriate furniture, a lawned area and a summer house, which is very popular with some service users during the summer months, as it gives them additional space. The home follows the Worcestershire Communicable Diseases and Infection Control Guidelines. A high standard of cleanliness is evident throughout the home. Following a recent visit from the Environmental Health Officer, some minimal improvements were recommended. These included a rack for chopping board storage and a flymesh for the kitchen door, and these have since been provided. Rockny House E52 S44977 Rockny House V248598 130905.doc Version 1.40 Page 19 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35 & 36 There is an experienced staff team at the home, who have skills relative to the work they are doing, which ensures the effective delivery of care. The obvious commitment of staff and management ensures that appropriate support is given to individual service users. Recruitment and selection procedures are detailed and thorough, and help to ensure the protection of residents. Training is provided, but the provision of additional care related courses will enable staff to be more competent in their work. The supervision provided to staff, enables a clear understanding of their role and responsibilities, and ensures that appropriate standards of service delivery are maintained. Rockny House E52 S44977 Rockny House V248598 130905.doc Version 1.40 Page 20 EVIDENCE: Staffing arrangements at the home are satisfactory. Each member of staff is provided with a job description and a contract of employment, and is made aware of their role and responsibilities. A staff handbook is in place, which details the expectations on staff in regard to the appropriate provision of care. The Code of Conduct and Practice produced by the General Social Care Council has been provided for staff. The rotas indicate that a minimum of two staff are on duty at all times when service users are at home. Regular staff meetings are held with minutes kept. Advice and guidance is sought from Peninsular in respect of any issues relating to the management of staff. The staff records confirmed that recruitment practices at Rockny House are satisfactory, with two references being sought and previous employment history explored, prior to an appointment being made. Criminal Records Bureau checks are also undertaken. Training is provided for staff at the home, although further development is needed specifically in relation to the more specialised areas of care related training, and the Learning Disability Award Framework (LDAF). The National Vocational Qualification(NVQ) Level 2 has been achieved by 2 members of staff, and 1 person has NVQ Level 3. A further 2 staff are commencing Level 2 training this month. The formal supervision of staff is now well established, and regular sessions are organised by the manager every 2 months. Appropriate records are maintained. Informal supervision is also provided in relation to the day-to-day practices within the home. Rockny House E52 S44977 Rockny House V248598 130905.doc Version 1.40 Page 21 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39 & 42 The Registered Manager is very experienced, and residents and staff benefit from living in a well run home. The individuality with which the care of each service user is delivered produces a very positive outcome for all concerned. The quality assurance system needs further developing to ensure that the views of service users and other relevant people are sought and responded to in an appropriate manner. The health, safety and welfare of service users and staff is promoted, and procedures are in place to ensure they are protected in regard to all safe working practices. Rockny House E52 S44977 Rockny House V248598 130905.doc Version 1.40 Page 22 EVIDENCE: The Care Manager Ms Katerina Gianini has completed the Registered Manager’s Award in both management and care, and is also an NVQ Assessor. She has a lifetime of experience in living with, caring for and supporting service users, having been brought up in her parents’ care home. For a brief period she ran an Adult Placement home, in her own family home. The manager seeks the advice of other professionals at an early stage if a problem arises. Since registration in September 2003, she had demonstrated her ability to manage the home, having coped with various unexpected, difficult issues, and at the same time having maintained a settled environment for service users. The Mulberry System for measuring the home’s success in achieving the stated aims and objectives, and fulfilling the statement of purpose of the home, is being introduced, but is not yet fully operational. A questionnaire has been developed, but the results now need to be audited and published annually, with a copy submitted to the Commission. The health and safety of service users is promoted and protected at the home. A satisfactory health and safety policy and procedure has been developed. Risk assessments in respect of all safe working practices have been completed and the Care Manager has a working knowledge of the relevant legislation. Annual servicing contracts are in place for all the utilities. Rockny House E52 S44977 Rockny House V248598 130905.doc Version 1.40 Page 23 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 x 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Rockny House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 2 x x 3 x E52 S44977 Rockny House V248598 130905.doc Version 1.40 Page 24 YES 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 24 Regulation 23 Requirement Dedicated facilities must be provided for staff who undertake sleeping-in duties at the home (Timescale of 15/09/05 not met) Timescale for action 31/03/06 2. 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. 4. Refer to Standard 23 24 39 Good Practice Recommendations Consideration should be given to the provision of further training for staff on the Protection of Vulnerable Adults from abuse A review of the premises should be undertaken and proposals submitted to the Commission for consideration Further development of the quality assurance system should be undertaken Rockny House E52 S44977 Rockny House V248598 130905.doc Version 1.40 Page 25 Commission for Social Care Inspection The Coach House, John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Rockny House E52 S44977 Rockny House V248598 130905.doc Version 1.40 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!