Inspection on 11/01/08 for Rockville House

This inspection was carried out on 11th January 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Rockville House 11/08/09

Rockville House 13/02/09

Rockville House 11/10/06

Rockville House 06/02/06

Rockville House 29/09/05

Rockville House 08/02/05

Rockville House 17/08/04

Rockville House 03/02/04

Similar services:

The Vicarage

7 Hyde Road

5 Seafield Road

Trevaylor Manor

12 Orchard Mews

Stallcombe House

Stepping Stones

Cornerstones

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 Rockville House 2a Rockville Park Plymstock Plymouth Devon PL9 7DG Lead Inspector Brendan Hannon Unannounced Inspection 11th January 2008 9:30 Rockville House DS0000003447.V352873.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 Rockville House DS0000003447.V352873.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. Rockville House DS0000003447.V352873.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rockville House Address 2a Rockville Park Plymstock Plymouth Devon PL9 7DG 01752 407130 01752 481624 sm.bailey@btopenworld.com 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) Independence South West Mr Stephen Michael Bailey Care Home 3 Category(ies) of Physical disability (3) registration, with number of places Rockville House DS0000003447.V352873.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Age 18-65yrs One Service User named elsewhere, who is under 18 years of age can reside at the home 11th October 2006 Date of last inspection Brief Description of the Service: Rockville Respite Centre is owned and managed by the registered charity Independence South West. The respite facility is purpose built on one level, and is adjacent to a day centre that is owned and managed by the same organisation. The service is registered to provide respite accommodation to a maximum of three service users who have a physical disability and who may also have a learning disability. The centre is situated in a residential area in the town of Plymstock, and is close to shops and leisure amenities. The centre has the use of two minibuses. There is a standard fee of £110 per night. Rockville House DS0000003447.V352873.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection was unannounced. Preparation for the inspection included analysis of the CSCI Annual Quality Assurance Assessment (AQAA), the last inspection report, and contacts with the home over the last 12 months. An inspection plan was developed from this information. We were in the home from 9.30am to 4.15pm. We identified three of the people that use the service and tracked their care during the inspection. The Registered Manager was spoken with at length during the inspection and we also spoke with some of the staff. We toured the building and found no significant issues of concern. An opinion on the service was sought from the Plymouth Community Learning Disability Health team, and their responses were positive. Various areas of documentation were inspected to evidence compliance with the National Minimum Standards. Documents inspected included assessments of peoples’ needs, their care plans and risk assessments. Also various records were inspected including medication administration records, health records, personnel recruitment and training records, and health and safety records. All the information gathered during the inspection was considered in the writing of this report. What the service does well: What has improved since the last inspection? A quality assurance system has been implemented. The detail of care planning and risk assessments continues to be improved. Ongoing investment in the facilities helps to make the unit a place that people can enjoy staying at as well as having their care needs met. Rockville House DS0000003447.V352873.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Rockville House DS0000003447.V352873.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 Rockville House DS0000003447.V352873.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people that use Rockville can be assured that their assessed needs will be met when they require respite care. EVIDENCE: Rockville offers each person that is considering using the service a Statement of Purpose and Service Users Guide. These documents are informative and comprehensive, having all of the elements necessary to meet this standard. However these documents are not presently in a format or language e.g. symbols, pictures etc, that people who were thinking of using the service could realistically use. Examples of the pre admission assessments that are made prior to service users staying at Rockville were seen. Physical, health, and emotional, care needs are assessed to ensure that staff are able to meet identified needs. Additional information regarding care needs is obtained from health and social care professionals, and from families. A person that is thinking of using the service would be invited for a visit. If this visit is successful, then the assessment and the manager’s recommendation to admit the person to the service, is decided upon by the Committee. Up to date contracts/statement of terms and condition for everyone that uses the service are in place and have been signed by each person or by their representatives. Rockville House DS0000003447.V352873.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The unit has a clear care planning process. This gives staff enough information to satisfactorily meet the needs of the people that use the service. Risk assessment documentation is not complete. People that use the service are encouraged to be as independent as possible during their stay at Rockville. EVIDENCE: During the inspection the documentation for four people that use the service was case tracked. Adequate care planning for respite stays was in place for each person. It was found that all those sampled had an up to date care plan on file. The manager stated that the staff were aware of the individual care needs as most people that stay for respite also use the day centre where the unit staff also work. Rockville House DS0000003447.V352873.R01.S.doc Version 5.2 Page 10 Discussion with staff evidenced that they do have a very comprehensive knowledge of individual peoples’ care needs and how these are to be met. The care plans listed individual care needs and how the staff would meet these needs. The plans also described any behaviour that may challenge the service and how this would be managed. Risk assessments were in place, and where appropriate moving and handling plans. A regular recorded ‘service users forum’ takes place in the daycentre so that people that use the respite service can meet together. At this forum choices of activities are discussed, and any other issues relating to an individuals respite stay at Rockville. Most people do not stay for more than one or two nights of respite care at a time, so involvement in the running of the centre is limited, but people are encouraged to become involved in cooking their meals, and keeping the centre clean and tidy. One person’s file did not contain an individual risk assessment, however the Manager assured us that work is in progress to produce a very detailed risk assessment for every person. Evidence of these risk assessments was seen in other service user files. Risks and choices appear appropriately balanced at Rockville, and people are encouraged to be as independent as possible during their stay. Rockville House DS0000003447.V352873.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal development is encouraged, and service users are enabled to maintain and develop their independent living skills whilst staying at the service. EVIDENCE: Management and staff said that independent living skills and independent personal care are encouraged as much as possible. As everyone that uses the service is a wheelchair user, there is a wide range of disability equipment at Rockville that supports people to attend to personal care and daily living tasks as independently as possible, such as hoists, easy access to all areas of the centre, assisted baths, and specially adapted bedrooms. A variety of activities are on offer to people while they are staying at Rockville including for example pub visits, local attractions, the cinema. There were photographs on display of people pursuing their favourite hobbies such as Rockville House DS0000003447.V352873.R01.S.doc Version 5.2 Page 12 fishing, visiting the donkey sanctuary, flying kites and shopping. The service users forum has improved the range of activities and meals on offer. There is a sensory garden and computers for people to use. A new television has been purchased for the unit and satellite channels and multi media facilities are available. The unit has the use of the centre’s several adapted vehicles. Mealtimes are flexible, and at weekends people can get up when they like. The menus showed a variety of wholesome and nutritious meals on offer. Meals taken are recorded individually for each person. The individual care needs of each person at mealtimes are recorded and are known by staff. Staff respect peoples’ privacy and knock before entering bedrooms and assisting people in the bathroom. Bedrooms and bathrooms are fitted with locks that ensure peoples’ privacy. Rockville House DS0000003447.V352873.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. 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 this service. The people that use the service can be assured that staff will treat them with respect and their personal care needs will be met whilst staying at Rockville. EVIDENCE: The care plans document peoples’ personal and health care needs. Three peoples’ care and medication was looked at in detail. A moving and handling plan is developed for each person that uses the service following discussion with them, their families and other health professionals, such as physiotherapists, if they are involved. All staff have undertaken moving and handling courses. Staff are aware of individual people’s health needs, and how they would meet them during their stay. The service has good links with the local GP surgery, and can telephone for advice or information from the District Nurse at this surgery. If a person is taken ill whilst staying at Rockville the main carer or family of the person are contacted initially. Rockville House DS0000003447.V352873.R01.S.doc Version 5.2 Page 14 Chart records are being used effectively to ensure that ongoing care is recorded accurately. These charts record for example sleep and personal care delivered. The chart records were organised and reasonably maintained. Medication is brought in by each person at the start of their respite stay, and is signed in by staff, and then counter signed. There is a medication procedure and policy in operation at the centre, and staff were familiar with this. Administration recording sheets were found to be accurate and adequately maintained. No homely remedies are kept centrally in the unit, instead people bring any non prescription homely remedies with them at the beginning of their stay. Medication is appropriately stored in a locked metal cabinet. Rockville House DS0000003447.V352873.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people that use the service can be confident that their concerns will be listened to, taken seriously and acted upon. EVIDENCE: The service has received no complaints in the last 12 months. A written complaints procedure is available in picture format and is prominently displayed in the centre. Concerns and complaints are recorded in detail along with actions taken to resolve the concern or complaint. Whistle blowing procedures are in place for staff. All staff had completed the protection of vulnerable adults training. All staff have been checked against the Protection of Vulnerable Adults (POVA) register and have a current Criminal Records Bureau (CRB) check in place. Any verbal or physical aggression from service users is understood by staff, and there are procedures in place to manage these occurrences. Service users bring their money in if they wish at the start of their respite stay. This money is signed in by staff and records are kept. Records seen were accurate and up to date. Rockville House DS0000003447.V352873.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. 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 this service. Rockville is well maintained, clean and warm. People that use the service have the specialist disability equipment they need to maximise their independence. EVIDENCE: The respite centre is attached to the side of the large detached building that accommodates the day care centre. The respite centre is on one level. There are three bedrooms that are fully accessible to people who have a physical disability. New Vellux windows have been fitted in the kitchen, shower room, and bathroom to replace the original windows fitted when the unit was built. New beds were purchased last year and in consultation with the people that use the service the bedrooms are to be redecorated and some new bedroom furniture will be purchased. New radio/CD players have been purchased for each of the bedrooms. Rockville House DS0000003447.V352873.R01.S.doc Version 5.2 Page 17 There are no key type locks on bedroom doors. Such locks would provide a facility for people staying at the unit to keep the contents of their room secure and increase their independence. There is no lockable storage space in the bedrooms. The fitting of locks to some of the bedroom furniture was discussed and would enable people to have access to a facility to store their personal belongings securely. The bathroom is a large room and is equipped with two hoists, and a Parker bath. There is also a soak away shower to maximise independence. The lounge is bright and homely and has a new television and new comfortable sofas. The large hallway is bright and open. The kitchen is fully accessible to wheelchair users and ensures maximum independence is possible. On the day of the inspection the centre was warm and clean and free from any offensive odours. The home’s laundry facilities are on the first floor of the main building and are therefore not accessible to the people using the service. There is an appropriate industrial washing machine and an industrial dryer which can meet the laundry needs of the people using the service. A yellow bag system for soiled waste is in use. Personal protective equipment is easily available to staff. At the previous inspection a person who was staying at the unit pointed out that the strips on the doorway floors bumped his wheelchair when he went over them and he thought they should be replaced. This issue was discussed with the manager and the problem was identified as structural and therefore not easily remedied. Much of the unit is quite utilitarian such as the dining area, main hallway and the bedrooms. This is due to both the wide open nature of facilities designed for wheelchair use and because of the short stay function of the unit. There was discussion about making the unit feel more domestic in nature. This perhaps could involve using pictures / posters to break up the extensive wall spaces. There was also discussion about making the entry area into the unit from the main centre more defined so that people feel that they are entering a specific unit that is different from the day centre. Rockville House DS0000003447.V352873.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people that use the service benefit from a staff team who are caring, committed and appropriately skilled and trained to meet peoples care needs. EVIDENCE: Staff rotas and discussion with staff evidenced that there are always two members of staff on duty while the unit is occupied. At night between 11pm and 7am there are two sleeping in staff. The manager stated that this staffing level is adequate to meet the needs of the people using the unit. The staff group is stable and the staff are experienced. There is minimal staff turnover. The staff that work in the respite unit also work in the day centre. Most people that use the service use the day centre during the day. As a result the staff know everyone very well, are very familiar with their care needs and have positive relationships with them. Information from the Annual Quality Assurance Assessment (AQAA) and from training records showed that basic training is being adequately maintained. Rockville House DS0000003447.V352873.R01.S.doc Version 5.2 Page 19 Basic training such as First Aid, Moving and Handling, Basic food hygiene and Health and Safety were up to date. 63 of the staff team have a National Vocational Qualification (NVQ) level 2 or level 3 in care. If all those engaged on an NVQ, complete their course then 100 of the care staff team will be qualified. Staff files evidenced that appropriate checks are carried out. Staff files contain copies of a Criminal Records Bureau (CRB) check, proof of identification, an application form and a medical fitness reference. Staff meetings take place on a regular basis and are recorded. Rockville House DS0000003447.V352873.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,41,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a clear and effective management structure operating at the service. The health, safety and welfare of the people that use the service is ensured while they are staying at the unit. EVIDENCE: The manager and staff, with the support of the Committee, continue to develop and organise the homes recording processes, policies and procedures to good effect. There is an open, positive and inclusive atmosphere in the unit. Rockville holds the Investors in People (IIP) award and has recently undergone an IIP inspection and as a result the award was renewed. A quality assurance system is generally in place. Information has been gathered regarding the service from the ‘service users forum’ and via Rockville House DS0000003447.V352873.R01.S.doc Version 5.2 Page 21 questionnaires that were sent to carers in September 2007. The information gathered was limited in scope and therefore was not collated. New materials are being obtained to support feedback from the people that use the service. Through discussion it was also felt useful if some feedback could be obtained from professionals involved with the service. Risk assessments for the building were on file and listed actions needed to minimise any potential hazards. A record of accidents is maintained and fire prevention records were found to be up to date and appropriate fire prevention equipment maintained adequately. The service has been registered with the local fire authority and has been given a Unique Reference Number (URN). The units fire evacuation and special needs are stored on the fire authority computer system to enable an immediate appropriate emergency response in the event of a fire alarm. All staff receive mandatory fire training annually. Staff have undertaken training in first aid, food hygiene, infection control and moving and handling. A member of staff undertakes a weekly health and safety check and these are recorded. Comprehensive safety checks have been carried out during the last year, as noted in the annual pre inspection questionnaire, including gas appliances, hoists, and electrical equipment. All hot water outlets have been fitted with water temperature control valves except for in the kitchen. All radiators available to people using the service have been covered to eliminate risk. These measures protect people from the danger of scalds and burns. Good management of health and safety protects the welfare of the people using the service and the staff. Rockville House DS0000003447.V352873.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 2 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 2 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X 3 3 X Rockville House DS0000003447.V352873.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3. 4. 5 Refer to Standard YA1 YA9 YA20 YA24 YA26 Good Practice Recommendations The Statement of Purpose and Service Users Guide should be produced in another format that is more accessible to the people who use Rockville. Each person should have individual comprehensive risk assessments, which should include risk assessments for all activities undertaken inside and outside Rockville. A list of side effects of the medication taken by service users when they stay at Rockville should be available to the care staff. Efforts should be made to make the unit feel more domestic. Lockable storage space should be provided in the bedrooms. Rockville House DS0000003447.V352873.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Rockville House DS0000003447.V352873.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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