Inspection on 11/10/06 for Rockville House

This inspection was carried out on 11th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 11/01/08

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 09/07/2008.

CARE HOME ADULTS 18-65 Rockville House 2a Rockville Park Plymstock Plymouth Devon PL9 7DG Lead Inspector Tina Maddison Unannounced Inspection 11th October 2006 10:00 Rockville House DS0000003447.V311591.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.V311591.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.V311591.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.V311591.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 6th February 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. Rockville House DS0000003447.V311591.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day. A variety of records and documents were examined, and discussion took place with the Registered Manager, two members of staff and two service users. A tour of the building was undertaken and all bedrooms were seen. Five service users surveys were sent out and three were received back, and three relative surveys were returned. A pre inspection questionnaire was returned to the Inspector by the Registered manager prior to the inspection. What the service does well: What has improved since the last inspection? All service users now have contracts in place and copies of their terms and conditions. Money taken in to Rockville by the service users is now recorded when taken in and amounts are recorded that are taken home. The kitchen has Rockville House DS0000003447.V311591.R01.S.doc Version 5.2 Page 6 benefited from new units that are fully accessible to physically disabled service users, and two new hoists have been bought. New beds have been purchased and areas of the service have been re decorated. A quality assurance system has been implemented and questionnaires sent out and service users views about the service have been collected. Risk assessments have been undertaken on activities in the home and this is an ongoing process. Monthly monitoring visits have been undertaken by a physically disabled person and these are recorded. 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.V311591.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.V311591.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): 1,2,3,4,5. Quality in this outcome area is good because service users can be assured that Rockville will meet their assessed needs when they require respite care at this service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Rockville offers prospective service users a statement of purpose and service users guide that is informative and comprehensive and contains all of the elements necessary to meet this standard. Consideration should be given to producing this document in a format that is accessible to the people who use Rockville. The Manager was able to produce the pre admission documents and assessments that are made prior to service users staying at Rockville. Physical, health, emotional and spiritual care needs are assessed by the Manager to ensure that staff are able to meet these needs at Rockville. Additional information regarding care needs is obtained from health and social care professionals, and from families. The prospective service user is then invited for a tea visit. If this visit is successful, and the service user thinks that they would like to use the service then the outcome of the assessment and the Managers recommendation goes to the Committee that oversees the service, and they will approve or not approve the application. Rockville House DS0000003447.V311591.R01.S.doc Version 5.2 Page 9 The need to have up to date contracts/statement of terms and condition in place for all service users was a recommendation from the previous inspection. These documents are now in place and have been signed by the service users or their representatives. Rockville House DS0000003447.V311591.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9. Quality in this outcome area is adequate because risk assessment and care planning documentation are not complete. Service users are encouraged to be as independent as possible during their stay at Rockville. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection five service users of the service were case tracked. Of these five service users it was found that three did not have up to date care plans on file. The Manager stated that these were being completed by staff, and they were aware of the individual care needs as most of the service users use the day centre that is attached to the respite centre, and the staff work in there as well, and know the service users very well, and have the information in order to meet their care needs. Discussion with staff evidenced that they do have a very comprehensive knowledge of individual service users care needs Rockville House DS0000003447.V311591.R01.S.doc Version 5.2 Page 11 and how these were to be met. On the other two completed care plans, there was no evidence that they had been recently reviewed. The care plans that were on file did list individual care needs and how the staff would meet these. 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 manual handling plans. Service users spoken with during the inspection confirmed that their opinions were taken into account when choosing activities to do when staying at Rockville, and which bedroom they preferred. The Manager hosts a regular recorded service users forum, where choices of activities are discussed, and any other issues relating to an individuals stay at Rockville. Most service users do not stay for more than one or two nights respite care at a time, so involvement in the running of the centre is limited, but service users are encouraged to become involved in the cooking of meals, and keeping the centre clean and tidy. Two of the service user files examined did not contain an individual risk assessment, however the Manager assured the Inspector that work is in progress by the staff to produce a very detailed risk assessment for each individual service user. Evidence of these risk assessments was seen in other service user files. Risks and choices appear appropriately balanced at Rockville, and the service users are encouraged to be as independent as possible during their stay. Rockville House DS0000003447.V311591.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,14,16,17. Quality in this outcome area is good because personal development is encouraged, and service users are enabled to maintain and develop their independent living skills whilst staying at the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users spoken with said that they can be as independent as possible at Rockville. Staff said that independent living skills and independent personal care are encouraged as much as possible. As all of the service users are wheelchair users, there is a wide range of disability equipment at Rockville that supports service users to attend to personal care and 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 service users whilst they are staying at Rockville including pub visits, local attractions, cinema, and there was picture evidence of service users pursuing their favourite hobbies such as fishing, visiting the donkey sanctuary, fly fishing, flying kites and shopping. There is a Rockville House DS0000003447.V311591.R01.S.doc Version 5.2 Page 13 sensory garden for the service users to use, and computers. The service users spoken with said that they enjoyed the activities on offer when they stayed at Rockville. The Centre has the use of its own adapted minibus. Service users said that mealtimes are flexible, and at weekends they can get up when they like. Meal times are flexible, and menus evidenced a variety of wholesome and nutritious meals on offer. Meals taken are recorded individually. Individual care needs at mealtimes are recorded and known by staff. Service users said that staff respect their privacy and always knock before entering their bedrooms and assisting them in the bathroom. Bedrooms and bathrooms are fitted with appropriate locks that ensure service users privacy and security. Service users said that they are able to have friends and families to visit whilst they are staying at Rockville. Rockville House DS0000003447.V311591.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Quality in this outcome area is good because service users can be assured that staff will treat them with respect and their personal care needs will be given in the way that they prefer. Individual physical, health and emotional needs will be met whilst staying at Rockville. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Manager creates a moving and handling plan for each service user following discussion with the service user, their families and physiotherapists if they are involved. All staff had undertaken moving and handling courses. 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 service user is taken ill whilst staying at Rockville, the Manager said that he would contact their family or carer. Medication is brought in by individual service users 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 spoken to were familiar with this. Administration recording sheets were found to be accurate and well maintained. No homely remedies are kept, instead service users bring Rockville House DS0000003447.V311591.R01.S.doc Version 5.2 Page 15 in any they are using with them at the start of their stay. It was recommended that a list of side effects of the medication in use is kept at the service. Medication is appropriately stored in a locked metal cabinet. Staff spoken to were very aware of individual service users health needs, and how they would meet them during their stay. Rockville House DS0000003447.V311591.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. Quality in this outcome area is good because service users can be confident that their concerns will be listened to, taken seriously and acted upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has a written complaints procedure that is available in a picture format and is prominently displayed in the centre. Concerns and complaints are recorded along with actions taken to resolve the concern or complaint and this is recorded in detail. Three relative survey forms were returned prior to the inspection and all three stated that they were aware that they could complain if they needed to. Three service users survey forms were returned and again all three stated that they knew how to complain. Two service users were spoken with during the inspection and they said that they thought any concerns were listened to by staff and acted upon. Whistle blowing procedures are in place for staff, and two members of staff spoken with during the inspection confirmed that they felt able to use this procedure if necessary. All staff had completed the protection of vulnerable adults training and all staff have been checked on the protection of vulnerable adults register and have a current Criminal Records Bureau check in place. Any verbal or physical aggression from service users is understood by staff, and there are procedures in place to manage this. 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. No money is stored at Rockville House DS0000003447.V311591.R01.S.doc Version 5.2 Page 17 the centre, and if there is money left then the service users take it home with them. Records seen were accurate and up to date. Rockville House DS0000003447.V311591.R01.S.doc Version 5.2 Page 18 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 because Rockville is well maintained, very clean and warm. Service users have the specialist disability equipment that they need to maximise their independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The respite centre is contained within a large detached purpose built building that also provides a day care facility for people who have physical disabilities and learning disabilities. The respite centre is on one level. There is three bedrooms that are fully accessible to people who have a physical disability. New beds have recently been purchased and in consultation with service users the bedrooms are to be decorated. One service user said that he thought there should be more pictures in the bedrooms. The large hallway has been redecorated and is bright and cheerful. Rockville House DS0000003447.V311591.R01.S.doc Version 5.2 Page 19 New kitchen units have been fitted and the kitchen is now fully accessible to wheelchair users and ensures maximum independence is possible. The bathroom is a large room and is equipped with two hoists and other equipment to maximise independence. The lounge is bright and homely and has a TV and various games and comfy seats. The two service users spoken with said that they thought the accommodation was comfortable and they enjoyed staying there. On the day of the inspection the centre was warm and clean and free from any offensive odours. One service user said that he would like the strips on the doorways to be replaced as they bumped his wheelchair when he went over them. Rockville House DS0000003447.V311591.R01.S.doc Version 5.2 Page 20 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): 32,33,34,35,36 Quality in this outcome area is good because the service users benefit from a staff team who are caring, committed and appropriately skilled and trained to provide care to service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff rotas and discussion with staff evidenced that there are always two members of staff on duty. Three relative survey forms returned stated that they all felt that there was always sufficient staff on duty. The staff group is a stable and experienced group of staff, and there has been no staff turnover since the previous inspection. The staff also work in the day centre that most of the service users attend during the day, and therefore they know the service users very well and are very familiar with their care needs and have very positive relationships with them. Staff files evidenced that appropriate checks are carried out. Four staff files were examined and all contained copies of a CRB check, proof of identification, and application form and medical fitness for the post. Two of the staff did not Rockville House DS0000003447.V311591.R01.S.doc Version 5.2 Page 21 have two references on file but had been employed at Rockville for many years. Staff spoken to were clear about their roles and responsibilities, and were aware of the structure of the management committee. Records evidenced that supervision takes place on a regular basis, and annual appraisals of staff are undertaken. Staff have professional goals that are recorded and staff confirmed that a variety of training opportunities are on offer. Staff meetings take place on a regular basis and are recorded. Rockville House DS0000003447.V311591.R01.S.doc Version 5.2 Page 22 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): 37,39,42. Quality in this outcome area is good because there is a clear management structure operating at the service that is effective. The health, safety and welfare of service users is promoted and this will ensure their safety whilst staying at the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager holds a degree in Social Policy and is scheduled to finish his Registered Managers Award next April. Mr Bailey has managed the service for a number of years and has the respect of the staff and was observed during the inspection to have a positive relationship with the service users. Staff commented that Mr Bailey has an inclusive and open style of management and an open door policy for staff and service users. Rockville House DS0000003447.V311591.R01.S.doc Version 5.2 Page 23 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. 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. Staff had 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. Appropriate insurance is in place for the service, and records relating to the minibus were examined, including insurance and current MOT. All staff are insured to drive the minibus. Gas and electrical testing had taken place recently. Portable electrical tests were undertaken in February 2006. Disability equipment such as hoists had been recorded as being regularly maintained and checked. Rockville has recently been awarded the Investors in People award. A quality assurance system is now in place, and the Manager has gathered information regarding the service from the service users forum and via questionnaires that had been sent to carers. He is now collating this information in order to define what areas could be improved, and subsequently devise an action plan. Rockville House DS0000003447.V311591.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 3 4 3 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 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 x LIFESTYLES Standard No Score 11 3 12 x 13 x 14 3 15 x 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Rockville House DS0000003447.V311591.R01.S.doc Version 5.2 Page 25 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. Refer to Standard YA1 Good Practice Recommendations The statement of purpose and service users guide should be produced in a format that is fully accessible to the service users who stay at Rockville. Individual holistic care needs and how these are to be met by staff at Rockville should be documented in individual service user care plans. These care plans should be regularly reviewed or when care needs change. Service users should have an individual risk assessment in place for all activities undertaken inside and outside of the centre when they stay at Rockville. A list of side effects of the medication taken by service users when they stay at Rockville should be compiled and made available to the care staff. All service users should have their individual risk assessments on file. The wooden strips on the doorways should be replaced to DS0000003447.V311591.R01.S.doc Version 5.2 Page 26 2. YA6 3. 3. 4. 5. YA9 YA20 YA9 YA24 Rockville House ensure that wheelchair users have easy access into all rooms at Rockville. 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