CARE HOMES FOR OLDER PEOPLE
Roclyns 344 South Coast Road Telscombe Cliffs East Sussex BN10 7EW Lead Inspector
Merle Blakeley Key Unannounced Inspection 23rd November 2006 10:00 X10015.doc Version 1.40 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 Roclyns DS0000021196.V303854.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 Older People. 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. Roclyns DS0000021196.V303854.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Roclyns Address 344 South Coast Road Telscombe Cliffs East Sussex BN10 7EW 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) 01273 583923 01273 568795 Mr Samood Mosafeer Mrs Bibi Hapsa Mosafeer Mrs Bibi Hapsa Mosafeer Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Roclyns DS0000021196.V303854.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. That a maximum number of nineteen (19) service users are to be accommodated. That service users must be aged 65 (sixty-five) years and over on admission. Only older people who have been assessed as requiring residential care can be accommodated. 6th December 2005 Date of last inspection Brief Description of the Service: Roclyns is situated on the coast road at Telscombe Cliffs. The home is within close walking distance of local shops and is on a regular bus route. The accommodation for residents is situated on the ground and first floor of the home, with communal space being provided by a large and comfortable lounge area and a homely dinning room with a smaller lounge attached. To the rear of the home residents have the opportunity to enjoy a large and well-maintained patio and garden. There is a lift available for those who do not wish to use the stairs to the first floor. Accommodation comprises of thirteen single rooms and three double rooms. Four of the single rooms and one double room have en suites facilities. The current fees range from £324.00 to £366.00. Additional charges are made for hairdressing and chiropody services. Roclyns DS0000021196.V303854.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced key inspection was carried out over a period of nine hours on 23rd November 2006. As well as this site visit information was also gained from a returned pre-inspection questionnaire, eight resident feedback survey forms, informal talks with six residents, a visitor, two staff, the deputy manager and both proprietors. The inspector had lunch with three residents. The site visit consisted of a tour of the premises, looking at the needs of four particular residents, document reading and observing staff interactions with residents. There are currently seventeen residents living at Roclyns. What the service does well: What has improved since the last inspection?
Four requirements were made during the last inspection and the home has now purchased a lockable medicines trolley. The home has also provided a more sturdy lock for the cupboard containing hazardous liquids and the home has been assessed by a qualified occupational therapist. None of the staff held NVQ qualifications at the last inspection. During this inspection it was noted that two of the staff hold NVQ qualifications with two more staff currently studying for care qualifications. A further two staff will possibly commence NVQ Level 2 training in 2007. The deputy manager has made some very positive changes by updating and reviewing the homes care plans, assessments and other records. The home has installed a new fire panel with new smoke detectors and emergency lighting. Some parts of the home have been redecorated. Roclyns DS0000021196.V303854.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. Roclyns DS0000021196.V303854.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Roclyns DS0000021196.V303854.R01.S.doc Version 5.2 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home carries out an assessment on all prospective residents. EVIDENCE: Two recent assessments were viewed and they contained all the necessary information to ensure the home can meet the person’s needs. Prior to admission prospective residents are visited either in their homes or in hospital. The deputy manager has recently devised a new assessment form for this purpose. Roclyns DS0000021196.V303854.R01.S.doc Version 5.2 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans have recently been improved. The current healthcare needs of residents are being met. Medication is being appropriately administered. Residents were seen to be treated with respect. EVIDENCE: Four care plans were viewed and the information they contained was well organised, informative and up to date. The deputy manager has recently revamped the care plan records so that they contain more in-depth information on residents. Life histories of residents are also being included into the care plans with the assistance of family members and friends. The current healthcare needs of residents were also viewed and the home has introduced two additional recording tools to screen residents for nutritional needs and skin viability. Residents are all weighed monthly and doctor’s visits are recorded. Residents care plans are reviewed on a six monthly basis and monitoring sheets and daily logs are also completed. Risk assessments have been
Roclyns DS0000021196.V303854.R01.S.doc Version 5.2 Page 10 produced. Overall it appears that the healthcare needs of residents are being met. Medication records were checked and the home is correctly administering medicines satisfactorily. The home has recently purchased a new medication trolley, which is securely sited within the home. Most of the staff have received medication training. During the day observations were made of how staff interacted with residents and it appeared that residents were treated with respect and dignity by the staff. Residents backed this up by saying that they were well treated and that they found the staff kind and caring. Roclyns DS0000021196.V303854.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home needs to expand the range of activities that are offered. Visitors are made welcome in the home. Residents state that they have choices. Residents appear happy with the meals that are offered. EVIDENCE: Residents were asked about the range of activities that were offered by the home and several stated that there was not enough to do. Recently staff have introduced card making with the residents, which they have enjoyed but it appears very little else is offered. The home will need to look at expanding the range of activities offered and do this in consultation with residents. Returned resident surveys have said that they would like consistent weekly activities to be offered such as arts & crafts on a certain day of the week and possibly gentle exercise classes to music on another day. Generally residents felt there was a certain amount of freedom they had within the home. Visitors are welcome in the home and one visitor was spoken to during this visit. She felt staff were friendly and that she was made welcome and was able
Roclyns DS0000021196.V303854.R01.S.doc Version 5.2 Page 12 to visit at most times of the day. Several residents also go out to visit their relatives. Five residents were asked as to whether they felt they had choices and autonomy in their lives. They all stated that they had and could make their own choices. The home has produced a four weekly rolling menu, which follows a fairly traditional theme. Resident’s likes and dislikes are displayed in the kitchen. Most of the residents said that they were happy with the meals the home provides although three did state that they would like more variety and choice. The cook was not working on the day of this visit so the deputy manager was preparing the lunch. The inspector joined some of the residents for an enjoyable lunch. It was noted that there did not appear to be any fresh fruit available for residents. The proprietors were asked as to whether this was provided and they responded that they leave it for families to bring in. It is important that the home provides fresh fruit and vegetables daily for all residents, as some may not have visitors every week. It was also noted that supper is given to residents at about 4.30 – 4.45 pm. This seems rather early as lunch is between 12 noon and 1pm and would mean that residents go over twelve hours until their next meal, which is breakfast. Residents are offered a hot drink early evening drink. This was discussed with the proprietors who stated that they would look into providing supper at a slightly later time. They would seek the views of residents about how best this can be carried out. Roclyns DS0000021196.V303854.R01.S.doc Version 5.2 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has produced policies and procedures for complaints and adult protection concerns. EVIDENCE: The home has produced a complaints policy and procedure regarding complaints and this is on display in the home. Five residents were asked if they knew how to make a complaint and four said they knew who to go to the other stated that she was not sure. The complaints record was looked at and no complaints had been made to the home or to the CSCI. The home has also produced policies and procedures for the protection of vulnerable adults. Most of the staff team have received training in adult protection. The home had not received any adult protection alerts. Roclyns DS0000021196.V303854.R01.S.doc Version 5.2 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The home is reasonably well maintained, however there were three safety issues that will need to be addressed. EVIDENCE: The home has a pleasant and friendly atmosphere and appears reasonably well maintained. There are two communal lounge areas where residents spend a lot of their time. In the larger lounge residents were sitting watching the television, it was noted that the television seemed quite small for the size of the room and some residents did state that they sometimes had difficulty seeing the screen. Whilst sitting chatting with residents in the small lounge area two of them said they felt cold. A small mobile radiator was being used and residents were seen moving it around the area. When the inspector felt the radiator it was extremely hot to the touch. If the home wishes to place additional heating in this small lounge then an alternative heating method
Roclyns DS0000021196.V303854.R01.S.doc Version 5.2 Page 15 needs to be found, as this uncovered radiator could cause an injury if a resident were to accidentally fall against it. Another uncovered heater was seen in one of the bedrooms and the home must carry out risk assessments to ensure that certain residents are safe to use these additional heaters in their rooms. During a tour of the premises it was also noted that the kitchen door and the lounge door were being wedged open. This is contrary to fire regulations and the home will need to provide these doors with magnetic closures. Since the last inspection the home has redecorated two bathrooms and one bedroom and new cabinets have been purchased for the kitchen. The proprietors have stated that they are hoping to redecorate the lounge/dining room areas in 2007. The home was found to be clean and tidy on the day. Roclyns DS0000021196.V303854.R01.S.doc Version 5.2 Page 16 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home appears adequately staffed. The home has not yet achieved 50 of staff being trained to NVQ level 2 and above. The home carries out suitable recruitment procedures. Staff receive core skills training. EVIDENCE: For the morning shift the home normally employs three care staff, the cook and a domestic cleaner. There are two staff on duty in the afternoon and for the night shift there is one waking night staff member and one sleep in staff member. Both proprietors are normally in the home during the week. On this particular day the cook was having a day off, so the deputy manager was in charge of preparing lunch. The staffing rotas were viewed and it was discussed with the manager/proprietors that these rotas would benefit from more detail. The rotas need to clarify the role of each staff member when they are on shift. The staff team have remained relatively stable and several staff have worked in this home for a number of years. The home currently employs twelve care staff and two ancillary workers. There are now two staff members who hold NVQ qualifications. This was discussed with the proprietors who stated that there are a further two staff
Roclyns DS0000021196.V303854.R01.S.doc Version 5.2 Page 17 currently studying for NVQ Level 2 and two staff who will commence this training in the near future. Several staff recruitment files were viewed and they were seen to contain all the required information. Staff training was also viewed and the courses staff have attended include food hygiene, manual handling, fire, adult protection and medication training. It was discussed with the proprietors that staff would also benefit from attending additional courses in dementia and continence awareness. Roclyns DS0000021196.V303854.R01.S.doc Version 5.2 Page 18 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The deputy manager has made some very positive contributions towards the efficient running of this home. The quality assurance programme needs to be expanded. Resident’s finances are safeguarded. The home tries to ensure that the health & safety of residents and staff is promoted. EVIDENCE: The proprietors are registered nurses and they both have relevant skills, qualifications and experience to care for older people. They have been running Roclyns for a number of years now. Both proprietors stated on the day that they are looking to promote the deputy manager to the position of registered manager of the home when she has completed the NVQ Level 4 qualification. The deputy manager currently holds NVQ Levels 2 & 3. The deputy manager
Roclyns DS0000021196.V303854.R01.S.doc Version 5.2 Page 19 who recently joined the home in August 2006 has already made some very positive contributions to the home by updating and redesigning care plans, records and other paperwork. Residents were asked about how the home was being run and all commented very positively. They said that both the proprietors were very approachable as was the deputy manager. Several also felt that the deputy manager had made some positive changes in the home since she had arrived. The home has produced a basic quality assurance programme, which needs expanding to include regular satisfaction surveys from residents, family & visitors and visiting professionals. From these surveys the home will be able to gauge how well the service is running by the comments and responses that are returned. Residents meetings are held and the proprietors have produced a programme of development for the maintenance and upkeep of the home. The home looks after small amounts of ‘pocket money’ for residents and some of these financial records were checked and were found to be in order. The home has recently had a new fire panel installed along with new emergency lighting. Three call points and all the smoke detectors have been replaced. Regular fire drills and fire training are carried out. The last fire test was carried out 20th November 2006. A professional fire safety company carried out a fire risk assessment on 8th November 2006 and the home is awaiting the report. Hot water temperatures are checked. Records of any accident are maintained. As mentioned previously in this report the home needs to provide magnetic closures for the kitchen and lounge doors and to provide safe and suitable heating appliances for the small lounge area. Risk assessments will also need to be carried out on any resident who has an additional heating appliance in their bedroom. Roclyns DS0000021196.V303854.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Roclyns DS0000021196.V303854.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? YES 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. 2. Standard OP28 OP12 Regulation 18(c) 16 (2) (m) (n) 23(4) 23(2)(p) Timescale for action That 50 of care staff obtain the 01/10/07 NVQ Level 2 Award. Previous Requirement That the home consults service 01/02/07 users and offers them a programme of regular enjoyable activities. To provide suitable fire closures 01/02/07 to the lounge and kitchen doors. To ensure that any additional 01/12/06 heating in communal areas and bedrooms is suitably guarded or has a cool touch surface. To expand the homes quality 01/03/07 assurance programme. Requirement 3, 4. OP19 OP25 5. OP33 24 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 OP15 Good Practice Recommendations To ensure that service users are offered fresh fruit on a daily basis and to ensure service users are consulted about the menu for further meal options.
DS0000021196.V303854.R01.S.doc Version 5.2 Page 22 Roclyns 2. 3. 4. OP27 OP15 OP30 To ensure that the staffing rota indicates who is on duty and their role. To consult with service users about changing the time they have supper. To offer staff additional training in dementia and continence awareness. Roclyns DS0000021196.V303854.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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
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