Inspection on 20/09/06 for Roland Care Home (Compton Road)

This inspection was carried out on 20th September 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Roland Care Home (Compton Road) 05/10/05

Roland Care Home (Compton Road) 01/12/04

Roland Care Home (Compton Road) 22/06/04

Roland Care Home (Compton Road) 03/02/04

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

CARE HOME ADULTS 18-65 Roland Care Home (Compton Road) 4 Compton Road London N21 3NX Lead Inspector Peter Illes Key Unannounced Inspection 20th September 2006 10:00 Roland Care Home (Compton Road) DS0000010635.V304086.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 Roland Care Home (Compton Road) DS0000010635.V304086.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. Roland Care Home (Compton Road) DS0000010635.V304086.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Roland Care Home (Compton Road) Address 4 Compton Road London N21 3NX 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) 020 8360 3713 020 8211 4539 amalyoland@aol.com Mrs Nilmarnie Gaithri Ranetunge Mr Dushmanthe Srikanthe Ranetunge Mr Amal B.D. Nawarathna Care Home 7 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7) of places Roland Care Home (Compton Road) DS0000010635.V304086.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. You may only accommodate service users in the two bedrooms located in the loft extension when they have been subject to an assessment by a competent person representing the service user and nominated by the placing agency. In the case of a service user who is self funding, the assessment must be undertaken by a competent person who is independent of the home e.g. Consultant Psychiatrist, C.P.N., Care Manager. This assessment must state clearly that the service user is able to escape from their room in the event of a fire, without the assistance of staff. A copy of this assessment must be retained in the home and be available for inspection. Any such assessments held by the home, must be subject to regular external review in accordance with the changing needs, abilities or condition of the service user. 5th October 2005 Date of last inspection Brief Description of the Service: 4 Compton Road is a home registered to provide accommodation and personal care for a maximum of seven younger adults with mental disorders. The home was first registered on 4th April 2000 and is one of four residential care homes belonging to Roland Homes, a company owned by Mr and Mrs Ranetunge. The home is a two-storey terrace house with a loft extension. On the ground floor, there are two bedrooms, a toilet, a kitchen and a lounge/dining room. On the first floor, there are three bedrooms and a toilet/ accessible shower. There are two bedrooms, an office and a bathroom on the second floor (loft extension). There is a small parking space at the front of the building and a garden at the back. The garden is paved and accessible to users. The home is located in a residential area near to Winchmore Hill. There is a bus service passing near the house. Local shops and other community facilities are within a short walking distance of the home. The home currently charges from £675 per week depending on the assessed needs of the service user. Information, including the contents of CSCI reports is available to stakeholders and a copy of the latest CSCI report is kept in the home’s lounge. The aim of the home is to provide high quality care and support to service users and to promote and maximise their independent living skills. Roland Care Home (Compton Road) DS0000010635.V304086.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The last inspection visit to the home was on the 13th March 2006. This was a brief visit and primarily involved a discussion with the registered provider. The previous inspection to that took place on the 5th October 2005 and included inspecting the majority of the key standards. The October 2005 inspection is referred to as the last main inspection in this report. This unannounced key inspection took approximately 8 hours with the registered manager and Mrs Ranetunge, one of whose roles is as the provider organisation’s service manager, being present or available throughout. There were 7 service users accommodated at the time of the inspection and no vacancies. The inspection included: meeting and speaking to all of the service users, three of them independently and a briefer independent discussion with a service user whose first language is not English; discussion with the registered manager and service manager and independent discussion with two care staff. Further information was obtained from a tour of the premises, a pre-inspection questionnaire and feedback cards from service users and other stakeholders as well as a range of documentation kept at the home. What the service does well: What has improved since the last inspection? Eight requirements were made at the last main inspection and the inspector was pleased to see that all of these had been complied with. The requirements were in the following areas: recording a specific area of service user need, two items of routine maintenance to the premises, two identified areas in relation to core staff training, ongoing qualification training for staff, ensuring the Commission had evidence of the registered manager’s qualification and a modification to the way that the accident book was recorded in. Roland Care Home (Compton Road) DS0000010635.V304086.R01.S.doc Version 5.2 Page 6 Two good practice recommendations were also made at the last main inspection and the inspector was pleased to see that these had also been appropriately acted on. The recommendations were in relation to requesting the formal minutes of minutes convened by health and social care professionals within a reasonable timescale and recording all the hours the registered manager worked on the home’s staffing rota. 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. Roland Care Home (Compton Road) DS0000010635.V304086.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 Roland Care Home (Compton Road) DS0000010635.V304086.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users needs are reassessed regularly, on a multi-disciplinary basis, to assist the home continue to meet their changing needs. Any prospective service user can be confident that their needs will be fully assessed and agreed with them prior to admission to the home to enable these to be effectively addressed when they move in. EVIDENCE: No new service users had been admitted to the home since the last main inspection. Three service user files were inspected at random and these contained a range of detailed assessment information that that is used to assess and monitor their current and changing needs. One service user in particular was vulnerable in identified areas and the assessment and review information was correspondingly detailed and thorough. Regular multidisciplinary reviews were recorded that had involved mental health care professionals, staff from the home and the service user. All involved including the service user had signed the review record. The service users needs were also subject to detailed three monthly in-house reviews that had been signed by those involved. On the latest record the service user had both signed and made their own comments on the record. The inspector was particularly impressed by the clarity and thoroughness of the above records. Roland Care Home (Compton Road) DS0000010635.V304086.R01.S.doc Version 5.2 Page 9 The other two files inspected also contained a record of regular reassessments of the service users needs, including multidisciplinary meetings. These were also clear, detailed and had been appropriately signed by those involved. The registered manager informed the inspector that any new service user would only be admitted to the home after a full assessment of need and a trial period to ensure that the home could effectively meet their needs. Evidence was seen that a good practice recommendation made at the last main inspection that minutes of care planning approach (CPA) meetings were requested if not received within four weeks from the date of the meeting had been acted on. Unfortunately despite this the minutes were still not always received from the relevant statutory agency in a timely manner. Roland Care Home (Compton Road) DS0000010635.V304086.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users assessed and changing needs are well documented in their care plans to assist the home’s staff and relevant others in meeting these needs. Service users are assisted to make as many decisions for themselves as they can to promote their independence. Service users are also supported to take appropriate risks in their lives to assist them to safely achieve their aspirations. EVIDENCE: Care plans for three service users were inspected and these were clearly linked to and reflected the assessed needs of the service users. The various elements of the plans described the identified need, specified goals to be achieved to assist meet the need and gave clear guidance to staff on how to assist the service user achieve these goals. The plans seen specified a comprehensive range of areas to be considered including: self care, domestic skills, personal relationships, leisure and recreation, community participation, mobility, physical and mental health, daily living skills, communication, social skills and work/ occupation/ education. Within these areas the goals were personalised Roland Care Home (Compton Road) DS0000010635.V304086.R01.S.doc Version 5.2 Page 11 and reflected the individual needs including religious and cultural needs. One care plan for a Gujarat speaking service user had been translated into that language to assist that service user. The home operates a key worker system and records were seen of a minimum of monthly key worker sessions on each of the files inspected. The home employs staff that also speak Gujarat who undertake key worker responsibility for the Gujarat speaking service users. Staff were seen to interact with service users throughout the inspection with service users being actively encouraged to make as many decisions for themselves as they are able. It was the inspector’s view that because of their particular needs some service users preferred staff to make decisions for them rather than making their own. Evidence was seen from observation and records inspected of staff resisting this and encouraging service users to exercise more independence where they could in their daily lives. An example of this included staff encouraging service users to participate in activities in the local community, one service user was being encouraged and supported to enrol at a local gym. Two other service users were being supported to take more responsibility for their meals including being allocated a cash allowance to buy their own food, shop for it and cook it. The inspector was informed that some service users had not been offered a key to the home for health and safety reasons. This was seen clearly recorded in the risk assessment inspected for one service user. One service user that speaks Gujarat had been offered a key to the home and had refused this. A record to this effect was seen on that service users file including a translation of that record into Gujarat. Service users are encouraged to manage their own finances as far as possible although one service user is subject to court of protection arrangements. The home assists service users open and operate individual bank accounts and satisfactory records of bank statements were seen on files inspected. Service users spoken to indicated that they were happy with the financial arrangements in place to assist them manage their money. Clear risk assessments were seen on the service user files inspected, they included specifying the identified risk and stating the benefits to the service user and others of minimising the risk. Those inspected were of good quality with clear guidance for staff on how to assist minimise the identified risks. Evidence was seen that the risk assessments were reviewed regularly with service users being involved in the process. A list was seen on each file inspected that indicated that all staff had read the latest reviewed risk assessments. As stated above the risk assessments for one Gujarat speaking service user had been translated to assist with this. The home has effective procedures that are implemented if service users are absent without informing staff of the reason for the absence. Evidence of specific multi-disciplinary agreements regarding this was seen on one service user’s care plan and risk assessment. The home notifies the Commission of any unexplained absences in a timely manner. Roland Care Home (Compton Road) DS0000010635.V304086.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 at least once during a 12 month period. 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. Service users enjoy appropriate activities including within the community that meet their needs and preferences including their cultural and religious needs and preferences. Appropriate contact with relatives and friends is promoted and encouraged in accordance with the service users wishes. Service users rights are responsibilities are respected and promoted within their daily lives. Service users also enjoy balanced and varied meals that meet their needs and preferences. EVIDENCE: Four service users attend external day services two days a week with one of these attending an Asian day centre. All of the service users have an activity plan for the week, individually agreed with them, and copies of these were sampled. Activities include a range of opportunities to develop independence skills including domestic tasks such as shopping, cooking and laundry. The inspector was informed that one service user is ready to move on from the home and that staff are assisting in negotiating how this will happen. Two Roland Care Home (Compton Road) DS0000010635.V304086.R01.S.doc Version 5.2 Page 13 service users are being assisted in being responsible for their own meals at the home as part of supporting them to become more independent. The majority of service users can travel independently in the community although one needs staff support if travelling outside of the local community. Another needs staff assistance generally when travelling outside of the home. The home’s notice board contained a range of information about events that were happening locally. One service user was keen to accompany the service user to another of the provider organisation’s homes during the inspection and was particularly keen as the visit was to include a trip to a local garden centre. Two of the service users accommodated are Hindu and are supported on a regular basis to attend the Hindu Temple in Neasden in northwest London. Other service users attend churches in the local area when they wish to and are supported by staff to do so if appropriate. Service users spoken to confirmed that they had freedom passes to access public transport. The provider organisation had arranged two holidays this summer for service users that wished to attend, one to Birmingham and a short break to Brighton. Service users spoken to who had participated in these indicated that these holidays had been enjoyable. The registered manager confirmed that the television in the home is able to receive channels where Gujarati and Hindi are spoken. He went on to say that the home also has access to a commercial sports channel on the television and that one service user is very keen on this. The registered manager stated that one service user was being supported to join a local gym and other service users are supported to swim at a local swimming pool on a regular basis. One service user told the inspector that there was not much to do at the home but in further discussion then went on to tell the inspector an appropriate range of activities that they did participate in. The majority of service users had contact with family and friends to varying degrees and evidence was seen that staff were assisting service users with these in a sensitive and individual way depending on the circumstances. Evidence was also seen that service users were supported with personal relationships, again in a sensitive and appropriate way. This was to support the service user and to assist minimise the risk of exploitation if that was considered necessary. Evidence was seen that service users were also counselled and assisted to seek support from relevant health care professionals to promote their sexual health if that was appropriate. All service users have access to keys to their rooms if they want them and staff respect service users privacy regarding this. As stated in the Individual Needs and Choices section of this report one service user had made an active choice not to accept a key to the house. The home has a keypad system for the front door for leaving the home and a key operated lock for entering it. Where service users do not have a key or access to the keypad code this is clearly recorded in a separate section of their individual risk assessments. Staff were seen to interact appropriately with service users throughout the inspection. Roland Care Home (Compton Road) DS0000010635.V304086.R01.S.doc Version 5.2 Page 14 Service users spoken to indicated that staff were supportive and appropriately friendly. The home operates several menus that were seen. There is a vegetarian menu that the two Hindu service users enjoy, a non-vegetarian menu for the majority of the service users and an individual menu for the service user that is ready to move on from the home. All of these menus showed a range of healthful and varied meals and service users spoken to told the inspector that they enjoyed their meals at the home. Evidence was seen from the monthly service user meeting minutes that meal choices and preferences were discussed and incorporated into the menus. One service user suffers from diabetes and was able to choose suitable meals that they enjoyed. Evidence was also seen that a local dietician was consulted for advice for some service users who needed support to control their weight. Different service users were seen enthusiastically preparing for the evening meal during the latter part of the inspection. The kitchen was clean and food appropriately stored. A range of health and safety records were inspected in the kitchen and found to be satisfactory. Roland Care Home (Compton Road) DS0000010635.V304086.R01.S.doc Version 5.2 Page 15 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 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. Service users receive appropriate personal support in accordance with their needs and preferences. Their mental and physical healthcare needs are met including through referrals to a range of community based health professionals and appropriate health screening as required. Service users are also generally well supported with their medication although a minor improvement is needed to ensure that service users remain fully protected in this area. EVIDENCE: The seven service users need varying degrees of support with their personal care. The majority need support and guidance with their personal hygiene while one needs some physical assistance. Guidance for staff on how to provide this care was recorded on the individual care plans. Service users spoken to stated that they were comfortable with the assistance they received from staff in this area. The registered manager stated that one Afro-Caribbean service user is assisted on occasion by a manager from a similar ethnic background from another of the provider organisation’s homes. This includes assisting the service user purchase culturally appropriate products for skin and hair care. The service user stated that she appreciates this. Other service users Roland Care Home (Compton Road) DS0000010635.V304086.R01.S.doc Version 5.2 Page 16 spoken to were also happy with the personal care provided to them, one stated that staff were very kind and that they were happy at the home. Service users are all registered with a G.P. and evidence was seen on files inspected that service users are supported to attend a range of appointments with relevant healthcare professionals as required. These appointments included with their: G.P., psychiatrist, GP, dentist, optician, community psychiatric services, therapy appointments, and a range of general outpatient appointments and health care screening at local health facilities. One service user is diabetic and is being appropriately supported by healthcare professionals with this. The registered manager stated that it was difficult obtaining chiropody services for service users other than for the person with diabetes. He showed the inspector a certificate of competence from a podiatrist indicating that the registered manager was competent to perform basic nail care. The registered manager stated that he assisted service users with their nail care where this was required and was planning to arrange the same training for some other staff. Medication was appropriately stored and medication and medication administration records (MAR) charts for three service users were inspected. These were generally satisfactory except that the medication container and MAR chart for one service user showed that a medication cream was prescribed to be applied externally three times a day. The MAR chart showed that recently the service user had refused to have the medication applied at midday while was compliant with the other two applications per day. The registered manager stated that the medication was intended to be applied on an as required basis up to three times a day. As the medication container and the MAR chart clearly specified the medication was to be applied three times a day a requirement is made that the GP be contacted for further advice and for appropriate action to be taken to resolve this discrepancy. One service user self-administers their medication and satisfactory procedures were in place to support them with this. The registered manager stated that the local pharmacy that dispenses medication for the home visited on a regular basis to inspect the storage arrangements and medication procedures. Staff that administer medication had received current training regarding this and training records sampled evidenced this. Satisfactory daily records of the temperature that medication is stored at were seen. Roland Care Home (Compton Road) DS0000010635.V304086.R01.S.doc Version 5.2 Page 17 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 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. Service users and relatives are able to express their views and concerns and have these appropriately dealt with by the home. Service users are also protected by satisfactory adult protection policies and procedures that staff are aware of. EVIDENCE: The home has a clear complaints procedure that had been reviewed in September 2006. Evidence was seen that complaints were a standing item on the monthly service user meetings agenda. The registered manager stated that each service user was given a copy of the complaints procedure as part of the service user’s handbook they received when they were first admitted to the home. Service users spoken to indicated that they felt confident to raise concerns and issues with the registered provider, registered manager or with staff if they needed to. One complaint had been recorded since the last main inspection and the record of this was clear and indicated that the complaint had been properly dealt with. The home had a copy of the current adult protection guidance issued by the London Borough of Enfield, the local authority the home is situated in. A copy of the provider organisation’s in-house procedure was also seen. This was detailed and clear. Evidence was seen that this had been reviewed and updated in June 2006. The inspector was informed that this procedure had been updated to show the latest local authority contact details for mental health services following some staff having undertaken recent training in adult protection provided by the London Borough of Enfield. A list was seen that all staff had signed to evidence that they had read the updated June 2006 Roland Care Home (Compton Road) DS0000010635.V304086.R01.S.doc Version 5.2 Page 18 procedure. No allegations or disclosures of abuse had been reported to the home since the last main inspection. Roland Care Home (Compton Road) DS0000010635.V304086.R01.S.doc Version 5.2 Page 19 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 the following standard(s): 24, 27, 28 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a home that is comfortable, has clear mechanisms regarding maintenance and redecoration and which meets the service users needs. The home was clean and tidy throughout creating a pleasant environment for both those that live and work at the home as well as for those that visit it. EVIDENCE: The home is a two-storey terrace house with a loft extension. On the ground floor, there are two bedrooms, a toilet, a kitchen and a lounge/dining room. On the first floor, there are three bedrooms and a toilet/ accessible shower. There are two bedrooms, an office and a bathroom on the second floor (loft extension). There is a small parking space at the front of the building and a garden at the back. The garden is paved and accessible to users. The inspector noted that there was some repair work being undertaken to the interior of the home by a handyperson during a tour of the building. The registered manager stated that he could access the provider organisation’s handy person at short notice for urgent repairs. The service manager showed the inspector a current copy of a three monthly health and safety report she had completed on the home. This also included a list of more routine repairs Roland Care Home (Compton Road) DS0000010635.V304086.R01.S.doc Version 5.2 Page 20 and redecorations that are needed. The service manager and registered manager both indicated that maintenance, redecoration and repairs of the home are carried out as required throughout the year. A requirement had been made at the last main inspection that staff monitor and record any episodes of incontinence so that when the provision of a carpet in the resident’s bedroom is reviewed the decision will be made taking into account the current needs of the resident. The registered manager stated that this had been complied with. The inspector was also pleased to see that requirements made at the last main inspection that the lock on an identified toilet door was repaired and that identified work to the lounge carpet and decorations had also been complied with. The home was clean and tidy throughout and had laundry facilities and infection control procedures that met the current service users needs. The inspector was pleased to see evidence that staff had now completed infection control training as required at the last main inspection. Roland Care Home (Compton Road) DS0000010635.V304086.R01.S.doc Version 5.2 Page 21 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An effective staff team is able to competently address the needs of the current service users. The home’s recruitment practises contribute towards service users protection. Service users are also supported by staff who are appropriately trained in areas relevant to service users needs and who are well supervised to assist them further in meeting service users needs and in their own personal development. . EVIDENCE: The names of eight care staff were recorded on the home’s staffing list and the home had one vacancy at the time of the inspection. The inspector was told that staff could work at any of the provider organisation’s registered homes although were primarily based at one of them. The inspector was told that this meant that short term vacancies could be covered without resort to the use of agency staff and generally works well. Staff spoken to independently confirmed the view that this arrangement worked well for them. Of the eight staff on the home’s list one had completed the national vocational qualification (NVQ) level 2 in care and two had completed NVQ level 3 in care. Two more were due to complete the qualification by the end of the year and another was enrolled to start in either September 2006 or February 2007. The inspector was told that the provider organisation remained committed to maintaining at least 50 of Roland Care Home (Compton Road) DS0000010635.V304086.R01.S.doc Version 5.2 Page 22 staff employed at NVQ level 2 or above as required in the national minimum standards. This complied with a requirement made at the last main inspection. A satisfactory staff rota was seen that showed two staff working during the day, one from 7.45am to 6pm and the other from 9am to 6.30pm. One staff member works 6.15pm to 8am the following morning including sleeping in duty from 10pm to 7am. There is an on call manager available out of office hours for advice or assistance. The registered manager generally works 9am to 5pm on weekdays although will cover occasional shifts at weekends or evenings. The inspector was pleased to see that a recommendation made at the last inspection that these shifts are also recorded on the rota had been acted upon. The inspector was informed that the staffing levels met the needs of the current service users and staff spoken to independently supported this view. The home had recruited one new staff member since the last main inspection although this person had subsequently left the home since that inspection. This staff member’s file was inspected and showed evidence of a good quality recruitment procedure. The file contained a criminal records bureau (CRB) check and protection of vulnerable adults (POVA) check taken out by the provider organisation prior to the staff member starting work, a clear application form, two references, a birth certificate and copy of the person’s passport. The service manager stated that new staff were not employed until a full CRB with POVA check had been obtained. The inspector clarified that in circumstances prescribed in the amended care homes regulations (2004), including supervision at all times, a new member of staff could be employed as long as an application for a CRB had been made and the organisation had obtained a POVA First clearance pending receipt of the full CRB. The home remains committed to staff training. The registered manager had recorded on the pre-inspection questionnaire that training had been provided for staff over the past twelve months including in the following areas: first aid, that met a requirement made at the last inspection; medication administration; fire safety training; infection control, that also met a requirement made at the last inspection; adult protection; toe nail cutting and food hygiene. Evidence to support his was seen from documentation in the home and from care staff spoken to independently. The registered manager also stated that all staff were supervised on a monthly basis and evidence of this was sampled on one staff file. This evidenced that supervision was recorded and the record signed by both the staff member and the registered manager. Staff spoken stated that their supervision sessions were helpful to them. Evidence was also seen that staff receive an annual appraisal. Roland Care Home (Compton Road) DS0000010635.V304086.R01.S.doc Version 5.2 Page 23 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and staff benefit from the home being effectively managed by the registered manager. Service users also benefit from the homes quality assurance systems that incorporate their views on the service. Effective health and safety procedures contribute to protecting service users, staff and visitors to the home. EVIDENCE: The registered manager stated that he had five years management experience and has passed his Registered Manager’s Award. A copy of his certificate in relation to this qualification was seen that complied with a requirement made at the last main inspection. The registered manager presented as being knowledgeable of both the needs of service users with a mental health diagnosis and of the issues involved in managing a care home. Staff and service users spoken to were complimentary about him and positive comments were also received in feedback cards previously received by the inspector. Roland Care Home (Compton Road) DS0000010635.V304086.R01.S.doc Version 5.2 Page 24 The home has an established quality assurance system including regular service user and other stakeholder surveys, the most recent having been undertaken in August 2006. Aims and objectives from these are drawn up for the home. The inspector was told that for this year these have included a service user short break holiday to the seaside, Brighton, and to actively support a service user to apply to join a local gym. The service manager also undertakes regular monitoring visits to the home and will send copies of these to the inspector from October 2006. A range of satisfactory health and safety documentation was inspected that included: a gas safety certificate, electrical installation certificate, portable appliance testing as well as fire evacuation procedures and servicing and testing of the home’s fire fighting equipment. The home had a current public liability insurance certificate. The inspector was also pleased to see that two requirements made at the last main inspection relating to first aid training for staff and the way that accidents are recorded in the accident book had been complied with. Roland Care Home (Compton Road) DS0000010635.V304086.R01.S.doc Version 5.2 Page 25 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 X 2 4 3 X 4 X 5 X 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 X 26 X 27 3 28 3 29 X 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 3 3 X 3 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 2 X 3 X 3 X X 3 X Roland Care Home (Compton Road) DS0000010635.V304086.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No 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 YA20 Regulation 13(2) Requirement The registered persons must ensure that the GP for an identified service user is consulted to resolve the discrepancy regarding the recorded usage of an identified prescribed medication and the frequency of the application of that medication that the service user is prepared to accept. Timescale for action 20/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Roland Care Home (Compton Road) DS0000010635.V304086.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Roland Care Home (Compton Road) DS0000010635.V304086.R01.S.doc Version 5.2 Page 28 - 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. 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