Inspection on 26/09/07 for Roland Care Home (North Circular Road)

This inspection was carried out on 26th September 2007.

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 (North Circular... 06/02/07

Roland Care Home (North Circular... 28/10/05

Roland Care Home (North Circular... 01/12/04

Roland Care Home (North Circular... 10/05/04

Roland Care Home (North Circular... 06/01/04

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

CARE HOME ADULTS 18-65 Roland Care Home (North Circular Road) 231 North Circular Road London N13 5JH Lead Inspector Duncan Paterson Key Unannounced Inspection 26th September 2007 10:00 Roland Care Home (North Circular Road) DS0000010621.V352245.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 (North Circular Road) DS0000010621.V352245.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 (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Roland Care Home (North Circular Road) Address 231 North Circular Road London N13 5JH 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 8886 0755 020 8211 4539 Mr Dushmanthe Srikanthe Ranetunge Miss Yolanda Martin Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (1) Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home may continue to accommodate a specific service user who is physically disabled. This condition will be reviewed should the care needs of the service user increase to a point where the home is unable to meet them. The home may only accommodate service users in the 2 bedrooms located in the loft extension after they have been subject to an assessment by a competent person representing the service user and nominated by the placing authority. 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. This assessment must clearly that the service user is able to escape from their room in the event of a fire, without the assistance to 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. 6th February 2007 Date of last inspection Brief Description of the Service: 231 North Circular Road is a care home registered to provide accommodation and personal care for a maximum of 6 adults with mental disorders. The home was opened in 1990 and is one of 4 care homes belonging to Roland Homes, a company owned by Mr and Mrs Ranetunge. Mrs Ranetunge, who is also the service manager for the four homes, was present for the inspection. The home is a two-storey terrace house with a loft extension. On the ground floor there is an open plan lounge/dining/kitchen area, a communal toilet (which is wheelchair accessible) and two single bedrooms (one of which has a shower cubicle which is wheelchair accessible). On the first floor there are two single bedrooms, a bath/ shower room, a separate toilet and a combined office/sleeping in room. In the loft there are two single bedrooms (each with an ensuite toilet facility) and a bathroom. At the front of the house there is a paved area for parking and at the rear of the house there is a garden which is partly paved and is accessible to service users. The home is situated within half a mile of shops, restaurants, transport and other community facilities located along Green Lanes in Palmer’s Green. The home currently charges from £675 per week depending on the assessed needs of the service user. Information, including the contents of CSCI reports Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 5 is made available to stakeholders. The home’s brochure states that the aim of the home is that service users will be provided with individual programmes of care, regularly reviewed to maximise stability and preserve independence. Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place on 26 September 2007. The inspection involved speaking with the people using the service, the staff on duty, the manager and Mrs Ranetunge. Care managers and relatives were spoken with on the telephone after the inspection. A standard form, the Annual Quality Assurance Assessment (AQAA), was returned to CSCI by the manager. This was taken into consideration. The inspection also involved the case tracking of three people’s care, the assessment of a range of the home’s records, procedures and forms as well as observation and a tour of the premises. For the purposes of this report, “the management team”, will be used to refer to discussions with the manager and Mrs Ranetunge. What the service does well: What has improved since the last inspection? Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 7 There have been improvements to the physical standards since the last inspection visit. A new skylight has been fitted to the dining room flat roof resulting in improved lighting to that area. New carpets have been installed as well as redecoration of much of the home including the communal areas. More of this redecoration work is planned. A new sofa and armchairs have been provided in the lounge. 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. Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 8 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 (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 9 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): 1234&5 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are effective assessment methods, which allow essential information for each new resident to be obtained so that staff can go on to provide a service geared to their needs. People who are new to the service are introduced gradually and carefully through a trial system and via communication with relevant professionals. EVIDENCE: I used the CSCI case tracking method throughout this inspection to assess the quality of the service. This involved selecting three people using the service and looking in detail at their care plans and other records held in the home. It also involved talking with people using the service about the care provided as well as talking with staff, the manager and relatives and care managers where possible. This allowed me to reach an overall judgement about the quality of the service provided. I was shown the home’s statement of purpose and was told that it was currently being updated. The statement of purpose provides a general section for all four care homes in the group as well as information about the specific care home, in this case North Circular Road. I was able to make some suggestions to the management team about information to include. For example, details about the manager needed to be updated and the specific Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 10 aims of the service (to assist people to live independently) could be made more explicit in the guide. CSCI is currently reviewing the registration certificates for each care home. Should the home’s certificate be amended in this review the details should be included in the updated statement of purpose. Two of the people being case tracked had been resident for a number of years. There was a range of assessment and review information available on their individual files which had been used to compile care plans aimed at meeting their needs. The third person I case tracked was admitted to the home in July 2007. The assessment information on file (from a NHS Mental Health Trust) was very detailed and provided relevant and specific details about the person’s needs. A care plan had been drawn up for use at this service. I was told by the management team that when there were vacancies at the service it was not unusual for there to be a number of referrals made for each vacancy. I saw that there is a detailed process of referral and trial before an admission is made. Often, people have been long stay patients in a hospital setting before they move to the service. I was able to see this process first hand as a person, who I did not case track, had recently been admitted to the service for a two week trial. The arrangements were discussed with the manager and a visiting Community Psychiatric Nurse (CPN). The feedback I received was that the trial was going well. The CPN said that she thought the staff had introduced the person to the service well. They knew, “what they were doing”, she said. A review meeting was to be held at the end of the trial period to consider whether the placement could become permanent. I saw contracts on the individual files of the people whose care I case tracked. All the people using the service are funded by local authorities. I discussed equality and diversity initiatives with the management team. Both the staff team and the people using the service are mixed racially and culturally. There are good relations between staff and people using the service and there is a good knowledge amongst the staff team about each resident’s culture, religion and individual wishes. I observed that staff worked effectively to create an atmosphere where staff and residents lived harmoniously together and were able to sensitively address challenges when they arose. Some examples of difficulties were given to me such as the occasional use of racially offensive language directed at staff from a previous resident. I was able to discuss how that had been addressed by the management team. There had been debriefing discussions with staff. I saw evidence of this on a staff supervision record. There had also been clear communication with the resident about unacceptable behaviour and use of language which was backed up by a relevant policy. However, there was some disappointment with other statutory agencies, who could not take a firmer line, and the wider discrimination in society. The service has a duty of care to the Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 11 people using the service and there can be a tension between that and the right not to be abused and discriminated against. Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 12 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6 7 9 & 10 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are detailed, flexible and regularly reviewed care plans which set out how they are working with residents to meet their needs. People using the service have been successfully included in the process of compiling care plans and risk assessments where possible as well as in decision making. EVIDENCE: I inspected the care plans for three people using the service as part of my case tracking. Discussions were held with two of the people as well as staff on duty and the manager. Relatives and care managers were spoken with on the telephone and observations were made during the inspection visit. The care plans were very detailed and well ordered. There were good records kept for each person about their needs and there were records of referrals to other professionals such as psychologists, dieticians, family therapists and chiropodists. The care plans were set out clearly. There was one example of a care plan having 17 different points the resident was receiving assistance with. There were goals and actions for each point and the overall plan was reviewed regularly. The resident, relatives (if available) and other professionals were Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 13 involved in the reviews as well. A good standard had been achieved in this standard and I saw the good standard across all three care plans inspected. When I spoke with the people using the service they confirmed that the work set out in the care plans was being completed by staff. For example, one resident said staff had helped him with a wide range of things including going on activities with his keyworker and receiving help to cook meals. I was told of restrictions, if any, that were in place relating to the people using the service. This was well organised with written records being maintained and staff being aware of any restrictions and how they needed to be managed. I discussed decision making with residents and staff. I identified that in the main people using the service are free to make decisions about all things. Including what they wish to do, what clothes to buy and about food and meals. In practice staff spend time either prompting or encouraging some of the residents to do things. For example, activities programmes have been set up for residents to do laundry and to cook meals as well as to go out of the home for activities. Some residents may be hard to motivate or engage with. Even to the point of trying to encourage a resident to spend some money to buy things like a laptop to assist with learning. I discussed with the management team how they look after residents money and looked at two records of money the manager holds for safekeeping. The majority of residents ask staff to look after, usually small amounts of money for them. There are safe deposit boxes available in bedrooms for residents to use as well. The two records I looked at were well kept and the procedures followed were clear. The manager said that the service does not act as an appointee for anyone. Either relatives or the local authority take responsibility. I saw individual risk assessments on the case files I looked at as well as overall risk assessments for the service. These were comprehensive and regularly reviewed and supported residents taking responsible risks. I was able to discuss with two residents how these risk assessments worked in practice. One resident did not like the arrangements but was cooperating and the other resident felt that the work staff had done assessing the risks and involving other professionals had been helpful. Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 14 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 12 13 14 15 16 & 17 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The systems in place allow and encourage people living at the service to take part in a range of activities both internally and externally. They also assist people to maintain contact with friends and relatives and to start to develop independent skills. EVIDENCE: I spoke with three of the six people currently resident in the home. I also spoke with staff, relatives and care managers and made some observations throughout the day. I identified that each person has a routine based on his or her interests, needs and any restrictions and risk assessments that are in place. For example, people attend day centres, job clubs and college classes and one person swimming. Others visit friends and family or have routines in place at the home where they may prepare their own meal a number of times each week. Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 15 One person living at the home I spoke with told me about his daily activities which were varied and included swimming, gardening and going to a job club as well as visiting his family and spending time out of the home. He also said that he went on a holiday arranged by the service. He said his keyworker assisted with the activities. I spoke with this person’s relative who confirmed that the activities took place and that staff were proactive in making sure that there were things for the resident to do. A care manager I spoke with told me that she had been impressed by the way the service had quickly got a resident involved in activities and a daily programme after admission, especially in activities of particular interest to the resident. I was able to discuss activities with the management team and to ask about resources and how residents’ interests were addressed. There is a good knowledge of the people who live at the home and their interests and the manager had been able to arrange for referrals to places such as colleges. For the people I case tracked I could see that there were good links with relatives. Both relatives I spoke to said that there was a good relationship with the service and that the manager or staff would telephone to discuss care arrangements at regular points. Relatives told me that the service was good and reliable and that arising matters had been addressed promptly by the service. One relative said that, although there had been minuses there had been, “a lot of pluses”. I observed a member of staff preparing a light lunch for two of the people living at the home. The other residents were out or had eaten earlier. The practice is to have a light lunch and the main meal in the evening with staff preparing a meal and a number of residents taking it in turns to cook their own meal. This practice assists with developing independent living skills as well as builds in more choice about food for residents. Some of the residents are assisted with shopping and then the cooking of a meal. I was shown a record of meals eaten by the people living at the home. The meals were reasonably varied and balanced Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 16 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 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The arrangements for personal and healthcare support are clearly set out in the care plans and have been discussed and drawn up with the people using the service. The manager and staff have been successful in making referrals to other professionals and specialists who can provide additional support. Medication arrangements are competently arranged and managed. EVIDENCE: I made observations throughout the inspection and discussed with residents their view of the support they received from staff including personal care. I then spoke with the management team about the arrangements and cross checked with the care plans. Overall, flexible arrangements are in place which allow a greater or lesser response from staff as needed. For example, one resident told me about the support he had from staff which was limited to assistance with going out of the home as he was confident to do other things himself. This allowed him to retain a high degree of independence. The care plans have detailed aims and objectives for staff about the help each resident needs as well as details about health care arrangements. There are comprehensive records of preventative health care appointments on each care Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 17 plan I looked at as well as details about referrals to other health care professionals such as chiropodists and psychologists. I inspected the medication arrangements and noted that the system used had records of receipt into the home for medication, the administration of medication and disposal where relevant. Training was discussed with the management team. I noted that one of the care staff had not received medication training but was advised that medication had been covered as part of the induction training and that further training would be available after successful completion of the probationary period. Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 18 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 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The complaints arrangements provide both opportunities for people using the service to raise concerns and ways for the manager and staff to respond appropriately and sensitively to concerns raised. The safeguarding adults procedure and training arrangements assist staff to be aware of abuse issues and to respond appropriately if needed. EVIDENCE: I inspected the complaints records. There had been two complaints recorded since the last inspection. One had been investigated and there were notes which provided details of the investigation. The second complaint had not been accepted for investigation and the reasons for that was discussed with the management team. I discussed complaints with the residents and relatives I spoke with. In general, I was told that people knew when and how to make complaints if needed. Although if there were any concerns these were addressed simply and easily in day-to-day communication. One resident said that he was not happy about some of the arrangements for care which including a limitation. This had been raised with the staff team and was also known to the relevant relatives and external professionals. I had some discussion with the management team about this and was able to identify that staff were providing care which was thoughtful and mindful of the resident’s concerns and wishes. And in a way that was as flexible as possible. I was shown the Safeguarding Adults policy and procedure for the service which was suitable. I was told that the management team had received Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 19 Safeguarding Adults ‘Train the Trainers’ training, which equips them to go on to train their staff. Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 20 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 - 30 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. A pleasant, welcoming and comfortable home is provided for the people using the service. Recent redecoration and adjustments have improved the facilities and further improvement work is planned. Some repair work to the garden patio and paved area is required. EVIDENCE: During the inspection I spoke to the people using the service in the communal area of the home as well as by invitation with three residents in their bedrooms. I also toured the building with the manager and spent some time in the garden. The manager showed me where there had been improvements. These include the communal lounge / dining area which has been redecorated and now has a new skylight which allows much more natural light. New chairs and sofas have also been bought. The entrance to the home has been decorated and has a new carpet. Some bedrooms have been redecorated and more work is planned. The home is on a busy main road and this can present some difficulties at the front of the home such as keeping the exterior clean and free from litter. Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 21 However, the front exterior was in a good condition and the entrance to the home is pleasant and welcoming. Overall, a pleasant, clean and welcoming environment has been established which is matched by a friendly and open atmosphere. Two visiting professionals I spoke with told me that they had been impressed by the pleasant nature of the home and helpfulness from staff. I had not visited this home before and felt very welcome when I arrived as well as throughout the inspection. I was able to see three bedrooms as I spoke with three residents in their rooms. Each room was attractively arranged, with a relatively large amount of space as well as a great deal of natural light. Two of the bedrooms had windows on two sides. Each bedroom was furnished comfortably with residents having brought in their own possessions which made the bedrooms their own. Each resident I spoke to told me they liked their bedroom and were happy to talk about their possessions and interests. There are a range of toilet and bathing facilities. There is a toilet and bathroom on both the first and second floors and a toilet on the ground floor. The two bedrooms on the second floor have en suite toilets and there is a shower facility in one bedroom on the ground floor. I was told that the ground floor toilet is to have new flooring installed which will improve the appearance of the room. There are some adaptations to the home to assist a service user who has physical disabilities. There are a couple of matters which need to be attended to. The majority of the exterior window frames are double glazed and are in good condition. However, the rear first floor exterior windows are not double glazed and the woodwork is in need of redecoration. This should be included in the annual repair and renewal work. The second matter is the rear garden and patio area which is paved in part. Parts of the paved area have become uneven and broken in places and could present staff and the people living at the service with a trip hazard. This must be repaired and made safe. A requirement is given about this. Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 22 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): 31 32 33 34 35 & 36 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. There is a friendly, motivated and competent staff team. Relevant training is provided. The introduction of new methods of staff induction training, which is to be provided to all staff, should provide staff with additional skills. Recruitment arrangements are sound as are staff supervision and support initiatives. EVIDENCE: In order to assess the staffing standards I spoke with the people using the service. I spoke with staff on duty, including the manager, observed staff working, looked at the staff rota and inspected the records of training, recruitment and supervision. I also spoke with visiting professionals and relatives. Staff are well liked and respected by all. The people using the service told me that they liked the staff and found them helpful. I observed good relations between staff and the people using the service. One person particularly praised his keyworker. Others told me that the manager was good and that he helped them. Visiting professionals told me that staff were helpful and had created a service that was addressing the needs of the people living there. I received Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 23 positive comments from relatives. They said that they were contacted by staff at the home on a regular basis and kept informed about care provision and any matters arising. Relatives said that they had found the service and the staff reliable and helpful. I was shown the staff rota. In addition to the manager there are two staff on duty between 9am and 2pm. In the afternoon and early evening there is one member of staff in addition to the manager. At night there is one member of staff. The management team advised that staffing levels could be increased if needed. For example, if the needs of the people living at the home increased. Staff are contracted to work in all four of the organisation’s care homes although there are five staff who work mainly at this home. I was told that this assists with covering shifts at all four homes and avoids the need to have agency staff. These arrangements are suitable and provide flexibility although will require regular review to ensure that the needs of the people using the service are met. I spoke with the two members of staff on duty and asked them about their recruitment, training and duties. Both said that they liked the work, that they felt supported and both were clear about their duties. I inspected three staff files in order to assess the quality of recruitment, training and supervision. Two of the staff whose files I inspected were relatively new members of staff. All the staff files had detailed records of recruitment with all the required checks having been made. I noted that the management team had introduced a useful initiative where new staff were tested on their understanding of resident’s needs to make sure that they understood and were clear. I noted that staff had been provided with a range of training and that induction had been provided. I discussed induction with the management team and was told that a new induction system was to be introduced. The plan being that all staff would receive this induction training. A new recording system was to be introduced. The management team undertook to provide me with a copy of this induction form for reference. I also discussed NVQ training with the management team. It was a little difficult to assess this standard as staff work across the four care homes for this organisation. However, I identified that five of the care staff, who work mainly at this home, had obtained NVQ qualifications. The standard is therefore met. The management team undertook to send me details of all staff working for the organisation and their NVQ qualifications. This will greatly assist with the assessment of this standard. I was shown supervision records for the three staff whose files I inspected. There was evidence of regular supervision. Staff confirmed that they received supervision when I spoke with them. Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 24 Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 25 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 38 39 41 42 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The staff team is lead by a capable manager who has been able to bring continuity, leadership and good levels of communication to the work of the home and the benefit of people using the service. There is a methodical approach to record keeping, maintenance and health and safety matters which means that these essential tasks are completed and kept up to date. EVIDENCE: I received positive comments from the people using the service, staff, relatives and visiting professionals. I also observed that there was a sense of purpose about the way the home was run. I observed that the manager was knowledgeable about the needs of the people running the service and that she was on top of day-to-day events. For example, whilst assisting with the inspection she took part in a meeting with other professionals, helped residents with their money and questions and got on with the work of the home. I Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 26 identified that there were clear systems of communication with staff and that the home’s systems were well organised and workable. I noted that the people using the service were included by nature of staff working closely with them and showing interest in them and their activities. I discussed the quality assurance initiatives with the management team. I was shown questionnaires which were used and had been returned by residents, relatives and professionals. I identified that there communication was good with relatives and visiting professionals. Each group told me, for example, that they were kept informed and that communication was clear. I discussed the possibility of the management team drawing up a quality assurance plan for the service. This would allow the service to include in a plan all quality assurance initiatives and would be useful to demonstrate work carried out. The management team undertook to consider this. I inspected the maintenance records, the servicing of equipment records, the health and safety checks and the risk assessments. I noted that detailed records existed and that equipment at use in the home had been regularly serviced including the fire safety system and equipment. A good standard had been achieved. Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 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 3 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 4 3 X 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X 3 3 X Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 28 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. 1. Standard YA24 Regulation 23(2)(b) Requirement The registered persons must ensure that the rear garden patio and paving is repaired and made safe. Timescale for action 01/12/07 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 (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Roland Care Home (North Circular Road) DS0000010621.V352245.R01.S.doc Version 5.2 Page 30 - 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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