Inspection on 15/08/05 for Roman House

This inspection was carried out on 15th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Roman House 17/04/07

Roman House 07/04/05

Roman House 15/09/04

Roman House 08/04/04

Roman House 04/11/02

Similar services:

Flint House

The Cotswold Home

Fairways

Treloar College

Rush Court

The Maypole Nursing Centre

Fir Tree Lodge

Chilmington House

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

CARE HOME ADULTS 18-65 Roman House Winklebury Way Basingstoke Hants RG23 8BJ Lead Inspector Laurie Stride Unannounced 15/08/05 10.00am 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 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 Stationary 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. Roman House H54 s11922 Roman House v237006 150805.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Roman House Address Winklebury Way, Basginstoke, Hampshire, RG23 8BJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01256 328329 Scope Mrs Laura Jane Christian CRH 26 Category(ies) of PD registration, with number of places Roman House H54 s11922 Roman House v237006 150805.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Bungalow 1 will have one member of staff awake at night. 2. Bungalow 2 will have one sleep in member of staff at night. Date of last inspection 07/04/05 Brief Description of the Service: Roman House is a registered service owned and managed by Scope, a national disability charity. The establishment provides accommodation, physical care, emotional support and structured activities for 26 adults with cerebral palsy and associated disabilities. The home is situated in a residential area of Basingstoke and is within close proximity to local amenities. The town centre and major leisure facilities are nearby. There are good community links. The home consists of the main building, which provides accommodation for 18 younger adults, a large communal lounge and dining area and a quieter area for service users to meet with visitors. There are also two purpose built bungalows, which have been equipped to provide homes for 4 service users in each property. A day service operates from the establishment, which includes many structured activities. Further activities continue to be pursued in the community to promote independence. Roman House H54 s11922 Roman House v237006 150805.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two annual inspections of the home and was unannounced. The visit lasted approximately five hours and included a partial tour of the premises, inspection of records, observation of working practice, and speaking with 5 service users, members of staff and the registered manager. What the service does well: What has improved since the last inspection? What they could do better: Moving and handling risk assessments need to be kept under regular review. Roman House H54 s11922 Roman House v237006 150805.doc Version 1.40 Page 6 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. Roman House H54 s11922 Roman House v237006 150805.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Roman House H54 s11922 Roman House v237006 150805.doc Version 1.40 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 standard(s) 2 Resident’s needs and wishes are assessed prior to admission to the home. EVIDENCE: The inspector had the opportunity of speaking with a recently admitted resident, who gave positive comments about the home and confirmed that he/she had been involved in the assessment process prior to admission. The care manager had met with the prospective resident for discussion about the move and had completed an assessment questionnaire and relevant reports for the home. A trial period of five days had initially been arranged so that all the facilities and activities on offer could be sampled. An advocate had also been involved in order to make sure that the prospective resident’s needs and aspirations were taken into account. An interim care plan, risk assessment and correspondence with the placing authority were on file and a review date had been set. The registered manager stated that the home looks at getting the right ‘mix’ of people in the home, thus taking into account compatibility issues and the needs and wishes of existing residents also. Roman House H54 s11922 Roman House v237006 150805.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 and 9 Staff provide support to enable service users to make informed decisions and to take responsible risks, with ongoing work in progress to review risk assessments. A score of ‘4’ was previously given for decision making and the home continues to exceed this standard. EVIDENCE: Residents confirmed that staff respect and support their right to make decisions. There are opportunities for residents to air their views and put forward their ideas at meetings with the management. The only restricted area is the kitchen and this is understood as being for health and safety reasons. Residents are encouraged to have their own bank accounts and can manage their own personal allowances, some with assistance from relatives. The registered manager said that the home had an open ethos that encourages residents to make choices and refer to relatives or representatives if they wish. Choice is also promoted through residents accessing the community and trying out services and facilities, rather than have all services brought into the home. Information on advocacy services was available. Roman House H54 s11922 Roman House v237006 150805.doc Version 1.40 Page 10 Risk assessments for individual residents’ activities had been reviewed and improved since the last inspection and contained more detailed information and staff guidelines. Manual handling risk assessments were in the process of being reviewed, as also required at the last inspection, by a senior staff member who had recently taken on the role after the previous post-holder left and had completed the relevant training in late June. The senior staff member and the registered manager had discussed and prioritised those residents needing reviews most urgently. The timescale on this requirement will therefore be extended. Roman House H54 s11922 Roman House v237006 150805.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 16 Residents benefit from a range of opportunities for personal development and through having their rights and responsibilities recognised within the daily routines of the home. A score of ‘4’ was previously given for education and occupation and the home continues to exceed this standard. EVIDENCE: Where possible and dependent on staff availability, residents can continue to take part in activities engaged in prior to entering Roman House. Opportunities for education include the day service and local technical college. Residents choose courses from the syllabus and some had recently finished a term of learning about subjects such as motor mechanics, bricklaying, literacy and numeracy. A new term was due to start in September. Staff at the home check the venues for access and look at individual risks and support needs in relation to resident’s choices. One resident attends a supported work centre. The day service at Roman House aims to provide a range of activities for all levels of need and ability and utilises staff and external tutors, for example art and craft, gardening, computers and communications. Other activities include ten-pin bowling, ice-skating, multi-gym, coffee morning discussions, Roman House H54 s11922 Roman House v237006 150805.doc Version 1.40 Page 12 aromatherapy, ‘look good feel good’, and day trips organised by the team leader. A life skills tutor provides opportunities for residents to learn more about budgeting, shopping, cooking and looking after their home, and also about how to complain about services. Privacy and dignity is recognised and outlined in the Statement of Purpose and includes the right to lock doors, that staff will knock and wait for an invitation to enter, and that personal care will be carried out in private. The Service User Guide also sets out the expectations, rights and responsibilities of both residents and service provision, for example in relation to having visitors after 10pm. It was confirmed through discussion with residents and the registered manager that staff promote residents rights and responsibilities. Residents receive their mail unopened or have an agreement with their key worker to read it with them. All residents have their own keys to the home and to their bedrooms. Roman House is a non-smoking home by residents’ decision and there are areas outside for people to smoke if they wish. Staff were observed interacting with residents throughout the home and residents could choose to spend time alone and whether to join activities. Roman House H54 s11922 Roman House v237006 150805.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 19 The health and personal support needs of residents are well met with evidence of consultation with relatives / representatives and access to specialist support. A score of ‘4’ was previously given for healthcare and the home continues to exceed this standard. EVIDENCE: Residents’ preferences about support, movement and transfers are risk assessed and recorded. The home has a policy regarding cross-gender care giving and tries to match resident and staff gender and people’s preferences. The rota is arranged as far as possible to ensure a mix of male and female staff on each shift. New staff are linked to an experienced member of staff for observation initially. Times for activities are agreed with residents and recorded in care plans, including times for getting up/going to bed, meals and bathing. Guidance is offered with regard to personal hygiene and is recorded in care plans. The registered manager said that the home works closely with resident’s relatives when agreeing care plans, particularly with regard to residents with high support needs, and keeps them informed about any changes to care and support. An overwhelming majority of resident’s relatives / representatives who responded to questionnaire comment cards said the home consulted them about their relative / friend’s care. Roman House H54 s11922 Roman House v237006 150805.doc Version 1.40 Page 14 Residents spoken with confirmed that they were happy with the support they received from staff and the way it was given. Those who returned comment cards stated they felt well cared for. Each resident had access to healthcare services and this was confirmed through discussion with individual residents and the registered manager and by looking at the home’s appointment book. Records showed individual appointments with doctor’s surgeries and outpatient clinics, podiatry, dentists, opticians, speech and language therapist, physiotherapist, and psychologist. The registered manager reported that there are six doctor’s surgeries and various dental practices used by residents. One resident told how they are encouraged to make their own appointments. Residents have access to wellperson clinics. Aids and equipment such as hoists are regularly serviced and records of this are kept on file. Roman House H54 s11922 Roman House v237006 150805.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 The home has a suitable complaints procedure to ensure that residents and their representatives feel their views are listened to and acted upon. EVIDENCE: The home’s complaint procedure was seen and included the contact details of the Commission for Social Care Inspection as previously required, as well as clear timescales for responses and instruction on keeping records. A summary complaint procedure is contained in the Service User Guide. Two thirds of resident’s relatives / representatives who responded to questionnaire comment cards said they were aware of the home’s complaints procedure. Two of the total fifteen said they had made a complaint in the past and expressed satisfaction with the home’s response and the overall care provided. All of the residents who gave comments said they knew who to speak to if they were unhappy with their care. Roman House H54 s11922 Roman House v237006 150805.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 30 The provision of effective infection control systems ensures that residents live in a safe and comfortable environment. EVIDENCE: The home has appropriate and relevant information and procedures on infection control. Low hand driers are provided in the main unit bathrooms and alcohol gel dispensers are sited throughout the building. The laundry is situated within the main building and laundry does not have to be taken through areas where food is stored, prepared or eaten. The laundry floor has an impermeable finish and the walls are readily cleanable. Hand washing facilities are available. The bungalows are also designed to ensure that the laundry area is separate from cooking and dining facilities. Washing machines are fitted with suitable hot-wash programmes and sluicing equipment is available. The home complies with the water supply regulations 1999 and has suitable valves in the washing machine pipe work preventing foul water contaminating the mains. The home employs a laundry assistant who sees that washing is carried out correctly. Staff have health and safety training including guidance on the use and storage of substances for cleaning. Roman House H54 s11922 Roman House v237006 150805.doc Version 1.40 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 and 36. Residents are supported and protected by suitable numbers of trained staff and the home’s supervision practices. EVIDENCE: A sample of the home’s staff rota was seen and staffing levels appeared sufficient to meet resident’s needs. A number of replacement staff were due to start work and residents confirmed that they participated in the selection process. The registered manager reported that the home had increased the staffing ratio in one of the bungalows in order to meet the needs of a recently admitted resident. Scope has a national training agenda that is organised at head office. All staff receive the structured induction training that includes health and safety, fire safety, cerebral palsy awareness, moving and handling, risk assessment and adult protection. The registered manager confirmed that the induction workbooks link in with Skills for Care and Learning Disability Award Framework (LDAF) standards and NVQ awards. Approximately forty percent of staff had achieved NVQ2 or above, eleven having completed the award and another nine working towards completion. Eight staff had current first aid certificates and there is a trained first aid practitioner on each shift. An approved moving and handling trainer is normally part of the staff complement of Roman House and this training is reviewed on an ongoing basis. A senior member of staff had recently taken over this role and had completed a relevant five-day training Roman House H54 s11922 Roman House v237006 150805.doc Version 1.40 Page 18 session. The registered manager had completed a ten-week course in working with challenging behaviour. Planned future training included food hygiene, safe handling of medication, insulin and diabetes courses. The home liaised with the district and continence nurses with regard to staff training. Through conversation with two senior staff responsible for supervising care staff, it was evident that formal recorded supervision took place on a regular basis and covered relevant areas such as resident issues, staff issues, training and promoting the aims of the home. Roman House H54 s11922 Roman House v237006 150805.doc Version 1.40 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 The home has well organised systems in place to obtain residents and other stakeholders views. EVIDENCE: The registered manager reported that the home was in the process of redevising its quality assurance survey with the aim of sending out questionnaires in September this year. Residents confirmed that they had regular meetings and records of these were kept. Details of the home’s complaints procedure and availability of inspection reports is contained in the Service Users Guide. Regulation 26 reports of monthly visits to the service by a senior manager were detailed and comprehensive and involved discussion with individual residents. Feedback from residents and their relatives / representatives who had responded to pre-inspection questionnaires was overwhelmingly positive and this was shared with the registered manager. All fifteen of relatives / representatives who gave comment confirmed that they were kept informed of important matters. Roman House H54 s11922 Roman House v237006 150805.doc Version 1.40 Page 20 Roman House H54 s11922 Roman House v237006 150805.doc Version 1.40 Page 21 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 4 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x 3 Standard No 11 12 13 14 15 16 17 x 4 x x x 3 x Standard No 31 32 33 34 35 36 Score x x 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Roman House Score 3 4 x x Standard No 37 38 39 40 41 42 43 Score x x 3 x x x x H54 s11922 Roman House v237006 150805.doc Version 1.40 Page 22 Yes 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 9 Regulation 15(b)(c) Requirement Moving and handling risk assessments must be kept under review and documentary evidence of this must be held in the home. This is a partially repeated requirement of 27/05/05. Timescale for action 10/10/05 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 Good Practice Recommendations Roman House H54 s11922 Roman House v237006 150805.doc Version 1.40 Page 23 Commission for Social Care Inspection 4th Floor, Overline House Blechyden Terrace Southampton, Hants SO15 1GW 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 Roman House H54 s11922 Roman House v237006 150805.doc Version 1.40 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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