Inspection on 17/04/07 for Roman House

This inspection was carried out on 17th April 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Roman House 15/08/05

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 Hampshire RG23 8BJ Lead Inspector Marilyn Lewis Unannounced Inspection 17th April 2007 10:00 Roman House DS0000011922.V331683.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 Roman House DS0000011922.V331683.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. Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Roman House Address Winklebury Way Basingstoke Hampshire RG23 8BJ 01256 328329 01256 328340 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) SCOPE Mrs Laura Jane Christian Care Home 26 Category(ies) of Physical disability (26) registration, with number of places Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Bungalow 1 will have one member of staff awake at night. Bungalow 2 will have one sleep in member of staff at night. Date of last inspection 15th August 2005 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. Information provided by the registered manager on the 21st March 2007, stated that the fees for the home ranged from £26,000 to £83,287 per year. Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report represents a review of all the evidence and information gathered since the last inspection including an unannounced visit to the home, which took place on the 17th March 2007. During the visit the inspector toured the home and met with eight residents service users, two visitors, an independent advocate, three support staff, the deputy manager and the registered manager. Records seen included care plans, risk assessments, medication, staff recruitment and training. What the service does well: Residents looked relaxed and said that they enjoyed living in the home. Good interaction was observed between staff and residents and staff were encouraging and supporting service users to make their own decisions and maintain their independence. Very good care plans are in place that gave detailed information about the care needs of the residents and guidance for staff on the support required to meet those needs. Clear risk assessments had been completed for all residents’ daily living and leisure activities. The risk assessments were being kept under review and a resident was aware of risk assessments in place to minimise the risk to their safety. Residents are able to receive personal care in their preferred manner and their likes and dislikes are documented in their care plans. Preferences for participating in daily activities such as the time they like to go to bed are recorded but are flexible to meet changing needs such as residents wishing to watch television later than usual. It was evident that the emphasis of the care provided at the home was on supporting the residents to live as independently as possible. Staff encourage residents to make decisions about their own life and also to participate in making decisions as a group for the home. A resident commented that they liked being able ‘to live my own life’ with help from staff. Residents are supported to participate in a wide range of activities both in the home and the community. Residents who have been assessed as able to do so go out on their own for visits to the local town, church and meet up with friends. All residents go out for trips such as to places of local interest in the home’s vehicles. Tutors and therapists visit the home to provide residents with the activities programme that includes arts and crafts, bowling and aromatherapy. Residents are also able to learn life skills such as budgeting and cookery. Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 6 Residents spoken with said that they enjoyed taking part in the activity sessions. One resident said that they appreciated being able to ‘do their own thing’ and spend time in their room as they wished. Two relatives met during the visit said that they were very involved in the care of their relative and that communication with staff was very good. The relatives said that they were very satisfied with the care provided at the home. An independent advocate visiting also said that communication was good. The home has very clear procedures in place for the safe handling of medicines. Residents who are assessed as able to do so are responsible for the administration of their own medicines. Residents are very involved in the planning of the homes’ menus and said that they liked the food provided. Staff supported residents who required assistance in a very sensitive and caring manner. Staff spoken with said that they received very good support from the registered manager and they spoke enthusiastically about their work at the home. New staff are recruited using the home’s robust recruitment procedures that includes the completion of Criminal Records Bureau (CRB) and Protection of Vulnerable Adult (POVA) checks, before they are able to start work at the home, to ensure they are suitable to work with the residents. Staff said that they are encouraged to attend training sessions and obtain qualifications and records seen indicated that staff had received mandatory training in moving and handling, food hygiene and first aid. Staff had received training in topics relevant to the service group such as epilepsy and the registered manager was arranging for staff to receive training in the care of people with cerebral palsy. The home has good systems in place to obtain the views of residents and their relatives on the quality of care provided at the home. What has improved since the last inspection? Staff who have received training in moving and handling and risk assessing have reviewed all the service users risk assessments for moving and handling to minimise the risks to service users and staff. Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 7 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. Roman House DS0000011922.V331683.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 Roman House DS0000011922.V331683.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): 1, 2 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with good information about life at the home and are able to visit before making a decision about taking a place there. No one is admitted to the home without a care needs assessment to ensure the home can meet their care needs. EVIDENCE: Prospective residents and their relatives/representatives are provided with the home’s Statement of Purpose and Service User Guide that give good information about life at the home. The documents include the qualifications and experience of the registered manager, the number of staff employed, arrangements for health care, admission process and medication. The current business plan for the home is also included. The documents state that the home’s policies and procedures are available on request. The registered manager said that the documents would be discussed with prospective service users if they wished, to ensure they understood the information provided. No one has been admitted to the home for a number of years and therefore there were no new assessments to assess. Blank report forms to be used when completing pre admission assessments indicated that a very detailed Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 10 assessment would be undertaken for any prospective new resident. Pre admission assessments seen for three residents provided good information about their care needs and included relevant information from care workers, care managers and health professionals. The registered manager said that the assessments would be completed both at the current home of the prospective resident and on their visits to Roman House. Family members and if appropriate, an independent advocate, are able to be involved with the assessment if the resident wishes. Residents are able to visit as they wish and spend time in the home before making a decision including over night stays and are admitted for an initial sixweek trial period followed by a multi disciplinary team review, to ensure the home is meeting the needs of the resident. Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 11 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 and 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to make their own decisions, live an independent lifestyle and their wishes are reflected in their detailed care plans. EVIDENCE: Care plans seen for three residents were very detailed and indicated that the residents were involved in their care planning. The plans contained assessments for all aspects of daily living activities such as bathing and stated what the resident could do for themselves, and what assistance was required by support workers. The plans seen showed evidence of regular review and were also updated as the needs of the residents changed. A resident said that they knew what was written in their care plan and were involved in reviewing of the plans and another resident said that they discussed their plans with their parents and staff. The registered manager said that with the residents consent, residents’ relatives or representatives were encouraged to attend a review of the care Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 12 plans at least annually. Records seen confirmed this was happening and relatives spoken with said that they were always contacted if there was a change to the care plans. A staff member said that if the care plans for a resident was changed they were told about the changes and were asked to read the plans and sign to confirm they had read and understood them. During the visit it was evident that residents were encouraged to make their own decisions about their lives. Residents were discussing their plans for the day with staff, with some going out shopping, some joining in activities arranged in the home and another spending time with relatives. A staff member said that it was the residents’ home and their lives and they had the right to make their own decisions. Residents are able to attend sessions on life skills provided by a tutor that includes budgeting and handling money and healthy eating and cookery. A staff member said that the course assists residents to gain the information needed to make decisions. The home has three vehicles of varying sizes that enable residents to access facilities in the community and a staff member said that the vehicles were well used. An independent advocate was visiting the home during the inspection visit. The advocate said that communication with the staff was good and they were always willing to listen to the resident’s wishes. Risk assessments were contained in the care plans for all aspects of daily living and leisure activities. The assessments were detailed and included guidance for staff on changing needs. For example one assessment told staff to increase fluids during the hot weather and that the resident although ambulant was not able to use stairways including escalators. The assessments showed evidence of regular review. One resident said she knew that risk assessments had been completed for her activities and that she was not able to make a hot drink alone as the risk was high, but she could get her cup and saucer ready. At the time of the last inspection manual handling risk assessments were being reviewed. Three staff members had received training in risk assessing and moving and handling and had reviewed all the moving and handling assessments and assessments seen indicated that they were keeping the assessments under review to meet the changing needs of the residents. Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 13 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): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported and encouraged to participate in their choice of daily living and leisure activities, are able to maintain contact with family and friends and are involved in the planning of meals. Residents’ rights and responsibilities are recognised by an enthusiastic staff team. EVIDENCE: The registered manager said that at present no residents were attending educational sessions outside the home. This was due to recent changes in the syllabus available at the local college. However the registered manager was having discussions with the college and other educational establishments to try to access suitable courses for the residents. In the mean time residents were Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 14 attending activities sessions held in the day centre. Tutors visit the home to provide tuition on life skills, art and crafts, computers and gardening. The interests and hobbies of residents were documented in their care plans and during the visit some service users discussed their programme of activities with the inspector. The residents said that they were very involved in the decisions as to what activities they would like to participate in. Residents living in the bungalows were assessed as having a greater degree of independence and following risk assessments, some went out on trips such as shopping in town on their own. During the visit one resident was preparing to go out shopping and he said that he enjoyed going into town and usually goes about three times a week. Another resident was going shopping with a staff member. The registered manager said that one resident had wished to find a job and now works at a local sheltered work centre Monday to Friday. One resident said that they enjoyed going ten-pin bowling and another said that the aromatherapy sessions were good. A resident said that she enjoyed craft sessions and showed the inspector some of her needlework and artwork. It was evident that residents were able to make their own decisions and staff respected their wishes. A resident said that he was really enjoying watching the world cup cricket on television in his room and this sometimes meant that he was staying up a lot later than usual. He said that he appreciated being able ‘to live my own life’. A resident excitedly told the inspector that she had been shopping for clothes because she was going on holiday with a friend from the home. The registered manager said that the home had close links with the local church and some of the residents attended services there. One resident who attends coffee mornings with members of the church has been able to hold coffee mornings in one of the bungalows for his church friends. One resident, whose close relative had died recently, had been visited by the minister before the funeral to help them make the decision as to whether to attend the funeral. The registered manager said that a resident of a different religion did not wish to participate in services or follow any dietary regime but that arrangements would be made should their wishes change. Two visitors spoken with during the visit said that they were able to visit at any time and came frequently. They said that staff were always welcoming and communication was very good. Three residents said that their relatives and friends came as they wished and they could talk with them in any of the communal rooms or in their own room. The registered manager said that there were no restrictions on visiting other than the residents’ wishes to receive them. Records seen indicated that relatives and friends visited frequently and some residents went out for trips or spent time at the family home as they wished. Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 15 Residents are able to hold a key to their own room and the home’s Statement of Purpose says that they have the right to lock their door if they wish. Staff were seen to knock on doors and wait before entering rooms and a staff member asked a resident if she would like to have her door closed when we toured the home as she was in the process of dressing. Through out the visit very good interaction was seen between staff and residents and staff encouraged the residents to make their own decisions about what they wished to do or how they wanted things done. Residents said that they met with staff to discuss the meals for the next month. Residents discussed with staff which meals or particular foods they would like to include in the menu and the menus were then developed taking this information into account. Residents said they liked the food provided and one said that there was always ‘plenty’. In the bungalows residents said that they helped to write the menus and prepare the meals. At lunch on the day of the visit staff were seen supporting residents who required assistance in a very sensitive manner. The cook said that special diets were catered for including one dairy free. The main meal for the day was a choice of cauliflower cheese or toad in the hole, fondant potatoes and spring green beans followed by fruit flan and cream. Roman House DS0000011922.V331683.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 and 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents personal care needs and health needs are well met and systems are in place for residents who are assessed as able to can administer their own medication. EVIDENCE: Residents’ preferences for how they wished to receive personal care were recorded in their care plans. One care plan seen stated that the resident liked to stand at the washbasin and wash and another documented the resident’s wish to wash their own face but then needed assistance. Care plans also documented residents’ wishes for the time they wished to get up and go to bed. One plan said that the resident liked to go to be late but that they would like to be reminded that an earlier time may be of benefit on evenings prior to a trip out the next day. Two residents spoken with said that they felt that assistance with their personal care was given as they wished and they also commented on staff allowing them to do as much as they could for themselves in order to maintain their independence. Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 17 The registered manager said that whenever possible, residents were able to choose which staff members assisted them and residents confirmed this. Rotas seen indicated that a mix of male and female staff were on duty for each shift to enable residents a choice of support worker. Care plans and records seen indicated that the health care needs of the residents were being met. Visits by GPs and other health professionals including the community physiotherapist, speech therapist, psychologist and district nurse were documented. Residents visited dentists and opticians in the community and records were also kept of visits to hospital outpatient departments. A resident said that he telephoned his doctor’s surgery to make his own appointments. Residents also visited well person clinics. A relative said that they were notified of any health care issues immediately and were involved in decisions as to whether professional advice should be sought. Records seen for one resident contained an exercise programme and listed staff who had received training to provide the exercises. The community physiotherapist had monitored and reviewed the exercise programme and had noted that it was going well. Staff said that the specialist equipment required to support the residents was provided and during the visit residents and staff were seen to use a wide range of equipment including hoists, stand aids, wheelchairs and walking aids. Staff had received training in the use of hoists and stand aids. One resident had been provided with a custom made bed that gave the support and safety required. Two residents, asked, said that they felt safe when staff were assisting them. A resident said that she visited an outpatient department at the local hospital for specialist shoes to aid their mobility. The home has very clear procedures for the safe handling of medicines. In the bungalows residents have a medicine cupboard in their own room and there is also a medicine cupboard in a locked cabinet in the corridor. One resident who lives in one of the bungalows administers their own medicines. Risk assessments and procedures are in place for the self- administration of medicines. The staff member responsible for medication in the main building, during the visit, described the correct procedures for the recording medicines brought into the home and on the disposal of unwanted medication. It was noted at lunchtime that one resident was given medication mixed with their food. The staff member said that this had been discussed with the GP and the resident’s relatives and they agreed that this was the most appropriate method for administering the service user’s medicines. This was documented in the residents care plans. Staff were recording the administration of controlled drugs on individual sheets. The staff member said that controlled drugs record books had been ordered and the systems would be changing as soon as the books arrived. Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 18 Sheets seen had been completed appropriately. Records checked for two residents matched the amount of controlled drugs held. Staff said that they had received training in the administration of medicines and records confirmed this. Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 19 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents know that any complaints will be taken seriously and acted upon quickly and they are protected by staff awareness of the prevention of abuse. EVIDENCE: Residents said that they would talk with staff if they had any concerns or complaints. One resident user said that the registered manager ‘would sort out’ any complaints’. Visitors also said they would discuss any concerns or complaints with the registered manager or person in charge at the time and they felt that the issues would be investigated and acted upon. The home has a complaints procedure that indicates who will investigate the complaint and timescales for the process. A copy of the complaints procedure was included in the home’s Service User Guide. The home has clear procedures in place for the protection of vulnerable adults and instructions for staff on reporting suspected abuse are displayed in the office. Staff spoken with were aware of the procedures to follow should abuse be suspected. The home has followed the appropriate procedures for reporting a recent incident that may have been suspected abuse and has worked with adult services to investigate the incident. The registered manager said that staff were discussing the most appropriate methods to provide residents with an understanding of the procedures. Staff received training in the protection of vulnerable adults during induction training. The deputy manager who is responsible for training in the prevention Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 20 of abuse was auditing the training records and arranging training sessions for staff members who were due to attend refresher courses. Records seen indicated that the home completes at least a POVA First check before new staff members start work at the home to ensure they are suitable to work with the residents. The home holds small amounts of money for some residents. Receipts are kept for all transactions. Records seen for three residents matched the amount of money held. The registered manager said that residents are encouraged to look after their own money and all have accounts with a national bank. A resident said that she had a cash box that she kept locked in her room. Residents are able to attend training sessions in life skills that include budgeting and managing money. Some of the residents have the support of an independent advocate. The advocate was visiting at the time of the inspection visit to support a resident during a review meeting with the registered manager. Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Roman House provides residents, visitors and staff with a pleasant, clean and safe environment. EVIDENCE: The home is situated in a residential area of Basingstoke. The main building has accommodation for eighteen residents who all have single rooms. There is also a large lounge with dining area, offices and kitchen. The upper floor of the main building has staff accommodation that is also used for staff training and meetings. The upper floor is not accessible to residents. There is good storage space for items such as specialist equipment in the home. The bedrooms in the main building are smaller than those in the bungalows and are only just the size to allow specialist equipment such as hoists to be used. The bedrooms are fitted with a hand basin. Residents said that they liked Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 22 their rooms though two said they would like more space. If they wish residents are able to lock the doors of their rooms. The lounge in the main building is large and residents said that the furniture was comfortable. A large television is provided in this room. There is a dining area in the lounge and the main kitchen is close by. Doors from the lounge lead out into the garden. There is also a smaller quiet lounge where residents can entertain visitors if they wish, in a relaxed quiet atmosphere. Another room is equipped for teaching service users daily living skills such as preparing meals. There are sufficient bathroom and toilet facilities in the main building and those seen looked clean. Some corridors in the main building looked a little worn and in need of redecoration. The registered manager said that there are business plans in place to replace the main building with three purpose built bungalows. The two purpose built bungalows are located next to the main building. Residents have their own bedrooms and there is a lounge, dining area, kitchen and laundry room. Bedrooms are fitted with en-suite facilities and some have overhead hoists that extend to the en-suite bathroom. The bedrooms are spacious and residents said that they really liked their rooms. The rooms contained many personal items such as televisions, music systems and computers. Both the bungalows were light and clean and looked well maintained. The home employs two maintenance men for the routine maintenance of the home. The main building and the two bungalows have entry systems to ensure only people known to the staff are able to enter the building to protect the safety of the residents. The home’s garden is accessible to all residents. During the visit some residents, supported by staff, spent time in the garden playing bowls. Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 23 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, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by staff who are recruited through robust procedures, know their role and responsibilities and receive the training and supervision needed to do their jobs. EVIDENCE: The home employs the registered manager, deputy manager, four senior support workers and twenty-one support workers. Separate staff are employed for administration, catering, domestic and maintenance duties. Additional staff are employed to support residents with the activities programme and there are also a number of tutors and therapists who visit the home. Staff spoken with were clearly aware of their roles and responsibilities and talked enthusiastically about their work supporting the residents to maintain their independence. Residents said that they liked the staff who were ‘great’, ‘very good’ and ‘lovely’. Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 24 Staff at the home said that they felt staffing levels had improved over the last year and there were sufficient staff members on duty to support the residents. Three residents also said that they felt sufficient staff were on duty but a visiting relative said that at times staff seemed to be busy with activities taking place and could not spend time with residents on a one to one basis. The registered manager said that she was aware of the pressure staff were under due to the changing needs of the residents and a recruitment drive was taking place. Three new support workers were due to start work when their CRB and POVA checks had been completed. Currently five staff members are on duty for each shift in the main building plus therapists and tutors during the day. One of the bungalows has two staff on duty for each shift and the other bungalow one staff member. The registered manager said that when agency staff are employed the agency is asked to send staff who have worked at the home before and are aware of the needs of the service users to provide continuity of care. An agency staff member on duty at the time of the visit said that he had worked at the home many times and the residents looked relaxed in his company. Ten senior support and support workers hold National Vocational Qualifications (NVQ) and five are in the process of completing the course. Four staff members are NVQ assessors and support staff involved in the training. Staff said that they felt the registered manager supported and encouraged them to attend training sessions. Training records seen indicated that staff received an induction course organised by Scope and mandatory training in moving and handling, food hygiene and prevention of abuse. Staff also received training in nutrition, health and safety. The registered manager said that a video on Epilepsy was shown to staff during a staff meeting and this was followed by discussion on the care of residents with epilepsy. Not all staff had received training in the control of infection. The registered manager said that this was being arranged as a matter of urgency. The home had recently had an outbreak of diarrhoea and vomiting that affected residents and staff. The registered manager also said that she was trying to organise training in the care of residents with cerebral palsy. At the time of the visit the registered manager needed to look at the individual training records for staff to identify training needs. Following the inspection visit the registered manager notified the inspector that a training matrix had been developed to provide clear information as to the training staff had received and ensure training required was arranged. The home has clear procedures for the recruitment of staff. Records seen for three staff members who had recently started work at the home contained all the information required including two written references. Criminal Records Bureau (CRB) and (Protection of Vulnerable Adult) checks had been completed before staff commenced work at the home to protect the safety of residents. Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 25 Staff said that they received regular supervision and records seen confirmed that supervision sessions were arranged every six to eight weeks. Staff who provide the supervision have received training in the process. Staff said that they knew the date for their next supervision session and said that the discussions included all aspects of care provision, performance and training. Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 26 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 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is very well run in the best interests of residents, who are protected by the safe working practices operated there. EVIDENCE: The registered manager has worked for Scope for nineteen years. Laura Christian holds NVQ level 4 in management and is in the process of completing the Registered Managers Award. During the visit it was evident that the registered manager had a very good rapport with residents, staff and visitors. Three staff members said that they received good support from the registered manager and visitors and the advocate said that communication with the staff at the home, including the registered manager and the deputy manager was good. Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 27 Four residents said that they felt able to talk with the registered manager or deputy at any time and records seen indicated that regular reviews took place with residents regarding their care. Group meetings for residents are held every six weeks regarding suggestions for the menus and meetings are also held for discussion on the day-to-day running of the home. Two residents said that they liked attending the meetings and having a chance to discuss life at the home. The registered manager said that questionnaires were given to residents annually to obtain their views on the quality of care provided at the home. Someone independent of the service, assisted residents to complete the questionnaires. Responses to the last survey indicated that residents were very satisfied with the service. Some residents had written small comments such as ‘ I would like to buy a new dress’ and staff had arranged for this to take place. Meetings are not held for relatives but the registered manager said that ‘an open door’ style of management was operated at the home and relatives were able to speak with her at any time. Relatives confirmed that they could contact the registered manager as they wished. Records seen indicated that staff meetings are held on a monthly basis. Staff said that they were encouraged to attend the meetings and were provided with a copy of the records taken at the meeting and signed to confirm they had read and understood them. During the visit hazardous substances such as cleaning fluids were stored safely. Health and safety notices were displayed around the home and staff had received training in health and safety issues including moving and handling. Staff were observed using appropriate methods for the safe moving and handling of residents. Protective clothing including disposable aprons and gloves were available and staff were seen to wear them as needed. Fire records seen indicated that regular checks were made on the fire safety equipment and emergency lighting. Records indicated that staff were attending fire drills but the recording of staff attendance needed to be clearer in which staff members had attended the drills so that the registered manager could confirm all staff had attended as needed. The kitchen looked clean and food was being stored appropriately. Records were being kept of the temperatures of fridge and freezers. The laundry rooms also looked clean and in good order. Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 28 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 x 4 3 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 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 x 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 x 3 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 4 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 3 4 4 x x 3 x Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 29 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Roman House DS0000011922.V331683.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. 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