Inspection on 07/04/05 for Roman House

This inspection was carried out on 7th April 2005.

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 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 17/04/07

Roman House 15/08/05

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 Laurie Stride Unannounced 07/04/05 10:30 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 Version 1.10 Page 3 SERVICE INFORMATION Name of service Roman House Address Winklebury Way, Basingstoke, 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 CRH 25 Category(ies) of PD registration, with number of places Roman House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. Bungalow 1 will have one member of staff awake at night. will have one sleep in member of staff at night. 2. Bungalow 2 Date of last inspection 15 September 2004 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 25 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 17 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 Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first of two annual inspections of the home and was unannounced. The visit lasted six and a half hours and included a tour of the premises, inspection of records, observation of working practice, and speaking with 5 service users and 5 members of staff. The manager was on leave at the time of the visit and the team leader assisted throughout the inspection. Since the last inspection there has been a change of registered manager, following the promotion of the previous post-holder. What the service does well: What has improved since the last inspection? The home continues to support service users to develop and maintain their independence and life skills through appropriate care planning and activities. Roman House Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Roman House Version 1.10 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 Version 1.10 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) These standards were not assessed on this occasion. EVIDENCE: Roman House Version 1.10 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) 6 and 9 There is a clear and consistent support planning system in place to provide staff with the information they need to satisfactorily meet service user’s needs. Staff provide support to enable service users to make informed decisions and to take responsible risks, however links between care plans and individual risk assessments were not always clear and in some instances written evidence of reviews and updates was required. EVIDENCE: A sample of 3 care plans was inspected and these were found to contain clear and detailed information relating to individual service user’s needs, goals and guidance for staff supporting them. Care plans included, for example, diagnosis and medical history, medication, communication, guidance on personal care, eating and drinking, abilities and goals. Service users confirmed that they had copies of their personal care plans in their bedrooms and that they attended reviews to which relatives and other representatives were invited. Written evidence of reviews was also seen on file. Roman House Version 1.10 Page 10 Service users were supported to take responsible risks, for example in accessing the community independently. An extensive range of general and specific risk assessments including the environment was contained in a separate folder. A number of risk assessments relating to individual service users were contained in one section rather than in the resident’s personal file. Links between personal care plans and generalised risk assessments were not clear. One service user’s care plan referred to a risk assessment that could not be located at the time of the visit. A comprehensive manual handling profiles folder contained individual risk assessments for all service users. There was a lack of documented evidence regarding any recent reviews of these. The team leader reported that this was possibly due to the current management change over period. Staff communications systems including daily reports and regular hand-overs were in place and staff on duty were aware of risks associated with individual resident’s needs. Roman House Version 1.10 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) 11, 13, 14, 15 and 17. The service is well organised in providing residents with opportunities for personal development both within and outside the home. Links with the community are good and support and enrich service user’s social and educational opportunities. The home consults service users about the range of leisure activities on offer and provides information to assist decision-making. The home’s visiting policy supports service users to maintain family links and friendships inside and outside the home. The meals in the home are good offering both choice and variety and catering for any special dietary needs. EVIDENCE: Service users have opportunities to learn and use practical life skills at day services, which are led by the team leader. A group of service users learning food preparation and cooking skills currently uses the life skills training room in the main building on a Monday morning. Another group is facilitated in the afternoon with a focus on those residents who would like to move into the bungalows and more independent living. A computer facility is available and used regularly on Wednesdays. A gardening tutor visits on Fridays and teaches service users relevant skills. There are also tutors for arts and crafts Roman House Version 1.10 Page 12 and visits from 2 aromatherapy practitioners. External opportunities for personal development are also made available, for example visits to Church groups and a fitness suite. Service users are encouraged and supported to access local services and facilities and information about these was available. At the start of the inspection, a large number of service users were going out to a Church communication meeting and this would also be a forum for discussing ideas for summer outings. The home owns 4 vehicles to assist service users with transportation. A number of service users access the community independently using dial-a-ride and public transport. Some residents were demonstrably aware of service users rights of access to public facilities under the Disability Discrimination Act. Service users could choose to take part in a range of leisure activities, for example trips to the theatre, local pubs and the Watercress Line. The team leader reported that the day service shuts down for 2 weeks in the summer and this time is used for taking trips further a-field, such as Cadbury’s World. The home was looking at visiting the Eden Project in June this year. Brochures about various activities are obtained so that service users can decide whether they would like to take part. There was a visiting policy on display in each building. Service users confirmed they could have visitors in the home and see friends and relatives outside the home. Significant relationships were recorded in resident’s individual care plans. The home had recently recruited a new chef who was keen to promote healthy eating and service user choice. Alternative food options were available at each meal. Mealtimes were observed to be relaxed and unhurried and staff sat with residents and gave appropriate assistance as needed. Staff are trained in the provision of percutaneous endoscopic gastrostomy (PEG) care and any special dietary needs are recorded in care plans. The staff member in one of the bungalows was also seen informing service users of a range of lunch options. Fresh fruit was freely available in the lounges. Roman House Version 1.10 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) 20 The systems for the administration of medication were thorough with clear and comprehensive arrangements being in place to ensure service user’s medication needs are met. EVIDENCE: The medication procedures were comprehensive and records were kept as per policy. Medication is ordered and supplied on a monthly basis. Most medication arrives from the pharmacy in blister packs with pre-printed record sheets and is first checked by 2 members of staff. The record sheet is then signed by one of the checkers to confirm everything is correct. There is also a monthly record kept of any returned medication to demonstrate that there has been no mishandling. The person who gives the medication signs the records. A number of staff are given medication training so that there is a trained member of staff on each shift. All staff are tested regarding their competency before they are allowed to administer medication. Medication is stored in a locked metal trolley and this is kept in a separate facility with a keypad to ensure only authorised access. Controlled drugs are stored appropriately and proper procedures and records are adhered to and kept. The home also keeps copies of all prescriptions. Roman House Version 1.10 Page 14 Roman House Version 1.10 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 and 23 The home has a suitable complaints procedure that requires some additional information. Training, policies and procedures are in place to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: The home’s complaint procedure was seen and this gave clear timescales for responses and instruction on keeping records. A local complaint record book was available and had no entries. The team leader said that the home would attempt to deal with any issues or concerns before these became complaints and that there were plans to provide service users with suitable training, but did not know the dates for this. A summary complaint procedure is contained in the Service User Guide. The procedure did not include contact details for the Commission for Social Care Inspection. Written procedures for the protection of vulnerable adults were held on site and the team leader had a lead role as advisor and trainer in this respect. Training is provided to all staff in recognising abuse and reporting and recording concerns. Staff members were able to demonstrate awareness of the procedures at the inspection. A number of service users controlled their own finances. The home’s policy on staff handling service user’s finances stipulates procedures for 2 staff signatures, receipts, recording and balance checks. The home has a safe that is available if service users wish to deposit money securely prior to banking. One service user had a history of hitting out at staff on rare occasions. Staff were made aware of how to prevent and deal with this through their induction and staff meetings. The staff does not use physical interventions. Roman House Version 1.10 Page 16 Roman House Version 1.10 Page 17 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) 24 and 28 The provision of modern, purpose built accommodation and continuing maintenance of the older unit ensures that service users live in a homely, safe and comfortable environment. EVIDENCE: The main building appeared generally well maintained in areas used by service users and was suitable for its stated purpose, spacious and comfortable. The two bungalows provide modern purpose built accommodation of a very high standard. Service users comments expressed a great deal of satisfaction with the accommodation and service. The premises are accessible to all service users and the home offers access to local amenities, public transport and relevant support services. Furnishings, adaptations and equipment are good quality, and are as domestic and unobtrusive as is compatible with fulfilling their purpose. The Environmental Health Officer visited on 13/05/04 and records of the visit were held on file. A range of comfortable and accessible communal spaces is provided within the premises. The main building has a large lounge and dining area and access to Roman House Version 1.10 Page 18 a well-maintained garden area with seating, a ball pool, and where BBQ’s are held during the summer. Each bungalow has a lounge and kitchen / diner and access to the grounds. Staff are provided with sleeping facilities and storage for personal items. Roman House Version 1.10 Page 19 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) 31 and 34 Service users are supported by staff who demonstrate a good understanding of their own and others roles and responsibilities. The home uses sound recruitment practices in order to protect service users. EVIDENCE: A number of the staff on duty talked about their roles and demonstrated their understanding of the main aims of the home; for example ensuring service user’s wellbeing, supporting people according to their needs, providing a safe environment and suitable activities, and improving the quality of resident’s lives. Written job descriptions were available. Staff commented that the home is good at improving the skills of workers and there is a good staff team. The management were seen as pro-active. Service users also made positive comments about the staff team. There is a mix of both male and female staff to meet service user’s support needs. The home also employs agency staff and asks for people who have worked there before and have got to know service users, in order to provide continuity of care. A sample of the home’s staff recruitment records was inspected. These contained proof of Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks, 2 written references, completed application forms and Roman House Version 1.10 Page 20 interview records, health declarations and, where applicable, copies of work permits. Staff confirmed that workers spend the first full week on induction training and all staff were reported to be taking part in NVQ training. The full induction training is completed within the first 6 months and includes adult protection awareness, health and safety training including manual handling, epilepsy and cerebral palsy. New staff also spend time on shift in a supernumerary capacity, shadowing experienced staff and getting to know the home and service users. Roman House Version 1.10 Page 21 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) 42 Safe working practices are observed to ensure the health and welfare of service users. EVIDENCE: During the tour of the premises no hazards were identified; for example wheelchairs and equipment were stored to prevent trip hazards when not in use and cupboards containing cleaning chemicals were locked. The kitchen area was clean and tidy and fridge / freezer temperatures were seen to be monitored and recorded. Food was stored as required and coloured chopping boards were used to avoid the risk of cross-contamination. The home keeps records of the maintenance, tests and inspections of appliances and equipment and these were inspected and found to be up-todate. These included boiler maintenance and gas safety certificates, hoist test inspections, fire systems and emergency lighting, fire extinguishers and radio nurse call system. A record was kept of staff fire drills and instruction. Roman House Version 1.10 Page 22 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x x x Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x 3 x x Standard No 11 12 3 x Standard No 31 32 33 34 Score 3 x x 3 Page 23 Roman House Version 1.10 13 14 15 16 17 3 3 3 x 3 35 36 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x Roman House Version 1.10 Page 24 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 9 Regulation 15(b)(c) Requirement Risk assessments must be kept under review and documentary evidence of this must be held in the home. The complaints procedure must include the name, address and telephone number of the Commission for Social Care Inspection. Timescale for action 27/05/05 2. 22 22(7) 27/05/05 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 Version 1.10 Page 25 Commission for Social Care Inspection 4th Floor Overline House, Blechynden 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 Version 1.10 Page 26 - 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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