Inspection on 17/08/06 for Romans

This inspection was carried out on 17th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Romans 22/11/05

Romans 08/07/05

Romans 15/09/04

Romans 10/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Romans 1 Roman Road Southwick Shoreham-By-Sea West Sussex BN42 4TP Lead Inspector Mrs H Church Unannounced Inspection 17th August 2006 09:00 X10015.doc Version 1.40 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 Romans DS0000014682.V306819.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 Older People. 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. Romans DS0000014682.V306819.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Romans Address 1 Roman Road Southwick Shoreham-By-Sea West Sussex BN42 4TP 01273 270100 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) West Sussex Housing Society Limited Post Vacant Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Romans DS0000014682.V306819.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd November 2005 Brief Description of the Service: Romans is registered with the Commission for Social Care Inspection to provide personal care for up to thirty people over the age of sixty-five in the category of Older People. The establishment is a three storey detached building situated in the town of Southwick in West Sussex. A plaque in the hall shows that Romans has been operating as a care home since 1956. Romans is situated approximately quarter of a mile from Southwick Green, the main shopping centre of Southwick and all its amenities and half a mile from the sea front. Accommodation is provided in thirty single rooms. The rooms are arranged over three floors with a lift giving access to all but four of the rooms. A lounge, sun lounge and separate dining room provide the communal space. The responsible person is Mr Tony Matthews who represents West Sussex Housing Society Limited, a voluntary organisation who owns the service. The registered manager’s post is currently vacant. Romans DS0000014682.V306819.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit took place over one day and planned to take part in the morning and over the lunch time period. The manager’s post is vacant and the temporary manager off duty so the assistant manager assisted the inspector with all of her enquiries throughout the site visits. The inspector noted staff spending quality time with individual residents, either in the lounge or in their rooms. A homely, friendly and relaxed atmosphere prevailed and the inspector was welcomed into all areas of the home. Although summer, most residents remained indoors. For the site visit, the inspector examined previous information and the Statement of Purpose and Service Users Guide that informs residents about the service. During the inspection, seven residents gave their views to the inspector. Without exception all comments were enthusiastic about the staff and their life there. One resident commented, “It is five star”. Two members of care staff said they felt very supported by the temporary management system and carried out their duties in a relaxed and positive manner. The care plans showed that the care provided is appropriate according to the needs of the residents and the right amount of support to maintain independence and ensure resident’s lives continue to improve was given. There were no requirements or recommendations made at this inspection. What the service does well: Romans Care Home is a well-established care home providing a friendly, homely arena where residents feel well supported. It is well maintained with some rooms exceeding the National Minimum Standards. In spite of temporarily managing two sites, the manager has maintained a supportive management leadership style to provide a good standard of individual care. Care staff are promoting care with independence and the underpinning services are maintaining a care home where resident’s needs continue to be the focus for all activity. Romans DS0000014682.V306819.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Romans DS0000014682.V306819.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Romans DS0000014682.V306819.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5. All new residents had been assessed before moving into the home. The staff at the home are meeting the residents identified needs. Relatives were given enough information to help them decide the home would be suitable Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: Four residents, including one resident in for respite care were case-tracked. Pre-assessments were seen for the four residents case tracked and noted to include all the areas required for making a decision. The Statement of Purpose and Service Users Guide are regularly updated and the Commission for Social Care Inspection and residents have all received updated copies. Contracts are in place and are shortly due to be revised to take into account the Office of Fair Trading’s latest report on contracts in care homes. Resident’s are either selffunding or funded by the local authority. Romans DS0000014682.V306819.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. All residents had an individual care plan set out for staff to follow. The home operates a policy where all medication is managed by care staff. Care staff are meeting the health care needs of the residents in a respectful manner. Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: Four care plans and assessments were examined and were seen to include the health, care and social needs of the resident. Risk assessments and nutritional assessments formed part of the care plans but one of these did not reflect the number of falls one resident was having and dates for reviews were altered. The home’s medication procedures showed safe practice with the handling, administration, storage and disposal of medicines. Staff have been assessed Romans DS0000014682.V306819.R01.S.doc Version 5.2 Page 10 as competent to undertake the medication procedure and monitor the risks for any resident electing to manage their own medication. MAR charts were accurate with no gaps noted in recording of administration of medicines. Links are made between residents needs and determine the care provided. A discussion arose over the medication for one resident discharged from hospital where the recorded information did not match the verbal information. It was agreed that only recorded prescribed medication would be given to prevent medication errors with general practitioner’s reviewing prescribed medication when required. Care plans reflect the needs of residents and the risks to their health, safety and welfare, including falls and pressure areas. The inspector noted the care plans contained updated information on the front of each record to inform staff of the current situation. Care plans were up to date and if the altered dates were accurate, reviewed regularly. The staff on duty were well informed about the care needed for the four residents case tracked. Two district nurses gave high praise for the referrals, following instructions and feedback given when the health care team are involved. Where specialist equipment had been identified, this had been provided. Romans DS0000014682.V306819.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Activities are suitable for current residents, visiting is positively encouraged and residents are served meals that are nutritious and appetising. Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: There are twenty-eight residents living in the home at present and care staffing hours are sufficient giving care staff opportunity to spend individual time with the residents. According to five residents, visitors are always made welcome. The visitor’s book confirmed this. A programme of activities was observed as being in situ and two residents confirmed this was provided. Currently, activities are based on resident’s wishes and abilities with any new activities being provided from residents’ requests. Activities range from individual to group activities and range from physical to mental activities led by a professional organisation. Staff will Romans DS0000014682.V306819.R01.S.doc Version 5.2 Page 12 accompany residents for trips out either to the local shops or local outside places of interest. The inspector noted from three residents comments that music activities are the most popular. A number of residents told the inspector that they were looking forward to the 50th Celebrations arranged for the end of August. The dining area looked very inviting and was arranged to encourage residents to sit at tables laid for up to six persons but also to communicate with other residents. The resident’s comments included praise for the home cooked food and found it fulfilling with good choices. The inspectors spoke with the cook and it could be seen that dishes were prepared according needs and wishes of the residents. The inspector observed the high quality of the home-made meal, all prepared from fresh ingredients. The menus are changed regularly according to feedback. Where residents prefer an alternative, this is provided and on the day of the inspection, a choice of three main dishes was being provided. It was clear that meals are a high focus for all residents. The kitchen was fitted with spacious and well-organised work surfaces with well-maintained equipment giving staff the means of providing a good choice of meals in a hygienic and specialist area. Where residents are unwell or prefer to eat in their rooms, individual trays are laid and staff assistance provided where residents are unable to manage without help. Dietary needs are recorded in the individual care plans and these are taken into consideration when planning meals. Weight charts showed that all aspects of health care and meal planning are linked. Romans DS0000014682.V306819.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18. Residents are confident that complaints are taken seriously and acted upon appropriately. Staff have had in-house training in adult protection procedures so are equipped to protect residents from abuse. Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The complaints procedure was displayed in the hallway with the Visitor’s Book and included in the Statement of Purpose and Service Users Guide. The complaints log was examined and one substantiated complaint was recorded regarding a meal. Four residents told the inspector that they had no hesitation in speaking to the staff or manager if there was anything they felt unhappy about. The staff confirmed that in-house training for Adult Protection Training had been given this year and the training was certificated. The induction and foundation training included some training aspects of this. The West Sussex Multi Agency Guideline was present in the office and made available to staff at all times. Romans DS0000014682.V306819.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19-26 inclusive. The indoor and outdoor areas used by residents are clean, safe and homely with good access to all parts. Resident’s rooms are suitable and homely. Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The inspector toured the building and examined specialist equipment to ensure residents are safe and enjoy surroundings. The indoor communal areas, garden and individual room areas are safe and well arranged to maximise independence without compromising a sense of freedom. Romans DS0000014682.V306819.R01.S.doc Version 5.2 Page 15 Throughout the tour the home presented as clean, pleasant and hygienic, equipment was being maintained and the redecoration, refurbishment programme continues. Some doors were not yet fitted with locks to meet standard 24.5/6 but discussion over these concluded with the information that requests are complied with. Meanwhile all residents have lockable furniture in their rooms. One radiator in the east stairwell is to be guarded if a smaller radiator can be obtained that allows the door to be opened safely. If not obtained, a risk assessment will be made following the monitoring of residents use of this area. Thermostatic valves are in place to restrict water temperatures to safe levels and protect residents from burns and scalds. As residents leave rooms, these are decorated according to the residents wishes, furnished and arranged to the needs of residents. One resident was very complimentary about the care taken to ensure the room was made homely. The garden and outside areas are well maintained and provide a pleasant outlook. Romans DS0000014682.V306819.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The duty rota indicated that sufficient staff with a suitable mix of skills and experience are on duty over the 24 hours period to ensure needs can be met. Recruitment processes were in place to ensure residents are protected. Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The inspector observed that the staffing rota, examined in conjunction with care plans, showed that the staffing levels do ensure residents needs can be met at all times. The inspector observed staff spending quality time with residents in the communal areas as well as ensuring residents who chose to remain in their rooms were given staff time as they needed or wished. During the fieldwork, the inspector spoke to residents about the time spent with staff and all of the comments were good. Residents also felt their privacy and dignity is maintained and three residents commented that “staff were kind and thoughtful” and one resident said “I give it all 5 stars”. Romans DS0000014682.V306819.R01.S.doc Version 5.2 Page 17 The homes use of agency staff is minimal as existing staff generally covers staffing absences but if needed, monies are available for this. The inspector observed that domestic and catering roles are staffed separately with staff having clearly defined roles for these. The inspector examined recruitment procedures to ensure that the home continues to meet this standard. Two staff records were examined in conjunction with their training records and noted that the recruitment process was good and that all staff, whether care or ancillary, complete the induction and foundation training course work. All staff have received mandatory training at appropriate intervals with periphery courses on the care needs of this group of residents also provided. National Vocational Qualifications at levels 2, 3 and 4 are continuously provided but although the home only meet 25 of care staff with National Vocational Qualifications, they are continuously working towards the 50 level. Records showed and staff on duty confirmed that they had only been employed following a Protection of Vulnerable Adults check and Criminal Records Bureau clearance. The staff on duty confirmed that training has been provided as per the training schedule and that there was no restriction on courses available to them. All staff had received some training applicable to their roles and level of expertise. Romans DS0000014682.V306819.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,38. The home is run in the best interests of the residents whose health, safety and welfare is promoted and protected. Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The manager’s post remains vacant but the temporary presence of the registered manager from their sister home Rosemary Mount has ensured the home is being managed safely with the assistant manager and a senior for Rosemary Mount providing a continuous presence. Staff are relating well to Romans DS0000014682.V306819.R01.S.doc Version 5.2 Page 19 this arrangement. The assistant manager is considering the Registered Managers Award to complement her National Vocational Qualification level 4. A Quality Assurance System has been devised but is under review as needs to be printed in a larger and more defined manner to assist residents to complete it more confidently. The staff meet regularly and ad hoc meetings are arranged with residents according feedback. Currently the society is planning a 50th birthday celebration in August for people in the community to see the home and meet the residents. A number of residents commented that they are looking forward to this event. The inspector observed the informal and on-going system of seeking views from residents and visitors at every opportunity during the site visit. Residents are encouraged to manage their own finances or a representative of the resident takes on the responsibilities for this. The supervision procedure was examined and this is being maintained at the right levels. Staff are finding this very helpful where no registered manager is in situ to provide a constant leadership style. Training needs are identified from this procedure. The inspector noted that the documents used to record accidents meet the Data Protection Act. Health and safety is maintained through training and servicing of necessary equipment. All equipment checks and servicing is carried out within the safe guidelines. Good moving and handling practise was observed that minimises risks to residents’ health safety and welfare. Policies and procedures were in place and had been updated recently. The inspector concluded that the health care needs of all of the residents were being safely met. Romans DS0000014682.V306819.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Romans DS0000014682.V306819.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 Romans DS0000014682.V306819.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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. 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