CARE HOMES FOR OLDER PEOPLE
Romans 1 Roman Road Southwick West Sussex BN4 4TP Lead Inspector
Mrs H Church Announced 08 July 2005. V236833 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 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 H60-H11 S14682 Romans V236833 080705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Romans Address 1, Roman Road, Southwick, West Sussex, BN4 4TP 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) 01273 421 660 01273 415 278 admin@whsh-ho-adsl.demon.co.uk Mr T Matthews Mrs Linda Francis Leach Care Home (CRH) 30 Category(ies) of Old age, not falling within any other category registration, with number (OP) - 30 of places Romans H60-H11 S14682 Romans V236833 080705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 15/09/04 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 responsible for the day-to-day running of the care home is Mrs Linda Leach. Romans H60-H11 S14682 Romans V236833 080705 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection, one of two required under the Commission for Social Care Inspection was planned to observe the morning activities and lunch provided for the residents. The manager was present and a number of care and ancillary members of staff. Two visitors, a visiting dentist and district nurse all gave high praise of the openness of the operation of the care provided and the support they received to visit or provide domiciliary care. A number of residents were in the lounge room socialising with each other having just finished breakfast in the dining room. The residents seemed generally happy and relaxed. One new resident told the inspector that she felt very much at home there and how much the staff were doing for her. Mrs Leach has recently updated the Statement of Purpose and Service Users Guide and these to the Commission for Social Care Inspection for their records. These documents include information on how the home is run and how changes can be made to improve residents lives there. During the inspection, nine residents were spoken with in the lounge and conservatory and four others privately in their rooms. Four of these residents’ records examined to see if the care provided was the care required. All residents were able to give a clear account of their life at Romans and without exception all comments were enthusiastic. It was clear that residents are encouraged to say what they like or don’t like about the home. The residents were cheerful and clearly happy to be there. The members of staff gave high praise for the support received from their manager and the care plans showed that care is provided as required. There were two requirements made regarding records. What the service does well:
Romans provides a warm, homely and friendly environment where the resident’s collective and individual needs are central to all its activities. Staff enable residents to own it listening to their comments or proposes for any changes that would improve their lives and by providing individual care. From residents and visitor’s comments and observing staff at work, it was clear that the outcomes for residents are good with staff committed to treat residents with respect and dignity.
Romans H60-H11 S14682 Romans V236833 080705 Stage 4.doc Version 1.40 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 H60-H11 S14682 Romans V236833 080705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Romans H60-H11 S14682 Romans V236833 080705 Stage 4.doc Version 1.40 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 standard(s) 1,2,3,4,5. All 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. EVIDENCE: The manager has updated the Statement of Purpose and Service Users Guide for all their residents, representatives and prospective residents. Four care plans, including a new resident’s records were examined and it was clear residents are being assessed prior to admittance to ensure the home would be able to meet their needs. The new resident confirmed this and had had two trial visits. Relevant risk assessments were in place and had been reviewed. It was clear that staff are well informed about the care needed and were updating records accordingly. Romans H60-H11 S14682 Romans V236833 080705 Stage 4.doc Version 1.40 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 standard(s) 7,8,9,10 All residents had an individual care plan set out for staff to follow. One resident has elected to manage part of their medication. Staff are meeting the health care needs of the residents in an appropriate and respectful manner. EVIDENCE: Four care plans gave clear information of the care needed with good risk assessments to inform staff how to minimise risks. For one resident who is prone to numerous falls, the records of these were absent. The manager agreed to ensure these are recorded in future. The information about the care provided demonstrated the extent of the care provided. Medication sheets were completed accurately and from the primary health care team representative, the district nurse, it was clear that appropriate referrals are made and care is followed up as directed. Staff were observed speaking to and caring for the residents and treating them with respect. Staff knocked on doors before entering and spoke to residents in a caring manner. Residents comments included “staff are very kind”, “staff are lovely”, “staff are good” and “we couldn’t do better”. Romans H60-H11 S14682 Romans V236833 080705 Stage 4.doc Version 1.40 Page 10 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 standard(s) 12,13,14,15. Activities are suited to the conditions and dependency levels of each of the current residents. Visiting is positively encouraged. Residents are served meals that are nutritious and appetising and these were praised. EVIDENCE: Activities are based on ability with staff assisting with these. The number and choice of activities has continued since the last inspection according to the views of the residents. Music and bingo sessions are popular. There are thirty residents living in the home at present but staff still seemed able to spend individual time with them. The visitors told the inspector they have always been made welcome and it was clear from the visitor’s book that visitors come every day at all times of the day and evening. The residents told the inspector that they really enjoyed their food. Although there has been a change of cook, which caused some difficulties when using agency staff, since the appointment of the new cook, it was clear that the meals are steadily improving again. At the time of the inspection the residents were being treated to fish and chips from the local shop. The dining room was very welcoming and tables prepared with all necessary items.
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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 standard(s) 16,17,18 Residents are confident that any complaints they may have are taken seriously and acted upon appropriately. Staff training in adult protection procedures is up-to-date so staff are equipped to protect residents from abuse. EVIDENCE: The home has a complaints procedure displayed and included in the Statement of Purpose and Service Users Guide. Two residents and a visitor said they knew who to complain to, but had no occasion to do so. The West Sussex Multi Agency guideline was available in the home and staff, when questioned appeared to know the procedures for protecting residents from abuse. Updated training has been provided and is also included in the National Vocational Qualification training that some staff are completing Romans H60-H11 S14682 Romans V236833 080705 Stage 4.doc Version 1.40 Page 12 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 standard(s) 19,20,21,22,23,24,25,26. The indoor areas used by residents are clean, safe and homely with good access to the rear garden. The resident’s rooms are suitable for their needs and are homely. EVIDENCE: During a tour of the home the inspector noted that a maintenance programme is in place to provide a safe environment. There are two ground floor communal rooms and a dining room furnished with tables accommodating four residents giving it a homely atmosphere. There is a passenger lift, inspected regularly, for access to first and second floors. All rooms are equipped according to the National Minimum Standards with thermostatic valves in place to restrict water temperatures to safe levels and radiators guarded. The home was clean and hygienic. Resident’s rooms were visited and were homely and comfortably furnished with personal possessions around them. Training records showed that staff have received training in fire safety procedures and fire risk assessments were in place.
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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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,30 The duty rotas did indicate that enough staff were on duty over the 24 hours period to meet needs. Recruitment processes are robust and ensure residents are protected. EVIDENCE: The inspector noted that staff had time to socialise with residents after breakfast and before lunch. The three members of staff spoken with said they had received updated mandatory training and felt well supported by the manager. The inspector examined records relating to the recruitment of new staff and noted that they met the National Minimum Standards. A new training schedule is in place to cover mandatory training and periphery courses relating to older people. Romans H60-H11 S14682 Romans V236833 080705 Stage 4.doc Version 1.40 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,36,38. The registered manager is Mrs Linda Leach. Mrs Leach has the qualifications and experience to manage the home EVIDENCE: Mrs Leach has completed the National Vocational Qualification level 4 in Management and the Registered Managers Award. The three members of staff said Mrs Leach supports the staff to carry out their roles and provides a clear sense of direction that puts residents at the centre of all activities. The inspector noted supervision for staff has lapsed. It was agreed that this be resumed as a matter of priority. Other records showed that all financial procedures are robust to protect the residents. The quality assurance questionnaire, examined on the last inspection, gave residents views priority. All areas were seen to be safe giving resident’s sufficient space for them to have personal possessions or necessary equipment to support their care needs and move around their rooms and communal areas safely.
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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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 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 Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 2 3 3 Romans H60-H11 S14682 Romans V236833 080705 Stage 4.doc Version 1.40 Page 18 MO 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 OP 08 Regulation Schedule 3 (j) 18 (2) Requirement The registered persons must record any accident affecting the resident with date, time and witness if applicable. The registered persons must ensure staff are appropriately supervised every two months. Timescale for action End Sept 05 End Sept 05 2. OP 36 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 Romans H60-H11 S14682 Romans V236833 080705 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection 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
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