Inspection on 17/12/08 for Roper House

This inspection was carried out on 17th December 2008.

CSCI found this care home to be providing an Good service.

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

Roper House 21/01/07

Roper House 03/10/05

Roper House 16/05/05

Roper House 27/10/04

Roper House 20/05/04

Roper House 15/01/04

Similar services:

The Royal School for Deaf Children - Westgate College

89 Hastings Avenue

39 Westway

24-26 St John`s Road

David Gresham House

Denecroft

4 Malham Drive

7 - 8 Hawthorn Way (RNIB)

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Roper House St Dunstans Street Canterbury Kent CT2 8BZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Christine Lawrence     Date: 1 7 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Roper House St Dunstans Street Canterbury Kent CT2 8BZ 01227462155 01227452351 nicola.oakes@rnid.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: The Royal national Institute for the Deaf care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 sensory impairment Additional conditions: Date of last inspection Brief description of the care home Roper House is a care home providing care, support and accommodation for people with a sensory impairment (deaf and deafblind). Service users may also need additional support with a learning disability or their mental and emotional health. The home is owned by the Royal National Institute for the Deaf (RNID). The home is located in the centre of Canterbury with all of its amenities. The home was opened in 1982 and consists of a large older building with a newer extension to the rear. All the homes bedrooms are single, with en suite toilet facilities and a bath or shower. There is a lift. There are extensive, very well maintained gardens to the rear. The current fees for the service at the time of the visit are £900 - £943 per week. Fees vary according to the needs of the resident. Information on the homes services and the CSCI reports for prospective residents/relatives will be referred to in the Service User Guide. The current inspection report is also on on display on the notice board in the entranceway to the home. The email address is: care.services@rnid.org.uk 27 Over 65 0 Care Homes for Older People Page 4 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection visit was unannounced and started at 10:00 and finished at 15:20. We, that is the commission for social care inspection (CSCI) looked at various records in the home and also used information sent to us by the manager and deputy manager through their completion of the Annual Quality Assurance Assessment (AQAA). Information from the previous inspection which took place in January 2007 was also referred to as well as the annual service review undertaken in February 2008. A tour of parts of the building was undertaken in the company of the deputy manager. We observed staff interacting with residents and we noted residents responses to staff. We spoke to staff on duty as well as the manager and deputy. Ten surveys were completed by residents and information from those surveys is referred to in this report. Care Homes for Older People Page 5 of 23 Care Homes for Older People Page 6 of 23 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 23 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that the home judges that it can meet their needs because it assesses their needs before they move in. Evidence: There have been no new admissions in the last twelve months. We looked at the records for one person who was the most recent person to move into Roper House as well as records of four other people. The records show that any admission is carefully planned and involves an assessment of someones needs. Individuals are involved in this process and we also saw examples of placing authorities assessments included in the information gathered. The assessment is used to compile a care plan and this includes, more recently, identifying wishes and goals to be acheived such as learning Braille. Care Homes for Older People Page 9 of 23 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from having an individual plan of care which identifies how their health and care needs are to be met. They are protected by the homes procedures for dealing with medication and they can be confident that they will be treated with respect. Evidence: We looked at five care plans for this inspection. These are based on up to date assessments and contain clear information for staff about how to support people with their personal care or particular health needs. The plans contain goals and objectives and these are monitored to see what progress is being made. Each resident has a keyworker who meets monthly with them to discuss any wishes or requests. Staff write brief comments on a daily basis. We were informed that there are plans to change the care plans over to a more person centred format and training for staff is planned for the New Year. The manager and deputy manager are also due to attend training regarding the deprivation of liberty safeguards, part of the Mental Capacity Act. Eight of the ten people who completed surveys answered always to the question Care Homes for Older People Page 10 of 23 Evidence: asking if they received the care and support they needed. One person said usually and one was not answered. The care plans contain records of the involvement of healthcare professionals including GPs, community nurses, opticians, dentists, chriopodist and specialist outpatient appointments. Some of the people living at Roper House have quite complex health care needs and the care plans seen for this inspection reflected clear information for staff. With the planned changes to care plans there is also the intention to have separate health care plans. Residents weight is monitored and there are assessments in place relating to nutrition. Seven people answered always to the qestion on the survey relating to receiving medical support and three answered usually. The home uses a monitored dosage system and medication is appropriately stored and the administration sheets were properly completed. Staff who give out medication have received training. The service has policies and procedures in place including for those people who would prefer to self-medicate. The treatment room, where medication is stored, has been moved to a different area within the home in order to improve the facilities generally but unfortunately because the work has yet to be completed (there are no hand washing facilities in the new room), residents still have to use the old area for some health care tasks to be completed. The new area is situated in a less busy part of the building and therefore would give residents a more discreet place to receive support. At the time of this inspection there was no date for this work to be completed. As noted above the care plans contain guidance to staff about preferences for personal care and there are policies and procedures in place to underpin the ethos of providing privacy and dignity at all times. Staff spoken to said this was a very important part of supporting people. The induction training provided at Roper House is in keeping with the common induction standards and privacy and dignity is included. We observed several instances of staff signing to residents in a way that supported privacy. Doors of bedrooms are fitted with light flashing systems and staff were observed to use them before entering rooms. Care Homes for Older People Page 11 of 23 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that their preferences will be identified and responded to and that they will be enabled to maintain contact with friends and family. Residents will be enabled to make choices and they will benefit from healthy, well-presented food at a time and place to suit them. Evidence: The care plans seen, as well as observations of residents during this inspection, reflected that people have routines and activities that they choose. People can make choices about meals, who to spend time with and whether to be on their own or in communal areas. The home is aware of peoples preferences regarding religion and we noted examples of how people could be supported. Some residents belong to social clubs outside Roper House. On the day of this inspection one person was on a day trip to London with support and another was out Christmas shopping with her key worker. There are no restrictions on family and friends visiting and there is a lounge upstairs which residents can use to receive visitors in private if they wish. Care plans and financial records showed that residents are supported to be as independent as possible but it was equally clear that staff would offer assistance and advice. Care Homes for Older People Page 12 of 23 Evidence: Residents indicated in the surveys that they liked the food at Roper House. They are offered choices and the kitchen staff indicated they could be responsive to last minute wishes. They are aware of the particular dietary needs of some residents such as with diabetes or a soft diet. The dining room has been extensively redecorated and improved, including specially designed lighting and the atmosphere for meals is social and unhurried. A member of staff said that it was a time for people to get together as well as just eating. Care Homes for Older People Page 13 of 23 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints would be handled objectively and in keeping with the homes appropriate procedures and residents or their representatives can be confident that any concerns will be listened to, taken seriously and responded to. Staff are aware of adult protection issues and there are systems in place which create an atmosphere for protecting residents from abuse. Evidence: There is an appropriate complaints procedure in place. All the residents who completed surveys said they knew how to make a complaint. Two of them said they would tell staff if they had any problems. Staff spoken to said some people were not always confident about speaking up and the monthly key worker meetings gave people an opportunity to express themselves. Staff have received training or instruction regarding the protection of vulnerable people. There are policies and in place procedures in place to underpin training including disclosure of abuse and bad practice (whistle blowing), safeguarding adults and financial procedures. Care Homes for Older People Page 14 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a safe, well-maintained home which is homely, clean, comfortable, pleasant and hygienic. Evidence: We toured much of the building, including some residents rooms and the laundry areas. There has been considerable redecoration in Roper House over the last ten months. Consultation with the Kent Association for the Blind (KAB) took place regarding colour schemes and lighting. The dining room, large lounge and various corridors have been decorated to a high standard and specially commissioned lighting has been installed. A maintenance person has been employed and there are systems in place to ensure that any work needing to be done is notified to him. The grounds at Roper House are well maintained and provide space and safety for people to enjoy, including those who have sight problems, or who are blind. There are no requirements noted from the fire safety officer or the environmental health officer. Roper House achieved four stars for the scores on the doors assessment. There is CCTV in place for security reasons only and does not intrude on residents daily lives. The home was clean and fresh. The home is currently short staffed with cleaners (we were informed that recruitment to fill vacancies is starting next week) but standards are still being maintained. One resident wrote, my bedroom is always lovely when Care Homes for Older People Page 15 of 23 Evidence: completing a survey for this inspection. All staff have received food safety training and 19 have infection control training. Hand washing facilities are appropriate and there is hand sanitizer spray in the entrance way for visitors to use. The laundry was satisfactory and the senior housekeeper talked through procedures demonstrating a knowledge of what is important. Personal protective equipment is available to staff in the toilets and bathrooms. Care Homes for Older People Page 16 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are met by sufficient staff who are competent, well trained and focussed on the individual. Residents are supported and protected by the homes recruitment procedures. Evidence: The home uses a rota to show who is on duty. There were sufficient staff on duty at the time of the inspection and this included staff on duty to enable one resident to go on a day trip to London and another to go out Christmas shopping at her request. The deputy manager gave examples of flexibilty within the deployment of staff, ensuring that the service can be responsive to residents needs and wishes where possible. There are staff employed who can be used when needed (bank staff). As noted previously there are two vacancies for cleaners which will be advertised shortly. Over 50 of the care staff have achieved national vocational qualifications of level 2 or above. Both the manager and the deputy said that the staff team is very committed and works hard to make a difference to residents lives. We observed staff signing with confidence and British Sign Language is very much part of the training programme. Our observations of staff, plus the information recorded in care plans and key worker sessions, showed that staff understand and focus on the individual. All staff receive deafblind awareness training and some staff have gone on (or are currently undertaking) more detailed training as Deafblind Communicators. The training and Care Homes for Older People Page 17 of 23 Evidence: development programme is targeted and focussed on the needs of the people who live at Roper House. There will be training in the New Year regarding person centred care planning ready for the new formats to be used. One member of staff said that the organization definitely gave opportunities for training. This was both in-house and with external trainers. There are trained trainers for various things already such as manual handling and we were informed that it is planned to have more people in the home who can deliver training. We looked at four staff records as part of this inspection. RNID have a dedicated human resources section who manage the process and support the local management. The recruitment procedure is robust and includes application forms, health declarations, references, interviews, terms and conditions of employment and CRB checks. Care Homes for Older People Page 18 of 23 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from the home being managed by someone who is competent, experienced and knowledgeable. Residents financial interests are safeguarded and their views are sought. Staff and residents have their health and safety promoted and protected. Evidence: The manager has a Diploma in Management Studies as well as a masters degree in strategic management. He is currently undertaking the NVQ 4 in care. He has over 20 years experience in care settings and has been the manager of Roper House for some years. The deputy is also doing the NVQ 4 in care. There are clear lines of accountability both within and external to the home. An annual development program is produced each year by the manager in conjunction with the staff team and this system supports the monitoring of how well the service meets the needs of the people living there. Residents are given opportunities to Care Homes for Older People Page 19 of 23 Evidence: provide feedback both formally and informally through discussion and through formal surveys. This is facilitated by an experienced volunteer who is able to communicate well with residents. The RNID undertakes visits to the home under Regulation 26 and there are regular audits. There are clear records and systems in place regarding residents finances and we looked at two for this inspection. Residents vary in their abilities and wishes about how they wish to be supported. We carried out a spot check on some of the service and maintenance records and found them to be appropriate and up to date. Staff receive training in health and safety subjects including first aid, food safety, manual handling, infection control and fire safety. Each resident has individualized procedures regarding evacuation in the event of a fire. There are various policies and procedures relating to health and safety. Care Homes for Older People Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 22 of 23 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 23 of 23 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!