Inspection on 03/10/05 for Roper House

This inspection was carried out on 3rd October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Roper House 17/12/08

Roper House 21/01/07

Roper House 16/05/05

Roper House 27/10/04

Roper House 20/05/04

Roper House 15/01/04

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Roper House St Dunstans Street Canterbury Kent CT2 8BZ Lead Inspector Christine Lawrence Announced 3 and 4 October 2005 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 and Care Homes for Adults 18 – 65*. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Roper House H56-H05 S23293 Roper House V242670 031005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Roper House Address St Dunstans Street, Canterbury, Kent, CT2 8BZ 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) 01227 462155 01227 452351 john.lynn@rnid.org.uk robert.isted@rnid.org.uk The Royal National Institute for the Deaf John Lynn Registered Care Home 28 Category(ies) of Sensory Impairment registration, with number of places Roper House H56-H05 S23293 Roper House V242670 031005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 16/05/05 Brief Description of the Service: Roper House is a care home providing care and accommodation for 28 people with sensory impairment. It 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 home’s 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. Currently there are 13 residents who are over 65 years of age and 10 who are aged between 18 and 65. The outcomes therefore reflect a mixture of the national minimum standards for older people and people aged 18-65. Roper House H56-H05 S23293 Roper House V242670 031005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection carried out over two days. On the second day Karen Green, who is a BSL translator, accompanied the inspector. Karen also is able to translate for Deafblind people. The inspector interviewed two members of staff and made observations of interactions between residents and staff. A tour of parts of the building was undertaken and various records were examined. The manager, John Lynn and the deputy manager, Robert Isted, also provided information. Nineteen residents completed comment cards for this inspection, as did eight relatives. The inspector and Karen Green joined residents for lunch. What the service does well: 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. Roper House H56-H05 S23293 Roper House V242670 031005 Stage 4.doc Version 1.40 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Standards Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Roper House H56-H05 S23293 Roper House V242670 031005 Stage 4.doc Version 1.40 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None These standards were not assessed at this time. Please see the report from the inspection of 16 May 2005 for more information about this home. EVIDENCE: Roper House H56-H05 S23293 Roper House V242670 031005 Stage 4.doc Version 1.40 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are 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 and 10 (Older People) and 6,9,16,18,19 and 20 (Adults 18-65) Residents’ health, care and social needs are set out in an individual plan. Their health care needs are met and they are protected by the home’s policies and procedures regarding medication. Residents are treated with respect and their right to privacy is upheld. EVIDENCE: Four Service User Plans of Care were viewed during this inspection. Sturdy, individual folders are used to store information and they are ‘labelled’ with residents’ names and photographs. The care plans are clearly laid out and Roper House H56-H05 S23293 Roper House V242670 031005 Stage 4.doc Version 1.40 Page 9 contain relevant objectives, with details of actions to be taken for each objective. A key worker system is operated at Roper House and this involves a monthly meeting between resident and key worker. Each resident has a cokey worker also. Residents are involved in setting objectives. Where necessary, separate, individualised procedures are established for residents exhibiting difficult behaviours. Reviews are undertaken, which include information from the Day Care provision within the home where appropriate. Examples were noted from the records, talking to management and observing residents of residents being enabled to take responsible risks. Risk assessments are in place, both general and specific, for instance going on holiday. There are written procedures in place, including information within the individual care plan folder, for dealing with a missing person. Residents have free unrestricted access to their rooms as they wish. All rooms are lockable and both staff and residents confirmed that privacy is respected. Seventeen residents were positive about this in their responses on the comment cards used for this inspection. A system involving flashing lights is used by anyone wishing to seek permission to enter a resident’s room. Mail is only opened by the recipient but staff will be on hand to offer assistance if required. Residents’ preferred form of address is known and used. There are facilities to enable those residents who wish, to make drinks and do their own laundry. The Inspector noted that a resident is supported to keep a pet. The level of assistance for personal care is noted within the care plan. Residents can choose to have a bath (including a Parker Bath) or shower and routines are flexible. Residents can choose to use hairdressers in the community but staff will also assist with hair care. Residents who wish and are able to, go shopping for clothes on their own and support is offered to those who wish/need it. Residents confirmed that they can choose what time to get up or go to bed. There are no shared rooms at Roper House and bathroom and toilet doors are lockable. Information seen in individual records indicates that residents’ health care needs are identified and responded to. Health care professionals such as opticians, dentist, chiropodist, general practitioners and community nurses are all variously involved with residents and specialist input is also noted. Staff either are able to use BSL or are currently learning but if a resident wishes independent interpreters will be accessed. A monitored dosage system is used to administer medication. There are policies and procedures in place. These are in keeping with the Royal Pharmaceutical Society of Great Britain’s published guidance. A risk assessment is undertaken if a resident wishes to be responsible for his or her own medication. Diabetes Awareness training, including the giving of insulin has been undertaken by those staff members who give injections. There is a detailed list of which staff have been given training and are therefore allowed to dispense medication. The system for administration involves two people working together to ensure that everything is done properly. One senior member of staff is due to undertake a training course. Staff spoken to were knowledgeable about medication storage and procedures. Roper House H56-H05 S23293 Roper House V242670 031005 Stage 4.doc Version 1.40 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with asssistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 (Older People) and 12,13,15 and 17 (Adults 18-65) Residents are supported and enabled to make choices about their lives and daily routines. Contact with friends and family and the wider community is facilitated and residents are provided with varied and wholesome food. EVIDENCE: Each person has opportunities to attend various educational/occupational activities, such as Adult Education classes and other facilities in the community. There is an activities resource within the home, with designated day care staff. Activities are responsive to individuals’ needs and wishes and include art and craft, board and computer games, Braille and Moon lessons, Roper House H56-H05 S23293 Roper House V242670 031005 Stage 4.doc Version 1.40 Page 11 aromatherapy, floral art sessions and coffee mornings. There are gardening facilities (horticulture sessions form part of the day care provision) and the garden has been improved to allow better access for Deafblind residents and any wheelchair users. The garden has also been the setting for several barbeques. All eight of the relatives/visitors who answered this question on the comment cards used for this inspection confirmed that they were made welcome when visiting. One person also said that they were always given a pleasant reception by staff answering the telephone. Facilities accessed within the community include swimming pool, bowling alley, theatres, cinemas, Deaf Club, Blind Club, church, local shops etc. Access to public transport is available for those residents who use it and there is also a minibus that the home uses to enable people to go to places. Everyone is on the electoral roll and the Inspector was informed that some people use postal votes and others attend polling stations. Residents are consulted about whether they wish to be involved with volunteers or ‘public’ events such as fetes or garden parties. Residents’ visitors are made welcome and there are no restrictions on visiting times. Facilities are available for meeting with visitors in private. Relatives and friends are also invited to social occasions. A Minicom is available to enable residents to communicate on the telephone. The inspector and BSL translator joined residents for lunch on the second day of the inspection. It was clear that residents enjoy the meals at the home and sixteen of them were positive about this in their comment cards. Times for meals are appropriate and the dining room is congenial. Special diets, for instance for diabetes, can be catered for. Drinks are available throughout the day. Meals are not rushed. Choices are available. There are regular menu surveys and consultation about the meals provided. The Inspector noted examples of residents being supported to be as independent as possible. It was also apparent that residents can choose to sit on their own if they wish. Information relating to diet is noted on care plans and weight is monitored. The Manager, John Lynn has acquired a nutritional assessment tool which can be used if any concerns are identified. Information about advocacy services is available within the home and staff will facilitate contact if required. Staff receive training regarding advocating on behalf of residents, which includes ensuring that residents have an awareness of the limits of staff involvement. There are five volunteers who are regularly involved with Roper House. There were lots of examples noted in records and through observation, of residents making choices. Residents confirmed this in discussions with the Inspector. Residents are encouraged and enabled to be as independent as possible regarding their personal finances according to their abilities and wishes. Roper House H56-H05 S23293 Roper House V242670 031005 Stage 4.doc Version 1.40 Page 12 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None These standards were not assessed at this time. Please refer to the report from the inspection of 16 May 2005. EVIDENCE: Roper House H56-H05 S23293 Roper House V242670 031005 Stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None These standards were not assessed at this time. Please see the report from the inspection of 16 May 2005 for more information about this home. EVIDENCE: Roper House H56-H05 S23293 Roper House V242670 031005 Stage 4.doc Version 1.40 Page 14 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 29 and 30 (Older People) and Standards 34 and 35 (Adults 18-65) the key standards to be inspected at leat once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 (Older People) and 34 and 35 (Adults 18-65) Residents’ needs are met by a staff team who have a mix of skills and experience and are trained and competent. Residents are protected by the home’s recruitment procedures. EVIDENCE: The management of Roper House is aware of the Department of Health guidance for staffing levels. The rota seen, as well as conversations with staff and residents, indicates that sufficient staff are on duty. Examples were noted of extra staff on duty for specific activities. There are 4 full time domestic staff and two cooks employed at Roper House. The staff records seen, along with discussions with a new member of staff and the manager, reflect that the home’s recruitment procedures include references, criminal record bureau checks, interviews, application forms and a commitment to equal opportunities. All staff are given written terms and Roper House H56-H05 S23293 Roper House V242670 031005 Stage 4.doc Version 1.40 Page 15 conditions of employment and a copy of the code from the General Social Care Council is given to each member of staff. Members of staff were observed to be responsive to residents. Training courses available reflect a commitment to increasing knowledge and awareness of the specialist needs of the people living in Roper House. Individual training records are maintained for each member of staff. These records indicate that a lot of training opportunities are available to staff. A new member of staff spoke very positively about the induction training she was being given. A more experienced member of staff confirmed that she was being given the opportunity to undertake level 3 NVQ Care. The training records are used in supervision to identify any individual training needs. The training provided relates to the needs of the residents. Roper House H56-H05 S23293 Roper House V242670 031005 Stage 4.doc Version 1.40 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s polies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 33, 35 and 38 (Older People) and Standards 23, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 and 38 (Older People) and 42 (Adults 18-65) Residents’ financial interests are safeguarded by the procedures in the home. The health and safety of staff and residents might be compromised. EVIDENCE: Roper House H56-H05 S23293 Roper House V242670 031005 Stage 4.doc Version 1.40 Page 17 The administrative staff confirmed that the systems for managing residents’ monies are the same as previously. Most residents have Post office savings accounts and some have bank accounts. The systems include two staff signatures for transactions, as well as the resident if he or she wishes. There are forms to complete which reflect the status of personal allowance and other valuables. The policy regarding the management of residents’ money and financial affairs is clearly written. The systems recognise individual wishes and abilities and residents are encouraged to be as independent as possible with their finances. There is no current certificate of a periodic inspection of the electrical installation. All other records relating to maintenance and service contracts were appropriate and up to date. Training courses and instruction relating to aspects of health and safety are undertaken within a rolling programme and at the time of induction training. There is a range of policies and procedures relating to health and safety. Fire safety checks are carried out and recorded appropriately and accidents and other incidents are recorded and reported either under RIDDOR or Regulation 37 of The Care Homes Regulations. Roper House H56-H05 S23293 Roper House V242670 031005 Stage 4.doc Version 1.40 Page 18 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 x 2 x 3 x 4 x 5 x 6 N/A HEALTH AND PERSONAL CARE ENVIRONMENT Standard No 19 20 21 22 23 24 25 26 STAFFING Score x x x x x x x x Score Standard No 7 8 9 10 11 Score 3 3 3 3 x Standard No 27 28 29 30 3 x 3 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No 16 17 18 Score x x x MANAGEMENT AND ADMINISTRATION Standard No Score 31 x 32 x 33 x 34 x 35 3 36 x 37 x 38 2 Roper House H56-H05 S23293 Roper House V242670 031005 Stage 4.doc Version 1.40 Page 19 None 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 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. 1. Refer to Standard 38 Good Practice Recommendations A copy of the relevant parts of the certificate of the periodic inspection of the electrical installation to be sent to the Commission when received Roper House H56-H05 S23293 Roper House V242670 031005 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 11th Floor International House Dover Place Ashford Kent TN23 1HU 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. Roper House H56-H05 S23293 Roper House V242670 031005 Stage 4.doc Version 1.40 Page 21 - 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. 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