CARE HOMES FOR OLDER PEOPLE
Roscarrack House Bickland Water Road Budock Falmouth Cornwall TR11 5BP Lead Inspector
Ian Wright Unannounced 30 August 2005 10.00 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. Roscarrack House D52-D04 S9125 Roscarrack House V233149 300805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Roscarrack House Address Bickland Water Road Budock Falmouth Cornwall TR11 5BP 01326 312498 01326 312498 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) Mr David Edwards & Mrs Maureen Edwards Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Roscarrack House D52-D04 S9125 Roscarrack House V233149 300805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection An unannounced inspection was completed on 6.1.05 Brief Description of the Service: Roscarrack House provides care for 19 elderly people. The home is situated on the outskirts of Falmouth in large grounds with extensive views over the open countryside. The home is approached by a long drive with car parking available. There is suitable wheel chair access. Accommodation is on two floors with a stair lift provided. The majority of bedrooms have en suite facilities that include a toilet and washbasin. The registered providers are Mr and Mrs Edwards. They are supported by Mr M. Gibbs the manager of the home. Suitably qualified and experienced care staff provide personal care within a relaxed, friendly atmosphere. Roscarrack House D52-D04 S9125 Roscarrack House V233149 300805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over six hours. The inspection was carried out on an unannounced basis. The inspector was able to speak to approximately half of the service users. The inspector also met with the owners Mr and Mrs Edwards, and Mr Gibbs the manager of the home. The inspector examined the care and business records, and inspected the building. What the service does well: What has improved since the last inspection?
There were no requirements at the last inspection. Roscarrack continues to provide a homely and caring environment for service users accommodated there. The registered provider have completed some redecoration. A delightful fishpond area has been developed in the garden, and there are plans an adjacent seating area.
Roscarrack House D52-D04 S9125 Roscarrack House V233149 300805 Stage 4.doc Version 1.40 Page 6 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. Roscarrack House D52-D04 S9125 Roscarrack House V233149 300805 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 Roscarrack House D52-D04 S9125 Roscarrack House V233149 300805 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) 1,3,4,5 Suitable information is provided to enable service users to make an informed choice to move in to the home. Suitable measures e.g. a pre admission assessment, and links with external professionals are in place so the registered provider can meet the needs of service users. EVIDENCE: A suitable statement of purpose (which outlines the facilities and services provided) and service user guide was inspected. All service users, and where appropriate, their representatives have received a copy of the service user guide. Pre admission assessments are completed before the service user comes to live in the home. From discussion and records it appears there are suitable links with external professionals such as general practitioners, chiropodists, social workers and district nurses. The inspector spoke to service users who said they were able to visit before formal admission was arranged. Roscarrack House D52-D04 S9125 Roscarrack House V233149 300805 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 Service users personal and health care needs are met appropriately. EVIDENCE: All service users have suitable care plans. These contain satisfactory information to enable staff to deliver care. Care plans are reviewed appropriately. Suitable links have been developed with GP’s, district nurses etc. Interventions by health care professionals are documented. The registered provider operates a satisfactory medication system. Medication records are kept appropriately. Staff who administer medication have received suitable training. The inspector spoke to several service users who said their rights were respected, and they were treated with dignity by staff. Staff were observed working with service users in an appropriate manner. Roscarrack House D52-D04 S9125 Roscarrack House V233149 300805 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 Routines and activities are tailored according to individual service users needs. Service users can receive visitors in the home when they choose. EVIDENCE: Service users said they could get up and go to bed when they wished, and have autonomy how they organised their time. More agile service users are able to go for a walk on their own. The home has extremely pleasant grounds where service users can choose to relax. Suitable arrangements are in place for service users to receive visitors. Service users can meet with their visitors either in their bedrooms, the dining room or the lounge. Roscarrack House D52-D04 S9125 Roscarrack House V233149 300805 Stage 4.doc Version 1.40 Page 11 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 standard(s) 16 Appropriate arrangements are in place so any complaints are resolved effectively. However more information must be provided regarding the complaints process to individual service users and where appropriate their representatives. EVIDENCE: The registered provider has a satisfactory complaints procedure, which is displayed around the home. However information regarding how to make a complaint must also be outlined in the service user guide and the policy file. Information how to make a complaint must be issued to service users, and where appropriate their representatives. However, service users the inspector spoke to said they had faith that the registered provider would listen to any complaints or concerns they had and resolve them. Roscarrack House D52-D04 S9125 Roscarrack House V233149 300805 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) 19-26 Roscarrack provides suitable accommodation to meet the needs of service users living there. The home is clean, pleasant and hygienic. EVIDENCE: The property is very well maintained, appears to be safe, is comfortable and homely. Furnishings and decorations are of good quality. The home has a large lounge where service users can choose to relax. Other facilities include a pleasant dining room, and suitable bathrooms and toilets. The home was clean and hygienic on the day of inspection. Bedrooms are suitable for purpose, and pleasantly decorated. Service users all said they were happy with their accommodation. Appropriate moving and handling equipment is provided. The home also has a stair lift, which is suitably maintained. Roscarrack House D52-D04 S9125 Roscarrack House V233149 300805 Stage 4.doc Version 1.40 Page 13 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 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, 29, 30 Suitable staffing levels are provided to care for service users. Staff are recruited and trained appropriately. EVIDENCE: Suitable staffing is provided. Rotas show: • There is a minimum of three staff on duty between 0730 and 1030 (however there is usually up to five staff on duty during this time). • Between 10:30 and 1400 there is between 3 and 4 staff on duty. • Between 1400 and 1730 there is between 2 and 3 staff on duty. • Two staff are on duty between 1730 and 2130. • There is one waking night and one sleep in member of staff on duty between 2130 and 0730. The registered providers outlined a suitable recruitment procedure. Staff records included appropriate information for example for each member of staff the registered provider obtained two references and a Criminal Record Bureau check. Records show staff have received appropriate training as required by regulation. Roscarrack House D52-D04 S9125 Roscarrack House V233149 300805 Stage 4.doc Version 1.40 Page 14 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, 37, 38 Service users benefit from a home which is suitably managed and run in their best interests. EVIDENCE: The registered providers have suitable skills, experience and knowledge to manage the home. The manager Mr Gibbs has national vocational awards in management and care at level 4. Staff are suitably supervised on a day to day basis and appear well developed, caring and effective. Management seemed approachable and friendly with other staff. There are regular staff meetings. Records examined regarding the management of the home, and in regard to service users care are appropriate. The registered providers operate a suitable quality assurance system. For example there is an annual quality assurance development plan.
Roscarrack House D52-D04 S9125 Roscarrack House V233149 300805 Stage 4.doc Version 1.40 Page 15 Health and safety precautions are satisfactory for example in regard to servicing of fire, moving and handling equipment, gas appliances, electrical equipment etc. However over the last few weeks records have not been kept regarding the testing of fire equipment. However these checks were previously maintained effectively. Roscarrack House D52-D04 S9125 Roscarrack House V233149 300805 Stage 4.doc Version 1.40 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 3 x 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 x 15 x
COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 3 3 x x 3 3 3 Roscarrack House D52-D04 S9125 Roscarrack House V233149 300805 Stage 4.doc Version 1.40 Page 17 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 16 Regulation 22 Requirement Information how to make a complaint must be outlined in the service user guide. Information how to make a complaint must be issued to service users Timescale for action 1.12.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Roscarrack House D52-D04 S9125 Roscarrack House V233149 300805 Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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