Inspection on 31/05/07 for Rosclare Residential Home Ltd

This inspection was carried out on 31st May 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Rosclare Residential Home Ltd 04/10/06

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Rosclare Residential Home Ltd 335 Ewell Road Surbiton Surrey KT6 7BZ Lead Inspector Jon Fry Key Unannounced Inspection 31st May and 14th June 2007 10.00a X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosclare Residential Home Ltd Address 335 Ewell Road Surbiton Surrey KT6 7BZ Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8390 4183 Rosclare Residential Home Ltd Care Home 19 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (11) of places Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th October 2006 Brief Description of the Service: Rosclare provides care and accommodation for nineteen older people including up to eight people who may have dementia. The home is situated in a residential area on the borders of Surbiton and Tolworth. It is close to public transport, churches, leisure facilities and local shops. The home has nineteen single bedrooms, eleven of which have en-suite toilets A copy of the home’s Statement of Purpose and Service User Guide can be obtained on request from the home. Current fees range between £500 and £515. Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by one inspector who spent seven hours in the home over two separate visits. The inspector talked individually with ten people living at the home. Two relatives or friends of individuals were also spoken with during the inspection. A number of records were examined and discussions took place with the manager and two staff members. Completed surveys were received from seven people living at the service and one relative or friend of a person living at the home. What the service does well: What has improved since the last inspection? What they could do better: Procedures for managing medication need to be further improved. A number of call bells were not working on the first day of our visit to the home. This had been raised as an issue at a previous inspection of the service in October 2006 and must now be properly addressed. Health and Safety checks for areas such as hot water and the fire alarm must take place regularly to protect the safety of the people living there. Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Good information is available to prospective users of the service about the home. Assessments are completed before people move in to make sure that their individual needs can be met. EVIDENCE: In surveys, all seven people who live at the home said that they had received enough information to make a decision about moving in. One relative also said that they were given the information they needed to make a decision about using the home. Typical comments from individuals included “good”, “I should hate to be anywhere else” and “I am very pleased with Rosclare”. Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 9 A user guide is available which contains information about the service provided. This is available in large print if requested. We recommend that other formats are looked at for the guide such as tape or pictures to make sure that it can be used by as many people as possible. We saw that there is an admissions procedure and that assessments are completed prior to anybody moving in. Once an individual comes to live there, a care plan is written based on these assessments. The assessments held by the home for three people were looked at. We saw that some good information was provided in these but this was not consistent. We have recommended that the home look at the assessment format in use to make sure that good quality person centred information is recorded. In surveys, six out of seven people who live at the home said that they had received a contract. The contracts in use do need to be reviewed to make sure that they clearly say what services are charged for in addition to the weekly fee. Information about fees must also be included in the user guide for the home. The service should additionally look at making the contract available in large print and in other accessible formats as needed. Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Care plans could be more person centred and better address the health, personal and social care needs of individuals. Arrangements for the handling, storage and administration of medication need to be consistently improved. EVIDENCE: Four people who live at the home responded ‘always’ when asked if they received the care and support they needed. Two people said ‘usually’. One person did not answer this question. One relative who completed a survey said that the home ‘always’ met the needs of their family member. We looked at the care plans for three people and the information provided covered areas such as mobility, diet and personal care. The plans are reviewed regularly by the home. Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 11 We saw that a very basic care plan was in place for one person who had been at the home for over four weeks. This was not sufficient particularly as the needs of the individual had increased since they came to the home. The care plans generally could be improved to contain more individualised information and to better address social needs. The manager has started to review the format in use and was developing a more ‘user friendly’ way of presenting important information for staff to use. Risk assessments need improvement. The current documents are like a checklist that shows areas where there may be a higher risk to individual safety. The home needs to show what actions have been taken to look at these areas and what they are doing specifically to reduce the risk to individuals. Four out of the seven people who completed a survey said that they ‘always’ received the medical support they need. Two people said ‘usually’ and one individual said ‘sometimes’. We saw that good records were kept of any contact with healthcare professionals for each person. The manager escorted a small number of people to see the doctor at the surgery on the first day we visited. Medication procedures need improvement. A number of issues were highlighted on the first day of inspection. These included incorrect storage of two items that should have been kept in a fridge and instances where the record of administration had not been signed by staff after a medication had been given. These problems had been addressed by the second day we visited but consistent improvement is needed in this important area. Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home offers a satisfactory range of activities. There is scope to improve this by making sure there is a full social care plan for each person and tailoring the activities more to individual preferences. People living at the home enjoy the food provided. EVIDENCE: Five people who live at the home responded ‘usually’ when asked if there were activities they could take part in. One person said ‘always’ and another individual said ‘sometimes’. A relative or friend of an individual said that they thought that people were “doing more socially now”. Comments from individuals included “we occasionally go out in the garden”, “there are lots of outings” and “I’d like more 1-1 time to chat”. Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 13 The home keeps a record of activities but this was not being consistently filled in by staff. Activities recorded included bingo, rides out in the manager’s car and dominoes. Organised trips had been made to a local school and a nursery for tea. As stated previously, care plans need to look more at social needs and these can then be used to organise the activities programme. Better records of who took part in the activities provided will then help to make sure that the individual needs of everyone living there are being addressed. Most people spoken with said that they enjoyed the food offered with comments including “very good”, “alright”, “not bad at all” and “lovely”. One person said, “It varies with the chefs”. In completed surveys, three of the seven people said they ‘always’ liked the meals served. Three individuals said ‘usually’ and one person said ‘sometimes’. We looked at lunch being served on both days we visited. People living at the home looked to enjoy the mealtime and the food being served. We have recommended that the home display the menus in large print or pictures to make sure that everyone knows what is being served. The blackboard in use may not be large enough for some people to see. There may also be opportunities to make mealtimes a more social occasion. Ideas to consider include people serving themselves at the table and for staff to eat their meals at table alongside the people living there. Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Individuals are protected from abuse. Concerns about the care provided are listened to and acted on. EVIDENCE: Five of the seven people who completed surveys said that they knew how to make a complaint. One person said ‘no’ and another individual did not answer. Records are kept of any concerns or complaints received and we saw that these are well maintained. The complaints policy and procedure is part of the guide for the people living there. We have recommended that this procedure be displayed in a large print or picture format. The home has a copy of the Royal Borough of Kingston Council’s Safeguarding Adults procedures. There has been one Adult Protection issue since the last inspection of the home. The home had cooperated fully with the Local Authority during this investigation. Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 15 Abuse awareness training is made available to staff. We saw that some newer members of staff still needed in depth training in this area although it is covered as part of their induction. Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 and 26. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living at the home generally enjoy a clean and comfortable living environment. The welfare of people living at the home is not fully protected by the call bell system. EVIDENCE: People spoken to were generally happy with the environment. Comments from individuals included “comfortable”, “it’s kept nice and clean”, “lovely” and “satisfactory”. One person said their room was “ok” but that the maintenance of the home could be improved. Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 17 We saw that the home generally provides a pleasant and comfortable place for people to live. Some areas are in need of updating and re-decoration but the owners have a programme in place to address this. During our first visit, we saw that some toilets did not have locks on the door and that a number of call bells were not working properly. These issues had been addressed by our second visit. It is essential that call bells are working at all times and that regular checks are carried out to make sure of this. The home was clean and fresh during both inspection visits. Four people who filled in surveys said ‘usually’ when asked if the home is kept fresh and clean. Three individuals responded ‘always’. Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are generally enough staff on duty to meet the needs of people using the service. People living at the home are protected by the recruitment procedures. There is an adequate staff training and development programme in place. Improvements to this would benefit the people living there. EVIDENCE: Three people who filled in surveys said that staff were ‘always’ available when needed. Three individuals responded ‘usually’ and one person said ‘sometimes’. Comments about staff included “very good”, “friendly”, “reasonably good” and “a good crowd”. One person said that “some are good and some are not so good. We looked at records kept for three members of staff. Recruitment checks were complete and these included a Criminal records Bureau (CRB) check. Staff are offered training in a number of topics such as manual handling, medication, Fire Safety and First Aid. 30 of staff have the NVQ Level Two Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 19 qualification and training for other staff members is ongoing. Records of induction training are kept for new care staff. These need to be mapped to the Skills for Care Common Induction Standards. It is essential that all care staff receive up to date training in Food Hygiene and Abuse awareness. Three individuals had not completed this training at the time of inspection. We have strongly recommended that all care staff receive further training in working with people with dementia. This should cover important areas such as person centred care, effective communication and the use of activities. Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 34, 35, 36 and 38. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a home that is generally well run. The arrangements to make sure of the health and welfare of people using the service need improvement. EVIDENCE: The manager has knowledge and experience of running a care service for older people. One of the owners and the manager have completed their NVQ Level Four qualification. Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 21 The home keeps money on behalf of some of the people living there. We saw that good records were kept for each individual. A system for staff supervision is in place. This means that staff meet regularly with their manager to discuss their work. Meetings are held to consult with people who live at the home. At the last meeting in April 2007, individuals had been asked about menus and planned trips out. The service also gives out questionnaires each year to ask people who use the service and their representatives about the service they are receiving. An annual development plan is also in place for the home. Satisfactory Health and Safety checks are made in areas such as Gas Safety, Legionella and electrical appliances. Improvements are required to make sure that weekly hot water and fire alarm checks take place and that these are fully recorded. Staff also need to make sure that potentially hazardous substances are kept locked away at all times. We found one instance where a cleaning product was stored in an open cupboard. Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 2 X 2 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 3 3 X 2 Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP1 OP2 Regulation 5 (1) (bc) Requirement In order to make sure that people living at the home or their representatives know how much they are paying for services, the user guide must include details of fees payable by individuals. These fees must also be clearly specified in any contracts used by the home. 2. OP7 15 (1) Each person must have a written care plan in place that details their individual needs in relation to health, personal and social care and how staff members will address these needs. This will to make sure that all individual needs are met by the home. (Previous timescale of 15/11/06 not fully met). 3. OP7 13 (4) In order to ensure the health and 01/09/07 welfare of people living at the home, risk assessments must fully detail how identified risks DS0000067005.V342099.R01.S.doc Version 5.2 Page 24 Timescale for action 01/09/07 01/11/07 Rosclare Residential Home Ltd 4. OP9 13 (2) are to be managed and the measures in place to do this. In order to fully protect the health and welfare of people living at the home, medication records must be correctly maintained at all times. Medication must be stored properly and given as prescribed with full and accurate records kept at all times. 01/08/07 5. OP12 16 (2) (m) (n) 23 (2)(c) 6. OP22 Full records of activities must be kept to make sure that individual social needs are met by the home. In order to make sure that individuals can get help from staff when they need it, call bells in good working order must be available in every room of the home. Regular checks need to be made on call bells to ensure that they are in working order at all times. (Previous timescale of 01/11/06 not fully met). 01/09/07 01/08/07 7. OP30 18 (1) (c) All care staff must receive up to date training in Food Hygiene and Abuse Awareness. This training is important to safeguard the welfare of individuals living at the home. Hot water temperatures must be regularly monitored to make sure that people living at the home are not put at risk when using baths, showers and other outlets. Full records must be kept of these checks. Potentially hazardous cleaning substances must be stored DS0000067005.V342099.R01.S.doc 01/10/07 8. OP38 13 (4) 01/08/07 9. OP38 13 (4) 01/08/07 Page 25 Rosclare Residential Home Ltd Version 5.2 securely at all times. This may protect the safety of individuals using the service. 10. OP38 23 (4)(a) Weekly safety tests of the fire 01/08/07 alarm system must take place to ensure the safety of people living at the home. Records must be maintained of these tests and made available for inspection. (Previous timescale of 01/11/06 not fully met). 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. 2. 3. Refer to Standard OP1 OP2 OP3 Good Practice Recommendations The user guide to the home should be made available in a variety of formats such as audiotape or pictures. It is recommended that the home makes sure that contracts are in plain English and in alternative formats as required. The assessment format should be reviewed to make sure that good quality person centred information is recorded. This can then be used to inform the care plan from when the individual moves in. The home should look at ways to make the care plans more person centred and better reflect the individual’s life and preferences. The plan in place should direct the care to be person orientated and not task based. Care plans need to give specific information about how the person likes the care and support to be delivered. Menus should be presented in user-friendly formats such as pictures or large print. Large whiteboards could also be used to present information and any changes. 4. OP7 5. OP15 Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 26 Mealtimes should be an opportunity for people to interact. Practices such as different ways of serving, varying numbers of mealtimes, and staff eating with people who live there should be considered seriously by the home. 6. OP30 It is strongly recommended that all staff receive training in caring for people with dementia. This should cover person centred approaches, effective communication and the use of activities. Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: 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 © 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 Rosclare Residential Home Ltd DS0000067005.V342099.R01.S.doc Version 5.2 Page 28 - 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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