CARE HOME ADULTS 18-65
Rose Court 12 Bradgers Hill Road Luton LU2 7EL Lead Inspector
Linda Cappello Unannounced Inspection 21st November 2005 14:00 Rose Court DS0000014955.V264178.R01.S.doc Version 5.0 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 Rose Court DS0000014955.V264178.R01.S.doc Version 5.0 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 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. Rose Court DS0000014955.V264178.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Rose Court Address 12 Bradgers Hill Road Luton LU2 7EL 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) 01582 482288 rose.court@craegmoor.co.uk Parkcare Homes (No. 2) Limited Ms Amanda Middleton Care Home 10 Category(ies) of Learning disability (10), Physical disability (10) registration, with number of places Rose Court DS0000014955.V264178.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 7th August 2005 Brief Description of the Service: Rose Court is a home for ten adults with learning disabilities, which is divided into two living units with six on the first floor and four on the ground. There are facilities on the ground floor for service users with a physical disability. Each service user has a single room with en suite facilities. There are additional toilets on each floor and on the ground floor there is a communal bathroom with a fixed hoist. A staff office is provided in each unit. There is a communal lounge, dining room and kitchen on each floor. There is a conservatory, which is used as the managers office. Work is in progress to restore the large garden so that it is usable. Rose Court is located in a residential area of Luton. A local college is within walking distance and the town centre, where there is a shopping precinct, various restaurants, pubs, cinema and sports facilities, is a short car ride away. The rail and bus stations are close by with a direct link to London and other major cities. Rose Court DS0000014955.V264178.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The purpose of this unannounced inspection which took place during the afternoon of 21st November 2005, was to assess those standards which were not included in the last inspection in August 2005 and to review whether the statutory requirements issued on 7th August 2005 had been met. During the inspection several of the residents spoke to the inspector and two invited the inspector to their bedrooms to talk and show their rooms. The inspector also spoke to 3 members of staff as well as the Manager and Deputy Manager. This report should be read in conjunction with the report written following the inspection in August 2005 for a more comprehensive assessment of the care provided by Rose Court. The inspector is grateful for all the help given by the residents and staff during this inspection. What the service does well:
The report written after the August 2005 inspection gives a very full description of what this home does well and only a few areas were looked at on this occasion. The home looks at the care needs that residents would have before they are admitted to the home and makes sure that the staff know how to look after people who come to live in the home. The home then makes sure that the residents know what the terms and conditions are when they live in the home, such as what they have to pay for and what the rules are. Staff support the residents to keep in touch with their friends and family and welcome visitors to the home. When residents need some extra support, perhaps because of a problem with a friendship, staff will help them. The inspector was told by residents “I like this home, they are like a family to me” “They give me a hug when I am a sad”. Residents know that if they are unhappy about anything they can tell the manager or any of the staff and they will be listened to. They also feel safe in the home and staff have been trained to know if people are at risk of being abused. Rose Court DS0000014955.V264178.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office.
Rose Court DS0000014955.V264178.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rose Court DS0000014955.V264178.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 5, EVIDENCE: The home undertakes an Outcome Based Evaluation when new residents are admitted and this ensures that all aspects of each individual’s care needs are considered. Care Plans are then developed based on the assessments. These were seen to be in place in relation to one resident who had been admitted most recently to the home. The home has now developed terms and conditions for each resident and these are presented in a way which makes them easier for the residents to read. Key workers have talked with each resident about what is in the terms and conditions and, where possible, the residents have signed them. Rose Court DS0000014955.V264178.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These key standards were assessed during the previous inspection. EVIDENCE: Rose Court DS0000014955.V264178.R01.S.doc Version 5.0 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 Residents are actively supported to maintain their relationships with family and friends EVIDENCE: The inspector spoke to several residents about their relationships with people who don’t live in the home and was told by all of them that they do have friends outside of the home and that sometimes they visit each other. Many residents said that their relatives visited them at the home and that some went to stay with relatives on occasions. They said that they could take relatives to their rooms when they visited to be private or could sit in the lounge with others if they wanted to. Some residents spoke of having boyfriends and girlfriends and said that staff were supporting them by talking to them and giving advice when it was needed. Staff were also able to tell the inspector about the sort of support they give to residents if relationships are becoming close and personal. The manager had established a positive contact with a community health education resource.
Rose Court DS0000014955.V264178.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 The systems by which medication is administered in the home have improved so that residents are protected. EVIDENCE: Following the last inspection, two statutory requirements were made about the way that the medication is administered in the home and the records were examined during this inspection to review whether the required changes had been made. It was found that the staff had not used correction fluid to amend the records and that only staff who had received specific training would administer medication by specialist means. Management plans for residents who were at risk of seizures had also been reviewed in consultation with the prescribing doctors. The home were advised to record more clearly the medication being sent to and received back from daycare. Rose Court DS0000014955.V264178.R01.S.doc Version 5.0 Page 12 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Policies, procedures and training are in place so that residents can be listened to and protected. EVIDENCE: The home has a complaints procedure in place and it is displayed on the residents’ notice board. The procedure has been drawn up in an easy read/pictoral format to make it more easily read. The home also holds residents meetings and is the venue for a regular meeting with advocates where any issues or concerns can be discussed. The minutes of recent meetings showed that residents had, for example, raised the issue of the downstairs bath needing repair and this was dealt with by calling in contractors. All members of staff, except for the two newest recruits, have undertaken training in identifying and preventing abuse. The home has policies and procedures in place in relation to the Protection of Vulnerable Adults. Residents, when asked, said that they felt safe in the home, and they were observed to have a trusting, open relationship with the staff on duty. Rose Court DS0000014955.V264178.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Service users live in a home, which is homely, clean and safe. EVIDENCE: During the last inspection, it was found that there were several hazards in the rear garden. The construction work in the garden has now been completed and the residents are reasonably protected from the water hazard. Their total safety cannot be fully guaranteed unless it is removed, however, the water is protected because of the presence of newts. A ramp has been installed in the garden so that it is accessible to people who have limited mobility. The rear of the garden has been tidied so that it could be put to some use for residents, although some rubbish still needs to be removed. The location of the washing machine in the downstairs kitchen has been discussed as an issue previously because of the risk of cross contamination. The staff are instructed not to do washing at the same time that cooking is being done in the kitchen. The Environmental Health officer should be asked for a view on whether this is a sufficient safeguard to residents. Whilst walking around the home during the inspection, it was seen to be clean, tidy and attractively decorated.
Rose Court DS0000014955.V264178.R01.S.doc Version 5.0 Page 14 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 Residents are supported by staff who have received training but there is no overall plan of training in place. EVIDENCE: The manager is active in identifying training needs in the staff group and was able to provide evidence of the training courses which staff had attended. However, there was no overall matrix in place showing what training needs had been identified for the coming year, including when mandatory training needed to be repeated. The budget allocated for each member of staff each month was seen and there did not appear to be any restriction on staff attending courses. A new member of staff said that she had received training in how to administer medication and was working through an induction workbook. She felt she had been very well supported since she started work and said she had been closely supervised. Rose Court DS0000014955.V264178.R01.S.doc Version 5.0 Page 15 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 Residents live in a home, which is well run by the manager, but their views are not formally sought on the quality of the care provided. EVIDENCE: The manager has been successful in her application to become the registered manager and in achieving the Registered Managers Award since the last inspection. The home continues to be well run by the manager and deputy manager who are very committed to ensuring that residents receive the care they need and are helped to lead as independent lives as possible. The home seeks the views of residents at meetings and encourages the involvement of advocates. However, there is no Quality Assurance procedure in place which would ensure that the views of residents, their representatives or other professionals are being routinely and formally gathered and a report being produced which assesses the success of the home in meeting its aims and objectives. The provider company has got advanced plans to introduce a Quality Assurance process next year. Rose Court DS0000014955.V264178.R01.S.doc Version 5.0 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Rose Court Score X X 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 2 X X X X DS0000014955.V264178.R01.S.doc Version 5.0 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 YA39 Regulation 24 Requirement The home must establish and maintain a system for reviewing and improving the quality of care provided, including consultation with residents and relatives, and produce an annual report. Timescale for action 30/06/06 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 YA35 Good Practice Recommendations A plan of the training needs of staff should be developed annually. Rose Court DS0000014955.V264178.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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