Inspection on 07/08/05 for Rose Court

This inspection was carried out on 7th August 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

Rose Court 12/01/09

Rose Court 05/03/07

Rose Court 21/11/05

Rose Court 10/03/05

Rose Court 12/01/05

Rose Court 16/04/04

Rose Court 05/03/04

Similar services:

Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

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Paradise Lodge

Grangewood

Upaya Ananda

15 Bramble Close

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

CARE HOME ADULTS 18-65 Rose Court 12 Bradgers Hill Road Luton LU2 7EL Lead Inspector Linda Capello Unannounced 07 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 I51 S14955 Rose Court V233825 070805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Rose Court Address 12 Bradgers Hill Road Luton LU2 7EL 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) 01582 482288 Parkcare Homes (No.2) Limited Vacant Care Home Only 10 Category(ies) of Learning Disability (LD) 10 registration, with number Physical Disability (PD) 10 of places Rose Court I51 S14955 Rose Court V233825 070805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10-03-05 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 disabilityEach 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 to1 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 I51 S14955 Rose Court V233825 070805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Sunday 7th August 2005 between 10.00hrs and 14.30 hrs. The deputy manager was on duty throughout the inspection and the manager attended for a short time, although it was her day off. The care and medication records of one resident were examined in detail and her care was tracked, including visiting her bedroom, the bathroom she uses and all communal areas of the home. The inspector was invited by three other residents to look at their bedrooms and they gave their views about the care they received at the home. The inspector was also invited to share Sunday lunch with three residents and further discussions and observations took place during the meal. The inspector would like to thank everyone for their help during the inspection. What the service does well: What has improved since the last inspection? Builders have been into the home and have made a ramp so that everyone can get into the garden and have made a nice patio area for people to sit at tables in the garden. Rose Court I51 S14955 Rose Court V233825 070805 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. Rose Court I51 S14955 Rose Court V233825 070805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Rose Court I51 S14955 Rose Court V233825 070805 Stage 4.doc Version 1.40 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 standard(s) 1,4,5 The home provides comprehensive information in an accessible format and offers pre-admission visits so that residents know what the home can offer them. The home has not completed Service User Agreements and Contracts with all service users so that the terms and conditions for residents have not been formally agreed. EVIDENCE: The home has produced its service user’s guide in an easy to read, pictorial format and the current residents were given the opportunity to express their views on its suitability and usefulness. This means that prospective service users, their families and social workers can look at the guide before admission to judge whether it may be suitable. One resident who had recently moved to the home confirmed to the inspector that she had had the opportunity to visit the home prior to admission, to see her bedroom and meet the other residents. In the case of the resident whose care was tracked during this inspection the Service User Agreement and Terms And Conditions document had not been completed. These must be completed for each resident so that there is clarity for residents, their families and social workers about what the home is offering and the expectations of residents. Rose Court I51 S14955 Rose Court V233825 070805 Stage 4.doc Version 1.40 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 standard(s) 6,7,8,9,10 Care plans and risk assessments were satisfactory so that resident’s care needs were clearly set out. Residents are encouraged to make decisions and to participate in the home. Staff are aware of confidentiality so that residents can be certain that information about them is not shared inappropriately. EVIDENCE: The care plans for one resident were examined in detail and discussed with her. Plans for most areas were seen and these were comprehensive, including her likes, dislikes and preferences. Whilst the plans had been written in a person centred way, the documents relating to person centred planning were not filled in. The home needs to ensure that work is begun on person centred planning in order to meet Valuing People guidance. There was evidence throughout the inspection through discussions with residents and staff that the residents are encouraged and enabled to make decisions about their lives and, where this was not possible or appropriate, this was recorded. The residents have a regular meeting with an advocate and a representative of a local learning disability forum to discuss any issues which the residents want to raise, particularly about the wider community. Rose Court I51 S14955 Rose Court V233825 070805 Stage 4.doc Version 1.40 Page 10 Residents who can manage their own finances are encouraged to do so and three residents spoke to the inspector about how they manage this and how they keep their money safe. The home provides opportunities for the residents to contribute to the running of the home. Regular residents’ meetings are held and these are chaired by a resident with a member of staff taking notes. Issues such as activities and holidays had recently been discussed. Residents also have a significant input into the decisions about meals. Residents who live upstairs and are more independent are able to choose and prepare their own meals with appropriate assistance. In the unit downstairs where residents are more dependent, they are encouraged to choose the meals they prefer and contribute to preparation according to their abilities. The home has not yet progressed to inviting residents to participate in the selection of staff or representation in management structures which it would need to do to fully meet this standard. Residents are encouraged to take responsible risks and these are assessed. Appropriate assessments were seen on the care records of one resident selected as a sample during this inspection. Staff’s awareness of the need to keep information about residents confidential was observed throughout the inspection. Staff were very careful to check with residents before discussing issues with the inspector and in front of other residents. When the resident was unhappy about this, the member of staff responded sensitively. The records were kept securely in the office. Rose Court I51 S14955 Rose Court V233825 070805 Stage 4.doc Version 1.40 Page 11 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 standard(s) 11,12,13,14,16,17 Residents are enabled and encouraged to lead fulfilling lives and to work towards increased independence. Residents are involved in menu planning so that the meals they eat are what they enjoy. EVIDENCE: Throughout this inspection, it was evident through observation and discussion with staff and residents that there is a significant focus on providing residents with a fulfilling lifestyle inside and outside the home. Residents are given opportunities both within and outside the home to develop their personal skills and there is a good sense of progression in the home. The six residents who live upstairs are working towards increased independence and it was evident that they each knew what stage they were at and where they were striving to be. They confirmed that they were receiving help to improve their personal skills and were given opportunities to work towards increased independence. For example, two residents showed the inspector the kettles in their rooms so that they were able to make tea whenever they Rose Court I51 S14955 Rose Court V233825 070805 Stage 4.doc Version 1.40 Page 12 wished to. One resident who had recently moved from another home was very pleased with how much more he could do and how much more independence he had been given. Each resident takes part in either education or occupation during the week, as appropriate to their age, abilities and interests. For example, one resident is attending a local college three days a week and the home is supporting her to achieve her ambition of working in an office. Residents in this home take part in a range of leisure activities in the local community and make good use of community facilities. The daily routines in this home allow a good deal of freedom, choice and independence. Staff were observed throughout the inspection, affording residents privacy by knocking on bedroom doors before entering and checking that residents wanted them to go in. Residents confirmed that they could lock their rooms if they wished to. The lunch that was served during the inspection was shared by the inspector and was found to be wholesome and appetising. One resident decided that she did not want to eat a roast meal and was instantly given several choices of meal. She chose to have a pizza and this was cooked for her. Rose Court I51 S14955 Rose Court V233825 070805 Stage 4.doc Version 1.40 Page 13 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 standard(s) 18,19,20 Personal care is given in a manner which takes account of residents’ individual preferences and needs and their healthcare needs are met. Staff must be assessed as competent to give medication by special means so that residents can receive the medication they need safely. EVIDENCE: The care plan examined set out the way that the resident preferred to be assisted with personal care, taking account of the person’s wish to be as independent as possible, whilst ensuring her safety. The resident was very aware of the need for staff to supervise her in some situations because of her medical condition and appeared, overall, satisfied with the way her personal care was provided. There had been some situations where she had tried to be independent but then got into difficulty and she felt that sometimes staff were a bit cross with her for having put herself in risky situations. She could, however, see why they were concerned. It was noted that residents are referred appropriately to other healthcare professionals for advice and support. For example, a physiotherapist had given advice on exercises for one resident and this were being facilitated by staff. An occupational therapist was due to come to the home to advise on a suitable hoist and there was an allocated nurse to review an epilepsy management plan. Rose Court I51 S14955 Rose Court V233825 070805 Stage 4.doc Version 1.40 Page 14 The medication records for one resident were examined and found to be in order other than that correction fluid was seen to have been used. Medication records must not be altered in this way. The dispensing pharmacist had given training to staff on the safe administration of medication, however, none of the staff had been assessed as competent to give medication by specialist means. One resident’s epilepsy management plan included this medication being administered and this situation must, therefore, be rectified without delay. The home must also ensure that there are certificates for all staff who have attended training as evidence that it has taken place. Rose Court I51 S14955 Rose Court V233825 070805 Stage 4.doc Version 1.40 Page 15 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 standard(s) These standards will be assessed at the next inspection. EVIDENCE: Rose Court I51 S14955 Rose Court V233825 070805 Stage 4.doc Version 1.40 Page 16 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 standard(s) 24,26,30 EVIDENCE: The home is located in a residential street which has a 6th form college opposite. The home blends reasonably well with neighbouring houses. The home has been extended and adapted resulting in a complicated internal structure but residents seem to cope well with the layout. As has been noted above, the home is separated into two distinct units with the more independent residents living upstairs and those requiring more help being downstairs. The home is brightly decorated and in a modern style. The two lounges are particularly attractive and some of the corridors have very bright murals painted on them. The home was clean on the day of the inspection and there were no offensive odours. The downstairs of the home is accessible to wheelchairs users and a ramp is under construction in the garden to enable wheelchair access to the large outside space. Contractors were still working in the garden and the inspector noted that several potentially dangerous tools had been left lying in the garden. The deputy manager said that this had been an ongoing issue and Rose Court I51 S14955 Rose Court V233825 070805 Stage 4.doc Version 1.40 Page 17 moved them during the inspection. Increased secure storage in the garden would be beneficial. There is a water feature in the garden which could pose a potential risk to residents. It has not been possible for the home to cover this in because there Is a protected species living in the pond. However, urgent action must be taken to ensure that residents could not fall from the end of the new ramp into the water. This could be a particular risk to wheelchair users. The garden is very spacious but is rather unkempt. The end of the garden is unusable because of the height of the weeds and the sides of the garden are in a similar condition. The grass area needed cutting. However, the new patio are is a positive addition for residents and, once all works are completed, the garden will provide a good useable space for residents. Four residents’ bedrooms were visited and all were found to be highly personalised. The residents took obvious pride in their bedrooms and it was immediately evident what their particular interests were. One resident did say that she would find it helpful to have a light switch by her bed so that when she got up to go to the toilet in the night, she could put the light on easily. One bedroom was too small to fit an easy chair in, although this particular resident did not seem to need one. The ground-floor communal bathroom could be made more homely and the controls on the bath need to be repaired. The laundry facilities are located in the kitchen where food is prepared and eaten. The implications of this situation will be further explored at the next inspection. Rose Court I51 S14955 Rose Court V233825 070805 Stage 4.doc Version 1.40 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards will be assessed at the next inspection EVIDENCE: Although these standards were not fully assessed on this occasion, residents spoke very positively about staff and there appeared to be a good relationship between staff and residents. Rose Court I51 S14955 Rose Court V233825 070805 Stage 4.doc Version 1.40 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,42 The residents benefit from a well-run home and, overall, they are kept safe by the home’s attention to health and safety. EVIDENCE: The home was being run very effectively by a newly appointed manager, who had previously been the deputy, and the deputy who had been promoted internally. Residents were, therefore, benefiting from the consistency and continuity of staff who knew them well. The manager and deputy had reviewed many of the practices in the home and were making changes to increase the freedom and choice of residents. The manager has submitted an application to become the registered manager. Only two matters of health and safety arose during this inspection. The dangerous tools in the garden were removed when the situation was highlighted to the deputy manager and a replacement for a broken shower door in one bedroom had already been ordered. Rose Court I51 S14955 Rose Court V233825 070805 Stage 4.doc Version 1.40 Page 20 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 3 x x 3 1 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 2 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 3 x x x 2 Standard No 11 12 13 14 15 16 17 3 3 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Rose Court Score 3 3 1 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 3 x I51 S14955 Rose Court V233825 070805 Stage 4.doc Version 1.40 Page 21 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 5 Regulation 5 Requirement The home must provide all residents with a contract which set out the facilities and services provided and the terms and condtions of providing accommodation and this must be signed by the residents or their representatives. Medication records must not be altered by using correction fluid . Staff must be trained, and be assessed as competent, to administer medication by special means. When residents need such medication, management plans must take account of the lack of trained staff . Residents must be protected from the risk of falling into the water feature in the garden . Timescale for action 31st October 2005 2. 3. 20 20 13(2) 13(2) 31st August 2005 30th September 2005 4. 24 13(4) 15th September 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Rose Court I51 S14955 Rose Court V233825 070805 Stage 4.doc Version 1.40 Page 22 No. 1. 2. 3. Refer to Standard 6 24 26 Good Practice Recommendations Staff should begin to undertake person centred planning with residents and this should be reflected in care plans Consideration should be given to providing secure storage in the garden. The positioning of light switches in bedrooms should be reviewed to ensure that residents have easy access to lighting during the night. Rose Court I51 S14955 Rose Court V233825 070805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Bedford 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 © 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 Rose Court I51 S14955 Rose Court V233825 070805 Stage 4.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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