Inspection on 22/09/05 for Rose House

This inspection was carried out on 22nd September 2005.

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 no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rose House 23/07/07

Rose House 16/01/07

Rose House 09/08/04

Rose House 17/05/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Rose House 63 Wigton Road Harold Hill Romford Essex RM3 9HB Lead Inspector Ms Edi O`Farrell Unannounced Inspection 22 September 2005 10:40 Rose House DS0000027891.V251231.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 House DS0000027891.V251231.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 House DS0000027891.V251231.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Rose House Address 63 Wigton Road Harold Hill Romford Essex RM3 9HB 01708 349212 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) Mrs Michelle Paddit Macadangdang Jean Davis Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Rose House DS0000027891.V251231.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th May 2005 Brief Description of the Service: Rose House is a registered care home for three people with learning disabilities, situated in a residential part of Harold wood. A variation in registration is nearly complete, as a fourth bedroom has been added by converting the loft. The property is an ordinary house in keeping with other local properties. Furnishing and decoration are domestic in nature, and the home is run so as to maximise the independence and choice of the service users. It is privately owned and the owner visits on a regular basis. There are currently three women living in the home, all of whom have long-term need of accommodation and personal support. The fourth place will also be offered to a female service user. All bedrooms are single, and furnished to match the needs and wishes of each service user. Care staff support service users, both within the home and in the local community, in order to ensure they have a full and satisfying lifestyle. Health needs are met by staff accompanying service users to appointments with health professionals, such as GPs. Currently night hours are covered by a sleep-in member of staff, but this will change to having a waking staff member once there are four service users. Rose House DS0000027891.V251231.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This, unannounced, inspection took place on a weekday from 10.40 to 12.40. Two service users were at home, with the third being at a day centre. The manager, who had been on leave at the last inspection, was also at the home, along with the deputy manager. This meant that some of the Standards that could not be assessed at the last visit were covered this time. This was the second visit for 2005/6, and all core Standards have now been assessed between the two visits. The two service users were asked for their views and experience of living in the home, and both gave examples of activities they enjoy doing. They also both spoke about their recent holiday, and how much they had enjoyed it. Care plans were examined, along with other records such as menus and staff recruitment files. The house was toured, including all bedrooms, and the loft conversion, and new conservatory were also looked at. Action in response to the Requirements set at the last inspection was checked. The service users, manager, and deputy are thanked for their hospitality and in-put to the inspection. What the service does well: What has improved since the last inspection? What they could do better: Some medication practices are still not quite right, so staff need to have more training. They also need some more training in how to always protect vulnerable adults from possible abuse. Care needs to be taken in both furnishing and allocating the new bedroom, due to it having a sloping ceiling. The manager is fully aware of these points. Rose House DS0000027891.V251231.R01.S.doc Version 5.0 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. Rose House DS0000027891.V251231.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 House DS0000027891.V251231.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): 1, 2, 3, 4, 5 & 6 Prospective service users, and their representatives, have the information they need to make an informed choice about where to live. They will be fully assessed, and know that if they choose the home it will meet their needs. They will have an opportunity to visit and ‘test drive’ the home, and will have an individual contract. EVIDENCE: The manager provided a copy of the revised Statement of Purpose, and this contains all the required information. Once the fourth bedroom is registered and ready for use a further amendment will be needed. This will be reviewed at the next inspection. There have been no recent admission, but full assessment of the current service users was carried out prior to them moving in. The manager and deputy manager are very clear about the need to fully assess anyone being referred for the fourth bedroom, including their compatibility with the three women currently living there. Based on their existing needs a decision has been taken to only offer the room to another female. The prospective service user will be invited to visit the home, and to spend time with the three service users, and their views will be sought. Each service user has a detailed care plan and an individual contract. Rose House DS0000027891.V251231.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): 6, 7, 8, 9, & 10 Service users’ needs, including changing needs are assessed, and care plans show how these needs are to be met. They make decisions about their lives where possible, and participate in the domestic life of the home. They are supported to take risks, and know that information about them is handled appropriately. EVIDENCE: The three care plans were examined, and the two service users were asked about their lifestyles and preferences. The daily logs were examined and discussed with the manager. The three current service users have lived in the home for some considerable time, so they and the staff know each other well. The care plans are reviewed twice a year, once internally, and once with the placing authority. Where there is a need for 1:1 care, for safety reasons, the manager has negotiated this with the placing authorities. This includes staffing to allow service users to access day centres. Where needs had changed these had been responded to by referral to specialist health professionals. Service user help staff with domestic chores, including doing their own laundry and room cleaning. At the last inspection the needs of service users were discussed with a member of staff, who demonstrated a sound knowledge of each of the care plans. The management staff present at this inspection have Rose House DS0000027891.V251231.R01.S.doc Version 5.0 Page 10 a very clear understanding of the needs of the three women, and how these should be met. Rose House DS0000027891.V251231.R01.S.doc Version 5.0 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 the following standard(s): 12, 13, 14, 15, 16 & 17 Service users have an opportunity for personal development, take part in age appropriate activities, and are part of the local community. They engage in appropriate leisure activities, and their rights and responsibilities are recognised. They are offered a healthy diet and enjoy their meals. EVIDENCE: Service users were asked how they spent their days, and the care plans were examined and compared to the daily records. The two women described their recent, two week, holiday to Butlins with obvious enjoyment. They also talked about going out for meals, shopping for the household food, attending clubs and day centres. The care plans had a good balance between individual and group activities. The service users were observed helping with the household chores and making lunch. They use local community facilities, such as the swimming baths. During a tour of the building the bathroom was locked, and as at the previous inspection, it was reported that this is because one service user goes in and plays with the water. This is also the reason given for the kitchen being locked Rose House DS0000027891.V251231.R01.S.doc Version 5.0 Page 12 when staff are not in there. The daily log, and the care plan, support the need for these restrictions. The menus have been reviewed in response to a Requirement set at the previous inspection. Fresh fruit and vegetables are provided, and food cooked from fresh wherever possible. Service users said that they liked the food, and they were observed to be enjoying sitting in the garden to eat their lunch. Rose House DS0000027891.V251231.R01.S.doc Version 5.0 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 the following standard(s): 18, 19, & 20 Service users receive personal support in the way they prefer, and their physical and emotional health needs are met. The service users are not fully protected by staff administering medication, as correct procedure is not always being followed. EVIDENCE: The care plans were examined and discussed with the manager. Health and personal care needs are identified, and arrangements made to see specialists, such as psychiatrists. Health needs are reviewed on an annual basis by the GP. Appointments are made with the chiropodist and optician etc, as required. The manager and deputy manager demonstrated a sound knowledge of the health and personal care needs of each service user. This included types of behaviour that each service user uses to communicate their feelings. The daily log gave a running picture of how these needs are met. Care plans will be being reviewed with the placing authorities within the next few months. At the last inspection a Requirement was set in relation to the administration of medication. This was because discontinued medication was still on the Medication Administration Charts (MAR) as though still being prescribed, and the wrong bottle of medication was being used in one case. The Requirement had been partly met but a check of the MAR charts and the medicine cabinet showed that other mistakes had been made. This was discussed with the Rose House DS0000027891.V251231.R01.S.doc Version 5.0 Page 14 manager, who agreed that staff needed further medication training. This is Requirement 1. Only staff who are judged to be competent must administer medication. This is Requirement 2. Rose House DS0000027891.V251231.R01.S.doc Version 5.0 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 the following standard(s): 22 & 23 Service users’ views are listened to and acted upon, and, in the main, they are protected from abuse, neglect, and self-harm. The recent handing of a door key to a work had the potential to place service users at risk. EVIDENCE: There have been no complaints since the last inspection, but there is a complaints procedure, and the manager was able to describe how she has dealt with them in the past. Service users tend to show dissatisfaction with things by their behaviour, and staff make changes in response to this. In reading the records it was noted that a member of staff had recently given a key to the house to a workman. This would have allowed this person, on whom no checks have been carried out, free access to the house. This is unacceptable both in terms of general security and the protection of vulnerable adults. This is Requirement 3. There have been no other adult protection issues, and there is a policy and procedure in place. Staff have previously received training, which in light of recent events, as outlined above, needs to be updated. This is Requirement 4. Rose House DS0000027891.V251231.R01.S.doc Version 5.0 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 the following standard(s): 24, 25, 26, 27, 28 & 30 Service users live in a homely, comfortable, and safe environment, which meets their needs. The home is clean, hygienic, and tidy. The current three bedrooms meet the needs of the service users, and are furnished to their choice and preferences. Care needs to be taken in furnishing the new bedroom, and in allocating it. EVIDENCE: The house was toured, including seeing all the bedrooms. This is a small house for adults with learning disabilities, who have long-term accommodation and personal care needs, and it is extremely appropriate for this purpose. A conservatory has been added to the back of the kitchen, which is to be used as an office for the manager, and as a private space for service users to have visitors. This meets a Requirement set at previous inspections. The path to the side and back of this must be levelled. This is Requirement 5 The loft has been converted to a bedroom with an ensuite shower and toilet, creating a very pleasant space. Once the new registration has been agreed Rose House DS0000027891.V251231.R01.S.doc Version 5.0 Page 17 care will need to be taken in both furnishing this room and in allocating it. This is because of the sloping ceiling. This is Requirement 6. In addition access to the new bedroom is by way of a new staircase from the first floor, which is narrow. The person who the room is offered to will need to be fully ambulant. A fire authority inspection was carried out on 31/08/05 and the inspecting officer has confirmed that the alterations and loft conversion meet the recommendations as per the building regulations for this type of premises. Planning permission and building control was sought and agreed. The home was very clean and tidy and furnished in a domestic and homely way. There is a downstairs toilet, and a bathroom and toilet on the first floor. This has a grab rail attached to the toilet, which is rusty in parts and needs replacing. This is Requirement 7. Rose House DS0000027891.V251231.R01.S.doc Version 5.0 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 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): 32, 33, 34, 35 & 36 Service users are supported by competent staff, and by the home’s recruitment policy and practice. Some staff are receiving supervision, but not to the level required, and staff meetings are not being held as often as they could be. Both are important means for the manager to develop the staff team, so they can support the service users effectively. EVIDENCE: Five staff files were examined and discussed with the manager. These included recruitment documents, which were all correct, and training and supervision records. In one file some of the training certificates related to clinical courses for nurses. It is inappropriate for these to be held in the home’s files, as they could mislead anyone seeing them, as the home is not registered for nursing care. This is Requirement 8. In response to a previous inspection a job description has been provided for the one member of staff who did not have one. The deputy manager is responsible for staff supervision, and some have been held, but not with the regularity required by the Standards. All staff must have supervision at least six times a year. This is Requirement 8. Rose House DS0000027891.V251231.R01.S.doc Version 5.0 Page 19 Rose House DS0000027891.V251231.R01.S.doc Version 5.0 Page 20 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, 38, 39, 40, 41, 42 & 43 The service users benefit from a well run home, which is run in their best interests. The health, welfare and safety of service users are safeguarded by the home’s policies and procedures and record keeping. Service users benefit from competent and accountable management of the service. EVIDENCE: The manager holds care and management qualifications, and is experienced in managing learning disability services. Her management style suits the home, as, whilst being aware of the legislative side of the work, she recognises that this is the home of the service users. A sample of Health and Safety documents were examined, these included gas and electricity checks. A recent fire authority inspection stated that the home has a ‘good system of fire safety management’. Rose House DS0000027891.V251231.R01.S.doc Version 5.0 Page 21 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 3 3 3 3 Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 2 3 2 3 X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 2 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Rose House Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 DS0000027891.V251231.R01.S.doc Version 5.0 Page 22 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 YA20 Regulation 13 (2) Requirement All staff whom give medication must attend a further, approved, course on the administration of medication. Only staff that are judged to be competent must administer medication. All staff must be mindful of security, and the protection of vulnerable adults at all times. People who have not had full checks must not be allowed free access to the home. All staff must have adult protection training. The path to the rear and side of the new conservatory must be levelled. The manager must give due care to the choice of furniture for the new bedroom, taking account of the sloping ceiling, and the needs of the service user who is offered the room. The grab rail attached to the upstairs toilet must be replaced. Training records held in the home must relate only to training that staff receive in relation to their work within the DS0000027891.V251231.R01.S.doc Timescale for action 31/12/05 2 3 YA20 YA23 13 (2) 13 (6) 30/11/05 30/11/05 4 5 6 YA23 YA24 YA25 13 (6) 23 (2) (o) 23 (2) (f) 28/02/06 31/12/05 31/12/05 7 8 YA27 YA35 23 2 (j) 18 (1) c 30/11/05 30/11/05 Rose House Version 5.0 Page 23 home. 9 YA36 18 (2) All staff must receive formal supervision at least six times each year. 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Rose House DS0000027891.V251231.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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 House DS0000027891.V251231.R01.S.doc Version 5.0 Page 25 - 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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