Inspection on 23/07/07 for Rose House

This inspection was carried out on 23rd July 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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rose House 16/01/07

Rose House 22/09/05

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 Julie Legg Unannounced Inspection 23 -24th July 2007 11: rd Rose House DS0000027891.V344704.R01.S.doc Version 5.2 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.V344704.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 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.V344704.R01.S.doc Version 5.2 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) rosehouseinfo@aol.com Mrs Michelle Paddit Macadangdang Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th January 2007 Brief Description of the Service: Rose House is a private owned care home, which is registered for four people with learning disabilities. The home is situated in a residential area of Harold Hill and is undistinguishable from other houses in the road. On the ground floor there is a kitchen/diner, a separate lounge, a toilet and utility room and a conservatory, which the manager uses as her office. Upstairs on the first floor there are three bedrooms and a bathroom/toilet that also has a walk-in shower. The home has recently had a loft conversion and there is now a fourth bedroom with an en-suite toilet and shower. The home is close to the local shops and a leisure centre and Romford shopping centre and the cinema are a short bus ride. The home is run as a family type home, which aims to promote independence and choice and to assist service users with developing daily living skills. All three service users attend day services, clubs and other leisure activities within the community. The Statement of Purpose is available to all service users and relatives. All of the service users have been given a Service User Guide. Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took pace over two days. The manager was present during part of the inspection and was given feedback by telephone the following day. Discussion took place with the manager and the member of staff on duty. Care staff were asked about the care that service users receive and were also observed carrying out their duties. The inspector spoke to two of the service users who were asked to give their views on the service and what it was like to live in Rose house. Relatives were also contacted and asked for their opinions of the service. A tour of the home was undertaken and all of the rooms were clean and free from any offensive odours. Service users’ files were case tracked; including care plans and risk assessments, together with the examination of other staff and home records. These included medication records, staff rotas, menus, accident/incident records and staff recruitment procedures and staff files. Additional information relevant to this inspection has been gained from the Annual Quality Assurance Assessment and the views of heath and social care professionals. The inspector had a discussion with the manager on the broad spectrum of equality and diversity issues and she was able to demonstrate a good understanding of the varied needs around religion, sexuality, culture, disability and gender. The manager said that people living at the home would prefer to be called service users and therefore this term is used in this report. The inspector would like to thank the service users, manager and staff for their input during this inspection. What the service does well: The service is small and flexible and is able to respond effectively to the needs of the service users and is operated for the benefit of the service users. All of the service users have a comprehensive care plan together with any necessary risk assessments and strategies that are compiled with the service users and relatives if appropriate and other professionals. Some of the service Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 6 users experience some behaviour difficulties however the staff are aware of the need to balance service users rights and choice with appropriate risk taking. The attitude and practice of the manager and staff promote opportunities for service users to remain as independent as possible and express their wishes and needs. What has improved since the last inspection? What they could do better: The daily records should be more informative and evidence care plan goals. There is some redecoration, maintenance and refurbishment needed in the hallway and the service users’ bedrooms. The manager must ensure that she employs sufficient numbers of care staff to ensure that care staff are not working excessive hours, as this could have a detrimental effect on the service users and the staff. A quality assurance of the service needs to be undertaken, taking into account the views of the service users, relatives and stakeholders. This information needs to be collated and a business plan developed for the home and the future of the service. Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 7 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. Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 8 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.V344704.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 and4 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Prospective service users and their families have the information they need to be able to make an informed choice about moving into the home. The assessment of needs and other information received from health and social care professionals means that the manager has detailed information to enable them to determine whether or not they can meet the needs of the prospective service user. Prospective service users are able to “test drive” the home prior to them moving in. This will enable prospective service users to decide whether or not they wish to move into the home. EVIDENCE: The Statement of Purpose and the Service User Guide have been revised and amended, to advise that the registered proprietor is now the manager. The Service User Guide is a useful document and each service user has been given a copy. The current service users have been living at the home for some considerable time and there have been no admissions since the last inspection. All three of the service users were assessed by their respective funding authorities and further information was gathered from health professionals, prior to the manager carrying out their own assessment. Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 10 There is currently a vacancy at the home and the manager stated that the admission process would be designed around the needs of the prospective service user and their compatibility with the three service users who live at Rose House. The prospective service user would be invited to visit the home, possibly an overnight stay and spending time with the service users. This will ensure that the prospective resident likes the home and that they all feel comfortable with each other. This transition period will also allow the staff to get to know the prospective service user and to know whether they can meet their needs. Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 and 9 People who use this service experience good outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users are supported by staff who know them well and care plans and risk assessments have been regularly reviewed and updated. This ensures that service user’ needs are being appropriately met. Service users are encouraged to incorporate risk in a controlled way into their everyday life. EVIDENCE: The three service users’ files were examined and these contained care plans and risk assessments. Staff were observed interacting with service users and some elements of the care plans were discussed with the manager. The care plans identify personal care, communication difficulties, and social care, home care skills, religious and health care needs and how these needs Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 12 should be met. One care plan stated ‘speak slowly to X and in short sentences’, another stated, ‘Y is able to make a cup of tea with supervision’. All of the service users also have a pen profile, which indicates their strengths and their likes and dislikes. There was evidence that care plans are being evaluated, reviewed and updated. All three service users have had a review from their funding authority and all three placements are stilled deemed suitable to meet the service user’ needs. A social care professional and a health professional both confirmed that they were satisfied with the placements. One professional stated, “ A lot of other homes would struggle with their behaviour”. Care plans were examined alongside the daily records and compared with the support being given. The care staff know the service users very well and give a detailed handover, however the daily records are too brief. These records need to reflect the well being of the service users and how they are involved in the life of the home and demonstrate how daily records evidence care plan goals. This is Requirement 1. All of the service users are able to participate (varying degrees) in activities within the home, assisting with tasks such as, settting and clearing the table, washing up, making a cup of tea and snacks, preparing the vegetables, putting the washing in the washing machine and dusting their bedrooms. All three of the service users attend day services and attend a Sunday church service. Service users are encouraged to handle money and to pay for their own personal items when visiting the shops or their day services. One service user stated, “ I can make tea”. Staff were seen interacting with the service users, their relationship was easy going and friendly but in a professional manner. Some aspects of the service users’ care were discussed with the manager, particularly in relation to their personal care, dietary, social and health care needs. The two service users who were at home during the inspection were able to give their views. One service user stated “I like it here”, the other service user was asked ‘if she was happy living at the house’ and she replied, “Yes I am”. There is a small and fairly stable staff team, who know the service users and their needs well. There is evidence that all three of the service users have improved in their physical and mental health since living at Rose House. One of the service users who does not have English as her first language is now able to understand and speak English, which has had a positive effect on her socialising with her peers at the day services. Risk assessments that were examined showed area identified such as, tasks and activities within the home, travelling to the day service, collecting rubbish and habitually touching the floor. They evidenced that service users are being supported to experience ordinary living within a safe environment. All of the risk assessments have been evaluated, reviewed and updated. This means that all of the risk assessments are reflecting the current risk situations with all of the service users. Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 13 Service users are consulted on the day-to-day running of the home; service user meeting are held and their views are taken on board regarding menu planning, holidays, redecoration and refurbishment of their bedrooms and some of the day-to-day activities within the home. Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 and 17 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users have the opportunities for personal development within the home. They also have access to day services and leisure activities within the community that are appropriate to age and culture. Service users have appropriate personal and family relationships. Their rights are respected and that are supported to take responsibility for their actions. Service users are provided with a varied and nutritionally balanced diet. EVIDENCE: Service users’ care plans identify lifestyle choice, such as local leisure activities, day services, and activities within the home and family contact. Daily logs record whether these activities have taken place. All of the residents have opportunities for some personal development within the home and community. All of the service users attend day services; one attends a day service in the Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 15 London Borough of Hackney. She attended this day service prior to her moving into Rose House and it felt that to move her would be too disruptive. The other two service users attend day services within the local authority (Havering) where that are able to take part in their favourite activities: cooking and arts & crafts. One service user stated, “I like cooking”, and during the inspection she watched a cookery programme on the television. Another service user stated, “I really enjoy colouring”. Care plans indicated that service users to varying degrees and with supervision are able to make drinks and snacks, assist with preparing the vegetables and writing the shopping list. Other activities within the home include; crocheting, drawing, gardening, puzzles and looking at magazines. The service users enjoy attending clubs, shopping, eating out, leisure activities within the community and attending church on a Sunday. Two of the service users enjoy attending a local club where they meet up with their friends from the day services. All of the service users enjoy shopping where they are encouraged with assistance to buy their own toiletries and clothes. Activities this month have included a trip to Bluewater, London Zoo, and the cinema and to a Chinese restaurant. A relative stated, “She has never been out so much”. One service user is Jewish and another is Muslim, neither are practicing their faiths and did not do so prior to coming to live at Rose House. These issues are documented as having been explored with the placing authorities and their families. Both have made a choice to attend a local church, where peers from their day centres also attend. All of the service users have a party to celebrate their birthdays and a service user’s family attended a recent party. The relative stated, “They put on such a nice party for her, we all really enjoyed ourselves”. All three service users are going to Somerset in September and will be staying in a cottage. Most of the service users have their own televisions in their bedrooms and there was evidence of their particular interests and hobbies; cuddly toys, posters, ornaments and photographs. The three service users see their families, some more regularly than others. One of the service users is taken to visit her sister at least monthly; another service user is encouraged to keep in telephone contact with her family and the manager advised the inspector that she is hoping to take one of the service users to visit her family in Sussex. There are no set ‘house’ rules and service users were observed to go about the home freely. At the time of the inspection, one service user was having a bath and then watched television and another service user was seen sitting and drawing. Staff have the overall responsibility for the cleaning of the home, however service users are able to participate at varying levels, such as, dusting their bedrooms, putting their clothes away and helping with putting their laundry in the washing machine. Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 16 Service users with staff guidance were involved with the menu planning. The menu is varied and on a four week rolling programme providing mostly home cooked food and reflecting service user choice and cultural dietary requirements; Halal meat is proved for those service users whose diet requires this, service users have a take away meal once a week and eat out twice a week. Breakfast consists of cereal and toast and sometimes scrambled egg and fresh fruit is available every day. On the day of the inspection lunch was cheese salad and the evening meal was a meat casserole with rice followed by jelly and fruit. Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users receive support in a way they prefer and their physical and emotional needs are met. There are policies and procedures that protect service users with the administration of medication. EVIDENCE: Care plans and daily records were examined and discussed with the manager. The care plans identify health and personal care needs and how these needs should be met. The service users require prompting and minimal assistance with their personal care needs. Service users were seen to be dressed in clothes that were appropriate for the time of year and which suited their personalities; one service user was wearing cropped trousers and a t-shirt and the other was wearing trousers and a blouse. A relative stated, “She is always nicely dressed when we visit and the staff take her to the hairdressers, to get her hair cut”. One of the Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 18 service users and her key worker had been shopping for new clothes at the weekend. She said, “I like the shops”. Records inspected showed that service users have personal health records. All of the service users are supported to access dental care, opticians, and chiropody. One of the service users is regularly seen by a community nurse from the Learning Disability Team and is reviewed annually under the Care Programme Approach; where the psychiatrist sees them. It was noted at the last CPA that ‘her behaviour had greatly improved and that her mental health had remained stable’. One of the service users is diabetic, the Diabetic Nurse sees her regularly and her condition is currently stable. Another service user exhibits behaviour that challenges and appropriate assistance has been sought from health professionals. Another service user has recently had a review of her placement and the social care professional stated, “She is a lot calmer, her behaviour is much improved and Rose House is meeting all of her needs”. One service user is Jewish and another is Muslim, neither are practicing their faiths and did not do so prior to coming to live at Rose House. These issues are documented as having been explored with the placing authorities and their families. Both have made a choice to attend a local church, where peers from their day centres also attend. There are policies and procedures for the handling and recording of medication within the home and staff have received medication training. The Community Pharmacist visits the home and checks the mediation and the recording and storage of medication; his last visit confirmed arrangements were satisfactory. Medication Administration Records (MAR) charts and the medication cupboard were checked during this inspection and no errors were found. None of the service users are able to administer their own medication and this is clearly recorded. Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The service users’ views are listened to and acted upon. Service users are protected by the policies and procedures and the monitoring systems within the home. EVIDENCE: The home has a clear complaints procedure, which is available in pictorial format. A copy of the procedure has been made available to all of the service users and to their relatives. Service users have access to an advocate from the North East London Advocacy service if required. Since the last inspection there has not been any complaints. The inspector felt confident that the manager would take any complaint seriously and would act upon it. The inspector advised the manager that any complaints however minor should always be recorded. The manager stated that she welcomes complaints and suggestions about the service. In discussions with the service users and relatives, it was obvious that they were aware of the how to make a complaint. Relatives that were spoken to stated that they were aware of the procedure and would have no hesitation in making a complaint, if required. Service users were asked, “Who would you tell if you were unhappy?” Both stated,” Would tell X (a member of staff)”. Both of the service users told the inspector that they were happy at the home and did not want to live anywhere else. Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 20 The home has a safeguarding Adults policies and procedures; these include the local authority (London Borough of Havering) policy and procedure, DOH document ‘No Secrets’ and the home’s own policy and procedure. There was signed evidence that these had been read by the staff. The manager was clear in what incidents needed to be referred to the local authority as part of the local safeguarding procedures. The member of staff that was spoken to was very clear on what constituted abuse and their responsibilities to report any potential abuse. Staff files indicated that all members of staff have either attended formal training in Safeguarding Adults in September. The home has policies and procedures for safekeeping and expenditure of service users’ money. One of the service users is subject to Court of Protection, to support and protect the management of her finances. Two of the service users’ monies were checked and found to be correct. There was a clear audit trail and receipts were available for all expenditures. Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26 and 30 People who use this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home is clean and free from any offensive odours. However some areas of the home need to be redecorated and some refurbishment needs to be undertaken to ensure that the service users’ home is safe and comfortable. EVIDENCE: The home is in keeping with other properties in the road. A tour of the home was undertaken including the service users’ bedrooms. The home is furnished in a homely fashion and the home was clean, tidy and free from any offensive odours. On the ground floor there is a kitchen/diner, a separate lounge, a cloakroom and a utility room. A conservatory has been added to the back of the house and this is the manager’s office. On the first floor there is three bedrooms and a bathroom, which has a bath and a walk-in shower. The home has undergone a loft conversion and on this floor there is another bedroom with an en-suite shower and toilet, currently this room is vacant. Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 22 The lounge was rather bare; there are no curtains at the window (screening fabric has been fixed to the glass) and only a few pictures on the walls. This is specifically due to the behaviour of one of the service users. The inspector had a discussion with the manager and suggested that as the service user’s behaviour had shown some signs of improvement that roller blinds might prove a suitable alternative and a few ornaments could be placed on the fireplace. The lower treads of the stair carpet have been frayed, again to the behaviour of a service user. The carpet needs to be repaired or replaced as this could put the safety of service users at risk. The window on top of the stair landing is broken and this needs to be replaced as again this could put service users at risk. The garden is a pleasant area for service users to use in the summer months, however the area could be tidier and the office chair removed. This is Requirement 2. The three bedrooms are of a good size; all three bedrooms were appropriately furnished and two of the bedrooms were personalised with pictures, photographs, televisions and cuddly toys. The third bedroom is sparse with just the bedroom furniture (the wardrobe is locked) and again with screening fabric fixed to the windows. This is due to the specific behaviours of one of the service users, who is unable to cope with curtains and other items in their room (this is detailed in their care plan including the reasons as to why it is necessary). The walls in this bedroom need to be painted and preferably in a calmer colour and the bed linen and curtains in all the bedrooms though clean are starting to look tired and faded. This is Requirement 3. The bathroom has recently undergone some refurbishment and a new walk-in shower has been fitted, this means that service users have a choice as to whether they bath or shower. Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 and 36 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Staffing levels are satisfactory and there are sufficient staff on duty, however some of the shifts are extremely long, which could have an adverse effect on the way service users are cared for. Staff have the skills and training and are appropriately supervised, which ensures that they are able to meet the individual needs of the service users. Staff recruitment policies and procedures are robust and this ensures that service users are protected. EVIDENCE: Duty rotas were inspected and they correlated with the staff member and manager on duty. Examining the staff rotas it was clear that there are sufficient staff on duty to meet the needs of the service users, there are three Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 24 service users living at the home and there is always one member of staff on duty and at times two members of staff are working. There is good staff retention within the home and permanent staff cover any absences, this ensures continuity of care to the service users. However the inspector was concerned to see that some of the shifts were extremely long; working a long day 9.00am-10.00pm and then a sleeping-in shift. The manager needs to be mindful that staff are not working excessive hours as this could have a detrimental effect on the way staff deliver care to the service users. This is Requirement 4. There is a recruitment policy and procedures. Three staff files were inspected and these showed that appropriate recruitment procedures were being followed; all of the files had a completed application form, an up to date Criminal Records Bureau (CRB) check and a Protection of Vulnerable Adults (POVA) first check, there was also copies of appropriate documentation such as, proof of identity, and permission to work. The files also showed a recent photograph and had written references. Staff files showed that mandatory training is taking place; staff have attended moving and handling, food & hygiene, health & safety, administration of medication, safeguarding adults, autistic disorder, first aid, risk assessment & fire awareness and understanding the principles of care. The registered provider has recently taken over the management of the home and is ensuring that all of the staff are undertaking an induction programme that is in line with the Skills for Care Council. The manager has completed a training profile for each member of staff, this identifies what training has been undertaken and what training is required. The majority of the staff have completed their NVQ 2 and two of the staff are undertaking their NVQ 3. Staff files indicated that supervision is taking place on a regular basis and the member of staff on duty confirmed this. Annual appraisals are being organised by the manager. Service users spoke positively about the staff, one service user stated, “I like going out with X, he is kind”. A relative stated, “The staff are really good, nothing is too much trouble” Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 25 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,41 and 42 People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The manager of the home is an experienced person and runs the home in the best interest of the service users. Systems need to be in place to ensure that service users can be confident that their views underpin the review and the development of the home. The home’s record keeping, policies and procedures safeguard the rights and best interests of the service users. Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 26 EVIDENCE: The registered provider has recently taken over the management of the home. She has extensive knowledge and experience of working with people with learning disabilities and associated mental health needs. This is a small home and therefore the service users’ needs are well known to the manager and staff and therefore they are able to provide a flexible and individual service. Service users get up and go to bed when they wish, they are able to eat at times that suit them and have some 1:1 time with their key worker. Staff are encouraged to support service users in accessing the community and keeping contact with families such as, taking one service user to visit her sister on a regular basis and for another service user to have frequent telephone contact with their parents who live some considerable distance. There are plans for this service user to visit her parents. Service user meetings are taking place every three months. Information from these meetings and from complaints, concerns and compliments, together with an annual quality audit (questionnaires to be sent to service users, relatives, stakeholders and any other significent parties) should be collated. This information will advise the manager on the quality of the service being provided and will enable her to develop an annual plan for the home. This is Requirement 5. The home has responsibility for the personal allowances of the service users and secure facilities are provided for their safekeeping, with records being maintained and accurate. Two of the service users’ accounts were checked and were found to be accurate with financial recordings up to date. The home is kept in a safe condition. A wide range of records were looked at including fire safety, emergency lighting, health and safety checks and accident/incident reports. Portable electrical equipment, the gas heating system and gas appliance have all been tested in the past eight months. Refrigerator and freezer temperatures are regularly taken. Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 27 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 Standard No Score 1 3 2 3 3 3 4 2 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 2 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X 3 3 X Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 28 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. 2. 3. 4. Standard YA6 YA24 YA25 YA33 Regulation 17(1) (a) 23(2)(b) 16(2)(c) 18(1) (a) Requirement All daily records should evidence care plan goals. All parts of the home must be kept in a good state of repair externally and internally. All of the service users’ bedrooms must be decorated and furnished adequately. The manager needs to ensure that staff are not working excessive hours as this could have a detrimental effect on the way staff deliver care to the service users. There must be a system in place for evaluating the quality of the care provided at the home, which takes into account the views of the service users and significent others. Timescale for action 30/09/07 31/10/07 31/10/07 30/09/07 5. YA39 24 30/11/07 Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 29 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.V344704.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU 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 Rose House DS0000027891.V344704.R01.S.doc Version 5.2 Page 31 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!