CARE HOME ADULTS 18-65
Rose Mount 138 Stourbridge Road Holly Hall Dudley West Midlands DY1 2ER Lead Inspector
Mrs Jean Edwards Unannounced Inspection 15th December 2005 10:00 Rose Mount DS0000025002.V273530.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 Mount DS0000025002.V273530.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 Mount DS0000025002.V273530.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Rose Mount Address 138 Stourbridge Road Holly Hall Dudley West Midlands DY1 2ER 01384 457855 01384 457855 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) Mr Paul S Dhillon Mrs Valerie Dhillon Mr Nigel Dhillon Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Rose Mount DS0000025002.V273530.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 07/07/05 Brief Description of the Service: Rose Mount is a small private Residential Care Home, providing accommodation for up to three adults under the age of 65 years who have learning disabilities. The Home is situated on a busy main road, with easily accessible bus routes to a number of nearby towns and shopping centres, Merry Hill, Dudley, Wolverhampton, Brierley Hill, Stourbridge etc. There are numerous local amenities within walking distance from the Home, Post Office, library, church, health centre, parks and pubs. There is limited car parking, two cars at the frontage to the property, with limited on road parking nearby. The accommodation provided consists of three good size single bedrooms, one on the ground floor and two on the first floor. There is a lounge/dining area, toilets, and bathing facilities. The office is located in the cellar. There is a garden and patio to rear of the Home, accessible to Residents. The Registered Manager and Joint Proprietors provide staffing. Rose Mount DS0000025002.V273530.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection visit took place over a weekday morning. The purpose of this visit is to assess progress towards meeting the national minimum standards for younger adults and towards required improvements identified at previous inspection visits. Inspection methods, which have been used to make judgements and obtain evidence include: a formal discussion with the registered manager who is also joint owner. A brief tour of the premises has taken place. The two residents accommodated were at home for some part of the inspection process. Both residents have willingly joined in the inspection providing information about their experiences during discussions. The joint proprietor, who is also the registered manager, has continued discussions with Dudley Social Services Department about the future direction of Rosemount, looking at other possibilities for the people to continue living at the home, maybe as tenants, with supported living arrangements. No decisions have been reached to date. What the service does well:
The two residents are encouraged by the manager/owners to treat Rosemount as their own home and to be as independent as they wish. During the inspection both residents used the kitchen to make their own breakfasts and drinks and washed their dishes without any prompting. One person prepared his own packed lunch to eat at work. Residents are able to make their own choices and are able to express their own wishes and pursue their own individual lifestyle. One person is able to work in full time employment at a local foundry; the other person does voluntary work for the health service and also uses a local social services day centre for opportunities for socialising. The home celebrates important events in residents’ lives. The manager and the two residents regularly visit the cinema at Merry Hill, though each person also has separate hobbies and interests, which they pursue independently. Residents are planning to spend Christmas day at Rosemount and one person will be a visiting relative on Boxing Day. The residents are able to enjoy their part ownership of a pet dog, a growing bullmastiff, Spike, who lives at the home on a part time basis. He also lives partly at the manager’s own home. One resident states that he loves animals and would like to do something with animals when he retires from work - he will be 60 years old in 2006.
Rose Mount DS0000025002.V273530.R01.S.doc Version 5.0 Page 6 The premises are maintained to high standards and the home is clean, tidy and homely. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rose Mount DS0000025002.V273530.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 Mount DS0000025002.V273530.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The majority of these standards have not been assessed. The home has not admitted any new residents for many years. The residents participate in multiagency reviews concerning their support. EVIDENCE: There are two male residents at Rosemount, who have lived at the home for more than eleven years. Both men continue to pursue fully independent lifestyles, one person works in full time employment, the other does part time voluntary work. Rose Mount DS0000025002.V273530.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): 6,8 There is a clear and consistent care planning system in place to adequately provide information to meet residents needs in a satisfactory manner. Residents are fully engaged in all decisions about the running of this home. EVIDENCE: There is evidence that both residents have a care plan in place. There are signatures to indicate their agreement. During discussions with residents during this visit they have confirmed that there is active involvement in developing and implementing their own care plan. This reflects their preferred lifestyle and routines, such as spending time alone or going out unaccompanied. Residents take an active role in the running of the home. Each person is provided with detailed information about what they can expect from the manager. The residents are regularly consulted about all aspects of their lives through care planning reviews, formal reviews, residents meetings and surveys. The home has good documentary evidences of the outcomes and decisions agreed with residents. Rose Mount DS0000025002.V273530.R01.S.doc Version 5.0 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14,16 Links with the community are good and these support and enrich residents social, work and educational opportunities. Residents are supported to take advantage of leisure activities. EVIDENCE: Both residents have willingly participated in parts of this inspection visit. Both residents have prepared their own breakfasts independently and cleared the dishes and kitchen area, without any prompting, and offered the inspector refreshments. One person continues to work in full time employment at a local foundry and continues to have a good social network of friends. There are no restrictions relating to visiting times at Rosemount and friends and families are welcomed, and are offered refreshments or meals. Information about residents’ family/friends relationships and links are documented in each person’s plans. Each person has a varying amount of contact with family and friends, with details of any additional support recorded in case files. Each person has details of advocacy services available. Rose Mount DS0000025002.V273530.R01.S.doc Version 5.0 Page 11 Both people continue to be able to access facilities in the community. For example shopping, use of the library and visits to the cinema. They generally plan outings and travel independently, though they both go with the manager to the Merry Hill cinema on a regular basis and have a weekly wander around the shops at Merry Hill. Both residents have spoken fondly about the pet dog, a bullmastiff, Spike who lives part of the time with the manager. This person states he loves animals and would like to have more contact in some way when he retires from his full time employment. The residents chose not to have an annual holiday during 2005, preferring day trips. However the manager needs to provide documentary evidence of offers made. Rose Mount DS0000025002.V273530.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 There are policies / procedures in place for the administration of medication, however the current residents have no need for any medication to be administered by the home. The health needs of residents are satisfactorily met. EVIDENCE: There is documentary evidence that both residents have an annual health check up with their own GP. One person has attended an appointment on 11 November 2005; the results of various tests are awaited. There is a health appointment index to track all health related visits, on each person’s case file, which is good practice. Discussions take place to ensure that residents understand the need to regularly check themselves for any abnormal / unusual changes in their bodies. Currently a resident is undergoing urgent investigations related to scarring on his lungs, discovered from an x-ray following an accident outside the Henry Launch Centre, whilst jogging to his voluntary job at Dove House. The home has not informed the CSCI as a Regulation 37 notification at the time of this visit. The situation relating to medication remains unchanged; neither of the two residents requires any prescribed medication. It has previously been agreed that should the need arise for any other medicines; both residents would be capable of administering their own medication. One person sometimes purchases Paracetamol for headaches and other homely remedies for his own use, as the need arises. He states he is currently taking cough medicine,
Rose Mount DS0000025002.V273530.R01.S.doc Version 5.0 Page 13 which he has purchased from the Merry Hill Centre. The Manager has recorded this decision in his individual plan, with his consent. The previous requirement to devise and implement a risk assessment with the resident for the selfadministration of his own purchases has been met. A copy of a homely remedy protocol devised by the CSCI Pharmacists has been given to the proprietor/manager during this visit. The manager must send a copy of the homes protocol for the residents use of over the counter medicines to their GP for approval. Rose Mount DS0000025002.V273530.R01.S.doc Version 5.0 Page 14 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 The home has a satisfactory complaints system with evidence that residents feel that their views are listened to and acted upon. EVIDENCE: There have been no complaints recorded in the home’s complaints log since the last inspection visit in July 2005. The residents spoken to state that they feel that they can voice any concerns either directly with the manager or staff at the social services department. Rose Mount DS0000025002.V273530.R01.S.doc Version 5.0 Page 15 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): These standards were assessed at the inspection in July 2005 and were satisfactory. EVIDENCE: Rosemount provides accommodation for up to three adults with learning disabilities. A brief tour of the premises demonstrated that the house is clean, homely and comfortable. Rose Mount DS0000025002.V273530.R01.S.doc Version 5.0 Page 16 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): 33 The two residents are currently well supported by the registered manager / joint proprietor. No other staff are currently employed at this small home. EVIDENCE: The two residents living at this home continue to demonstrate a high level of independence, requiring very minimal support. One person has been reassessed as no longer needing residential care by Dudley Social Services. The other person is due to be reassessed in the near future. The is staffed by the Registered Manager and Joint Proprietor, providing cover for the home as follows; 06.45- 10.00 am and 16.00- 20.00 Monday to Friday by the Registered Manager. 10.00 – 13.00 and 17.00 – 21.00 Weekends by Registered Manager and the Joint Proprietor. It is stated that the staffing arrangements are varied at times to meet the needs of the service users, and the hours are recorded retrospectively. Rose Mount DS0000025002.V273530.R01.S.doc Version 5.0 Page 17 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): 39, 41, 42, 43 EVIDENCE: The registered manager has met the previous requirement to provide accredited risk management training for any persons involved in undertaking risk assessments and provide documented risk assessments, with control measures and risk management strategies. He has undertaken risk management training completed through Touchwood Training on 13/10/05, which he feels has been useful. He is now in the process of reviewing risk assessments relating to the residents and the wider service and environment. Progress is being made with the planned development of the residents surveys, as required by standard 39 with the results to be included in the service user guide. The manager has obtained a standardised format from the Mulberry House company. Rose Mount DS0000025002.V273530.R01.S.doc Version 5.0 Page 18 Although there are no accidents recorded one of the residents states he had a fall outside on his journey home from work. The manager needs to retrospectively record the details of THs accident. The status of the home has changed since the last inspection in that it has become a limited company, with a change to shares held by each person and the registered address, which is now at the accountants. The details of the changes must be officially notified to the CSCI office, Halesowen. Rose Mount DS0000025002.V273530.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X 3 X X Standard No 24 25 26 27 28 29 30
STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 3 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score N/A N/A 3 N/A N/A N/A CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Rose Mount Score X X 2 X Standard No 37 38 39 40 41 42 43 Score X X 2 X X 2 2 DS0000025002.V273530.R01.S.doc Version 5.0 Page 20 YES 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) Timescale for action To forward a copy of the protocol 01/02/06 for the residents use of homely remedies to their GP for ratification. To progress the planned development of the service users surveys, as required by standard 39; and include the results in the reviewed service user guide (Timescale of 31/05/05 and 31/08/05 not fully met) To submit regulation 37 notifications relating to any event adversley affecting the residents well being, for example serious health concerns The registered person must ensure that there is a supply of blue plasters in the kitchen at all times (Timescale of 31/07/05 not met) To retrospectively record the details of THs accident on a journey outside the home To ensure the details of the changes relating to the status of the home and company be officially notified to the CSCI office, Halesowen
DS0000025002.V273530.R01.S.doc Requirement 2 YA39 24 13(1) 17(2) 01/03/06 3 YA41 13(1) 17(2) 01/02/06 4 YA42 13(4) 23(2) 01/02/06 5 6 YA42 YA43 13(4) 39 01/02/06 01/02/06 Rose Mount Version 5.0 Page 21 7 YA43 25 To produce a business and financial plan for the Home, with a copy forwarded to the CSCI, for consideration. (Timescale of 31/05/05 and 31/08/05 not met) 01/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA14 Good Practice Recommendations The registered manager needs to provide documentary evidence of offers of annual holidays and alternatives and decisions reached by each person Rose Mount DS0000025002.V273530.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA 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 Mount DS0000025002.V273530.R01.S.doc Version 5.0 Page 23 - 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!
