Inspection on 10/05/05 for Roseacres Residential Care Home

This inspection was carried out on 10th May 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Roseacres Residential Care Home 18/09/09

Roseacres Residential Care Home 28/05/08

Roseacres Residential Care Home 23/10/07

Roseacres Residential Care Home 28/02/07

Roseacres Residential Care Home 10/08/06

Roseacres Residential Care Home 28/02/06

Roseacres Residential Care Home 02/12/04

Roseacres Residential Care Home 14/07/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Roseacres Residential Care Home 80-84 Chandos Avenue Whetstone London N20 9DZ Lead Inspector Tom McKervey Announced 10 May 2005 @ 09:30 am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. 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. Roseacres Residential Care Home Version 1.10 Page 3 SERVICE INFORMATION Name of service Roseacres Residential Care Home Address 80-84 Chandos Avenue, Whetstone, London N20 9DZ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8445 5589 020 8445 5589 Dr Sanjeev Kanoria of Aermid Healthcare Ltd Mrs Nena Adams PC Care Home only 43 Category(ies) of DE(E) Dementia over 65 registration, with number OP Old Age of places Roseacres Residential Care Home Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1 One specified service user who is under 65 years of age may remain accommodated in the home. 2 The home must advise the registering authority at such times as the specified service user either attains 65 years of age or vacates the home. Date of last inspection 2 December 2004 Brief Description of the Service: Roseacres is a care home registered to provide care for 43 older people, some of whom may be experiencing symptoms of dementia. Service users bedrooms are located on both the ground and first floors with a passenger lift providing access to the first floor. There are 27 single bedrooms and eight doubles. Communal rooms include interconnected lounges and the dining area. All the communal rooms are on the ground floor. There is a large, attractive and well maintained garden to the rear of the property. Roseacres is owned by a company called Aermid Healthcare. The company owns other care homes as well as a domiciliary care service. Roseacres is situated in a pleasant residential area close to shops and other amenities in the area of Whetstone. Roseacres Residential Care Home Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was carried out over a period of eight hours. The purpose of the inspection was to monitor progress since the last visit to the home. The inspection process included a full tour of the premises, reading service users’ care plans, and discussing with them, and the staff, their experience of living and working in the home. There were no visitors to the home during the inspection. Twenty –eight comment cards were sent to the Commission for Social Care Inspection prior to the inspection, the majority of which were favourable. Where there were criticisms, these were reported to the manager and were addressed during the inspection. The registered manager and deputy were present throughout the inspection and fully cooperated in the process. The inspector concluded that the quality of care was very good and the home was well managed, with a dedicated staff team with high morale. The inspector was concerned to find that there were many shortcomings in the layout and décor of the building, and the majority of the requirements in this report address these issues. One requirement has been restated, and an immediate requirement was made about a potentially dangerous health and safety issue. The registered person must address the environmental requirements in this report or risk enforcement action being taken. What the service does well: What has improved since the last inspection? Roseacres Residential Care Home Version 1.10 Page 6 At the last inspection, six requirements were made, five of which had been complied with. These were: That fluid balance charts are provided for service users who have catheters. Provision of a screen in Room 31 to provide privacy for the two service users who occupy this room. Room 19: The window surround has been repaired and the room has been redecorated. Room 26: Window restrictors have been repaired, and the large window replaced. The fire door between numbers 80 and 82 now closes properly. The registered provider carries out monthly visits to the home. However, the reports of the visits are not being sent to the CSCI. The fire alarms are tested weekly. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Roseacres Residential Care Home Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Roseacres Residential Care Home Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 5. (Standard 6 does not apply to this home). Service users and their representatives are given sufficient information about the service to enable them to make a decision about admission to the home. EVIDENCE: The Statement of Purpose and Service Users Guide contain all the information required in Schedule 2, National Minimum Standards. The case files of five service users were examined. They contained comprehensive assessments by care managers and assessments by the home staff. A contract for a service user who had recently been admitted, contained relevant details about the terms and conditions and was signed by the service user. The home does not provide intermediate care. Roseacres Residential Care Home Version 1.10 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 & 10 Service users’ healthcare needs are met by a range of healthcare professionals and by a staff team who are kind and caring. However, the dignity and privacy of service users is being compromised by the poor layout and environment of the building. EVIDENCE: Five care plans were examined. They contained good assessments of service users’ needs. There were appropriate goals set and the required actions to meet them were written. There was a fluid balance chart recorded for one service user who had a urinary catheter. The case files contained records of a full range of healthcare appointments to hospital, dentists and opticians. There were records of regular visits by the G.P to the home. A physiotherapist provides weekly keep-fit sessions. Two staff were observed supporting a service user who was using the toilet. It was noted that the toilet door was wide open during this process and the dignity of the service user was compromised. Roseacres Residential Care Home Version 1.10 Page 10 When the inspector drew the staff’s attention to this matter, the staff demonstrated the constrained access to the toilet, especially when the service user required a wheelchair or walking frame. A requirement is made for this matter to be addressed by the proprietor. Service users who were spoken to, confirmed that the staff were very kind and caring. Roseacres Residential Care Home Version 1.10 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 There are appropriate activities provided for the enjoyment of the service users, and they are able to choose food from a wholesome and varied menu. However, the dining room environment is not congenial and is in need of redecoration. EVIDENCE: Roseacres Residential Care Home Version 1.10 Page 12 1. An activities programme was seen. This showed that appropriate activities were provided, including bingo, arts and crafts. An outside entertainer provides music sessions once a week, and a physiotherapist also provides a session in reminiscence therapy. The inspector spoke to a hairdresser, who attends every week. The visitors’ book showed that there are frequent visits by relatives. Service users who were spoken to, stated that they made choices about the time of getting up and going to bed, what clothes to wear, choice of meals and whether or not to join in organised activities. The menus showed that there was a good variety of food provided, with evidence of choice. The inspector observed the service users having lunch. The meal was well cooked and attractively presented. Two different main courses and a choice of pudding were provided. The inspector noted that the staff supported some service users eating their meal in an unhurried and sensitive manner. Most of the service users who were spoken to, stated they were satisfied with the food provided., and that a snack meal is offered in the evening. The meals are taken in the dining room and a small conservatory. However, the dining room walls are in need of redecoration, and the rather old carpet is torn in places, and needs to be replaced. There was only one freezer available, which is insufficient storage for the number of people in the home, and as commented under Standard 24, the kitchen space is very inadequate, No relatives visited the home during the inspection. However, a large number of comments from relatives were sent to the inspector, the majority of which, were very complimentary about the staff. For example; “Overall, the care and attention my sister receives is unquestionably faultless. I have nothing but praise for the staff and management at Roseacres. They are a credit to their profession”. Concerns which were expressed by two relatives, were passed to the manager who agreed to meet with them and discuss the issues at the nearest opportunity. Roseacres Residential Care Home Version 1.10 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17 & 18 Service users are protected from possible risks of harm or abuse, by staff awareness and satisfactory procedures. EVIDENCE: Three complaints were recorded in the complaints book. These matters had been dealt with within proper timescales and had been resolved satisfactorily. There was evidence in the case files of some service users accessing legal representation from solicitors. There are Adult Protection and Whistle-blowing procedures in place. Three care staff and the hairdresser who were spoken to, demonstrated an awareness of elder abuse issues and knew how to report concerns. Staff records showed that they have attended training in adult protection. Roseacres Residential Care Home Version 1.10 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25 & 26 There has been some improvement to the décor in some bedrooms and corridors, but no improvement in communal lounge and dining areas. The personal care of service users is compromised by the ground floor layout, which does not provide adequate toilet and bathing facilities. The working conditions of staff in the kitchen and laundry, are poor because of inadequate space and ventilation. Service users, staff and visitors are at serious risk of injury by the dangerous state of the walls at the entrance to the home. EVIDENCE: A full tour of the premises was carried out, including five service users’ bedrooms. Interior The home employs a maintenance person, and there was evidence that some redecoration had been done in some bedrooms and upstairs corridors, particularly where requirements had been made at the last inspection. Roseacres Residential Care Home Version 1.10 Page 15 The bedrooms seen, were comfortably furnished, and there was evidence of personal possessions. However, in Room 21 some plaster was missing from the wall. Service users stated that they were happy with their bedrooms. The communal furniture in the lounge and dining room was suitable and appropriate for the needs of the service users. However, as stated in the last inspection, the kitchen space is inadequate for the size of the home and uncomfortable to work in. There is insufficient space for the laundry, and the floor needs to be resealed. As stated elsewhere in the report, access to the small downstairs toilet is inadequate for service users who have problems with mobility. Although there is a hoist available for the downstairs bathroom/toilet, the staff stated that the door is too narrow to use it. The lounge needs redecoration and the carpet is torn in several places and needs to be replaced. Exterior The large garden was attractive and well maintained. The paving leading to the front door was uneven. It was noted that some pebble-dash had fallen off the walls and had fallen through the Perspex canopy at the entrance to the home. This is a dangerous hazard and an immediate requirement was made to address this. Some window panes were broken at the front of the home. At the time of the inspection, the home was clean and tidy and there were no offensive odours. Roseacres Residential Care Home Version 1.10 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 & 30. Service users’ interests and welfare are safeguarded by satisfactory staff recruitment procedures and training. EVIDENCE: The manager stated that there were no vacancies for care staff. The staff rotas were examined. They indicated that there were six staff on duty during the day, and three waking staff on duty at night. These were adequate levels for the number of service users currently in the home, (38). The manager stated that when the number of service users increases to 40 or more, staffing levels are increased. A part-time staff has been recruited for the laundry. Five staff had attained NVQ 2, two at NVQ 3, and thirteen more were currently on the programme. The records of four new staff were examined. Neither of the two references for one of these staff were from their last employer, otherwise, the records included all the information required, including CRB/POVA checks. The records also showed that new staff received induction and TOPPS foundation courses. Roseacres Residential Care Home Version 1.10 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 35, 36, 37 & 38 The manager provides clear leadership throughout the home and is well supported by staff who demonstrate awareness of their roles and responsibilities. There is no clear development plan for the home and no system for ascertaining service users’ views about the service provided. Service users, staff and visitors to the home are at risk from falling masonry and from fire exits which may not have proper escape mechanisms fitted. EVIDENCE: The manager is a qualified nurse and is experienced in caring for older people and running a care home. She is currently training towards the Registered Manager’s Award. The manager is supported by a deputy who had been in post for two months. Roseacres Residential Care Home Version 1.10 Page 18 Service users, relatives and staff were complimentary about the manager and expressed confidence in her ability to run the home effectively. The inspector observed that there was an open and friendly atmosphere and relations between the manager, staff and service users were very positive. Staff stated that the manager and deputy were very approachable and supportive. There was a relaxed and friendly atmosphere in the home. Reports of senior managers’ monthly visits to the home were available for inspection. However, these reports are not being sent to the Commission for Social Care Inspection, which is a requirement. A quality assurance audit of the service had not been conducted and there was no business and financial plan available for inspection. The manager stated that no personal money is held in the home on behalf of service users, but that service users and their representatives are billed by the company’s finance department, for fees and any additional purchases. There were records of regular staff supervision and annual appraisal. The inspector noted that records were well maintained and up to date and they were kept securely. Two policies about adult protection were examined and were in order. The fire log showed that the alarms had been tested weekly. There were records kept of the temperatures of food, fridge and freezers. Certificates of safety were seen for gas and electrical appliances, and COSHH materials were stored securely. There was a risk assessment completed for one service user who insists on having the bedroom door propped open. The inspector was concerned that some designated fire escape doors did not have approved release mechanisms. A requirement was made that the manager requests the fire safety officer to carry out an assessment of the building. As noted under Standard 19, there is a serious health and safety risk from falling masonry at the front of the building. Roseacres Residential Care Home Version 1.10 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 x x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 1 2 2 3 3 3 x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 x 1 3 3 3 2 Roseacres Residential Care Home Version 1.10 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 10 Regulation 23(2)(j) Requirement The registered person must improve the access to the downstairs toilet to assure the privacy and dignity of service users. The registered person must replace the carpet and improve the decor in the dining room and lounge. The registered person must provide additional freezer capacity for food storage. The registered person must carry out repairs to the exterior walls at the front of the building. This is an immediate requirement. The registered person must review the kitchen and laundry space and inform the CSCI of the plans to improve the space and ventilaiton limitations. This requirement is restated from the previous inspection. The registered person must redecorate Room 21. The registered person must repair the paving and broken window panes at the front of the home. The registered person must Version 1.10 Timescale for action 31/7/05 2. 15 23(2)(d) 31/7/05 3. 4. 15 19 23(2)(l) 23(2)(b) 31/7/05 17/5/05 5. 19 23(2)(a) 31/7/05 6. 7. 19 19 23(2)(d) 23(2)(b) 31/7/05 31/7/05 8. 21 23(2) 31/7/05 Page 21 Roseacres Residential Care Home 9. 33 24(1)(a) 10. 34 25 11. 38 24(1)(a) improve the access to the downstairs toilet for service users who have mobility problems. The registered person must send 30/6/05 reports of the monthly visits to the Commisssion for Social Care Inspection. The registered person must 30/9/05 make available for inspection, a financial and business plan for the home. The registered person must seek 30/6/05 advice from the fire safety officer about the release mechanisms on the designated fire exits. 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 Good Practice Recommendations Roseacres Residential Care Home Version 1.10 Page 22 Commission for Social Care Inspection Solar House 1st Floor, 282 Chase Road Southgate London N14 6HA 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 Roseacres Residential Care Home Version 1.10 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. 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