Inspection on 23/10/07 for Roseacres Residential Care Home

This inspection was carried out on 23rd October 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 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 28/02/07

Roseacres Residential Care Home 10/08/06

Roseacres Residential Care Home 28/02/06

Roseacres Residential Care Home 10/05/05

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 Key Unannounced Inspection 09:20 23rd October 2007 X10015.doc Version 1.40 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 Roseacres Residential Care Home DS0000010509.V336947.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 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 DS0000010509.V336947.R01.S.doc Version 5.2 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 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) 020 8445 5554 020 8445 5589 www.aermid.com Aermid Health Care Limited Mrs Nena Adams Care Home 43 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0) of places Roseacres Residential Care Home DS0000010509.V336947.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One specified service user who is under 65 years of age may remain accommodated in the home. 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. 28th February 2007 Date of last inspection Brief Description of the Service: Roseacres is a care home registered to provide care for 43 older people, some of whom may have dementia. Residents’ bedrooms are located on both the ground and first floors with a passenger lift and chair lift providing access to the first floor. There are 27 single and four double bedrooms. At the time of the inspection, major internal improvement works were about to commence, as a consequence of which, the proprietor intends to reduce the number of people accommodated to 35. The communal rooms, which are on the ground floor, include interconnecting lounges, a conservatory and a dining area. There is also a small toilet and a bathroom with toilet on the ground floor. There is a large, attractive garden to the rear of the property that is accessible to wheelchair users. Roseacres is owned by a company called Aermid Healthcare. The company owns other care homes as well as a domiciliary care service. The care home is situated in a pleasant residential area close to shops and other amenities in the area of Whetstone in North London. The fees for the service range from £454 to £700 per week, depending on whether bedrooms are shared or single with en-suite facilities. Roseacres Residential Care Home DS0000010509.V336947.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted over one day, in a period of eight hours. The visit was part of the Commission’s inspection programme to check compliance with the key standards. I was assisted in this inspection by an inspector colleague Jane Ray, and also by an “expert-by-experience”, Suzanne Clarke. This person is independent of the Commission for Social Care Inspection, but has personal experience of residential care services. The expert by experience assisted me by speaking to people who live in the home and speaking to the staff who were on duty. The expert-by-experience’s comments are included where appropriate, in the body of this report. The registered manager was present throughout the inspection and I was also able to meet three new senior managers who work for the company. From them, I was informed about major improvement plans for the environment and the overall quality of the service. The inspection process included a tour of the premises, reading residents’ case files and other records, and discussing with them about their experiences of living and working in the home. Several staff were also interviewed and their records were examined. The staff were observed interacting with the residents when providing care and support. What the service does well: There is good information about the home, which is useful for people who are potential users of the service and they can visit and spend time there before deciding to move in. There is a homely and relaxed atmosphere, with plenty of interaction between residents and staff, and residents can choose between a good range of activities. People who live in the home are supported in the observance of their religion and culture. The residents and/or their relatives are invited to take part in drawing up care plans and staff ensure that there is good access to healthcare professionals when residents are ill or are due for check-ups. Medication is administered safely and recorded appropriately. The residents say they like their meals and they can choose alternatives to the menu. The manager spends time speaking to residents and their families, which results in a low level of complaints and any concerns being dealt with promptly. Residents’ welfare is protected through good recruitment procedures that ensure staff are properly screened and through staff training and supervision. In addition, regular health and safety checks are carried out and there is a maintenance person employed to attend to any necessary repairs. Roseacres Residential Care Home DS0000010509.V336947.R01.S.doc Version 5.2 Page 6 The manager and the majority of her staff have worked at the home for many years. This provides continuity of care for residents, and helps to maintain a good team spirit. What has improved since the last inspection? What they could do better: The company must ensure that all the improvement plans for the environment are implemented within the timescales set in this report. Residents whose care is funded by local authorities, must be given contracts explaining the terms and conditions of the service, including all costs and what these cover. All records of residents finances that are held on their behalf must be kept in the home and be available for inspection so that they can be confident that their finances are properly managed. A deputy should be appointed to support the manager in the day-to-day management of the service. A care plan must be implemented for a specific resident to show that they spend quality time outside their bedroom so that they are not totally isolated from other residents. There needs to be thorough cleaning of bedrooms where there are unpleasant odours and the maintenance issues identified in this report must be addressed to ensure the comfort and well-being of the residents and their visitors. Staffing levels at night must be increased to ensure that residents are safe and their needs are being met. This requirement was made at the last inspection but had not been complied with. The electric wiring circuits and the water system must be tested to ensure that the health and safety of residents, staff and visitors are protected. Roseacres Residential Care Home DS0000010509.V336947.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. Roseacres Residential Care Home DS0000010509.V336947.R01.S.doc Version 5.2 Page 8 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 Outcomes Statutory Requirements Identified During the Inspection Roseacres Residential Care Home DS0000010509.V336947.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 5. People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service and speaking to residents. Potential service users and their relatives are able to assess the home’s suitability by the information provided and the opportunity to view the facilities. Pre-admission assessments ensure that residents can be confident about the home’s ability to meet their needs. Private-funding residents have service contracts, but residents who are funded by local authorities and who pay top-up fees, do not have written information about what these cover. EVIDENCE: The home has an up to date Statement of Purpose and Service User Guide, both of which will need to be amended when the refurbishment works are completed and the home reduces the number of places available. Roseacres Residential Care Home DS0000010509.V336947.R01.S.doc Version 5.2 Page 10 In the case of the twelve residents who were self-funding, their records contained signed contracts of the terms and conditions of the service and what was covered by the fees. However, there were no contracts in place between the home and the residents who were funded by local authorities. These should contain information about families’ contributions and what the local authorities fees cover. Pre-admission assessments of residents’ needs, in which service users and/or their representatives had been involved, had been carried out by the referring care managers and the manager of the home before admission. The assessments were comprehensive in providing life histories and covered areas such as mobility, mental function, social, cultural and religious needs. All potential service users and their representatives are invited to view the home and can spend a day there, before deciding to move in. Care staff have been trained in the care of people with dementia. The expert by experience interviewed several residents. She reported; “I spoke with a few residents who were able to converse, to see if they liked living at Roseacres. They were all complimentary about the home and the food. I asked two ladies, who have become friends and who appeared to stay together, if they were happy at the home. One lady, who was more communicative, said that she likes living at the home as there is a nice atmosphere, but she misses her piano as she had played since she was 8 years old. Her friend nodded agreement with everything.” Roseacres Residential Care Home DS0000010509.V336947.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including examining residents’ case files. The service involves individuals in the planning of care that affects their lifestyle and quality of life. The residents are treated with dignity and respect by the staff, and their health and welfare is protected by access to professional healthcare and safe administration of medicines. EVIDENCE: Each resident has an individualised care plan that includes an assessment of their needs and objectives of their care. I sampled four care plans, which focus on the strengths of the resident and “activities of daily living”; for example, requirements for personal care, sleep patterns, ability to communicate and mobility. The care plans also addressed physical conditions, e.g. skin, feet, and risk assessments of nutritional needs and risk of falls were documented. The care plans were being monitored on a monthly basis by each resident’s key worker. Roseacres Residential Care Home DS0000010509.V336947.R01.S.doc Version 5.2 Page 12 It was noted that residents or their representatives had signed the care plans to show their involvement in compiling the plan. One resident had a pressure ulcer, which they had when admitted to the home. This was being treated by the district nurse and the record indicated that it was responding well. The staff have attended training in the prevention and management of falls, and charts were used to monitor falls if they occur. Accidents were well documented and appropriate actions were taken, e.g., referral to the G.P or A&E department. The G.P attends the home once a week, and residents’ health records contained information about being referred to specialists, e.g. chiropodists, dentists and opticians, and all residents were being weighed regularly. At the time of the inspection, all residents were reportedly in good health and no-one was on full bed rest. There is an appropriate procedure for the safe administration of medicines. Staffs’ signatures were accurately recorded in the administration of medicines, (MAR) sheets, and the residents’, (or their representatives), consent for medication to be administered, had been obtained. The medication trolleys were kept locked and firmly secured to the wall in the small conservatory. The residents looked well cared for, clean and appropriately dressed, and the inspectors observed the staff providing care and support in a dignified, courteous and friendly manner. The expert by experience reported that all the residents spoken to, said that the carers were patient and kind. Roseacres Residential Care Home DS0000010509.V336947.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): All of these standards were assessed. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including observing the residents and examining their records. People who live in the home are happy with their lifestyle, which meets their social, religious and recreational needs. The majority of residents are supported to exercise choices and control over their lives, but there is a risk that a particular resident may become socially isolated. The standard of food is good, wholesome and balanced and is provided in congenial surroundings. EVIDENCE: A qualified occupational therapist visits the home twice a week and conducts reminiscence groups and keep-fit sessions. Outside entertainers are engaged once a month. The home used to have an arts and crafts tutor, but this person left recently. I was informed that two care staff are going to train as activities coordinators in December 07 to provide stimulating activities for residents. Two new large modern televisions have recently been provided, which residents appeared to be watching with interest. Roseacres Residential Care Home DS0000010509.V336947.R01.S.doc Version 5.2 Page 14 There is an activities board that was out of date and should either be removed or accurately written up, as it might cause the residents to be confused. There is a large well maintained garden that residents told me was very popular, particularly in the summer. The expert by experience reported; “I spoke with a bright, alert gentleman who had lived at the home since his wife died. He had a sunny room, overlooking the garden. He was very happy and enjoyed going to the ‘Reminiscent’ and ‘Exercise’ sessions on Wednesdays and Fridays. He enjoyed reading the daily paper and watching television and going into the garden, when the weather was fine”. A Rabbi provides religious services to Jewish residents and a nun provides communion to Catholics. Residents’ birthdays are always celebrated. The visitors book showed that the majority of residents receive frequent visits from relatives and friends, although there were not many visitors on the day of the inspection. I observed the staff leading a sing-song with the residents after lunch, most of whom joined in. Residents who were able to converse, said that they could go to bed at a time of their choosing and they picked their own clothes out for the day. They could choose what activities they wished to join in or opt out. I was concerned about one resident who appears to spend all their time in their room. I was told that this person has advanced dementia and can be noisy and disruptive and cause distress to other residents. I was also told that the carers spend time with this resident on one-to-one activities, but I found no records to evidence this. There is a danger of this person becoming very isolated and I am making a requirement for this issue to be addressed. There was a four- week menu which had plenty of variety, including fresh fruit salad. The expert by experience and I enjoyed a lunch with the residents of shepherds pie and beans with crème caramel for dessert. The main course was hot and tasty. There was an alternative meal choice of omelette and one person had meatballs instead, which he said he enjoyed. The supper menu for that day was asparagus soup, bread & cheese, macaroni cheese & tomato followed by strawberry mousse. There were plentiful stocks of food stored in the kitchen. The dining room provided a restful environment where people could converse with each other in comfort. The tables were laid with linen tablecloths, condiments and a choice of orange juice or water. We observed that the carers were very attentive to those who were unable to feed themselves, and supported them in a caring and unhurried manner and spoke to them quietly whilst they ate and drank. Roseacres Residential Care Home DS0000010509.V336947.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 17 People who use this service experience good outcomes in this area. This judgement has been made using available evidence, including speaking to residents and inspecting complaints records. Residents are protected from abuse through appropriate procedures being put in place and through staff training in this subject. EVIDENCE: The complaints log showed that there were no complaints in the past year. The manager showed us completed relatives’ surveys, which indicated that they were satisfied with the services provided. This included a section about awareness of the complaints procedure. There are procedures in place about Adult Protection and “Whistle-blowing”. The staff I interviewed, were knowledgeable about abuse issues and about how to report concerns about poor practice. Since the last inspection, the manager ensured that the whistle-blowing procedure was re-issued to all staff. Staff records showed that the majority of staff had attended training in adult protection and further courses was booked in the coming weeks. The expert by experience report states; “In summary, all the members of staff I spoke with were attentive and caring and this was confirmed by all the residents’ comments. The residents seem happy living at Roseacres where there is a relaxed atmosphere. Roseacres Residential Care Home DS0000010509.V336947.R01.S.doc Version 5.2 Page 16 Roseacres Residential Care Home DS0000010509.V336947.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23 & 26 People who use this service experience poor outcomes in this area. This judgement has been made using available evidence including visiting all areas of the home. The ground floor facilities are too cramped and small for the number and level of dependency of residents who have difficulty with mobility. There have been some improvements in the standard of accommodation in the past year and there is a commitment to make further improvements to the facilities, which will increase the comfort and lifestyle of the people who live in the home. The home is generally clean and tidy, but more diligence is needed to eradicate bad odours that can be offensive to residents and visitors to the home. EVIDENCE: During several previous inspections, I made requirements about the poor environment in the home relating to lack of space and appropriate bathing and Roseacres Residential Care Home DS0000010509.V336947.R01.S.doc Version 5.2 Page 18 toilet facilities on the ground floor. This also applies to the laundry, which is too small to cope with the volume generated by the residents. The company is about to start major refurbishment of the property to address these problems. This includes improving the access to the downstairs toilet and bathroom and increasing the laundry space by moving it to the basement. Until the above works are completed, these requirements are being restated. During the inspection, I met three senior managers from Aermid, who had recently joined the company. They acknowledged that the accommodation was of a poor standard, but were very keen to implement the necessary changes to improve the lives of the residents and the quality of the service. The Annual Quality Assurance Audit, (AQAA) document, which was submitted, contains comments from the manager about obtaining new curtains and bed linen that match, throughout all the bedrooms when the refurbishments are completed. Better ventilation has already been installed in the kitchen, making it safer and more comfortable for the catering staff, and the lounge area looks more spacious by a better arrangement of the furniture. New chair tables have been purchased. Other improvements have been made by converting two small double rooms to single occupancy rooms, and several bedrooms have been redecorated. The entrance to the home has been improved by attractive plants and flowers and the garden looked particularly attractive and well maintained. The care manager has plans to convert the unused basement bedrooms to an activities area for residents. When touring the premises, I noted that the floor of the passenger lift was damaged and could cause someone to trip, and there were unpleasant odours in some bedrooms. Generally though, the home looked clean and tidy. Other issues identified were; several chairs in the lounge are old and worn and should be replaced, and the door handle of the toilet in Room 24 was broken I noted that a washing machine and a drier had been out of commission for six months. I asked the manager to have these machines repaired immediately, and I have been informed that the machines are now back in use. Roseacres Residential Care Home DS0000010509.V336947.R01.S.doc Version 5.2 Page 19 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): All these standards were assessed. People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including discussions with staff and examining their records. There are sufficient numbers of staff available during the daytime, but staff numbers need to be increased at night to meet the residents’ needs and improve their safety. Residents benefit from staff being well trained and they are protected by thorough screening procedures when new staff are recruited. EVIDENCE: At the time of the inspection, there were twenty-seven residents in the home. The staffing levels had been reduced to reflect the decreased number of residents and showed that there were currently five care staff on the morning shift, four in the evening, and three at night. The home was originally three houses that had been interconnected to form one property. The staff told me that they felt the staffing levels were too low and did not take account of the current high dependency of the residents, many of whom require two staff to support their personal care. At night, one member of staff is responsible for each area and that person also brings breakfast in bed for many of the residents. This is in addition to assisting them to wash and dress before the morning shift starts. Although Roseacres Residential Care Home DS0000010509.V336947.R01.S.doc Version 5.2 Page 20 there is an alarm call system for summoning help from all areas of the home, I was concerned that there could be significant delay in attending to residents in an emergency during the night. Therefore, I am restating a requirement from the last inspection that an additional staff be employed on night duty, which would provide a “floating” person to cover the three areas of the home. The staff records showed that they had undergone a written induction when they started working in the home and had undergone mandatory health and safety training. More than 50 of staff had attained National Vocational Qualification level 2 and all care staff had been trained in dementia care. The records of new staff, also showed that references and Criminal Records Bureau checks had been obtained before they started working at the home and they had been given contracts of their terms and conditions of employment. Roseacres Residential Care Home DS0000010509.V336947.R01.S.doc Version 5.2 Page 21 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36 & 38 People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including discussion with the management team and inspection of records. The new management team has a strong commitment to improve the quality of the service, which will benefit the residents and improve staffs’ morale. The residents and their representatives are consulted about the service and their views are acted on to improve quality. Residents’ finances are generally well managed but complete records need to be available in the home for inspection to ensure that their financial interests are protected. Health and safety procedures are generally good, but the electric wiring circuits and the water system must be tested to ensure that residents, staff and visitors are not put at risk of harm. EVIDENCE: Roseacres Residential Care Home DS0000010509.V336947.R01.S.doc Version 5.2 Page 22 The manager is a qualified nurse and is very experienced in caring for older people, particularly those with dementia. She has also attained the Registered Managers Award, which is aimed at enhancing skills in managing care homes. The company has recently brought in a new senior management team, consisting of a care manager, a chief operations manager, and a facilities director. The inspectors appreciated that all three managers made themselves available to us and inform us about their plans to improve the service. I was concerned to find that the manager had resigned earlier this year and had left the home to take up a post elsewhere. However, after a few weeks, the manager returned to Roseacres following an approach from the proprietor. My concern was, that the Commission for Social Care Inspection was not informed at the time about these events, which is a breach of the regulations. A separate letter has been sent to the proprietor about this matter. In previous inspections, I reported that the staff morale was low because staff did not feel valued by the company. This situation appears to have been improved by the new senior management team who met with the staff and listened to their grievances. The staff told me they greatly appreciated this and said they were willing to give the new managers time to implement improvements in their terms and conditions of employment. The manager of the home completed an AQAA, which is a self-assessment of how the home meets the National Minimum Standards. This document also identifies areas where improvements are needed, which the management intend to implement. The manager has a written budget for the running of the home, which includes major items of expenditure, for example a food budget. An audit of residents and relatives views about the quality of the service was recently carried out by questionnaires and the completed surveys indicated that they were satisfied with the services provided. A senior manager visits the home each month to monitor the service and a report of these visits is sent to the Commission. Residents’ personal finances were examined by my inspector colleague. In the majority of cases, these are managed by relatives or other appointees. Any money held in the home on the residents’ behalf, is kept in a safe, which only the manger has access to. Income and expenditure records are kept and these were checked and found to be accurate. However, in two residents’ cases, the company manages their finances. The inspector was unable to have access to these records because the finance director was not available on that day. A requirement is made for these records to be always available in the home for inspection. Staffs’ records showed that they received one-to-one supervision to monitor their performance and identify further training needs. Staff said they found this helpful and enabled them to discuss any issues with their line managers. The manager conducts a health and safety audit of the home each month to identify hazards. Health and safety records showed that the gas, fire and emergency lighting systems, portable electrical appliances, lifts and hoists had Roseacres Residential Care Home DS0000010509.V336947.R01.S.doc Version 5.2 Page 23 been serviced. Fire alarms were tested weekly and regular drills took place. However, the electric wiring circuitry and the water systems were overdue for testing and a requirement is made to have these done. COSHH materials were stored securely. Roseacres Residential Care Home DS0000010509.V336947.R01.S.doc Version 5.2 Page 24 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. 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 2 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 1 X 3 X X 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 2 3 X 2 Roseacres Residential Care Home DS0000010509.V336947.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 OP2 Regulation 5(1)(b)(c) Timescale for action Contracts of terms and 31/12/07 conditions of the service must be issued to residents whose care is funded by local authorities. A specific resident must be 30/11/07 supported to spend time outside their room to prevent being isolated. Residents’ bedrooms must be 30/11/07 thoroughly cleaned and kept free from unpleasant odours. The floor of the passenger lift 30/11/07 must be repaired or replaced to prevent accidents. The door handle of the toilet in 30/11/07 Room 24 must be repaired. The registered person must 31/01/08 improve the access to the downstairs toilet and the bathroom for residents who have mobility problems. This requirement is restated from the previous inspection. The previous timescale was 30/06/07. All worn armchairs must be 31/01/08 replaced to improve the comfort DS0000010509.V336947.R01.S.doc Version 5.2 Page 26 Requirement 2. OP12 12(3) 3. 4 5. 6. OP26 OP19 OP19 OP21 16(2)(k) 13(4)(a) 23(2)(b) 23(2) 7. OP24 16(1)(c) Roseacres Residential Care Home 8. OP27 18(1) of the residents. The registered person must 30/11/07 increase the staffing level at night to ensure that residents are safe and their needs are being met. This requirement is restated from the previous inspection. The previous timescale was 30/04/07. All financial records held on 30/11/07 behalf of residents must be kept in the home and be available for inspection. The electric wiring circuits and 30/11/07 the water system must be tested to ensure that the health and safety of residents, staff and visitors are protected. 9. OP35 17(2) Schedule 4.9 13(3)(4) 10. OP38 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 OP31 Good Practice Recommendations A deputy should be appointed to support the manager in the day-to-day management of the service. Roseacres Residential Care Home DS0000010509.V336947.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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. 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