Inspection on 28/02/06 for Roseacres Residential Care Home

This inspection was carried out on 28th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 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 Unannounced Inspection 09:45 28 February 2006 th 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.V270252.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 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.V270252.R01.S.doc Version 5.0 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.V270252.R01.S.doc Version 5.0 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. 10th May 2005 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 be experiencing symptoms of dementia. Residents’ 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, which are on the ground floor, include interconnecting lounges and the dining area. . There is a large, attractive 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 in North London. Roseacres Residential Care Home DS0000010509.V270252.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over a period of five hours and fifteen minutes. The purpose of the inspection was to monitor progress since the last visit to the home. The inspection process included a 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 was one visitor to the home who was spoken to during the inspection. The registered manager was present throughout the inspection and fully cooperated in the process. What the service does well: What has improved since the last inspection? What they could do better: “A number of requirements made at the last inspection have not yet been met and have been restated in this report, with a new timescale for compliance. In the “Timescale for Action” column, the date in ordinary type relates to the timescale given at the last inspection. The date in bold type relates to the new timescale. Further information about unmet requirements can be found in the relevant standard. Unmet requirements impact upon the welfare and safety of service users. Roseacres Residential Care Home DS0000010509.V270252.R01.S.doc Version 5.0 Page 6 Failure to comply by the revised timescale will lead to the Commission for Social Care Inspection considering action to secure compliance. Better attention to the residents care is needed, particularly the shaving of male residents. The system for accounting and signing for medication must be improved. A survey must be conducted and a strategy produced for addressing the many problems of space in the home to improve the working conditions of staff and the comfort and welfare of residents. This should be part of the business and financial plan for the home. To protect residents, recent photographs of all staff must be obtained as proof of identity. The proprietors should hold meetings with staff about their concerns in order to improve their morale. Two health and safety issues were identified. 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. Roseacres Residential Care Home DS0000010509.V270252.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Roseacres Residential Care Home DS0000010509.V270252.R01.S.doc Version 5.0 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 the following standard(s): 2, 3 & 5. Standard 6 does not apply Service users and their representatives are able to visit the home to enable them to make a decision about the suitability of the service to meet their needs. All service users have a comprehensive assessment by care managers and the manager of the home prior to admission. EVIDENCE: At the time of the inspection, there were seven vacancies in the home. The records of two new residents 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 manager explained that the other resident’s contract had been sent to the relatives for signing but had not yet been returned. The manager said that the relatives of both residents had visited the home on behalf of the service users who had dementia, prior to admission. Roseacres Residential Care Home DS0000010509.V270252.R01.S.doc Version 5.0 Page 9 Roseacres Residential Care Home DS0000010509.V270252.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 7, 8 & 9 There are appropriate care plans in place to guide staff in meeting the residents’ needs. However, some residents, particularly males, need better support in their personal care. Errors in the administration of medicines, put residents’ health and safety at risk. Although some monitoring of the incidence of falls takes place, better information is needed to monitor and prevent incidents. EVIDENCE: The care plans of the two new residents were examined. They contained good assessments of their needs. There were appropriate goals set and the required actions to meet them were written. There were risk assessments documented about the risk of pressure ulcers. There were also assessments about mobility and there was monitoring of falls. However, the method of monitoring these was not very useful as a preventive tool, as it did not indicate patterns relating to time of day or areas of the home, and did not identify which residents sustained the most falls. A recommendation is made to obtain advice from health professionals about monitoring and prevention of falls in the home. Roseacres Residential Care Home DS0000010509.V270252.R01.S.doc Version 5.0 Page 11 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. All residents had been offered flu vaccinations. A physiotherapist provides a session on keep-fit, and another on reminiscence on a weekly basis. It was noted that three male residents were unshaven and another resident’s clothes were stained by food. A requirement is made to address these issues. The medication standards were examined. Examples of staffs’ signatures were recorded in the administration of medicines, (MAR) sheets. However, two errors were identified; • A medication, which had been recorded as administered, had not been given. • Two tablets were missing from a resident’s blister pack. A requirement is made to address this issue. Roseacres Residential Care Home DS0000010509.V270252.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 13 & 15 There is an open visiting policy for relatives. The residents are able to choose meals from a wholesome and varied menu and the dining room environment has been improved to provide a congenial environment. EVIDENCE: Roseacres Residential Care Home DS0000010509.V270252.R01.S.doc Version 5.0 Page 13 The visitors’ book showed that there are frequent visits by relatives at various times of the day and weekends. Those residents who were able to converse, stated that they could choose the time of getting up and going to bed, what to wear, and whether or not to join in activities. Since the last inspection, the dining room has been decorated and new carpet has been laid, which has greatly improved the environment. The menus showed that there was a good variety of food provided, with evidence of choice. Following the last inspection, a new freezer had been purchased to provide additional food storage. There were ample stocks of food. The inspector observed the service users having lunch. The meal was well cooked and attractively presented. There were two main courses on the menu and a choice of pudding. The inspector noted that the staff supported some service users eating their meal in an unhurried and sensitive manner. Most of the residents who were spoken to, stated they were satisfied with the food provided and that a snack was available in the evening. Roseacres Residential Care Home DS0000010509.V270252.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 16 & 18 There are good systems in place to protect residents from possible risks of harm or abuse, including staff training and satisfactory procedures. EVIDENCE: Two complaints made within the past year were recorded in the complaints book. These matters had been dealt with within the appropriate timescales and had been resolved satisfactorily. There are Adult Protection and Whistle-blowing procedures in place. Care staff 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 DS0000010509.V270252.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 19, 21, 24 & 26 Although some requirements from the last inspection have been complied with, concerns remain about space issues in the home, which affect the residents and staff. EVIDENCE: A tour of the premises was carried out, including five service users’ bedrooms. Several requirements relating to repair and maintenance issues had been complied with. The dining room and lounge had been redecorated and new carpet was also laid, and in Room 21, a wall had been re-plastered. In Room 21, a wall had been re-plastered. Anew floor has been laid in the kitchen. The call-bell system had recently been serviced, and was working properly when checked. As stated in previous inspections, there are serious concerns about space in the home, including; • The kitchen space is inadequate for the size of the home and uncomfortable to work in. Roseacres Residential Care Home DS0000010509.V270252.R01.S.doc Version 5.0 Page 16 • • • • There is insufficient space for the laundry. Access to the small downstairs toilet is inadequate for residents who have problems with mobility. Staff complain that the “Care station” is too small for them to work in and conduct handovers. There is no proper staff room for staff to eat in and change clothes, and this space is also used for hairdressing and is on a fire escape route. The requirement is restated for the proprietors to undertake a survey of this area of the home and provide a solution to address these concerns. The requirement is also restated to replace the broken windowpanes at the front of the home. The manager said that the poor ventilation in the kitchen was being addressed and quotes for this work were currently being obtained. At the time of the inspection, the home was clean and tidy and there were no offensive odours. Roseacres Residential Care Home DS0000010509.V270252.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 & 29 There are sufficient staff on duty to meet the residents’ needs and staff receive appropriate induction and ongoing training. Recent photographs of staff must be obtained as proof of their identity. EVIDENCE: The manager stated that currently, there were no vacancies for care staff. The staff rotas indicated that the number of staff on duty were adequate for the number of service users currently in the home, (36). The manager stated that when the number of service users increases to 40 or more, staffing levels are increased. A part-time administrator has been appointed, and 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. There were references and CRB/POVA checks. However, there wasn’t always a clear photograph of the member of staff to ensure proof of identity. A requirement is made to address this matter. The records also showed that new staff received a written induction and they attend TOPPS foundation courses. Roseacres Residential Care Home DS0000010509.V270252.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 36 & 38 The manager provides clear leadership for staff. However, the proprietors should meet with the staff to discuss their concerns about their terms and conditions of service and their facilities. Some health and safety issues must be addressed to ensure the welfare of residents and staff. 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, in which she hopes to qualify in April 2006 The manager had been supported by a deputy, but he has recently left on promotion and the post has been advertised. Roseacres Residential Care Home DS0000010509.V270252.R01.S.doc Version 5.0 Page 19 The manager is held in high regard by the staff who were spoken to. However, they expressed concerns about their terms and conditions, particularly in relation to the lack of a proper space to have their breaks and change their clothes, as noted under Standard 19 above. They said that they did not feel valued by the proprietors of the home. Some staff appeared to have difficulties attending staff meetings, which were often held in the evenings. A recommendation is made for meeting times to be varied to enable all staff to attend. It is also recommended that the proprietors meet with the staff on occasions during the year to discuss their concerns. Formal staff supervision had not taken place recently, which the manager said would be restarted when the deputy manager post was filled. A requirement is made to address this issue. COSHH materials were stored securely and the fire log showed that the alarms had been tested weekly. There were gaps in the record of the temperatures of fridge and freezers. Although fire escapes were recently fitted with appropriate devices, one fire escape door had a bolt fitted, which contravenes fire regulations. Requirements are made to address these health and safety issues. Roseacres Residential Care Home DS0000010509.V270252.R01.S.doc Version 5.0 Page 20 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 X 3 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 X X X 2 X 2 Roseacres Residential Care Home DS0000010509.V270252.R01.S.doc Version 5.0 Page 21 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 OP7 Regulation 12(3) Requirement The registered person must ensure that residents’ personal care is improved, particularly shaving of male residents. The registered person must ensure that all medication is properly accounted and signed for. The registered person must improve the access to the downstairs toilet for residents who have mobility problems. This requirement is restated from the previous inspection. The previous timescale was 31/07/05. The registered person must review the kitchen and laundry space and inform the CSCI of the plans to improve the space and ventilation limitations. This requirement is restated from the previous inspection. The previous timescale was 31/07/05. The registered person must repair the broken windowpanes at the front of the home. This requirement is restated DS0000010509.V270252.R01.S.doc Timescale for action 31/03/06 2. OP9 13(2) 31/03/06 3. OP21 23(2)(j) 31/05/06 4 OP19 23(2)(a) 31/05/06 5. OP19 23(2)(b) 31/03/06 Roseacres Residential Care Home Version 5.0 Page 22 6. OP19 23(3) 7. OP21 23(2) 8. OP29 7,9,19 9. OP32 21(1) 10. OP34 25 11 OP38 13(4)(c) 12 OP38 23(4)(b) from the previous inspection. The previous timescale was 31/07/05. The registered person must provide appropriate changing and personal storage facilities for the staff in the home. The registered person must improve the access to the downstairs toilet for service users who have mobility problems. This requirement is restated from the previous inspection. The previous timescale was 31/07/05. The registered person must ensure that a recent photograph is obtained for all staff as proof of identity. The registered person must ensure that staff meetings are held at various times to facilitate attendance by all staff. The registered person must make available for inspection, a financial and business plan for the home. This should also address all the issues about space utilisation in the home. The registered person must ensure that the temperatures of fridges and freezers are recorded daily. The registered person must remove the bolt from the fire escape door. 30/06/06 31/05/06 30/04/06 30/04/06 31/05/06 31/03/06 31/03/06 Roseacres Residential Care Home DS0000010509.V270252.R01.S.doc Version 5.0 Page 23 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 2 3 Refer to Standard 7 OP32 OP19 Good Practice Recommendations The registered person should seek advice from health professionals about monitoring and prevention of falls. The registered person and proprietors should hold meetings with staff to hear any concerns and grievances. The registered person should provide suitable facilities for staff to conduct handovers and carry out their administrative tasks. Roseacres Residential Care Home DS0000010509.V270252.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Southgate Area Office 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 DS0000010509.V270252.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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