Inspection on 01/02/06 for Rosebank

This inspection was carried out on 1st February 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rosebank 08/08/07

Rosebank 14/08/06

Rosebank 30/12/04

Rosebank 25/08/04

Rosebank 02/02/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Rosebank 58 Bergholt Road Colchester Essex CO4 5AE Lead Inspector Marion Angold Unannounced Inspection 1st February 2006 12.05 Rosebank DS0000017921.V282403.R01.S.doc Version 5.1 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 Rosebank DS0000017921.V282403.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rosebank DS0000017921.V282403.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Rosebank Address 58 Bergholt Road Colchester Essex CO4 5AE 01206 853091 01206 273165 whcock@supanet.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Michael Cockman Mrs Marie Cockman Warren Cockman Care Home 7 Category(ies) of Learning disability (7), Learning disability over registration, with number 65 years of age (7) of places Rosebank DS0000017921.V282403.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 7 persons) Persons of either sex, over the age of 65 years, who require care by reason of a learning disability (not to exceed 7 persons) The total number of service users accommodated must not exceed 7 persons 16th August 2005 Date of last inspection Brief Description of the Service: Rosebank is a detached property, in a residential area, on the outskirts of Colchester town centre. Local shops, the train station and a large supermarket are within a few minutes walk and the town centre can be accessed either by walking or public transport. The home is registered for seven people with learning disabilities and the individuals currently in residence have been there for many years. Most of the accommodation offered is in single rooms on first floor level, to which there is no lift. Residents have a choice of communal areas and an ample back garden. There is roadside parking at the front of the home (restricted Monday to Friday 8.00-10.00 and 16.00-18.00 hours); parking for three cars at the back, is accessed along an unmade track. Rosebank DS0000017921.V282403.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 12 noon and 6.30 pm. In the Manager’s absence, the Inspector spoke with the owners, Mr M Cockman and Mrs M Cockman. Mr Cockman was covering a shift and Mrs Cockman, who was on call, came in especially to facilitate access to staff records. Staff and residents also assisted with the inspection, a part of which involved observation and the examination of records. Following the inspection, Mr M Cockman brought to the CSCI local office, by arrangement, various documents, which could not be located on the day of inspection. This inspection covered the core National Minimum Standards not inspected in August 2005 and the shortfalls identified on that occasion. Therefore, to give a more complete picture of the home, this report should be read in conjunction with the last one. Of the 14 Standards inspected on this occasion, 8 were met, and 6 presented minor shortfalls. What the service does well: Rosebank continued to be run on family lines and one resident, who spoke with the Inspector, expressed the view that everyone was well cared for. Care plans were detailed, covering a range of needs and strengths providing clear and appropriate instructions to staff. From observing situation, it was evident that the care plans were working documents and residents received personal support in ways that suited them. They received appropriate support to understand and meet their physical emotional health needs. and one that also and With varying degrees of support, residents participated in local community activities and had contact with the people who mattered to them. A befriender/advocate had been arranged for one person, who had no family or friends to represent them. The views of service users formed a significant part of the home’s quality assurance system. What has improved since the last inspection? The frequency of care plan reviews had been increased from annual to twice yearly, as recommended. As recommended at the last inspection, thought had been given to personcentred activities for residents with higher levels of dependence. The Rosebank DS0000017921.V282403.R01.S.doc Version 5.1 Page 6 Inspector looks forward to seeing further evidence of developments along these lines at future inspections. As recommended at the last inspection, the home had sought further advice from an occupational therapist about one person’s needs. More fruit and vegetables had been introduced onto the menu; one of the Providers said they would continue to experiment with new ways of serving fruit and vegetables to overcome residents’ reluctance to eat them. One resident said that they enjoyed all food and were happy with the menus. Arrangements had been made to increase the comfort and dignity of residents, when protecting their clothes at mealtimes. Records for relatively new staff showed that they were receiving appropriate supervision every two months. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rosebank DS0000017921.V282403.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rosebank DS0000017921.V282403.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these Standards were inspected. EVIDENCE: NMS 2 was not inspected because all the residents had lived at Rosebank for a number of years. Rosebank DS0000017921.V282403.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 Residents’ needs and progress were being monitored at appropriate intervals. EVIDENCE: Care plans were detailed, covering a full range of needs and strengths and providing clear instructions to staff. From a sample of three, it was evident that they had been reviewed after six months, rather than annually, as previously. Some additional comment had been included to provide a measure of their effectiveness. For example, the results of introducing a new activity for one person had been documented. Records also evidenced that staff had been invited to comment on the existing care plan prior to the reviews. The Inspector looks forward to seeing the continuation of this process at future inspections. Rosebank DS0000017921.V282403.R01.S.doc Version 5.1 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 14 and 15 Residents were supported to engage in appropriate leisure activities, participate in the local community and have contact with the significant people in their lives. EVIDENCE: A member of staff described various ways in which they supported residents with appropriate activities during the day. One person’s care plan showed that a new activity had been introduced. When the Inspector arrived, two residents were out shopping with one of the owners. Three residents had gone out independently. One resident said their week consisted of planned activities, such as literacy and numeracy classes, attending a day centre, cleaning their rooms or ironing, and unstructured days, when they could do as they wished. Another person had a season ticket to attend football matches. The lounge contained various home entertainment resources and two bedrooms inspected reflected the various interests and hobbies of their occupants. One resident reported that they had enjoyed the holiday arranged for everyone by the Providers. Rosebank DS0000017921.V282403.R01.S.doc Version 5.1 Page 11 Although the last entry in the visitor’s book was in October 2005, examples were given of residents being supported to maintain contact with their family and an advocate/befriender had been arranged for someone, without family or friends. A pay phone was available in the entrance hall and one resident said they could take the call in the office, if they wanted privacy. Residents also had mobile phones, if they were able to use them. One person had made local friends, but did not bring them back to Rosebank. The home had taken a balanced approach to an ongoing situation, involving one resident’s contact with someone outside the home. In this process they showed understanding of the person’s needs and rights, as well as the presenting risks. The home continued to follow a four-week cycle of menus. Following observations made at the last inspection more fruit and vegetables had been introduced onto the menu, although one of the owners stated that they had found the range of fruit and vegetables residents would eat to be very limited. However, one resident said that they enjoyed all food and were happy with the menus. A member of staff said that residents would be offered an alternative if they said, or showed, that they were not enjoying their meal. Rosebank DS0000017921.V282403.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Residents received personal support in ways that suited them and appropriate support to meet their physical and emotional health needs. Some practices in relation to the administration of medication warranted review. EVIDENCE: Instructions to staff about assisting one resident with their toileting programme were clear about allowing the person time and privacy. During the inspection, this person was assisted according to these guidelines and the member of staff was observed knocking before entering their room, even though the person was not able to invite them in. Since the last inspection, residents had been given new aprons and one person, whose comfort and dignity had been in question, was now protected in a more suitable manner. Mrs M Cockman said that three residents were able to arrange their own medical appointments and did so from time to time. One person confirmed that this was the case and that they also went to an optician and dentist. A pictorial guide for residents attending the dentist was available in the office. Chiropody, inoculations and incontinence advice had been arranged appropriately. Minutes of a recent residents’ meeting showed that the new NHS health action plan had been introduced and explained. Rosebank DS0000017921.V282403.R01.S.doc Version 5.1 Page 13 Arrangements for one resident to administer their own medication were working well, as confirmed by the person concerned. Staff continued to administer medication in pairs. On this occasion, the person who gave out the medication, under the guidance of the senior, also signed the Medication Administration Records (MAR). They said it was the usual practice for staff to work in pairs, with the more senior person in a mentoring role. The Inspector advised that new staff complete medication training before putting their signatures to the MAR. Although there was no written protocol for a PRN (as needed) medication, Mrs M Cockman explained that it was only used in one particular situation. The MAR sheets did not include photographs of residents for identification, although their photographs were attached to the front of their care plans. A list of people, trained to administer medication, and their sample signatures was not with the MAR at the time of inspection, although one of the owners brought such a list, with the home’s Protocol for Drug Administration, to the local office of the Commission on 22/03/06. The owners acknowledged that leaving one person’s eye drops in the wet room had been an oversight, but they said that the prescribed creams, belonging to individual residents, were left there by design to ensure they were applied after showering. The Inspector advised that these must not be left on display. Rosebank DS0000017921.V282403.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Residents were well treated and listened to but, in the event of an allegation or suspicion of abuse, staff could take the wrong steps if they are not able to locate the home’s protection of vulnerable adult procedures. EVIDENCE: No complaints had been received since the last inspection. The complaints procedure was displayed and also available in pictorial form and on tape, with the Service User Guide. One resident said that they liked all the staff and felt everyone was well cared for. A member of staff explained how they made sure they had understood what a resident was saying to them. Residents’ meetings gave them an opportunity to express their views and wishes and have them documented. It was suggested to Mrs M Cockman that all residents are given the opportunity to attend, even if they are not able to contribute verbally. Mrs M Cockman said they had requested places on the Protection of Vulnerable Adults (POVA) workshop, provided by Essex Vulnerable Adults Protection Committee and were waiting for the dates to be notified. Subsequently, arrangements were made for three staff to attend on 23/2/06. In the Manager’s absence, Mrs M Cockman was unable to locate the home’s POVA procedures, although clear guidelines were available for dealing with verbal or physical aggression. The POVA procedures, brought to the CSCI Colchester office after the inspection, had been revised in January 2006, and were in line with locally agreed protocols. Rosebank DS0000017921.V282403.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Residents live in a homely and clean environment, but particular aspects of the premises warranted some improvement. EVIDENCE: The home was clean and some areas were in a satisfactory state of repair and decoration. However, a partial tour of premises showed that other areas were in need of attention. For example, the radiator in the hall had not been covered and was very hot to touch; paint was peeling from the wall in the laundry; one upstairs bedroom window, opening out onto a lower roof, needed replacement restrictors; other windows and the front door were in need of maintenance and several carpets were worn. Mr M Cockman brought to the office on 22/02/06 a Quality Assurance report, dated October 2005 (which could not be located on the day of inspection). This identified the improvements needed and a prioritised action plan. The Inspector understood that the owners were considering ways of achieving the work with minimum disruption to residents. The owners affirmed that they had taken action to comply with the Environmental Health Officer’s requirements. Rosebank DS0000017921.V282403.R01.S.doc Version 5.1 Page 16 The laundry was suitably located away from the kitchen and contained appropriate equipment and a locked cupboard for cleaning materials. However, the problem with peeling paint needed to be addressed. Infection control procedures could not be located during the inspection, but were brought to the office at a later date and found to be satisfactory. Personal protective clothing was available for staff and one person showed in discussion that they used these items appropriately. However, for the purpose of infection control, communal towels should be removed from bathroom, wet room and toilets, and alternative arrangements made for residents and staff to dry their hands. At the last inspection it was recommended that a different chair be obtained to meet the particular needs of one resident and the home had since taken advice on this matter from an occupational therapist. Rosebank DS0000017921.V282403.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 and 36 Night-time staffing arrangements could compromise the wellbeing of residents with higher levels of dependency. In the main, recruitment practice protected residents, although certain inconsistencies were identified. Residents benefited from appropriately supervised staff. EVIDENCE: When the Inspector arrived, two residents were out shopping with one of the owners, leaving one member of staff in charge of the two residents at home; three residents had taken themselves out independently. Typically, two people covered each shift, one of which might be the manager or provider. Duties included cleaning, shopping, meal preparation and record keeping. The Manager continued to be involved in training for much of the week. Mrs M Cockman acknowledged that night support workers spent some of their shift asleep on a couch in the office. One resident said this was not a problem for them. If they wanted assistance, they could ask. Mrs M Cockman reported that all the residents slept well or were mobile and independent; night staff were not required to make routine checks because residents found this disturbing. The Inspector advised that some means must be found of ensuring the safety and wellbeing of residents who were unable to seek help for themselves during the night. Rosebank DS0000017921.V282403.R01.S.doc Version 5.1 Page 18 Inspection of records for the 4 newest members of staff showed that most of the required documentation, including Criminal Record Bureau disclosures, was in place. On one file there was only one reference, although two referees had been named on the application form. Two staff, who had worked at Rosebank for more than 3 months, did not have contracts of employment/statements of terms and conditions. Records, on four files sampled, evidenced that appropriate staff supervision was taking place at approximately two monthly intervals. Rosebank DS0000017921.V282403.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 The views of residents formed a significant part of the home’s quality assurance system. EVIDENCE: Rosebank’s Annual Development Policy set out the proposed methods for assessing and monitoring the quality of the service. These included user, representative and staff satisfaction surveys. The exercise was carried out prior to a report being produced in October 2005, which Mr M Cockman presented at the CSCI Colchester office on 22/02/06. This represented a promising beginning and the inspector looks forward to seeing the cycle of review, planning and action repeated and developed this year. Rosebank DS0000017921.V282403.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 X 33 2 34 2 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 3 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 2 X X X 3 X X X X Rosebank DS0000017921.V282403.R01.S.doc Version 5.1 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 YA20 Regulation 13 Timescale for action The registered persons must 31/03/06 be able to evidence that all staff administering medication have received accredited training in the areas covered by Standard 20.10. This requirement has exceeded agreed timescales for action. The registered persons must also ensure that medication is appropriately secured after use and not left on display. The registered persons must 31/03/06 ensure, so far as reasonably practicable, that all parts of the home, to which service users have access, are free from hazards to their safety. They must also ensure that the home is well maintained. The registered persons must 31/03/06 ensure the safety and wellbeing of residents, who are unable to seek help for themselves during the night. The registered persons must 31/03/06 ensure that they carry out all required checks before prospective employees begin DS0000017921.V282403.R01.S.doc Version 5.1 Page 22 Requirement 2. YA24 13, 23 3. YA33 18 4. YA34 17, Sch4 19, Sch2 Rosebank 5. YA23YA30YA 37YA40 13, 17 work at the home and retain all the information and documentation stipulated under these regulations. This requirement has exceeded agreed timescales for action. The registered persons must 28/02/06 ensure that staff have access at all times to the home’s protection of vulnerable adult procedures and all other policies and records they need. 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 YA20 Good Practice Recommendations The registered persons should ensure sample signatures of staff administering medication are kept with the Medication Administration Records and that individual photographs of service users are attached for identification. The registered persons should remove communal hand towels and make alternative arrangements for staff and residents to dry their hands. The registered persons should ensure that 50 of staff have achieved, or are in training for, the National Vocational Qualification in care, Level 2, by 2005. This Standard was not inspected; therefore the recommendation has been brought forward. 2. 3.. YA30 YA32 Rosebank DS0000017921.V282403.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Rosebank DS0000017921.V282403.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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