Inspection on 12/04/05 for Roseberry Gardens 36

This inspection was carried out on 12th April 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Roseberry Gardens 36 17/12/08

Roseberry Gardens 36 13/04/07

Roseberry Gardens 36 06/06/06

Roseberry Gardens 36 22/02/06

Roseberry Gardens 36 01/09/04

Roseberry Gardens 36 27/05/04

Roseberry Gardens 36 03/03/04

Roseberry Gardens 36 10/02/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

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Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 36 ROSEBERRY GARDENS London N4 1JJ Lead Inspector Teferi Degeneh Announced 12 April 2005 @ 9:30 am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. 36 ROSEBERRY GARDENS Version 1.10 Page 3 SERVICE INFORMATION Name of service 36 Roseberry Gardens Address 36 Roseberry Gardens, London, N4 1JJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8800 3230 020 8800 3230 Mr Jessie Espino and Mrs Angelina Espino Mr Jessie Espino Care Home 3 Category(ies) of Learning disability (3), Learning disability over registration, with number 65 years of age (3), Mental disorder, excluding of places learning disability or dementia (3), Mental Disorder, excluding learning disability or dementia - over 65 years of age (3) 36 ROSEBERRY GARDENS Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. Limited to 3 people of either gender who have a mental disorder (MD) 2. and who may also fall into the category of old age (MD(E)) 3. and have a learning disability (LD) Date of last inspection 19/4/05 Brief Description of the Service: 36 Roseberry Gardens is a care home situated in Haringey, close to the facilities of Green Lanes and within a short bus journey to Wood Green Shopping Centre. There are three single bedrooms, a galley kitchen and a dining room combined with a lounge. One of the bedrooms is on the ground floor and the other two are on the first floor. There are small front and rear gardens. The home has a stated purpose of providing a “high quality 24-hour residential care for you whilst supporting you and maintaining your independence and choosing your choices”. 36 ROSEBERRY GARDENS Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection carried out on the 12th of April 2005 starting at 9:30 am. The manager and two people who live at the home were present during the inspection. A care worker arrived at the home while the inspection was in progress. The care worker and the two people who live at the home were spoken to as part of this inspection. The service users’ files were seen and other documents and records such as the home’s policies, procedures, various certificates in relation to the business and the building, the visitors’ book and the diary were examined. The inspector had a guided tour of the premises and the manager was present throughout the inspection. The manager and the staff have done quite well to address most of the issues raised at the previous inspection. Nine of the fourteen areas of concern identified have now been completed by the registered person. The outstanding five areas are restated for the manager to complete within specified timescales. The registered person agreed during the feedback session of this inspection that she would comply with all the requirements stated. What the service does well: What has improved since the last inspection? The manager has carried out a number of improvements she was asked to complete at the last inspection. For example, care staff have attended training on food hygiene and administration of medication. The manager has also given a device to a service user so that they can press it if and when they needed staff attention. The manager has formulated a rota, which ensures that the home is covered at all times. There is a system in place to ensure proper staff recruitment. The safety and well being of the people who live at the home have become a top priority and the home has updated risk assessments and 36 ROSEBERRY GARDENS Version 1.10 Page 6 associated care plans. The manager has developed a policy and procedure on the protection of vulnerable adults from abuse and has obtained copies of relevant documents from a local authority. There are certificates to show that electrical items in the home are tested for safety. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 36 ROSEBERRY GARDENS Version 1.10 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 Standards Statutory Requirements Identified During the Inspection 36 ROSEBERRY GARDENS Version 1.10 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 standard(s) 1, 2, 4, 5 The home has satisfactory policies and procedures in place to ensure that prospective service users have sufficient information and an opportunity to see the premises before admission. EVIDENCE: The Statement of Purpose and the admissions’ procedure are detailed and clear. Admission to the home is dependent on the outcome of assessments by social workers and the manager. The files of the people who live at the home contained copies of signed contracts which detailed terms and conditions of the service. Assessments have been completed and care plans updated. Service users and relatives have visited the home before admission. Both people who live at the home confirmed that they are happy living there. 36 ROSEBERRY GARDENS Version 1.10 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 standard(s) 6,7,9,10 Satisfactory systems are in place for reviewing care plans, risk assessments and for ensuring privacy and dignity of service users. EVIDENCE: Care plans and risk assessments have been reviewed and it was evident from the documents that the service users were involved in these reviews. A call alarm has been provided for one person so that they can seek help when if they needed it. The home and the placing authority are looking for an alternative accommodation for one person who requires a home, which is fully accessible for people with a physical disability. The manager sits with service users and discusses issues. One person attends a day centre three times a week. This person said they are happy with their activities at the day centre. They spent the other days doing activities of their choice, which included visiting a local library, going for walks in the parks or watching television programmes at the home. The other person said they did not do much and they would like to go out more often. Discussion with the person and records showed that families and friends regularly visited the person and occasionally took them out to the shops and cafés. The responsible person supports the people who live at the home with their finances. Personal allowances are given to the service users weekly. These are 36 ROSEBERRY GARDENS Version 1.10 Page 10 appropriately recorded. One person who lives at the home explained their satisfaction with the support they received and said that they were able to spend their money on items of their choice. The staff spoken to demonstrated good knowledge and experience of supporting people in a care home. They were aware of their responsibility to ensure the dignity and privacy of people when providing personal care. They said they always knocked on the doors and waited for permission before entering bedrooms. They confirmed that they have read the home’s statement on confidentiality and gave a satisfactory description of how to handle information given to them in confidence. The two people who live at the home expressed their satisfaction with the way the staff talked to them. However, a comment had been received before this inspection stating that a member of staff “talks disrespectfully to other residents”. From observations and discussions with the two existing people who live at the home and a member of staff it was evident that the staff treated the people who live at the home respectfully and with dignity. It is evident from records of the staff that none of them have achieved a care qualification equivalent to NVQ level 2. This is recommended, in order to achieve compliance with National Minimum Standard that at least 50 of staff have a care qualification equivalent to NVQ level 2 by 2005. 36 ROSEBERRY GARDENS Version 1.10 Page 11 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 standard(s) 12, 13, 15,16,17 The home provides good food which meets the needs of people who live at the home but the social and leisure activities provided have not been sufficient to stimulate and enable service users to be as active as possible. Appropriate procedures are in place to store and administer medication. EVIDENCE: Service users were consulted about the type and times of meals they eat. Weekly menus were displayed. The two people who live at the home confirmed that the manager consulted them about the types of food to be included in the menu. The people spoken to said they did not observe specific religious or cultural practices but they believed that the home could provide if they wished or requested a specific food. They said they were happy with the preparation and presentation of the meals. Staff records showed that all members of the staff have attended basic food hygiene training. Records and a discussion with one person who lives at the home confirmed that relatives regularly visited. The relatives are able to sit in a bedroom with the person for private talks. Occasionally, the relatives are able to take the person out to cafés, shops or to the park. The person said they would like the staff to take them out frequently. The other person who lives at the home said 36 ROSEBERRY GARDENS Version 1.10 Page 12 they would like to contact their relatives. They said they have not heard from a family member for a number of years. The registered person commented that the home has not received a reply to the letters and phone calls made to the relative of the service user. An assessment of the premises and discussions with the manager and the people who live at the home showed that bedrooms are lockable and keys are provided. The home has arranged day trips. There is no record to indicate that the people who live at the home have had a holiday away from the home. One of the persons who lives at the home said they would like to go on holiday somewhere in the country. They said that they have not had a proper holiday for a long time. This was discussed with the manager who said that they would talk to the people who live at the home and to social workers to organise a week’s holiday away from the home. 36 ROSEBERRY GARDENS Version 1.10 Page 13 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 standard(s) 18,19, 20 The needs of service users in relation to personal and health care are met with evidence of service users seeing dentists and opticians and being looked after with respect and dignity. EVIDENCE: Times for getting up and going to bed are not restricted and a person of the same gender provides self-care in private. Both people who live at the home were happy with the way personal care was provided. Another person, who needed support with personal care, said they were satisfied with the staff approach in providing care with privacy and dignity. One person said they were independent in undertaking personal care. They said they have been to a dentist and an optician for checkups. At the previous inspection the registered person was required to consult with a qualified occupational therapist and confirm in writing to the Commission for Social Care Inspection that an updated assessment of the premises and facilities has been undertaken and that appropriate aids, adaptations and equipment have been provided. The registered person said a process has started to move the person who uses a wheelchair to a more appropriate accommodation. Written correspondence was available for inspection to show that discussions have taken place between the home and the placing authority to move the person with a physical disability to a suitable accommodation. 36 ROSEBERRY GARDENS Version 1.10 Page 14 All staff who administer medication have relevant training. Medication is kept in a locked cabinet and correct recordings were made on the day of the inspection. 36 ROSEBERRY GARDENS Version 1.10 Page 15 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 standard(s) 22 and 23 The complaints’ process is non-existent with little information available to service users and lack of clarity about the process of investigation. However, the home’s procedures in respect of the protection of vulnerable adults from abuse are satisfactory. EVIDENCE: A complaint about the home has been received by the Commission for Social Care Inspection and is currently being investigated. The registered person and the people who live at the home mentioned instances of complaints made to the home by one of the persons who used to live at the home. The details of these complaints were not recorded in the official complaints book. However, it was confirmed by the registered person and one of the persons living at the home that the complaints were about a washing machine and a cooker which were dealt with. The minutes of the service users’ meeting showed that a cooker and a washing machine had been replaced as a result of the complaints made by one person. In a separate discussion with a support worker it was revealed that eight complaints had been recorded in a separate notebook. The complaints procedure was clear but there was no evidence to suggest that the procedures were followed and the complaints were dealt with systematically by the home. It was evident from discussions with the people who live at the home that the registered person has not publicised the home’s complaints procedure. At the previous inspection the registered person was required to provide service users, relatives and visitors with a written complaints procedure. This requirement is restated. There is satisfactory procedure in respect of policies and procedures of the protection of vulnerable adults from abuse. Relevant copies of the placing authorities procedures have been obtained. The staff spoken to have satisfactory knowledge regarding the protection of vulnerable adults from abuse. The service users had a positive attitude about the staff. 36 ROSEBERRY GARDENS Version 1.10 Page 16 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 standard(s) 24 and 30 The home has not taken sufficient action with regard to the risk assessment of the premises by a qualified occupational therapist thus putting the welfare and health and safety of one service user at risk. EVIDENCE: A number of positive actions have been taken as a result of the requirements from the previous inspections. For example, the manager has provided a ramp to the front of the house to facilitate easy access for the service user who uses a wheelchair. The visitor’s room has been cleaned and decorated. A service user said they liked their bedroom for which they have been given door keys. An alarm call has been provided for a service user who uses a wheelchair. The manager has not complied with the previous requirement, which stated that the needs of the service user who has mobility difficulty must be assessed, and the service user provided with a shower and a toilet with appropriate adaptations, including wider doors that allow wheelchairs in and out of the room. Satisfactory policies and procedures in relation to the control of infections and communicable diseases have been put in place. 36 ROSEBERRY GARDENS Version 1.10 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 35 and 36 The number of staff at the home and the training opportunities provided to them are not sufficient to ensure satisfactory care and support for the service users. EVIDENCE: There are three part time care staff and the two providers working at the home. A discussion with the registered person and the rota showed that at least one of the providers is constantly at the home covering all shifts including sleep-ins. Care staff are called in to cover limited hours during early or late shifts. As mentioned elsewhere in this report a person who lives at the home feels their needs are not fully met in respect of frequently going out of the home. A member of staff spoken to confirmed that they have had induction when they started work at the home. The files showed that the staff have attended a range of training programmes including medication administration, health and safety, basic food hygiene and first aid. However, none of staff currently employed at the home has achieved a care qualification equivalent to NVQ level 2. The registered person said one member of the staff is undertaking a nursing training and another member is about to embark on NVQ training. It is evident from the files that the staff have had regular recorded supervision. 36 ROSEBERRY GARDENS Version 1.10 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42 The home does not have a robust system of quality assurance, which enables service users and stakeholders to have feedback regarding their views about the home. Even though fire and electrical safety are checked and up-to-date, the lack of appropriate facilities and a risk assessment of the premises put the safety and well being of one service user at risk. EVIDENCE: The premises are still in need of risk assessment to enable to ensure the health and safety of a service user with mobility difficulty. However, there is evidence to indicate that the registered person has contacted the placing authority to tell them to reassess the suitability of the home to the current needs of one service user. A ramp has been provided to the front of the building and a service user has been given a call bell. Records showed that fire alarms and smoke detectors are regularly checked. Portable electrical appliances have been tested and a certificate was available. The gas boiler and the cooker were positively checked on 8/4/05. 36 ROSEBERRY GARDENS Version 1.10 Page 19 The manager has developed a system of quality assurance. Service users have completed questionnaires but the outcome is yet to be written up. There was no evidence to suggest that the home has consulted relatives and professionals regarding the quality of the services. 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 4 3 Standard No 22 23 ENVIRONMENT Score 1 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 36 ROSEBERRY GARDENS Score 3 3 x 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Version 1.10 Page 20 LIFESTYLES Standard No 11 12 13 14 15 16 17 Score x 3 1 x 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 1 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 1 x x 3 x 36 ROSEBERRY GARDENS Version 1.10 Page 21 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 18 Regulation 18(1)(a) (b)(c) Requirement The registered person must consult with a qualified occupational therapist and confirm in writing to the Commission for Social Care Inspection that an updated assessment of the premises and facilities has been undertaken and that appropriate aids, adaptations and equipment have been provided. The assessment must cover the needs of the service user who uses a wheelchair. This requirement is restated. The registered person must reassess the service user who has mobility difficulty and provide them with a shower and a toilet with appropriate adaptations, including wider doors that allow a wheelchair in and out of the room. The registered person must provide service users, relatives and visitors with a written complaints procedure. The registered person must collate feedback received through quality assurance questionnaires and devise an Version 1.10 Timescale for action 31/5/05 2. 18 23(2)(a) 31/5/05 3. 22 22(5) 31/5/05 4. 39 24(1)(2) (3) 31/5/05 36 ROSEBERRY GARDENS Page 22 5. 13 16(2)(m) action plan, which addresses any shortfalls in the quality of the service. Service users, relatives and professionals must be informed of the outcome of the quality assurance system. The registered person must consult service users about their social interests, and make arrangements to enable them to engage in local, social and community activities and to visit, or maintain contact or communicate with, their families and friends. 30/6/05 6. 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. Refer to Standard YA32 YA33 Good Practice Recommendations The registered person should ensure that at least 50 of the care staff achieve a care qualification equivalent to NVQ level 2. It is recommended that the registered person review the staffing level to ensure adequacy and consistency of support to the people who live at the home. 36 ROSEBERRY GARDENS Version 1.10 Page 23 Commission for Social Care Inspection North London Area Office Solar House, 1st Floor 282 Chase Road 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 36 ROSEBERRY GARDENS Version 1.10 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!