Inspection on 13/04/07 for Roseberry Gardens 36

This inspection was carried out on 13th April 2007.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Roseberry Gardens 36 17/12/08

Roseberry Gardens 36 06/06/06

Roseberry Gardens 36 22/02/06

Roseberry Gardens 36 12/04/05

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

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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 Roseberry Gardens 36 London N4 1JJ Lead Inspector Jackie Izzard Unannounced Inspection 13th April 2007 09:00 Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 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 Roseberry Gardens 36 DS0000010771.V333375.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 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. Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Roseberry Gardens 36 Address London N4 1JJ 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 8800 3230 020 8211 8098 Mr Jessie Espino Mrs Angelina Espino Mrs Angelina 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) Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Limited to 3 people of either gender who have a mental disorder (MD) and who may also fall into the category of old age (MD(E)) or have a learning disability (LD) and who may also fall into the category of old age (LD(E)). Date of last inspection 6th June 2006 Brief Description of the Service: 36 Roseberry Gardens is a small 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 two small lounges. 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 is owned by Mr and Mrs Espino who live in the home. The weekly fees of the home depend on the assessed needs of service users but currently the weekly fee is £420.00. Following Inspecting for Better Lives the provider must make information available about the service, including inspection reports, to service users and other stakeholders. Inspection reports produced by the Commission of Social Care Inspection (CSCI) are available upon request from the registered manager/provider. Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection. Mrs Angelina Espino, the registered manager, was present throughout the inspection. The inspection included discussion with Mrs Espino, individual discussion with the person who lives at the home and the examination of records and policies. The premises were inspected and the requirements from the last inspection followed up. The owners, Mr and Mrs Espino, live at the home. One person lives at the home and has lived there with the Espinos for eight years. There have been no other people placed at this home for some years. What the service does well: What has improved since the last inspection? What they could do better: Care plans need to be reviewed more often, at least every six months and changed whenever a person’s needs change. The person who the care plan is for should be involved in writing it and should sign it and be given a copy. Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 Page 6 All medication given by staff to a person living in the home must be recorded on their medication sheet and signed for when it is given. The kitchen doors must not be wedged open as these are fire doors and the emergency lighting must be tested and records kept on a regular basis. The home needs to make an action plan of what will be improved in the next year. This should be based on the views of the person living at the home and any professionals involved in their care as well as the owners’ own views. A failure to comply with this requirement on three consecutive inspections indicates a lack of commitment to continuous improvement of the service provided. 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. Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 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 Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 4 People using the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Prospective residents are assessed by the manager to ensure their needs can be met before moving to the home. They can visit and try out the home before making a decision to stay there. EVIDENCE: The current resident of the home had lived there for eight years. His assessment was inspected and found to be a satisfactory reflection of his stated needs. The manager told the inspector she has recently assessed two people who are living in St Ann’s hospital with a view to them being placed at the home. She also explained that somebody came for some trial visits including overnight stays in the past year before it was decided that he would not move into the home. Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 People using the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living at this home are supported to take risks as part of an independent lifestyle and make decisions for themselves. However, their changing needs are not reflected in the care plans which are not updated regularly enough. EVIDENCE: At the last inspection the registered person was required to ensure that care plans are reviewed and the resident and, as required, their representatives are involved. The care plan was inspected during this inspection and addressed the person’s needs in the areas of personal care, background history, physical Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 Page 10 and mental health, medication, relationships, leisure, finances, culture/religion, day care/education, employment. The plan had last been reviewed on 30 April 2006. This is a year ago and one aspect of the plan was no longer accurate. The manager was reminded of the requirement to review the care plans at least six monthly and whenever the person’s needs change. A requirement is made at the back of this report. Records showed that the person living at the home had a community care review in October 2006 and a Care Programme Approach review in January 2007. A further review is due on 27 April. Discussion with both the person living at the home and the manager showed that the person’s needs were known well and he thought his needs were well met by the manager. The person living at the home is able to travel independently. They said they have keys to the front door and their bedroom. An assessment of the file showed that risk assessments have been completed for the person who lives at the home. This person told the inspector that he is supported to take decisions for himself and that no restrictions are imposed upon him. The home has a procedure in place for if a resident should go missing but this is not a risk for the current resident. Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are supported to take part in leisure activities Their individual lifestyle preferences are respected and they are given rights and responsibilities. Cultural and religious needs are known and addressed. EVIDENCE: The inspector talked to the person living in the home about his life there and then looked at records and questioned the manager . The resident attends sheltered employment locally but said he would like to work in a different place. Records of a review confirmed this had been addressed and the manager said he is welcome to attend his preferred place whenever he wishes to. Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 Page 12 The resident said the meals were satisfactory and that he is able to prepare snacks. There was a limited supply of fresh food in the kitchen which was of adequate quality. The manager said she will encourage the resident to vote at the forthcoming local elections. The resident attends organised trips with others and goes to the library and shopping with the manager. The manager said that there is always herself or her husband in the house and that the resident is able to go out with them and does so, attending family parties, etc. The resident said he visits friends and the manager said that a friend visits him at the home. He also said his privacy was well respected. He has unrestricted access in the home other than in the proprietors’ bedroom. He was able to explain his cultural and religious needs and preferences and explained how these were met. Smoking is allowed in one designated room which meets the needs of the resident and others. The resident said he feels like “one of the family.” Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 People who use the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Although health and personal care needs are addressed some poor practice with regard to medication means that residents are not protected by safe medication procedures at this home. EVIDENCE: The person living at the home’s personal care needs were met and there was evidence of his health needs being addressed through regular visits to the GP, including general check ups on request which is positive. He had also attended other health appointments and records were made of the outcome. There was a concern identified by the inspector during the inspection. One of the persons’ prescribed daily medicines was not recorded on the Medication Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 Page 14 Administration Record (MAR sheet). This was discussed with the manager and the inspector observed that this medication was stored in the medication cabinet and decanted into pots. This practice increases risk of errors with medication and should not be used. A requirement is made to cease this practice and also to ensure all medication given is recorded on the MAR sheet when given. A requirement is also made to undertake a risk assessment regarding a personal medication issue which is confidential. Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living at the home are listened to and know how to complain should they wish to. The manager knows how to respond if there was an adult protection issue in the home. EVIDENCE: Inspection of the complaints record showed no complaints had been made in the last year. The person living at the home said that he has made no complaints and does not wish to do so. He said he is listened to and his requests and needs are acted on. The manager has attended training in the abuse of vulnerable adults and was able to explain to the inspector what she would do in the event of a disclosure or suspicion of abuse. The home has adult protection policy and the local authority’s adult protection procedures. With regard to financial matters, the registered person keeps records and receipts of all transactions made by or on behalf of the resident. Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 Page 16 Although on the presinspection questionnaire it was reported that the person manages his own financial affairs this was found not to be the case. Benefits are paid to the manager who then gives them to the person. Records of these weekly payment are kept and signed for. The manager said she is the appointee for this person at present. There are no family members available to support the resident with management of his finances. Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 People who use the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Ouse where the stand of cleanliness and décor is adequate. People living here have a homely environment which is cleaned and maintained to an adequate standard. Their privacy is respected. EVIDENCE: The home is located in a residential street close to shops and cafés of the Green Lanes Road half way between the Turnpike Lane and Manor House Underground Stations. Each person who lives at the home has a single bedroom and there are communal areas including the kitchen. . The person who lives at the home said he is satisfied with the facilities of the home. He said they watch television either in the lounge or in their bedroom. Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 Page 18 The lounge television does not receive BBC 2 and the manager was advised by the inspector that before new people move in, a television providing all basic channels should be provided. The standard of cleanliness on the day of the inspection was adequate. The resident said he is given privacy in his room. Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 People who use the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are supported by a small number of staff who are trained to meet their needs. EVIDENCE: The registered persons live at the home and one or both of them is always on duty. The person living at the home verified this. The manager is a qualified mental health nurse. There are rare occasions where another person works at the home. Two part-time care staff occasionally work at the home. At the previous inspection in June 2006, documents showed that these staff have attended training in relation to medication administration, health and safety, basic food hygiene, mental health awareness and first aid and one is currently undertaking training to achieve a nursing qualification. For this reason, staff records were not inspected on this occasion. The home has a recruitment procedure and new staff are employed based on the outcome of interviews and Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 Page 20 written references. No new staff members have been employed since the last inspection. Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 People who use the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home meets the needs of the current resident but there is little attention given to quality assurance and making improvements in the service. Health and safety of residents is adequately protected but improvements must be made regarding keeping fire doors closed and testing emergency lighting regularly to further protect people from risk of fire. EVIDENCE: Mrs Espino has been the manager of the home since 1987 and she states that she had a long experience of working with people with mental health needs. Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 Page 22 The person who lives at the home said that he can talk to the manager and his views are acted on. The manager said she has developed a questionnaire to be used as a tool of gathering feedback from the people who use the service and from visitors and professionals A requirement made at the last inspection to undertake a quality assurance exercise and devise an action plan for the home has not been complied with. This requirement was explained to the manager again and a new shorter timescale agreed for compliance. This requirement has been restated three times and this indicates a lack of attention to ensuring that people are satisfied with the quality of service offered and to making improvements. Records showed that the gas boiler was serviced on 28/04/06 and the manager was reminded that this is due for the annual service. Records in the home showed the fire alarm was tested weekly. There are smoke detectors and fire fighting equipment in the corridor and in the kitchen. Smoke detectors are also tested weekly and records made of these tests. No incidents/accidents have been recorded. There were no records of tests of the emergency lighting and a requirement is made to ensure these are tested regularly by a professional along with the fire alarm and a record made of the test. The manager tested the emergency lighting with the inspector during the inspection and it was found to be working properly. There is a current electrical installation certificate which is due for renewal in July 2008. There had been no inspection by the local Environmental Heath Department. Kitchen doors were wedged open and a requirement is made to cease this as these are fire doors. Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 Page 23 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 3 3 X 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 x 3 X 1 X X 2 X Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 Page 24 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15(1)(2) Requirement The registered persons must ensure that care plans are reviewed and updated at least every six months and whenever there is a change. The person whose plan it is must be fully involved in the review of the plan. The registered person must take the following steps to ensure safe procedures regarding medication: • Cease practice of decanting tablets from their containers • Ensure all medications are recorded on the MAR sheet when given to a resident • Undertake a risk assessment about misuse of medication and involve GP Timescale for action 30/06/07 2. YA20 13(2) 30/05/07 Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 Page 25 3. YA39 24(1)(2) (3 The registered person must collate feedback received through quality assurance questionnaires and devise an action plan, which addresses any shortfalls in the quality of the service. Service users, relatives and professionals must be consulted and informed of the outcome of the quality assurance system. This requirement is restated. (Timescales of 31/05/05 and 30/04/06 and 30/09/06 not met.) A development plan for the home must be written and a copy sent to the CSCI. The registered persons must ensure fire doors are kept closed. The registered persons must ensure Emergency lighting and the fire alarm system in the home is tested regularly and a record made of these tests. 30/06/07 4. YA42 5. YA42 23(4)(c)(i) 23(4)(c)(v) 11/05/07 30/06/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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. Extracts may not be used or reproduced without the express permission of CSCI Roseberry Gardens 36 DS0000010771.V333375.R01.S.doc Version 5.2 Page 27 - 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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