Inspection on 06/06/06 for Roseberry Gardens 36

This inspection was carried out on 6th June 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 3 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 13/04/07

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

Norbury Crescent (30)

Edenvale

Wadham Avenue

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 Mr Teferi Degeneh Key Unannounced Inspection 6th June 2006 09:30 Roseberry Gardens 36 DS0000010771.V291385.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 Roseberry Gardens 36 DS0000010771.V291385.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. Roseberry Gardens 36 DS0000010771.V291385.R01.S.doc Version 5.1 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 8800 3230 Mr Jessie Espino 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) Roseberry Gardens 36 DS0000010771.V291385.R01.S.doc Version 5.1 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 22nd February 2006 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. Information about the home including service users’ guide and the CSCI Inspection reports are available from the home by contacting the providers. The weekly fees of the home depend on the assessed needs of service users but currently the weekly fee is £420.00 Roseberry Gardens 36 DS0000010771.V291385.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The was unannounced inspection conducted over a period of 3½ hours, commencing at 9:30 am and concluding at approximately 1.00 pm. Mrs Angelina Espino, the registered provider, was present throughout the inspection. The inspection activity undertaken included conversations with the person who lives at the home and the examination of staff and service user’s files. The other documents such as service user’s financial records and records in respect of health and safety were inspected. Finally, the premises were inspected. What the service does well: What has improved since the last inspection? What they could do better: There is a need to involve the people who live at the home and their social workers and relatives when care plans are reviewed. The person who lives at the home needs to be supported to trace their relatives and re-establish contact. The risk assessments need to be improved by not only identifying possible risks to the service users but also by stating how the risks can be managed or eliminated. The registered person needs to implement a quality assurance system which provides details of how stakeholders are consulted and what actions are taken to improve the quality of the service. Roseberry Gardens 36 DS0000010771.V291385.R01.S.doc Version 5.1 Page 6 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. Roseberry Gardens 36 DS0000010771.V291385.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 Roseberry Gardens 36 DS0000010771.V291385.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New service users are confident that their admission to the home is dependent on the outcome of their needs assessment and the ability of the home to meet their needs. EVIDENCE: No new service users have been admitted since the last inspection. Discussions with the registered person showed that two prospective service users have been referred to the home. The registered person said the prospective service users have been to the home as part of their assessment. She said she has also visited the service users. The current service user said they have met with the prospective service users and that they would be happy if they new service users moved to the home. The registered person mentioned that she has to complete further assessment of the prospective service users to decide if their needs can be met at the home. There is a written procedure of admission. Roseberry Gardens 36 DS0000010771.V291385.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, 7, and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has not done enough to ensure that the service user and their representatives are involved in the review of care plans. The service user is not confident that the registered person can help them locate their relatives and re-establish contact with them. The quality of the risk assessment can be improved by identifying not only the risk areas but also by developing appropriate strategies of managing the risks. EVIDENCE: The service user’s file was assessed. It was evident from the file that the registered person keeps daily records of her contacts with the service user. At the last inspection the registered person was required to ensure that care plans are reviewed and service users and, as required, their representatives are involved. Even though the registered person indicated at the last inspection that a care plan review had been arranged, there was no evidence to suggest that this has taken place. The person who lives at the home said they would be happy if they have an opportunity to discuss their care plan with their social worker. The service user said they wanted to discuss how to locate the address of their relatives and how to re-establish contact with them. Roseberry Gardens 36 DS0000010771.V291385.R01.S.doc Version 5.1 Page 10 The service user 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. However, the risk assessment does not provide sufficient information as to how to manage or eliminate the identified risks to the service user. The service user said they are happy with the services and the opportunities they have at the home. They said they could get up and go to bed at the time of their choice. Roseberry Gardens 36 DS0000010771.V291385.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 15, 16, and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The activities and the food provided at the home are good and the service user is engaged. EVIDENCE: The person who lives at the home attends a day service. They said they walk to and from their day activity daily and that they are happy meeting new people there. They said they are paid some money for doing work at they day centre. The service user said they have made some friends at the day centre. They also go to the shops and the park. Observations indicated that the there are good interactions between the service user and the registered person. The service user stated that they have lived in the area for quite a long time and that they know the local facilities. Discussions with the service user showed that there are no friends or relatives to visit them at the home. However, the service user would like to re-establish contact with their relatives. At the previous inspection it was discussed that the registered person would use various means including the internet to trace the service user’s relatives. The registered person said she would try to find the addresses of the service user’s relatives and would support the service user to contact them. Roseberry Gardens 36 DS0000010771.V291385.R01.S.doc Version 5.1 Page 12 The service user stated that they live as part of the family. They said that they are happy with the registered person and the staff. They said that they are satisfied with the variety, quantity and presentation of the food provided at the home. The service user said their cultural needs are met in terms of the meals they have at the home. Roseberry Gardens 36 DS0000010771.V291385.R01.S.doc Version 5.1 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 the following standard(s): 18, 19, and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ health care needs are met by the home’s procedures of medication administration and provision of ongoing medical care. EVIDENCE: The person who lives at the home stated that they are satisfied with the manner in which the registered person and the staff interact with them and support them with their personal care. It was evident from discussions and records that the service user is independent in attending to their personal care. Records showed that the service user has been supported to see their general practitioner and a dentist. Medication is kept in a locked cabinet and there is a procedure for medication administration. The registered person and the staff who administer medication have undergone medication administration training. The medicines and medication administration record sheets were assessed and were found to be correct. The service user said they are able to communicate with the staff and the registered person. Roseberry Gardens 36 DS0000010771.V291385.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has satisfactory systems in place to ensure that service users are protected from abuse. The complaints procedures are clear and service users are reassured that they can make complaints to the registered person. EVIDENCE: The person who lives at the home said that they know how and who to complain to if they have concerns. They said that the registered person listens to them. It was mentioned earlier that the registered person is trying to find out the addresses of the service user’s relatives so that they can re-establish contact. The home has a complaints procedure. The service user has the local office address of the Commission for Social Care Inspection. The home has adult protection policy. All the staff who work at the home have undergone satisfactory CRB checks. The registered person has obtained a copy of the local authority’s adult protection procedures. The registered person keeps records and receipts of all transactions made by or on behalf of the service user. Roseberry Gardens 36 DS0000010771.V291385.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are satisfactory facilities in the home and the needs of the person who lives at the home are met. 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 lounge has been recently refurbished with the provision of new tiles and double glazed doors. The person who lives at the home said they are satisfied with the facilities of the home. They said they watch television either in the lounge or in their bedroom. The service user has keys to their bedroom and the front door. The home was clean and tidy on the day of the inspection. There is a policy on the control of infections. Roseberry Gardens 36 DS0000010771.V291385.R01.S.doc Version 5.1 Page 16 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): 32, 34, and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are reassured that the staff employed at the home are appropriately vetted and trained. EVIDENCE: At the last inspection a requirement was made for the registered person to ensure that all people working at the home have satisfactory current CRB checks. The inspection of the staff files showed that the requirement has been complied with and the staff have undergone CRB checks. As mentioned elsewhere currently there is one service user at the home. The registered manager and her husband, who is joint provider, are at the home on most days. Two part-time care staff occasionally work at the home. Discussions with the registered person and the documents showed that the staff have attended training in relation to medication administration, health and safety, basic food hygiene, mental health awareness and first aid. A member of staff is currently undertaking training to achieve a nursing qualification. The home has a recruitment procedure and new staff are employed based on the outcome of interviews and written references. No new staff members have been employed since the last inspection. Roseberry Gardens 36 DS0000010771.V291385.R01.S.doc Version 5.1 Page 17 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): 37, 39, and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Even though the management of the home is good, the certificate of registration is misleading and that system of quality assurance has not been fully implemented. Service users do not know whether or not their views are considered and if the home has a plan of action to improve the services and facilities. EVIDENCE: The certificate of registration shows that Mr J Espino is the registered manager. It was evident from discussions that Mrs A Espino is the manager and the service is jointly owned by both Mr and Mrs Espino. It was discussed that there was a need to look into how the discrepancies in the certificate of registration in relation to the registered manager needs to be corrected. 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. The manager has a care and management qualification equivalent to NVQ level 4. The person who lives at the home said that they can talk to the manager and they are happy with the way the home is run. Roseberry Gardens 36 DS0000010771.V291385.R01.S.doc Version 5.1 Page 18 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 service user who currently lives at the home has completed the questionnaire. The manager is yet to consult with professionals from the health service and social workers. The home was clean and tidy. Records showed that the gas boiler was serviced on 28/04/06 and the fire alarm was tested monthly. There are smoke detectors and fire fighting equipment in the corridor and in the kitchen. No incidents/accidents have been recorded. Roseberry Gardens 36 DS0000010771.V291385.R01.S.doc Version 5.1 Page 19 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 X 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 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X Roseberry Gardens 36 DS0000010771.V291385.R01.S.doc Version 5.1 Page 20 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 14; 15(1)(2) Requirement Timescale for action 31/07/06 2 YA9 3 YA39 The registered person must ensure that service users and, as appropriate, their representatives are involved in the review of assessments and service plans. 12(1)(a);14(1) The registered person must 31/07/06 (a), 15(1)(2) ensure that the service users’ risk assessments are detailed and contain strategies of managing or eliminating any risks identified in the assessments. 24(1)(2) (3) The registered person must 30/09/06 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. (Timescales of 31/05/05 and 30/04/06 not met). Roseberry Gardens 36 DS0000010771.V291385.R01.S.doc Version 5.1 Page 21 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 YA15 Good Practice Recommendations The registered person should support the service user to locate and to keep in touch with their families Roseberry Gardens 36 DS0000010771.V291385.R01.S.doc Version 5.1 Page 22 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. 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