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Inspection on 09/08/05 for Rosecroft Care Ltd

Also see our care home review for Rosecroft Care Ltd for more information

This inspection was carried out on 9th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Rosecroft provides a caring, supportive and empowering environment for the service users. There is a good range of activities based on individual and collective needs. The staff work positively with the service users assisting them to communicate their needs and develop greater levels of independence and confidence. Service user documentation and the organisation`s policies, procedures and operating systems are maintained to a high standard. There is good leadership in the home ensuring staff and service user opinions are heard and the service continues to develop. Health and safety processes are well maintained and there is a good staff development programme.

What has improved since the last inspection?

The management and staff team continue to examine the support and care that is provided looking to innovate and further develop the service. The structure of the management has changed with the introduction of deputies at both homes. The level and nature of activities available to service users continues to expand. Mr and Mrs Ulph have recently completed the Registered Managers Award.

What the care home could do better:

The home provides a good service to the service user group allowing sensitive and thoughtful care and support. Mrs Ulph considered that the systems now in place prioritize a high quality of service delivery and there may now be opportunity to address areas of the environment that would benefit from redecoration and attention.

CARE HOME ADULTS 18-65 Rosecroft Care Ltd 71 Meehan Road Greatstone New Romney, Kent TN28 8NZ Lead Inspector Geoff Senior Unannounced 9 August & 16 Nov 2005 10:00 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. Rosecroft Care Ltd H56-H05 Rosecroft Care Ltd S23525 V241793 090805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Rosecroft Care Ltd Address 71 Meehan Road, Greatstone, New Romney, Kent, TN28 8NZ 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) 01797 361601 Rosecroft Care Limited Lisa Jane Ulph Care home only 5 Category(ies) of Learning Disability x 5 registration, with number of places Rosecroft Care Ltd H56-H05 Rosecroft Care Ltd S23525 V241793 090805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25/02/05 Brief Description of the Service: Rosecroft is registered as a Care Home for up to 5 adults with a learning disability. Rosecroft Ltd is the Registered Provider and Ms. L. Ulph is the registered manager. Rosecroft is a detached chalet bungalow situated in a residential area of Greatstone, a short walk away from the local amenities and the beach. There is service user accommodation on 2 floors and comprises 2 ground floor and 3 first floor single rooms There is a ground floor bathroom with ‘walk in’ shower and WC and a first floor Bath and WC. The staff work a rota that includes staff on the premises at night `on-call. There are no staff specifically employed to undertake meal preparation and cleaning. The Officer was informed that care staff and some of the residents carry out these duties. Administration and maintenance are undertaken predominantly by Mr & Mrs Ulph.According to its Aims and Objectives, Rosecroft provides care for adults with a learning disability and challenging difficulties in a secure environment, which respects individuality and promotes the development of service users’ potential socially acceptable behaviour and self esteem Rosecroft Care Ltd H56-H05 Rosecroft Care Ltd S23525 V241793 090805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection, which was unannounced, was undertaken during two visits to the home. The first, on 9/8/05 was curtailed, as the manager had been taken ill that morning and the remaining staff were preparing to take the service users out. The second visit was on 16/11/05 and commenced at approx 1:30 pm. The inspector was able to meet and talk with Mr. And Mrs. Ulph, staff on duty and briefly with one of the service users. A range of documentation was viewed and staff /service user interaction observed. What the service does well: What has improved since the last inspection? What they could do better: The home provides a good service to the service user group allowing sensitive and thoughtful care and support. Mrs Ulph considered that the systems now in place prioritize a high quality of service delivery and there may now be opportunity to address areas of the environment that would benefit from redecoration and attention. Rosecroft Care Ltd H56-H05 Rosecroft Care Ltd S23525 V241793 090805 Stage 4.doc Version 1.40 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. Rosecroft Care Ltd H56-H05 Rosecroft Care Ltd S23525 V241793 090805 Stage 4.doc Version 1.40 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 Rosecroft Care Ltd H56-H05 Rosecroft Care Ltd S23525 V241793 090805 Stage 4.doc Version 1.40 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) Not assessed at this visit EVIDENCE: Rosecroft Care Ltd H56-H05 Rosecroft Care Ltd S23525 V241793 090805 Stage 4.doc Version 1.40 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) Not assessed at this visit EVIDENCE: Rosecroft Care Ltd H56-H05 Rosecroft Care Ltd S23525 V241793 090805 Stage 4.doc Version 1.40 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 standard(s) 11-17 The home provides a good range of therapeutic and leisure activities based on personal needs, wishes and interests. Family and friends are welcomed into the home and contacts with the community are maintained. EVIDENCE: Staff in the home have worked positively with the service users to establish interests, likes and dislikes. They are supported by the management to provide a range of formal and informal activities and events for both recreational and therapeutic purposes. At the time of the visit a number of the service users were at the Day opportunities centre, one had been with staff members to purchase the house provisions. Each Service User has a specifically designed agenda to enable them to fulfil a meaningful life at the Home. This is reinforced with clear care planning and management strategies. It was reported that the wishes of Service Users are acknowledged and responded to appropriately and that access to any specific services would be facilitated. Most of the resident group have a fairly well established pattern of social/educational activity, there is a weekly programme of activities based upon Service User wishes; these activities are flexible to meet daily needs. Rosecroft Care Ltd H56-H05 Rosecroft Care Ltd S23525 V241793 090805 Stage 4.doc Version 1.40 Page 11 All Service Users are offered an annual holiday funded by the Home. Visitors are encouraged and welcomed with restrictions placed only in accordance with the wishes of, and convenience to, the Service User. They may be received in the resident’s own room or in communal areas The office may be made available if more privacy is required. Family links are maintained and encouraged where it is the wish of the Service User. Visits to the family home would be arranged with the agreement of the Service User. The staff keep in contact with significant others to update them on progress and changes. The Service User group is generally well established and the staff are aware of food likes, dislikes and preferences. Meals are provided mainly based on these wishes, but also taking into account the need for a reasonably balanced diet. Records are kept of meals provided. Rosecroft Care Ltd H56-H05 Rosecroft Care Ltd S23525 V241793 090805 Stage 4.doc Version 1.40 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 standard(s) 18,19. Staff respond to service users in a sensitive, non- patronising manner within a friendly and mutually respectful atmosphere. Healthcare issues are monitored and addressed EVIDENCE: The staff endeavour to provide Service Users with appropriate personal support in a dignified and sensitive manner. General day to day routines and activities are flexible. It was reported that although the majority of Service Users require a degree of assistance and guidance in matters relating to personal hygiene and appearance, it is only offered when required. The Inspector observed the staff responding to service Users in a supportive and non-patronising manner. The health care needs of the service users are monitored and addressed. Health issues are identified, documented and acted upon with advice from specialists. Additional equipment and facilities are assessed and provided where service users have changing levels of need. Rosecroft Care Ltd H56-H05 Rosecroft Care Ltd S23525 V241793 090805 Stage 4.doc Version 1.40 Page 13 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) Not assessed at this visit EVIDENCE: Rosecroft Care Ltd H56-H05 Rosecroft Care Ltd S23525 V241793 090805 Stage 4.doc Version 1.40 Page 14 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) Not assessed at this visit EVIDENCE: Rosecroft Care Ltd H56-H05 Rosecroft Care Ltd S23525 V241793 090805 Stage 4.doc Version 1.40 Page 15 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) 31-36 Recruitment procedures provide protection for the service users. Staff are supported to access training courses to enable them to work more effectively with the service users. EVIDENCE: Rosecroft offers staff a good development programme. There is a comprehensive induction process that staff are supported to work through. Mandatory training is provided and staff receive updates, refresher and service specific courses as required. The Management is aware of the expectations of the standard regarding NVQ level 2 training. Three support workers are to commence level 2 training in Nov 2005. The staff team is generally well established. Several members of staff are able to use Makaton as an aid to communication. There is a general rota pattern that provides for 2 support workers/proprietors on shift during the day with one on call on the premises at night. A member of the management team or senior staff are always ‘on call. Staff members undertake catering, laundry and domestic duties as well as care support duties. The Management confirmed that staffing levels are increased at times of need to ensure that choice, opportunities for social and individual activities and the management of emergencies are not diminished or compromised. The management indicated a good awareness of the need to ensure adequate checks are made on all potential staff to determine suitability and protect the Rosecroft Care Ltd H56-H05 Rosecroft Care Ltd S23525 V241793 090805 Stage 4.doc Version 1.40 Page 16 Service Users. Company recruitment/induction and probation procedures are in place. Staff files contain appropriate reference checks and all staff have current CRB checks. Rosecroft Care Ltd H56-H05 Rosecroft Care Ltd S23525 V241793 090805 Stage 4.doc Version 1.40 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 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) 37-43 There are robust health and safety and quality assurance processes, ensuring that the home is run according to the best interests of the service users. The health, safety and welfare of all is promoted and protected. The home benefits from a well-trained and experienced management team with clearly defined roles and responsibilities. EVIDENCE: Mr and Mrs Ulph expressed a clear vision for the direction of the home, which had been effectively communicated to staff. They are well supported by senior staff in providing clear leadership. Staff demonstrated an awareness of the expectations, duties and responsibilities of their role. Mr and Mrs Ulph have recently completed the Registered Managers Award, Mrs Ulph is a trained nurse and has maintained her registration. The staff and service users benefit from an open and inclusive management approach and have opportunity to express opinions at regular meetings. Rosecroft Care Ltd H56-H05 Rosecroft Care Ltd S23525 V241793 090805 Stage 4.doc Version 1.40 Page 18 There are systems in place for regular health and safety checks and staff are offered relevant training. A comprehensive range of policies and guidelines promote safe and appropriate working practices. The Inspector spoke with Mr and Mrs Ulph who have responsibility for accounting and financial matters relating to the business. There were no contra indications to the continuing financial viability of the Home. Public and employers liability insurance policies are in place. Mrs and Mrs Ulph are in control of the home and in day-to-day contact as management and in a support worker role. There are formal and informal systems in place for quality assurance. Rosecroft Care Ltd H56-H05 Rosecroft Care Ltd S23525 V241793 090805 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 3 3 3 4 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Rosecroft Care Ltd Score 3 3 x 3 Standard No 37 38 39 40 41 42 43 Score 3 4 3 4 4 4 3 H56-H05 Rosecroft Care Ltd S23525 V241793 090805 Stage 4.doc Version 1.40 Page 20 no 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 Regulation Requirement Timescale for action 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 Good Practice Recommendations Rosecroft Care Ltd H56-H05 Rosecroft Care Ltd S23525 V241793 090805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford, Kent TN23 1HU 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 Rosecroft Care Ltd H56-H05 Rosecroft Care Ltd S23525 V241793 090805 Stage 4.doc Version 1.40 Page 22 - 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!