CARE HOME ADULTS 18-65 Rosedene 22 Rosewarne Road Camborne Cornwall TR14 8BE
Lead Inspector Lowenna Harty Unannounced 19th April 2005 09:30 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. Rosedene Version 1.10 Page 3 SERVICE INFORMATION
Name of service Rosedene Address 22 Rosewarne Road Camborne Cornwall TR14 8BE 01209 714238 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) Mr Alcwyn Samuel Henry Parker-Price Mrs Gwyneth Helen Parker-Price Care Home 4 Category(ies) of Learning Disability over 65 years of age (4) registration, with number of places Rosedene Version 1.10 Page 4 SERVICE INFORMATION
Conditions of registration: All service users to be aged 50 years or above upon admission. Date of last inspection 4 October 2004 Brief Description of the Service: Rosedene is a registered home providing accommodation and personal care for up to 4 adults with a learning disability who must be aged 50 years or over when they are admitted. It is owned and managed by the registered providers, who live in the home and provide most of the necessary care and support to the service users themselves. They are assisted by a part-time carer. The home is close to the centre of the town of Camborne and within easy reach of local shops and services. The home is able to provide transport for service users should they need it. The home is a detached, two-storey, family dwelling with a spacious front garden and a patio. Service users’ private accommodation is situated across both floors. The upper floor is reached via a staircase. All of the service users are provided with single, furnished bedrooms. Two of the bedrooms have wash hand basins. The home has three bathrooms, two on the ground floor and one on the first floor. Service users have their own lounge and the use of the family dining room. Service users have some access to the kitchen, but this is limited because it is quite small. They have own tea and coffee making facilities near to their lounge. The aim is to provide service users with care in a comfortable and homely setting and to encourage them to be involved in a wide range of activities in the local community. All the service users attend day care and/or college placements during weekdays; they are helped to get to social clubs and resources in the local community during evenings and weekends.
Rosedene Version 1.10 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection as part of the home’s annual inspection programme on April 19 2005 starting at 9.20 am. The inspector was at the home for four hours and forty minutes. The inspector undertook the following activities whilst at the home 1. Inspection of records, including assessment information and care plans and information on the part-time staff member employed to work at the home. 2. Discussion with the registered providers of the home on how it operates on a day-to-day basis 3. Inspection of the building 4. Individual interviews with each of the three service users, which were held in private with the inspector. 5. Observation of daily life of service users in the home, including their interaction with the registered providers and each other. What the service does well:
The service provides a safe and comfortable home for the four service users living there. All of them stated that they enjoy life in the home and they have busy, active lives. They have a lot of contact with people in the local community including their own families and staff at the work or day placements they go to during weekdays. The registered providers take them out at weekends and they are given opportunities to go on holidays of their choice. The home provides a secure and stable base for the service users living there. There have not been any admissions recently and none are expected. Meals are particularly good and the registered providers take service users out for meals on special occasions. Service users health and personal care needs are fully met. They all appeared physically well, were smart in their appearances and fashionably dressed at the time of the unannounced inspection. Service users are able to talk to the registered providers or people outside of the home if they have any concerns about their care. They all have their own bedrooms, which are comfortable and provide them with privacy. Service users are aware of their care plans and attend their reviews. Rosedene Version 1.10 Page 6 What has improved since the last inspection? 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. Rosedene 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 Rosedene 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) 2 & 4 Service users participate in the assessment process, which is clear and thorough. They are encouraged to visit the home before they are admitted, in accordance with the home’s admissions procedures and statement of purpose. EVIDENCE: No new service users have been admitted to the home since the previous inspection. There are no current or expected vacancies. The home has full written assessment information, including risk assessment information on the service user most recently admitted to the home and it has been signed by the service user as evidence of their participation in the process. Service users’ social workers and family representatives, where relevant have been involved in their placements in the home. The statement of purpose contains clear information on the home’s admission’s procedures that includes a policy of ensuring that service users can visit the home before they are formally admitted to it. Their contracts provide for a minimum 3-months “settling in” by new service users. Rosedene 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 Service users assist in developing individual and very person centred care plans that fully reflect their needs, but which could be improved by more clearly reflecting their personal goals and targets. They are assisted to make decisions about their own lives on matters that affect them, through care plan reviews, quality assurance meetings and informal consultation on a day-to-day basis. EVIDENCE: Service users have person-centred written care plans that they have signed. The formats have been revised and improved recently and service users are transferring to the new format as their six-monthly reviews take place. There was discussion at the inspection about the value of including a section on goals and targets for service users in the new format. There are formal quality assurance meetings with service users every six months, with records kept. Service users access a broad ranged of resources in the local community and have frequent contact with professionals and others from outside of the home who would be able to advocate on their behalf if necessary. All of them said that they are sufficiently involved in decision making in the home during interviews held in private with the inspector.
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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 & 17 Service users are active in the local community in a range of activities including formal work or day care placements during the working week and social activities outside or working hours. They are provided with wholesome, home-prepared meals in accordance with their needs and are satisfied with the food provided to them. EVIDENCE: All of the service users were out at their respective day care activities/ placements at the time of the inspection and the inspector returned to the home in the early evening to interview them after they returned for the evening. They all expressed satisfaction with the activities and meals provided for them at the home. They are regularly consulted on their food preferences and there are satisfactory records of the food provided to them. The home has an unmarked vehicle that is suitable for taking service users out and they are taken out on a regular basis, including to evening social clubs and meals out. In the home they have their own bedrooms with televisions and music equipment and are encouraged to pursue their hobbies and interests. They have a lounge of their own, with television and a spacious front garden with a patio and barbecue.
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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 Service users’ personal support and health care needs are considered as part of the care planning process and appear to be fully met in ways that encourage them to maintain their independence and dignity. EVIDENCE: Service users’ assessments and written care plans fully address their personal and health care needs. The home’s statement of purpose clearly states that the home is not suitable to provide for people with extensive personal care needs or those who require nursing care provision. The registered providers are on hand to provide prompting and/or low level support and assistance as required and service users are encouraged to maintain their independence with regard to their washing, bathing, dressing and choice of clothing. All of the service users appeared to be appropriately and fashionably dressed and well cared for with regard to their personal appearance. There are sufficient lockable bathrooms for them to maintain their privacy and dignity in these respects. Records provide evidence that service users are assisted to access a range of NHS professional healthcare providers from outside of the home. Rosedene Version 1.10 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 standard(s) 22 The home has a clearly written complaints procedure that is readily available to service users and their representatives. The registered providers have systems for formal and informal consultation with them to ensure that complaints are heard and responded to at an early stage. EVIDENCE: The home’s written complaints procedure is included in the home’s statement of purpose and service users’ guide, which has been shared with service users. Service users stated that they are satisfied with the care and services provided to them during interviews held in private with the inspector. They all have ready access to relatives and/or professionals outside of the home to whom they can voice concerns if they feel unable to raise them directly with the registered providers, although most stated that they would first raise any concerns with the registered providers. The home holds bi-annual formal quality assurance meetings, with minutes kept during which the registered providers actively encourage service users to state their views on the services provided to them at the home. Rosedene Version 1.10 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 standard(s) 24 & 30 Service users live in a family home environment, which is comfortable, ensures their safety as far as is reasonably practicable and is clean and hygienic. EVIDENCE: Service users are provided with comfortable, furnished single bedrooms, which are lockable. They have a lounge of their own and sufficient bathrooms to meet their needs. They have access to tea, coffee and snack making facilities although the kitchen is not suitable for them to access independently for the preparation of meals. There is evidence of ongoing improvements to the home’s environment. The home has a new front door, the windows in the front of the building have been replaced and there is a new patio that is almost completed. The registered providers have recently attended basic food hygiene refresher training and have booked to attend health and safety training shortly. There are suitable records and risk assessments in respect of fire safety, records provide evidence of gas and electrical appliance testing and maintenance on an annual basis and the service users have been provided with individual risk assessments with a view to ensuring their safety and that of others in the home. There are written policies and procedures in respect of the control of infection and the home appeared clean and tidy throughout at the time of the unannounced inspection.
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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, 32, 33, 34, 35 & 36 The registered providers have recently employed a single, part-time member of staff to assist them with cleaning in the home and to undertake occasional evening care work with the service users. Recruitment was fair, safe, effective and suitable for the nature of the employment although the registered providers should retain interview records. The staff member has been provided with good access to training and is well supervised. EVIDENCE: There are full records of the hours worked by the part-time staff member. Since the previous inspection the registered provider’s own children have ceased undertaking voluntary work in the home. Service users already knew the staff member through one of their social clubs and like them. There is a clearly written job description and person specification for the post. The staff member completed a written application with a full and complete employment history and two written references were supplied. They have undergone appropriate safety checks. They have been provided with access to suitable training and are provided with suitable support and supervision from the registered providers. Rosedene 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, 41 & 42 The home has a quality assurance system that is suitable for the small scale of the business, this informs care practices and planning for the home and is linked to its business plan. There are adequate systems to ensure the health, safety and welfare of service users. The home has appropriate records and suitable storage for them. Service users and/or their representatives are able to access them if they wish. EVIDENCE: There are bi-annual formal quality assurance meetings with service users, with records kept. Outcomes of these are used to inform the home’s annual business plan. The home manages complaints effectively and all the service users stated that they are satisfied with the care and services provided to them. There are clear records of all hours worked by the home’s part-time staff member. Suitable records are in place in respect of all aspects of health and safety and arrangements have been made for appropriate training in this respect for the registered providers and the part-time staff member. Records Rosedene Version 1.10 Page 19 relating to service users appear to be clear and up-to-date, include risk assessments and management plans and are stored securely. 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 x 3 x 3 x Standard No 22 23
ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 x x x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x x x x x 3 Standard No Standard No 31 32 Score 3 3
Page 20 Rosedene Version 1.10 11 12 13 14 15 16 17 x 4 x x x x 4 33 34 35 36 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x 3 x 3 3 x Rosedene 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 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. 2. Refer to Standard 6 34 Good Practice Recommendations Service users care plans should include targets and goals Interview records for staff should be retained. Rosedene Version 1.10 Page 22 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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