Inspection on 12/01/07 for Roselands

This inspection was carried out on 12th January 2007.

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

Other inspections for this house

Roselands 01/12/08

Roselands 28/11/05

Roselands 27/06/05

Roselands 14/12/04

Roselands 13/09/04

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Thorndene

Insight - Eastchurch

Southfields

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33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Roselands 50 Reculver Drive Beltinge Herne Bay Kent CT6 6QF Lead Inspector Christine Lawrence Key Unannounced Inspection 12 January 2007 10:00 Roselands DS0000045738.V301303.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 Roselands DS0000045738.V301303.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. Roselands DS0000045738.V301303.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Roselands Address 50 Reculver Drive Beltinge Herne Bay Kent CT6 6QF 01227 360738 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) Mrs Julie White-Fort Mr Gary White, Mrs June White, Mr Donald White Mrs Christine Fagg Care Home 15 Category(ies) of Learning disability (15) registration, with number of places Roselands DS0000045738.V301303.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28 November 2005 Brief Description of the Service: Roselands is registered to provide care for up to fifteen adults with learning disabilities aged 18-65. The residents have been identified as preferring a quieter pace of life. Roselands is situated in Beltinge, a village on the outskirts of Herne Bay. The home is a detached, two storey property at the end of a lane overlooking the sea. It has its own vehicle. The gardens are spacious and to the side and rear of the house. There is limited parking space within the grounds but a small municipal car park is directly opposite the home. Information about the home, including the last inspection report would be made available by the home on request. Written information provided by the manager in September 2006 confirmed the weekly fees as £728.47. Roselands DS0000045738.V301303.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and started at 10.00 and finished at 16.30. The inspector looked at various records in the home and also used information sent to the commission by the manager before the visit. Information from the previous inspection was also referred to. The inspector spoke with several of the residents and was invited to see two bedrooms. A tour of the parts of the rest of the building was undertaken. The inspector joined some of the residents for lunch and made observations of staff interacting with and supporting residents. Comment cards were sent to the health and social care professionals involved with the home and three replied. What the service does well: 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 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. Roselands DS0000045738.V301303.R01.S.doc Version 5.2 Page 6 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 Roselands DS0000045738.V301303.R01.S.doc Version 5.2 Page 7 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents’ individual aspirations and needs will be assessed. EVIDENCE: Four individual records were looked at for this inspection. It is clear that new residents will only be admitted after a detailed assessment process which includes getting information from the placing authority’s representative. The assessment information is used to compile a care plan. The format being used in the home is based on person centred planning and focuses on an individual’s wishes as well as their needs. Roselands DS0000045738.V301303.R01.S.doc Version 5.2 Page 8 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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their changing needs will be noted in their individual plans and that they will be supported to make decisions and take risks to enable as independent lifestyle as possible. EVIDENCE: Four individual records were looked at for this inspection. The individual records are contained in a ring binder. They are organized into sections with an index, making information easy to find. The plans cover a range of topics which vary from resident to resident, reflecting that these are individual plans. Information within the individual plan leads on to risk assessments which contain any actions that staff must be aware of. Person centred planning is part of the overall care plan and Mrs Fagg, the manager explained that she is still looking at ways of improving on the format to make it more personal for each individual. Regular reviews are undertaken to ensure that information and objectives to be achieved are up to date. There is a formal annual review Roselands DS0000045738.V301303.R01.S.doc Version 5.2 Page 9 with the placing authority. Residents are involved as much as possible as are their relatives/representatives. The organization is aware of the importance of independent advocacy and one particular example of how a resident was supported was noted from this inspection. The records viewed, as well as the comments from those residents spoken to, showed that people are encouraged and enabled to make choices. This would be for a variety of things from choices relating to daily routines, food and what clothes to wear to whether or not to attend a day activity or to spend time alone in one’s own room. Roselands DS0000045738.V301303.R01.S.doc Version 5.2 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. 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. Activities and involvement in the local community, as well as support for personal relationships will be provided for residents. Their rights will be respected and their responsibilities recognized. They will benefit from being offered a healthy diet and a sociable setting for mealtimes. EVIDENCE: The following activities are available within the home:- reflexology, listening to music, dancing to music, watching films and television, card making and other craft work, gardening and games. Not everybody joins in everything but individuals are encouraged and enabled to do what suits them or what they wish. Staff members clearly know what individuals enjoy doing. Lots of examples were given of residents using local facilities. The rota shows that staff are on duty at weekends and evenings in sufficient numbers to allow for activities to be supported. Residents are on the electoral roll and two residents spoke about having the opportunity to vote. Roselands DS0000045738.V301303.R01.S.doc Version 5.2 Page 11 There were lots of examples of family and friends being involved. In some cases the home facilitates this contact by providing transport. There are various social occasions throughout the year that people are involved in and/or invited to. Although residents vary in their abilities it is clear from talking to residents, observing staff support and interaction and talking to the manager and staff, that opportunities are created or made the most of with regard to rights and responsibilities. Some residents have keys to their rooms where this is appropriate and wanted. Residents can and do choose to spend time in their own rooms. Those that are able are encouraged and supported to carry out personal and housekeeping tasks. One of the important parts of supporting residents who are less able is the fact that the staff have got to know them and their preferences and this is passed on to any new staff. Some residents need help in eating and this was observed at the time of this visit. It was done with discretion and gentleness and at the residents’ own pace. Many of the residents had gone out for lunch on the day of the inspection. Residents spoken to said that they enjoyed the meals. The inspector was informed that special occasions such as birthdays are celebrated with special meals. There is also a regular ‘theme’ night when different types of food are tried. The menu provided for this inspection showed a variety of meals. Roselands DS0000045738.V301303.R01.S.doc Version 5.2 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. 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. Residents are protected by the home’s policies and procedures regarding medication and their physical and emotional needs will be responded to. EVIDENCE: As previously noted residents who are able to make choices are encouraged to do so regarding any preferences they have about their personal care and support, their choice of clothing and style and their daily routines. Two residents who spoke to the inspector were very clear about how they made choices and decisions. Those who are less able to communicate their wishes are still supported and enabled to demonstrate preferences. One health/social care professional said that the level of understanding of residents’ needs was excellent. The records seen indicated that residents’ health care needs are met. Various health care professionals are involved with the residents one of whom commented that communication with visiting professionals was very good on Roselands DS0000045738.V301303.R01.S.doc Version 5.2 Page 13 individual client needs. Christine Fagg, the manager, is working on improving the health action plans in use to ensure they are personalised. Medication is appropriately stored and the administration sheets were properly completed. Only three members of staff currently give out medication. They have been trained and they are all senior members of staff. There are policies and procedures relating to medication which were reviewed in May 2006. The three health/social care professionals who completed comment cards for this inspection answered yes to the question about residents’ medication being appropriately managed. Roselands DS0000045738.V301303.R01.S.doc Version 5.2 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. 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. Residents are protected from abuse and their views are listened to and acted on. EVIDENCE: Two residents spoken to indicated that if they were fed up or unhappy about something they would know who to talk to. There are regular residents meetings and the keyworker system is another way of ensuring that residents can express dissatisfaction. Staff are using Makaton signs to assist in their understanding of some residents wishes. The manager explained that family members would be encouraged to say if anything was not quite as they wished for their relative. There have been no complaints either to the home or through social services. Staff have received adult protection training and written guidance. There are policies on adult protection, management of residents’ money and whistle blowing. Staff spoken to were clear about their responsibilities with regard to protecting the people in their care. Roselands DS0000045738.V301303.R01.S.doc Version 5.2 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. 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. The home is clean, comfortable and safe for the residents. EVIDENCE: The home is decorated and furnished very well. It is spacious, bright and homely. The building is in keeping with the local community. A maintenance man visits the home one day per week and senior staff will note if anything needs doing. The garden is accessible and spacious and the manager and residents informed the inspector that there are plans for the garden to be redesigned. The home was clean and free from any unwanted odours. The laundry facilities are appropriate and there are policies and procedures in place relating to infection control. Roselands DS0000045738.V301303.R01.S.doc Version 5.2 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. 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. Recruitment and training of staff will have a beneficial impact on residents. EVIDENCE: During this inspection the inspector observed staff helping and supporting residents. They were respectful, patient and clearly know the residents. Expressions of affection were appropriate and there was banter and humour which residents looked to be comfortable with. Regular workshops are provided in house by the local community learning disability team. This includes Makaton and understanding dementia. More than half the staff team have acquired a national vocational qualification (NVQ) and although there have been problems with NVQ providers, the home is still enabling staff members to access this training. Three staff records were looked at for this inspection. They reflected that the recruitment procedures are thorough and include references, interviews and criminal record bureau checks. The manager explained that any prospective staff member is invited to visit the home for a day or part day so that residents can meet them. The General Social Care Council’s codes are given to staff in a Roselands DS0000045738.V301303.R01.S.doc Version 5.2 Page 17 down loaded format. The inspector suggested that the manager acquire copies direct from the GSCC. The home provides induction and ongoing training, both mandatory and specialised for the client group. Although the induction training appeared relevant the inspector advised that the Common Induction Standards (CIS) from Skills for Care should be looked at ensure the home’s induction is in keeping with what is recommended. Staff spoken to said they had opportunities for training which they valued and thought were useful for their work supporting the residents at Roselands. Roselands DS0000045738.V301303.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well run home and their opinions are sought. Their health and safety is promoted and protected. EVIDENCE: The manager is currently undergoing her NVQ assessment for level 4 care and management. She is an experienced person who demonstrated her knowledge of the client group at Roselands throughout this inspection. She attends the workshops provided by the community learning disability team to ensure she is keeping her own skills and knowledge up to date. Although unfortunately Mrs Fagg does not have direct access to the Internet she is aware of the websites which provide up to date information relating to the care and support of the residents at Roselands such as Valuing People, Skills for Care and the Learning Disability Award Framework and she can access them from head office. Roselands DS0000045738.V301303.R01.S.doc Version 5.2 Page 19 The home is visited on a frequent basis by the providers’ representative who is the Area Manager. Although his visits conform to the ethos of Regulation 26 there is no report written on a monthly basis. It is also clear that the manager and the owners are committed to maintaining standards and looking at ways to improve but as yet there is no formal quality monitoring report or plan which can be made public and shared with current and future residents and their representatives. Health and safety training is provided for staff. There are a variety of policies and procedures relating to health and safety all of which have been reviewed and updated where necessary. The manager said that there is currently no schedule for servicing wheelchairs but they are regularly cleaned and staff would note if there was any problem. She said she would look at formalising this. A spot check on other maintenance and service contracts showed that everything was appropriate and up to date. The fire safety logbook showed that regular checks are carried out and recorded. There are risk assessments in place for the environment as well as for fire safety. Accidents are appropriately recorded. Roselands DS0000045738.V301303.R01.S.doc Version 5.2 Page 20 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 3 3 X 3 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 3 X X 3 X Roselands DS0000045738.V301303.R01.S.doc Version 5.2 Page 21 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. 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. Refer to Standard Good Practice Recommendations Roselands DS0000045738.V301303.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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