Inspection on 19/06/06 for Roselands

This inspection was carried out on 19th 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 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 10/11/05

Roselands 07/10/04

Roselands 06/05/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Roselands 8-10 Stanford Road Norbury London SW16 4PY Lead Inspector Peter Stanley Key Unannounced Inspection 19th June 2006 9:30am X10015.doc Version 1.40 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 DS0000025830.V297860.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 Older People. 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 DS0000025830.V297860.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Roselands Address 8-10 Stanford Road Norbury London SW16 4PY 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 8764 6045 NO FAX Mr Nizma Hosanee Mrs Zeidah Bannon Hosanee Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th November 2005 Brief Description of the Service: Roselands is a 16 bedded domestic-style building within a residential street, very closely situated to the busy Norbury High Road shopping area and to excellent transport links formed of a number of bus routes to Croydon, Brixton, Clapham and Central London and the railway link to Croydon, Thornton Heath and Central London. The home comprises two interconnected houses, with three floors being accessed via a passenger lift. Each floor provides a large lounge and dining area, service users move between these lounges, with the ground floor lounge providing the social focus of the home. The home provides bathrooms and toilets on each floor, or on half-landings between floors. The home aims to accommodate more able older people, and is not suitable for people who have a physical disability as the home is accessed from the front by a small number of stairs. Many of the home’s service users are able to manage their own care, with service users being encouraged and assisted to access local community facilities. The home has a large and pleasant garden, which is well maintained. Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection that was completed over half a day. The inspection involved discussion with the registered provider/manager, Mr Nizma Hosanee, the care manager, Hannah Oozeerally, staff on duty and service users. The inspector spoke to a wide range of service users and to staff on duty. Care records and other documentation were examined, and one recent admission was case-tracked. As a result of this inspection, all four previous requirements have been met. There are no new requirements. There is one recommendation which relates to the advantage that could be gained from the home’s care manager attending Croydon’s ‘training for trainers’ adult protection course. The evidence from this inspection confirms that Roselands is a very well managed home, with high standards in the quality of care and support that is provided. The evidence across all standards inspected is that there is a firm commitment to maintaining standards of good practice in all aspects of the home’s day-to-day operation, and that the home provides an open, friendly and inclusive environment for its residents. The home was observed to provide an open, friendly and inclusive environment for its’ residents, this being evidenced from discussion with several of the home’s service users, and from the completion of a small number of questionnaires. As evidenced in key documents and policies, and as observed on this and previous inspections, there is a strong commitment to promoting the welfare, independence and rights of the home’s residents. Both service users and staff expressed very positive views regarding the home and the way in which it is being run. What the service does well: Service users are being provided with the information, which they require, to enable an informed choice as to where they would like to live. Service users are being provided with a copy of the home’s terms and conditions at the point of moving into the home. The home is able to demonstrate that service users’ needs are being properly assessed, and that the range of needs presented is being sensitively and appropriately met. Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 6 Service users are having their health, personal and social care needs set out in a very comprehensive and detailed individual plan of care, with review taking place on a regular, monthly basis. The health care needs of service users are being fully met, with thorough and ongoing monitoring of service users’ health, sensory, and physical care needs. Service users are being well protected by the home’s medication policy and procedures. Accredited medication training has been extended to all care staff. Service users are being treated with respect in all aspects of their daily living, and are having their right to privacy upheld. Service users are being provided with a full and varied range of opportunities for recreational and social activity that is in accord with their social, cultural and religious needs. There is full consultation with service users regarding their specific interests and choice of activities. Service users are being encouraged and assisted to maintain contact with their family and friends, and to access and maintain links with the local community. The home has an open door policy, with service users at the home being assured of privacy and respect when receiving visitors. Service users are being actively enabled to exercise choice and control in their day-to-day activities and routines, with appropriate support from staff being provided to help to facilitate this. Service users are evidenced to receive a wholesome and appealing diet in pleasant surroundings at times convenient to them. Service users expressed praise for the quality of the food served. The home has an appropriate complaints policy and procedure in place. Clear information for raising complaints is made available, and service users and their relatives/friends are encouraged to raise any concerns they may have. The legal rights of service users within the home are evidenced to be well protected and promoted. Service users are encouraged and assisted to vote if they wish. Service users live in a safe, well-maintained environment, with access to safe and comfortable communal facilities. Risk assessment of the home and individuals are in place for their protection. Service users’ rooms were observed to be safe, comfortable and pleasantly decorated, reflecting service users’ personal identities, and being suited to their individual needs. Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 7 The home has the numbers and skill mix of staff sufficient to meet the needs presented by the home’s service users, and to ensure their safety. Staff are being provided with the necessary induction and training with which to competently perform their work duties. The home is being managed in the best interests of the home’s service users. The management approach is evidenced to be open and enabling, and conducive to creating a positive and inclusive atmosphere in the home. The home’s quality assurance processes are evidencing extensive consultation with service users, relatives and other parties, and are demonstrating that the home is meeting its aims and objectives. Service users’ financial interests are being appropriately safeguarded. The inspector was satisfied that the health, safety and welfare of service users and staff are being appropriately promoted and protected. All safety checks and certification are in place. What has improved since the last inspection? The views and wishes of service users and their relatives, regarding the eventuality of the service user’s infirmity or death, are being respected. Staff training in bereavement and loss has recently been provided. The home’s policies, procedures and practice evidence that service users are being protected from abuse and are living in a safe environment. All staff have now completed statutory adult protection training. There has been an ongoing programme of renovation, with external decoration of the home, and internal decoration (and re-carpeting) of both communal areas and some service users’ rooms. The home presents as clean, pleasant and hygienic. All staff have now completed approved infection control training. Service users are being protected by the home’s recruitment policy and procedures. The home is now ensuring that it obtains an up-to-date criminal records check for any new staff appointment. Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 8 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. Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 to 5 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users are being provided with the information, which they require, to enable an informed choice as to where they would like to live. Service users are being provided with a copy of the home’s terms and conditions at the point of moving into the home. The home is able to demonstrate that service users’ needs are being properly assessed, and that the range of needs presented is being sensitively and appropriately met. EVIDENCE: Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 11 The home has compiled a Statement of Purpose outlining the aims and objectives of the home, and the facilities and services it provides. The Statement of Purpose includes all the information detailed in Schedule 1 of the Care Homes Regulations (2001). An addendum to the Statement of Purpose has been added, giving updated details of the qualifications and experience of the home’s management and care staff. The home has also developed a Service User’s Guide which is written in a format/language suitable for the service users and contains all the elements of regulation 5(1),(2)&(3). This document is complemented by a very comprehensive charter of residents’ rights. Both the Statement of Purpose and the Service User’s Guide have recently been reviewed, in April 2006. Quality assurance reports have now been included. All prospective users are invited to the home and to move in on a trial basis, based on their needs and choices. Staff also visit prospective service users in their own home or current setting, so as to gain as full a picture as possible of their needs and lifestyle. The Registered Provider is keen to ensure that new service users are compatible with existing service users. The service users of this home tend to be very independent and relatively able. The Registered Provider aims to admit service users who are fairly independent with their self-care and whose needs are relatively low to medium dependency. The Statement Of Purpose states that the home is unable to offer placement to service users who are wheelchair users, or to those who are mentally impaired or who have nursing needs. The home does not accept emergency admissions, and does not offer intermediate care. All service users are issued with a Placement Agreement, which clearly sets out the terms, and conditions that apply to their placement in the home; this is written in plain English and is signed by the service user or his/her representative. Referring local authorities provide written contracts, which provide detailed information relating to the legal basis and terms on which the placement has been agreed with the home and the service user. New service users are only admitted on the basis of a full assessment undertaken by a person who is suitably qualified to do so. This may involve a social services care manager and relevant professionals, in an initial care management assessment, and a thorough assessment and risk assessment by the home’s manager or care manager. The assessment fully involves the service user, his/her relative or delegated representative, and any relevant professionals that have been party to the referral. Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 12 The home has admitted one new service user since the last inspection in February 2006. The inspector examined the service user’s file and found that a full care management assessment, outlining the service user’s care needs, had been obtained from the referring local authority, and that assessments and risk assessments had been completed by the home. These include a ‘choice assessment which includes very detailed and comprehensive information regarding the wishes and preferences of the service user in relation to their daily care, routines and activities. The inspector viewed a sample of service users’ care plans, these having been reviewed on a regular monthly basis. Records of the service user’s initial sixweekly and subsequent three-monthly reviews were also evidenced. Three monthly formal reviews are held to which the service user, his/her relatives/representatives, care manager and GP are invited. The inspector spoke to a number of service users. Many positive comments were made regarding the home and the care provided by staff, with service users presenting as being very settled, content and well supported. Independence in daily living is encouraged wherever possible and there is a strong enabling ethos within the home, with service users being encouraged to lead as fulfilling lives as possible. This is linked to very detailed and thorough monitoring of service users’ wishes, preferences and needs, as indicated in service users’ files. The various assessments (including choice, independence and service users’ rights) and service user plans indicate that care and support needs are being very well assessed and met in this home, and that service users and their relatives are being fully involved in the assessment, review and care planning process. Staff possess relevant qualifications, and there is an ongoing and comprehensive training programme which is tailored to the care and support needs of this client group. Staff and training records indicate that the home has the requisite range of skills and abilities with which to meet the needs of the home’s service users. Staff on duty present as caring and alert to individual needs, and were observed to be spending time in engaging and interacting purposefully with service users. The inspector spoke with two staff members, both of whom indicated that they enjoyed their work and felt well supported in carrying out their duties. Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 13 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 to 11 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users are having their health, personal and social care needs set out in a very comprehensive and detailed individual plan of care, with review taking place on a regular, monthly basis. The health care needs of service users are being fully met, with thorough and ongoing monitoring of service users’ health, sensory, and physical care needs. Service users are being well protected by the home’s medication policy and procedures. Accredited medication training has been extended to all care staff. Service users are being treated with respect in all aspects of their daily living, and are having their right to privacy upheld. The views and wishes of service users and their relatives, regarding the eventuality of the service user’s infirmity or death, are being respected. Staff training in bereavement and loss has recently been provided. EVIDENCE: Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 14 Service users’ care plans are being compiled on the basis of the initial assessment prior to admission, on admission and during residency. Care plans are viewed by the home as being ‘living documents’. The inspector examined the care plan for a recently admitted service user. This evidenced the full involvement of the service user, and his nearest relative, in identifying his needs, wishes and preferences, and in drawing up the care plan. The home’s care plans set out the individual needs of the residents and how the home aims to meet them. These are being reviewed on a regular, monthly basis. All care plans are signed by service users, with service users being given the choice as to whether they wish to be fully involved in drawing these up. All service users have access to the relevant health professionals. All service users are registered with a local surgery that has two GP’s, though any service user wishing to retain his/her GP can do so if still living within the GP’s catchment area. There is a routine weekly visit to the home. Service users may be visited at the home, or at the surgeries and have the choice of being seen by a male or female GP. An NHS chirpodist visits once every three months, training in foot care having been provided to staff when visiting in 2004. The home uses a domiciliary dental practice, with visits by a dentist and a dental hygienist to the home taking place on a six-monthly basis. Advice on oral care was given to staff on a recent visit in October 2005. There are no specific health concerns or continence issues at present in the home. Written records of nutritional screening for service users are maintained. These include nutritional assessments and plans, monthly weight charts and records of food consumed. The home has detailed and comprehensive policies and procedures in place which cover privacy, dignity and confidentiality. The home’s management gives this area a high profile, an information session having been held with staff, in January 2006, when these issues were discussed. Service users are assisted to complete questionnaires in relation to their privacy and dignity, these fully exploring the expectations of service users in relation to all aspects of their care. The questionnaires are used in the writing of service user plans and are reviewed annually. The review of these documents includes further discussion of service user’s rights and ensures service users are aware of the complaints procedure. The service users themselves complete a number of these questionnaires. These documents represent excellent examples of good practice and demonstrate a commitment to addressing service user’s privacy and dignity. Issues of privacy and dignity are discussed at service user’s meetings on a regular basis. The inspector spoke to a number of service users and received positive feedback regarding their privacy and dignity being respected by staff. Service users indicated that they are able to see relatives or friends in privacy, a quiet Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 15 upstairs lounge, or a small visitors room being available if required. A phone is available for private phone calls in the visitors’ room. Privacy and dignity were observed by the inspector to be respected within the home, with staff knocking on service users’ doors before entering, and staff interacting in a caring and sensitive way with service users. Service user plans detail individual wishes and preferences in regard to their daily living and routines, and as to how they wish their care to be provided. The inspector received feedback from a number of service users, which indicated that their privacy and dignity is being respected. There is a small, quiet upstairs lounge, or a small visitors room, where visitors can be received, or in the privacy of the service user’s own room. There has been one death at the home within the last 12 months. Service users’ wishes regarding the eventuality of their infirmity or death are recorded on service users’ files, with the nearest relative being involved, wherever possible, in this process. The religious, spiritual and humanitarian needs and wishes of service users are respected and noted, together with detail of any wishes regarding practical issues and funeral arrangements. The home has a policy and procedure on ‘death and dying’; this was revised in January 2005. Following discussion with the care manager at the last inspection, the home’s provider/manager has, as an accredited trainer in this area, provided training in bereavement and loss to staff at the home. From the feedback provided, this has proved beneficial in developing awareness of issues relating to bereavement and loss, and in enabling staff to develop insights and skills to assist in supporting service users when a death in the home, or family bereavement, occurs. Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 16 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 to 15 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users are being provided with a full and varied range of opportunities for recreational and social activity that is in accord with their social, cultural and religious needs. There is full consultation with service users regarding their specific interests and choice of activities. Service users are being encouraged and assisted to maintain contact with their family and friends, and to access and maintain links with the local community. The home has an open door policy, with service users at the home being assured of privacy and respect when receiving visitors. Service users are being actively enabled to exercise choice and control in their day-to-day activities and routines, with appropriate support from staff being provided to help to facilitate this. Service users are evidenced to receive a wholesome and appealing diet in pleasant surroundings at times convenient to them. Service users expressed praise for the quality of the food served. Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 17 EVIDENCE: The home offers a wide range of activities that all service users are given the option of participating in. These are publicised on the notice board in the home’s main reception area. The activities in the home are designed to reflect the interests and choices of the service users, each service user, on admission, being asked to provide information regarding their wishes and interests. Service users are regularly consulted by their key workers, and at service users’ meetings regarding their preferences regarding activities and outings. There is a regular activity programme, which includes music, games, quizzes, bingo, exercise, dancing and library visits. Service users are encouraged to involve themselves in daily routines, including assisting with tidying their rooms, with laying table and food preparation, or assisting with daily trips to purchase fresh fruit and vegetables from local shops. Service users are encouraged to access facilities in the community, with key workers assisting service users to access shops and parks where help is needed. Links with the local community are encouraged with service users being enabled to visit the library or cinema or to attend a social club or day centre. There is a local Darby and Joan club very close to the home, which service users can attend if they wish to do so. There are communal lounges on the ground, first and second floors. Most service users tend to use the main ground-floor lounge, where service uses can read newspapers or books, or watch television, though some service users were in the quieter first floor lounge. The inspector spoke to a number of service users. Feedback received was generally very positive with service users expressing their satisfaction with the range of activities offered, and indicating that they are able to exercise choice and control in determining their daily activities and routines. The inspector spoke with one service user who regularly accesses public transport, visiting places of historic interest within the Croydon area. Another service user described how he regularly goes out, to the shops or visiting friends. Staff were observed to be positively engaging with service users and helping to create a friendly and stimulating environment. There was not, however, any evidence of activities (formal or informal) being facilitated with groups or individuals during this inspection. The home provides occasional outings to places of interest, these being publicised on the notice board. These are usually for small groups of service users, including those who feel less able to go out on their own. A large group day outing to Littlehampton is being planned for some time in August, previous day trips to the seaside having proved very popular. Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 18 The home undertakes a questionnaire about choice with all service users. This is an extensive document covering a wide range of choice areas, information from which is integrated into service user plans. Most service users manage their own financial affairs. All service users have an allocated care manager or are known to a Local Authority Reviewing team. The home tries to ensure the attendance of both care managers, and relatives and friends (subject to the service user’s wishes) at formal reviews. While no service user has an external advocate, advocacy information is made available at the home. Food served in the home has been evidenced to be of a high standard and served in large quantities. Service users again expressed favourable comments regarding the food, and there is positive feedback detailed in the CSCI’s and the home’s service user surveys. The menus are pre-planned and fully represent the preferences of service users. The range of food served is varied and nutritious. Lunch is the main meal, which includes a choice of main courses, with fresh vegetables, and a pudding for dessert being included. The evening meal is always soup and bread followed by a choice of snack meals such as fish cakes, scrambled eggs etc. Service users are able to help themselves to snacks in between meals. Fresh fruit is always provided with bowls of fruit being observed to be available in the communal lounges. Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 19 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 to 18 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home has an appropriate complaints policy and procedure in place. Clear information for raising complaints is made available, and service users and their relatives/friends are encouraged to raise any concerns they may have. The legal rights of service users within the home are evidenced to be well protected and promoted. Service users are encouraged and assisted to vote if they wish. The home’s policies, procedures and practice evidence that service users are being protected from abuse and are living in a safe environment. All staff have now completed statutory adult protection training. EVIDENCE: There have not been any complaints since the last inspection, and none during the last 12 months. The complaints procedure is simple and clear, it sets down the process for managing complains and ensures they are dealt with promptly and effectively. Details are included in the Service User Guide. A complaints book at the home details the outcome of any complaint and what action (if any) was taken. Service users, their relatives/representatives are encouraged to raise any concerns that may arise. Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 20 The inspector spoke to a large number of service users during the inspection. The feedback received indicated that service users feel safe and secure in this home, with staff being perceived as caring and supportive. No adult protection, or any other concerns, were raised, and none have been recorded. The home has a policy on rights. All service users are registered to vote and are supported where necessary to attend the polling station. While none of the current service users feel that they need advocacy services, the home holds information on advocacy services should they be required. Service user files include a “rights assessment” for each service user. This has been designed to ensure that each service user is made aware of his or her rights and that the home has ascertained what this means for each individual. Vulnerable Adult Procedures for the protection of adults are in place, together with the local authority Vulnerable Adults Policy, a copy of which is available in the home. A whistle blowing policy is also in place. Clear guidance is provided to staff about these policies with staff being made aware of the nature of various forms of abuse and the procedures for reporting any suspicions initially to senior staff. The care manager advised the inspector that there is discussion of adult abuse and adult protection procedures within service users’ meetings. A requirement for all care staff to complete statutory adult protection training has now been fully met. The inspector has previously discussed the need for the care manager to attend the ‘training for trainers’ course in adult protection that is run by Croydon Council; this would enable the care manager to cascade the statutory training to staff within the home. A recommendation applies. Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 to 26 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users live in a safe, well-maintained environment, with access to safe and comfortable communal facilities. Risk assessment of the home and individuals are in place for their protection. Service users’ rooms were observed to be safe, comfortable and pleasantly decorated, reflecting service users’ personal identities, and being suited to their individual needs. The home presents as clean, pleasant and hygienic. All staff have now undertaken approved infection control training. EVIDENCE: Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 22 The inspector completed an inspection of the premises. The home presents as safe and well maintained, with spacious communal areas, bedrooms, and garden. The home is laid out over three floors, accessed by lift or stairway. There is a small flight of stairs leading up to the front door. The home was found to be clean, tidy, and in a generally good decorative state throughout. Monthly checks by the management team identify any areas of redecoration required. There has been recent external redecoration of the home, and there is an ongoing programme of internal decoration that has so far included redecoration and re-carpeting of the ground floor lounge, reception area, corridors, stairways and some service users’ rooms. The inspector looked at a number of service users’ rooms. These were observed to be safe and fit for the purpose. These presented as pleasantly decorated and arranged, reflecting individual preferences and tastes. Service users are able to bring personal possessions and items of furniture with them to the home. The inspector spoke to a number of service users, including two who were in their rooms at the time. The views expressed indicated that service users are generally happy with their rooms, and that these are meeting their needs, no concerns being expressed. The inspector spoke to one service user who is sharing a room and established that both service users are happy with this arrangement. Adaptations have been made to various areas of the environment to ensure the health and safety of the service users. One bathroom has an ambu-hoist and grab rails are in place in the other bathroom. The hoist is being serviced on a 3 monthly basis. Handrails are in place on the staircases. Any adaptations or specialist equipment that is needed for service users is assessed by an occupational therapist on an individual basis as and when needed. The home was found to be clean, pleasant and free from any offensive odours. The laundry is sited in the basement, well away from the kitchen. The home has a contract for the collection of clinical waste; however the home is not currently working with anyone who uses incontinence pads. The washing machine has a sluice facility. Policies and procedures are in place to deal with the safe handling of clinical waste. All staff at the home are familiarised with the home’s infection control procedures, and have received approved infection control training. Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 to 30 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home has the numbers and skill mix of staff sufficient to meet the needs presented by the home’s service users, and to ensure their safety. Service users are being protected by the home’s recruitment policy and procedures. The home is now ensuring that it obtains an up-to-date criminal records check for any new staff appointment. Staff are being provided with the necessary induction and training with which to competently perform their work duties EVIDENCE: The inspector examined the staff duty rota. This evidenced that two carers are on duty throughout the day, with one waking, and one sleep- in at night. The inspector understands that an additional care staff member is employed to work during the busiest time of each day. A cleaner is on shift daily. The home does not use any agency staff. Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 24 One new staff member has been recruited and has completed her induction programme. The home has generally thorough recruitment procedures in place. A concern from the last inspection, regarding the failure of the home to have obtained an up-to-date CRB and POVA check for a new staff member, has been addressed, and up-to-date CRB certificates were found to be in place for this and a more recent staff appointment. All other recruitment and identity checks were evidenced to have been satisfactorily completed. The home organises a comprehensive induction programme that is in line with NTO (National Training Organisation) workforce training targets. New induction and foundation standards have been included in the induction. The induction programme is ongoing over a period of six weeks, and comprises both training and observation. The home has a comprehensive programme of staff training, the home’s care manager taking a lead role in this area. Staff are encouraged to study for their National Vocational Qualifications (NVQ) in Social Care, 5 staff currently having an NVQ Level 2, 1 an NVQ Level 3 and 1 an NVQ Level 4. Another staff member is currently studying for an NVQ Level 3. All staff are closely monitored as to their training needs, these being fully discussed within supervision and appraisal meetings. Staff attend training in health and safety, fire safety, first aid, food hygiene, basic infection control, health and safety, manual handling, medication and adult abuse. There has also been recent training in adult protection, risk assessment, and bereavement and loss. Formal training and distance learning is supplemented by practical advice and information sessions from health care professionals, including recent half day sessions from a chiropodist and a dental hygienist. Issues pertaining to good practice and staff development are thoroughly discussed within staff meetings, as evidenced in the very detailed minutes that are recorded. Discussion with staff members on duty indicates that staff feel very well supported by management and that their training and development needs are being fully addressed. Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 25 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 to 38 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home is being managed in the best interests of the home’s service users. The management approach is evidenced to be open and enabling, and conducive to creating a positive and inclusive atmosphere in the home. The home’s quality assurance processes are evidencing extensive consultation with service users, relatives and other parties, and are demonstrating that the home is meeting its aims and objectives. Service users’ financial interests are being appropriately safeguarded. The inspector was satisfied that the health, safety and welfare of service users and staff are being appropriately promoted and protected. All safety checks and certification are in place. Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 26 EVIDENCE: Both the home’s provider manager and deputy manager are very experienced in terms of their qualifications and background, and exemplify a very enlightened, caring and committed approach to managing the home. Throughout the inspection, they were able to demonstrate an in-depth knowledge and understanding of the physical, psychological, cultural and spiritual needs of older people, and a thorough knowledge of the relevant regulations and care standards that apply. These are routinely discussed within staff meetings, staff development being a high priority. There is a comprehensive programme of ongoing support and training for staff. The evidence across all standards inspected is that there is a firm commitment to maintaining standards of good practice in all aspects of the home’s day-today operation, and that the home provides an open, friendly and inclusive environment for its residents. As evidenced in key documents and policies, and observed in practice, this includes a strong commitment to promoting the welfare, independence and rights of the home’s residents. Both service users and staff expressed very positive views regarding the home and the way in which it is being run. Feedback received from residents both verbally, and from questionnaires, was almost universally praiseworthy, no concerns being expressed. The care manager and deputy manager, who were in charge on the day of inspection, were observed to interact well with both staff and service users and to provide a positive model of care and support. Both staff and service users are encouraged to participate in the day-to-day running of the home, with staff and service user meetings being held on a regular, monthly basis. Service users are assisted and enabled to be as independent as possible and to exercise choice and control in their daily routines and activities. Staff members spoken to by the inspector indicated that they feel very well supported by management and enjoy working at the home. The home has been developing its quality assurance processes, with regular canvassing of the views of service users and relatives through detailed questionnaires that have been developed. Service users families are consulted about the conduct of the home and their views are regularly sought by means of the telephone, invitations to reviews, and for some, regular visits to the home, where relatives are able to meet and talk directly with care staff and the manager. At the request of service users ‘formal’ meetings are held on a monthly basis. The home has been developing a quality assurance audit based on the returns from questionnaires and other feedback. This provides a tabulated layout of the audit results and an evaluation of the feedback received. An annual development plan has now been completed, this providing a link with the home’s forward planning. Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 27 Where possible, service users are enabled to retain control over their finances, with all but four service users being independent in managing their own finances. The home maintains records of service user’s monies with all transactions being accounted for with a receipt and a signature. There are secure facilities for the safekeeping of monies kept on behalf of service users. All health and safety checks were evidenced from records to have been completed. These include electrical installation and appliances, hoist and lift maintenance, gas, fire alarms/emergency lighting/call systems, water/ legionella, food hygiene and environmental health. The inspector noted that there are daily checks being completed for water temperatures throughout the home, with thermostatic valves having been fitted. A new boiler was installed at the home on 24/11/04 providing effective and efficient central heating and hot water supply for the home. Fridge and freezer records are also being maintained on a daily basis. Risk and fire risk assessments of the home are being updated on a 3 monthly basis. Risk assessments for individuals are in place for their protection. Approved fire training was last held in June 2005, with the home’s own fire safety training being updated on a 3 monthly basis. Records indicate that fire drills are being held on a monthly basis. Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 28 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 4 4 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 3 3 3 3 3 Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? None 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. 1 Refer to Standard OP18 Good Practice Recommendations Roselands DS0000025830.V297860.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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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