Inspection on 27/06/05 for Roselands

This inspection was carried out on 27th June 2005.

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 12/01/07

Roselands 28/11/05

Roselands 14/12/04

Roselands 13/09/04

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Southfields

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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 CT6 6QF Lead Inspector Wendy Gabriel Announced 27/06/05 at 09:15 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. Roselands H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Roselands Address 50 Reculver Drive, Beltinge, Herne Bay, Kent, CT6 6QF 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) 01227 360738 Mrs Julie Ann White-Fort Mrs Christine Margaret Fagg Registered Care Home 15 Category(ies) of Learning Disabilities x 15 registration, with number of places Roselands H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14/12/04 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 prefering a quieter or slower pace of life. Roselands is situated in Beltinge, a seaside village on the outskirts of Herne Bay. The Home is a detached two storey property at the end of a lane overlooking the sea. The Home has its own vehicle, enabling Service Users to be taken to various sources of recreation. The gardens are mainly to the side and rear of the property, and at the time of the inspection, a large surrouding wall was being renewed. There is limited parking space within the grounds but a municipal car park is directly opposite the Home. The Providers have applied to change the registration from Learning Disability to Learning Disability and Dementia, to more fully reflect the care offered at Roseland’s. Roselands H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. At the announced inspection of Roselands, the Inspector was pleased to be introduced to the residents as a matter of priority. During the course of the day the inspector observed the staff integrating with the residents and communicating in an appropriate and friendly manner. Several residents showed the Inspector their bedrooms and pointed out favourite items such as their artwork on display on the walls. The home was seen to be comfortably and attractively furnished and presented a light, clean and homely environment. The Inspector received several comment cards from families and friends of residents in Roselands. Comments included; “(resident) continually tells us how happy she is – her welcome has been wonderful”, “I am very satisfied with the care given to (resident)”,”cannot fault Roselands in any way, staff are so caring and dedicated”, “so grateful for the kindness shown to (resident) - is enjoying a very good quality of life”,”(resident) has improved in leaps and bounds”, ”would put a value of 11 out of 10, more than I could ever have hoped”, Another stated that their relative had been ill in hospital and the staff had maintained a visiting rota and he considered that this had been over and above the staff normal call of duty. One relative commented that the transport had recently been withdrawn. When asked about this, the Registered Manager said that the original vehicle is to be replaced by a new vehicle with special wheelchair access facility but in the meantime vehicles were borrowed from the sister home belonging to the same Registered Owner. Staff training was discussed and the Inspector was informed that the NVQ training provider had unfortunately gone into solvency and that the Registered Owner was actively seeking a suitable replacement to continue their commitment to NVQ training. Not all the staff had undertaken the mandatory training required by the Commission for Social Care Inspection; but the Registered Manager confirmed that courses were being sought and some had been booked for the near future. A member of staff confirmed the Registered Owners’ commitment to training and said that courses on specialised needs such as dementia, stroke, diabetes and epilepsy are undertaken. Some residents have dementia and the Inspector observed that the staff attitude to the very complex needs of the residents to be one of inclusion and enabling. Various activities were underway including drawing, watching a musical on the large tv, walking in the garden and going out to a club for one resident. Further environmental risk assessments to the home and grounds are to be completed and storage of toiletries in the en-suites is to be risk assessed according to the individual needs of residents. There is an ongoing redecoration programme for the home and a bathroom is to be converted to a shower room. Roselands H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 6 What the service does well: What has improved since the last inspection? What they could do better: NVQ training has been delayed due to circumstances outside of the homes’ control, however, a new source for training is being organised and the Registered Owner will be able to resume getting the full complement of staff NVQ trained. Not all the staff had completed all of the mandatory training but further courses were being sought. Further environmental risk assessments are to be identified. Roselands H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 7 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 H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 8 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 Roselands H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 9 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) 1-6 Prospective residents are given suitable information and invited to visit the home to enable an informed choice to be made about living there. A contract of terms and conditions is give to residents or their families. EVIDENCE: Suitable written information about the home is given to residents and their relatives. Prospective residents are invited to visit the home on a regular basis before a final decision is made to become a permanent resident. This gives the resident and their family/supporter the opportunity to get to know the other residents, the staff and the home. The inclusion of family and other previous carers allows the home to assess if they can meet the physical and emotional needs of the resident. There is ample evidence of pre admission assessments by the home and other involved Health care professionals. The Registered Manager said that they had so far, been given a great deal of back up from family and previous carers of new residents to the home. A statement of terms and conditions is given to residents or their families upon admission. Roselands H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 10 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) 6-10 The care planning system is clear and consistent to provide staff with suitable information to meet residents’ needs. Risk assessments support residents to achieve their individual choices. Confidential information is held securely. EVIDENCE: Care plans are compiled by the Registered Manager and key worker to the resident after a settling in period and are informative about personal, social and health care. There was ample written evidence of residents having access to Health care professionals. There was evidence of quarterly reviews of the care plans or more often as the need arose. Reviews, supported by family, community nurse, physiologist and care manager as appropriate are included in the care plans. Risk assessments are undertaken on different aspects of individual residents needs. A requirement for further risk assessments regarding storage of toiletries in ensuite bedrooms was made. All confidential information is held securely in a locked office and is available on a need to know basis. Staff were observed engaging with residents in a suitable manner to meet different communication needs. It was evident by observing residents that they trusted the staff supporting them as the gentle chatter and huge smiles Roselands H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 11 confirmed. The Inspector was delighted to be greeted so warmly by residents as she was introduced to them. Roselands H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11-17 Residents are offered a variety of social and community opportunities. Families and friends are welcomed to the home. Dietary needs are well catered for to meet different choices and requirements. EVIDENCE: Roselands aims to provide a quieter pace of life for older people with learning disabilities. However, the Registered Manager and staff were very clear in stating to the Inspector that dementia and old age should not be a barrier to the right to participate in different activities. Activities at the home include a singer/entertainer who visits 6 times a year. The Registered Manager said families and friends are invited and a party arranged to accompany the entertainment. Residents would be encouraged to dress up in their best clothes to make the event special. Parties for Burns night, Easter and Christmas are also arranged. Communion is brought into the home for identified residents’. Ad hoc celebrations take place as when the staff arranged a picnic tea in the garden to ‘celebrate’ the last days of summer before the storms that had been forecast appeared. The home has transport that, at the time of the inspection, was in the process of being renewed to enable better wheelchair access. Roselands H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 13 Residents enjoy trips to local community events, the pub for fish and chips and individual residents go to the Umbrella club and Day Opportunities School (previously known as Centre). Residents have ‘pen pals’ and they exchange picture postcards, often of places they have visited. Families are invited to many events and are welcomed into the home to try to enhance the ‘family’ environment that is the ethos of Roselands. Meals are chosen from a four weekly menu and staff are aware of the usual likes and dislikes of individual residents. The menu offers a choice of meals and special diets are catered for. Roselands H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18-21 The health, personal and emotional needs of residents are identified and well met with evidence of good multi disciplinary working. The Medication system will be improved by suitable training for more staff and provision of up to date British Pharmaceutical society administration advice. EVIDENCE: Details of personal support for residents’ are recorded in the individual care plans. These include details of emotional, physical and health care needs. Residents are referred to appropriate specialists when potential problems are identified. The Registered Manager said that support is available from a psychiatrist and psychologist and evidence of this was seen. Medication is provided on a monitored dosage system. The home is to obtain a copy of the British Pharmaceutical society ‘The Administration of medicines in care homes’. In the meantime the Inspector gave the Registered Manager a small version of the same document. The Registered Manager stated that only three people including herself are trained to administer medication and the Inspector recommended that further training be sought for other staff in the event of those persons being unavailable. The Inspector recommended further training courses are sought other that the supplying pharmacist training. Medication training certificates were not seen for this standard at this time. A requirement was made for specimen signatures to be obtained of the staff who Roselands H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 15 administer and sign for medication given. Medication administration records are otherwise well maintained. The Registered Manager stated that the home aims to provide care for residents who are terminally ill with advice and support form GP, District Nurse and other Health care professionals as required. Residents would only go to hospital if the Health care professionals recommended it as the only course of action. Roselands H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 16 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) 22-23 The home has a satisfactory complaints procedure. Procedures and training for addressing adult protection issues are in place. EVIDENCE: There is a complaints procedure in the home including an assurance that all complaints will be responded to within 28 days. The Inspector suggested that the simple, clear and concise complaint procedure on display in the home be used in place of the basic written procedure currently used in the statement of purpose. No complaints have been received or recorded since the previous inspection. A member of staff said that there are residents meetings. Care plans indicate residents’ individual choices and likes and dislikes. Workshops for staff on understanding adult abuse are undertaken and a suitable policy specific to the home is maintained. Further information on adult protection has been received by the home. The Registered Manager agreed with the Inspectors’ suggestion that this might be reviewed to ensure that only the sections pertinent to staff be made available to them; as much of the new information is for management purposes only. A whistle blowing policy could not be found at the time of the inspection and the Registered Manager said that there is one available and agreed to provide evidence of it by 4th July 2005. Roselands H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 17 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 Recent investment has significantly improved the facilities of this home creating a very comfortable, attractive and safe environment for residents. Bathrooms and bedrooms are private and hygienic. EVIDENCE: The home is presented in a very comfortable and homely manner. Decoration and soft furnishings are of a very good quality and the entire home was seen to be clean and bright and hygienic. Several bedrooms have en-suite facilities and there are adequate bathing and toilet facilities. Bedrooms are individual and cosy. Some specialized equipment is available for identified residents’ including bedrails. The Registered Manager said that this year one bedroom is to be completely redecorated and a bathroom is to be converted into a shower room. One resident told the Inspector that he liked being in his bedroom and that on the day of the inspection he had had enough of being outside and was happy being quiet in his room. He also pointed out his artwork that was on the bedroom walls and that he enjoyed undertaking. There was evidence in his room of equipment to enable him to enjoy his hobby. Roselands H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 18 All rooms contain personal items that make each room individual and reflect the likes and dislikes of residents. The communal areas are spacious and light with different areas for dining, relaxing and watching t.v. The garden is in the process of having a large surrounding wall rebuilt. Some flowerbeds had been removed and had been covered with turf. The building works had been suitably guarded for safety. The premises overlook the sea and are in keeping with the local community. The laundry equipment meets the temperatures required for safe infection control. Residents were seen accessing various parts of the home including bedrooms during the time of the inspection. Roselands H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31-36 The staff has a good understanding of residents’ needs. Recruitment policies are in place and have been carried out. Training needs are identified, however, due to instances outside of the homes control, further training is required to meet this standard. EVIDENCE: The home employs suitable recruitment and employment policies. Job descriptions are in place. The Registered Manager informed the Inspector that the home uses a TOPSS accredited induction system for new staff. The rota was noted to be fully covered and there were sufficient staff in the home on the day of the inspection to meet the individual needs of the residents’. Staff training was discussed and the Inspector was informed that the NVQ training provider had unfortunately gone into solvency and that the Registered Owner was actively seeking a suitable replacement to continue their commitment to NVQ training. Not all the staff had undertaken the mandatory training required by the Commission for Social Care Inspection; but the Registered Manager confirmed that courses were being sought and some had been booked for the near future. A member of staff confirmed the Registered Owners’ commitment to training and said that courses on specialised needs such as dementia, stroke, diabetes and epilepsy are undertaken. Staff spoke with great enthusiasm about working in the home and being able enabled by the management ethos of the home to meet the needs of the residents’. Roselands H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 20 Staff supervision is regularly undertaken and recorded appropriately. Warm and friendly interaction was seen between residents’ and staff during the day. Roselands H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37-43 Residents’ benefit from a well managed home. Health and safety is promoted by suitable policies and regular maintenance. Residents rights are respected through reviews and care planning. EVIDENCE: The Registered Manager has been in post for over a year and previously had a senior management post within the group; she is currently completing her NVQ4 and stated she is keen to promote further training for the staff. The Registered Manager and the Registered Owner are supported by staff who demonstrate an awareness of their roles and responsibilities. The Registered Owner visits the home several times a week and staff said that she has regular contact with both the residents’ and the staff. Resident’s rights are sustained through regular reviews including the input on Health care professionals. As indicated in the summary; comments from relatives and friends were positive and complimentary about the care given to the residents’. Roselands H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 22 The Registered Owner and the Registered Manager maintain health and safety records and as far as is reasonably practicable ensure the health safety and welfare of the residents’. Maintenance certificates were viewed and seen to be in date. The fire precautions checks were kept up to date. The homes insurance certificate was in date. The Registered Manager agreed to seek advice about the viability of fire door strips that may have been painted over during redecoration. The Registered Manager stated that the Registered Owner would allocate funds for any reasonable request to provide facilities for the residents’. Roselands H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Roselands Score 3 3 2 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 24 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. 4. Standard 9 42 20 35 Regulation 12 12 12 18 Requirement Timescale for action 01.07.05 Risk assess storage of toiletries in en-suite bedrooms Environmental risk assessments 01.10.05 to be increased. Specimin signatures of staff who 28.06.05 administer medication are to be obtained. Further training as identified is to 01.10.05 be arranged. 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. 3. 4. Refer to Standard 20 20 23 42 Good Practice Recommendations A copy of the British Pharaceutical society The administration of medication in care homes is to be obtained. More staff to be suitably trained with a recognised course to administer medication. The whistle blowing policy is to be shown to the inspector by 4th July 2005. Advice to be sought regarding fire door strips. Roselands H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent, TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Roselands H56-H05 S45738 Roselands V225719 270605 Stage 4.doc Version 1.30 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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