CARE HOME ADULTS 18-65
Rosemerryn 2a Cadogan Road Camborne Cornwall TR14 7RS Lead Inspector
Lowenna Harty Unannounced Inspection 10th February 2006 09:30 Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 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 Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 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. Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Rosemerryn Address 2a Cadogan Road Camborne Cornwall TR14 7RS 01209 610210 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) Spectrum Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 6th September 2005 Brief Description of the Service: Rosemerryn is a home providing accommodation and personal care for up to three adults with a learning disability. It is run by Spectrum, an organisation that provides specialist care in small units for people with autistic spectrum disorders. Spectrum aims to provide its service users with appropriate support in a domestic style environment in a community setting, as far as is possible. Spectrum employs a manager and a team of care staff to work directly with the service users in the home. Senior managers from within the organisation visit as necessary and provide additional support. The home is a two-storey, detached house, located in the town of Camborne. It is set in its own grounds, slightly off the street, within easy reach of the town’s amenities. Service users are provided with their own bedrooms, two of which, are on the ground floor. The home has a communal lounge, separate dining room, conservatory and kitchen. There is a laundry room, two bathrooms and an office. There are no specific adaptations for people with physical or sensory disabilities, but parts of the home could be adapted to assist them, if necessary. Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 10 February 2006. It lasted for approximately four and a half hours. The purpose of the inspection was to ensure that service users’ needs are appropriately met and the placement results in good outcomes for them. This involved looking at documents written for them and about them; an inspection of the home’s environment, time with service users and staff to observe the life in the home, and discussion with the person in charge of the home. The principle method used was case tracking. This involves looking at all the care notes and documents for a single service user and following this through with interviews or observation of them and staff working with them. This provides a useful, in-depth insight as to how service users’ needs are being addressed. At this inspection, two service users were case tracked. There was evidence of considerable improvement in care standards at this inspection as a result of more stable management arrangements and work is continuing to improve it further to provide service users with a safe and comfortable home in which they can develop their skills and independence. What the service does well:
Service users take part in a range of activities in and out of the home, according to their individual needs and interests. They were all involved in different activities at the time of the inspection and staff were available to assist them. They are helped to develop and maintain appropriate relationships with their relatives and other people in and out of the home. Spectrum’s senior managers provide staff with additional support and guidance in this respect. Service users are aware of their rights and responsibilities in respect of their placements in the home through their individual service users’ guides. These set out the expectations of them, including their participation in household tasks to develop their skills and independence.
Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 6 Service users are encouraged to eat a varied and balanced diet so that they maintain good physical health. The service user who was interviewed at the time of the inspection said that they are satisfied with the meals provided to them at the home. Service users are assisted to access a range of NHS healthcare providers to assist them maintain good physical and mental health. This includes specialist service providers if they need them. They are all registered with local primary care services. Service users have written information in their individual placement guides on how they can make their views known and make formal complaints about aspects of their care and services they are not satisfied with. The home provides service users with adequate space and it well located, being near to a town, but slightly off the main road, so that service users have privacy. It is comfortable and homely in most parts inside the building. The home was clean and tidy throughout at this inspection, which was unannounced, and there are good systems and procedures in place to protect service users and staff from infection. The home’s staff are recruited fairly and on the basis that they are suitable safe to work with vulnerable adults in a care setting. The home is kept mainly safe for service users, with suitable tests and checks of safety equipment and training for staff. What has improved since the last inspection?
There is now evidence that admission to the home is on the basis of a detailed assessment of service users’ needs because written assessment information was available for both of the service users whose cases were tracked at this inspection. This includes consultation with people who know them, such as family members and/or professionals working with them in their former placements, so that they can be confident the home will be suitable for them. Service users are now given information about the home and the terms and conditions of their placement, in pictorial and translated formats, if necessary, so that they can read about it for themselves, if they wish. Of the two service users whose cases were tracked at this inspection, one had a detailed written care plan, which addresses all their personal, health and social care needs, including needs relating to their background, culture and religion, which had been shared with their representatives. A similar care plan
Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 7 was in the process of being drawn up for the most recently admitted service user. The home has links with a local advocacy service and one of the service users whose case was tracked had been referred, since the previous inspection. All service users have detailed, written risk assessments and risk management plans to enable them to take risks in ways that are as safe as practicable, to develop their skills and independence. These relate to activities they undertake in and out of the home and clearly set out restrictions that may be necessary to protect them and/or other people. These are shared with service users’ representatives and external professionals involved in their care. All confidential information is now stored securely, in a lockable office. Service users’ daily care records have improved and are completed daily to show how their weekly activity plans are carried out. Information to guide staff on how to protect service users from abuse is more readily available to them so that they can refer to it, should they need to. There are now copies of the multi-agency procedures for each of the service users’ placing authorities, to be used in conjunction with the local multi-agency procedures. Some of the rubbish from outside the building has been cleared away, so that it appears tidier and safer for service users when they make use of the garden and there was no odour of damp in the building at this inspection, which was unannounced. The home’s manager has drawn up a staff-training plan and Spectrum has introduced a new five-day induction programme for new staff so that more staff have the training they need to work safely and effectively. Formal supervision of care staff has improved, with clear records to demonstrate that they are supported to think about and develop their skills and working practices for the benefit of service users. More stable management of the home has resulted in considerable improvements for service users. The home’s current manager is very experienced in working for Spectrum and has formal qualifications in management. He is currently applying to the Commission to be registered as manager. Records are now stored securely and confidentially for service users so that they can maintain their privacy in relation to personal information about themselves, if they wish to do so. Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 8 What they could do better:
Information on service users’ terms and conditions needs to include information on the amount of their fees, so that they are fully informed of their financial liabilities. Newly admitted service users should be provided with written care plans, drawn up in consultation with them and/or their representatives, earlier in their admission. It may be necessary to review and revise their care plans more frequently with them, while they settle into the home, particularly if their needs are complex, but initial plans should be clear to service users within the first week of their placement. Service users who would benefit, should be provided with access to specialist speech and language therapy assessments and treatment so that they can maximise opportunities to communicate with staff working with them. Service users’ written care plans should provide more clear and detailed goals for them to work towards, to help them develop their practical skills and independence as far as is possible. Service users’ written care plans should be provided to them in alternative formats, similar to their statements of terms and conditions, so that they can access the information directly and meaningfully. New service users should be referred for independent advocacy, particularly in situations where their needs are complex, to provide them with external support and advice and oversee their rights. Service users, who would benefit, should be assisted to access dental healthcare services, as not all of them are currently registered with a dentist. There should be clear information from service users or their representatives on their wishes in the event of their becoming seriously ill or their unexpected deaths, so that staff can respect them, in accordance with the home’s written policies and procedures. The home’s written procedures for the protection of vulnerable adults from abuse should be reviewed and updated and the home’s manager should undertake further training in this so that staff are fully informed of current best practice. More work is needed to make the outside of the building attractive and safe for service users, with particular reference to the steps and path at the side of the building. The conservatory is currently being used and needs to be redecorated so that it is more attractive for service users.
Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 9 A greater proportion of the staff team should undertake formal training in how to protect service users and others from infection risks and they should have access to additional specialist equipment for use in emergency situations. More staff should complete training to achieve formal qualifications in care work so that service users can have improved confidence in their knowledge, skills and competence. A greater proportion of them should undertake training in safe handling of medicines to reduce the risks of service users being harmed by medication errors. Service users would benefit from the home’s manager having additional time to complete the outstanding tasks to improve the home further. They and other people, from outside of Spectrum, involved in their care or concerned for their welfare should be more fully consulted about their views on how they would like the home to develop in the short term and the future, as part of the ongoing quality assurance process. Whilst the home is kept mainly safe, there needs to be more consideration of risks to service users from falls, both inside, due to a steep internal staircase and outside, due to the apparently unsafe steps and poorly maintained paths at the side of the building. 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. Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 10 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 Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 2&5 Prospective service users’ needs are assessed so that they can be confident that the home will be suitable to meet their needs. Service users are provided with statements of the conditions of their placements in the home but need improved information on the terms so that they are fully informed of their rights. EVIDENCE: There was detailed, written assessment information available in respect of both of the service users whose cases were tracked. This includes evidence of appropriate multi-agency and multi-disciplinary consultation, where necessary. Assessment information includes consideration of service users’ personal, social and healthcare needs, including needs in relation to their backgrounds, culture and religion and detailed risk assessments to ensure that the home will be suitable for them. There were copies of the home’s service users’ guide, which also functions as an individual contract and statement of conditions for each service user, on their personal files. These are translated into photographic and pictorial formats for them so that they can access the information directly. Service users are not currently given information on the terms of their placement with regard to the amount of their fees, including details of their personal contributions. They must be given this information so that they are fully informed of their personal liabilities. Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 12 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 the following standard(s): 6, 7, 9 & 10 Improvements are needed to ensure that service users are aware of their care plans and are provided with meaningful goals to achieve. They should be provided with more opportunities to make decisions about their lives. They are helped to take risks to develop their skills and independence in ways that are as safe as practicable. Information about them is kept securely and appropriately to ensure confidentiality. EVIDENCE: Of the two service users who were case tracked, one had a written care plan but the other did not. This was in the process of being developed with their multi-disciplinary team at the time of the inspection but there was no interim document, although they had been placed at the home for several weeks. The home’s care plan format considers service users’ personal, social and healthcare needs, including needs relating to their backgrounds, culture and religion. There needs to be improved evidence that service users are consulted as fully as is possible on the contents of their care plans, through assisting them to develop their communication skills, where appropriate and providing them with copies of their care plans in alternative/ translated formats that are meaningful to them. There should be more detailed and specific goals for
Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 13 service users to work towards, particularly in relation to their developing their skills in activities of daily living so that they maximise their independence. Service users are able to make some decisions about their lives, in accordance with their written care plans and risk assessments. There was detailed risk assessment information in respect of the service user whose care plan is in the process of being drawn up with risk management plans in place to ensure their and other people’s safety. One service user had been assisted to access a specialist advocacy service. The most recently admitted service user should be similarly referred, particularly with regard to the development of their care plan and agreement of their risk management plan. There are detailed written risk assessments and risk management plans for each of the service users to enable them to take risks to develop their skills and independence in ways that are as safe as is reasonably practicable in the home’s setting. These are regularly reviewed. Any restrictions needed to protect service users and/ or others are clearly listed in their risk assessment and agreed with their representatives or external professionals involved in their care. The home’s service users’ guide contains a statement on confidentiality to inform service users and their representatives about how they can access their personal records, should they wish to do so. Records are kept securely in a lockable office and are separate for each service user. Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 12, 15, 16 & 17 Service users are provided with access to a range of suitable activities in accordance with their needs and preferences. They are supported and encouraged to maintain and develop appropriate relationships with other people. They are provided with information on their rights and responsibilities in respect of their placements in the home. They are provided with a varied, balanced diet to maintain good physical health. EVIDENCE: Service users engage in a range of activities on an individual basis, in and out of the home. There are sufficient staff to support them in this. Their daily care records back up their weekly activity plans. The home provides them with transport to enable them to access local resources in the community according to their needs and preferences. Service users’ written care plans and/or risk assessments and weekly activity plans address their needs with regard to maintaining and developing relationships with family members and other people. Some service users attend a local social club on a regular basis, with assistance from staff. Spectrum’s senior managers are available to provide support and advice to
Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 15 service users and staff with regard to managing complex issues around personal and social relationships. Service users have information on what is expected of them as residents of a care home. This includes the expectation that they will participate in household tasks such as shopping and cleaning, to help develop their skills and independence and clear information on the house rules. Menu plans and service users’ individual daily records provided clear evidence that they are given a healthy, varied diet of mainly home prepared meals. They are able to access the kitchen to prepare meals and snacks for themselves, depending on their individual risk assessments and staff are available to support them as necessary. The service user who was interviewed said that they are satisfied with the food provided to them at the home. Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 16 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 the following standard(s): 19 & 21 Service users’ healthcare needs are generally well met but a specific need for one of them should be addressed. Service users’ wished in respect of their ageing, illness and death should be ascertained so that they can be respected. EVIDENCE: Service users’ healthcare records provided evidence that they are assisted to access a range of NHS healthcare professionals, according to their individual needs. They are registered with local primary care services and access specialist care services as necessary. One service user should be assisted to access dental care services. There are written procedures to guide staff with regard to management of issues around service users’ ageing, illness and unexpected deaths. They are all young and in good physical health, but their individual wishes should be ascertained so that staff are aware and can respect them, if necessary. Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 17 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 the following standard(s): 22 & 23 There are systems in place to listen and act on service users’ views but specific improvements are needed to improve formal systems for protecting them from abuse, neglect and self-harm. EVIDENCE: Service users’ individual placement guides contain copies of Spectrum’s formal complaints procedure, which informs them of how they can make their views known if they have concerns about the services provided to them at the home. The service user interviewed at the time of the inspection said that they are satisfied with the care and services provided to them. There are written procedures to guide staff on what they should do if they suspect a service user is being abused in the home, which are readily available to staff. This includes Spectrum’s internal procedures as well as the local multiagency procedures and service users’ placing authority procedures. There is evidence that staff are recruited on the basis of safe and effective recruitment and selection procedures and are suitable to work with vulnerable adults in a care setting. The y never work in isolation with service users, who benefit from the team approach. Spectrum’s internal procedures should be reviewed and updated to ensure that staff are informed by the latest guidance and current best practice. The home’s manager should undertake multi-agency training in the protection of vulnerable adults from abuse and cascade this to staff working in the home to fully inform them of how they operate in practice. Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 18 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 the following standard(s): 24 & 30 The home is comfortable but needs improvement to make it more attractive and safer for service users. There are good systems in place to ensure the home is hygienic, subject to a specific improvement, so that service users and staff are protected from the spread of infections. EVIDENCE: The home is a domestic-style building, which is comfortably furnished and well decorated inside. There have been ongoing improvements, including the provision of new kitchen units and refurbished, improved bathroom facilities. The conservatory, which was not being used at the last inspection, has been opened up as a storage/ activities area for service users, but it is tatty and unattractive and should be re-decorated and tidied up for them. Risk assessments need to be made of the internal staircase, which is quite steep and the external steps next to the conservatory, with action plans to protect service users from avoidable injuries. There has been some improvement to the outside of the building, but further work is needed to make it safer and more attractive for service users. In the meantime, risk assessments need to address specific hazards effectively. Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 19 There are clear, written instructions for staff on infection control in the home and they are provided with training in this. There are plentiful stocks of protective equipment although staff should also have a stock of protective masks. There are suitable procedures and facilities for dealing with heavily soiled laundry to protect service users and staff from risks of infection. The home appeared clean and tidy throughout at the time of the unannounced inspection and at this inspection there was no odour of damp anywhere. The home’s manager said the source had been identified and the problem dealt with. More staff should undertake training in infection control, so that there is at least one person with this training on duty at most times. Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 A greater proportion of the staff team needs to achieve qualifications so that service users have confidence in the people who care for them. Staff are recruited on the basis of fair, safe and effective recruitment practices so that service users can be confident they are suitable to work with them. Staff have good access to ongoing training although some improvements are needed. Staff are well supported and supervised to provide a good standard of care to service users. EVIDENCE: Staff records indicate that of a team of 15 care staff only one has achieved formal qualification to NVQ level 2 or above although a further two are undergoing final accreditation. Nevertheless, this falls far short of the recommendation in the National Minimum Standards that at least half the staff team should be qualified. Records held in the home indicate that staff are recruited on the basis of written applications, standard interviews in accordance with equal opportunities legislation and best practice and that checks required by law are completed before they start work. Staff are recruited on the basis that they are suitable and safe to work with vulnerable adults in a care setting. The home’s manager has drawn up a staff-training plan and ensures that staff have regular access to ongoing training provided by Spectrum. All new staff now undertake a five day induction course, which covers most aspects of safe
Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 21 working practices and essential information to enable them to work with service users in a specialist setting. Because of the size of the staff team, there is usually a good skills mix among the people working in the home although, as previously mentioned, there should be a greater proportion of staff with infection control training. Staff should also undertake training in the safe handling of medicines to better protect service users from medication errors. There are written records to show improved formal supervision of care staff, both individual 1:1 records and records of team and house meetings. The home’s manager works alongside staff and has opportunities to observe their work in practice on a day-to-day basis. Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 22 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 & 42 The home is mainly well run for the benefit of the service users, subject to a specific improvement. Systems to ensure their views are formally considered need improvement. Records are safely and appropriately maintained for the welfare and protection of service users. The home is kept mainly safe for service users, subject to some specific improvements to reduce risks of accidents. EVIDENCE: The home’s current manager is in the process of applying to be registered with the Commission. He has already made some notable improvements since the previous inspection, is qualified to NVQ level 4 in management and regularly undertakes training to update his knowledge and skills. He would benefit from additional management time, off the working rota, to complete the outstanding requirements and recommendations. The home’s manager has drawn up an annual development plan for the home, which includes specific budgets for housekeeping and service users’ activities and there are records of regular visits to the home by Spectrum’s senior
Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 23 managers to monitor the quality of the care and services provided at the home. There is a lack of evidence of independent input to the quality assurance process, however, by external stakeholders, such as professionals working with service users from outside of Spectrum and their relatives or advocates. Records reviewed at this inspection appeared to be up-to-date, were clear and well written and kept separately from each other. Personal records were locked away in a lockable office to ensure confidentiality for service users. Written environmental and fire safety risk assessments are complete and upto-date. There is improved evidence that staff are adequately trained to maintain a safe environment for themselves and service users, particularly with the introduction of the new induction training. The home’s written risk assessments should be updated, however, to address risks of falls on the steep internal stairs and the apparently unsafe external steps and paths. Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 24 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 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 2 X 2 3 X 2 X 3 2 X Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA5 Regulation 5(1)(b) Requirement Service users must be provided with written information on the terms of their placements in the home, including the amount of their fees. The external areas of the home must be made safe for service users, including external steps and walkways. The conservatory must be redecorated. The home’s quality assurance process must provide for consultation with service users and their representatives. Timescale for action 01/04/06 2. YA24 13(4) 23 23 24(3) 01/06/06 3. 4. YA24 YA39 01/06/06 01/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA6 YA6 Good Practice Recommendations Newly admitted service users’ care plans should be drawn up with them within the first week of their placement in the home. Service users who would benefit, should be assisted to
DS0000009117.V282896.R01.S.doc Version 5.1 Page 26 Rosemerryn 3. YA6 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. YA6 YA7 YA19 YA21 YA23 YA23 YA30 YA30 YA32 YA35 YA37 YA42 access specialist speech and language therapy services. Service users’ individual care plans should contain more specific and detailed goals to assist them to develop their skills and independence in practical activities of daily living. Service users’ care plans should be available to them in alternative formats, which provide them with meaningful information in a direct way. Service users should be provided with routine access to independent advocacy services. Service users, who would benefit, should be assisted to access dental care services. Service users’ wishes in the situation of their developing a serious illness or in the event of their death should be included in their care plans. The home’s written procedures for the protection of vulnerable adults from abuse should be reviewed and updated. The home’s manager should undertake multi-agency training on the protection of vulnerable adults from abuse and cascade this to staff working at the home. Staff should be provided with protective masks for use in emergency situations, to prevent infection risks. A greater proportion of the staff team should undertake training in infection control. The proportion of staff qualified to NVQ level 2 should be increased towards achieving the 50 level indicated in the National Minimum Standards. All staff handling medicines should undertake training in doing so safely. The home’s manager should be provided with sufficient management time to complete work towards fully achieving the National Minimum Standards. The home’s written risk assessments should address specific risks to service users using internal stairs and external steps and paths, which may present hazards due to falls. Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
© 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 Rosemerryn DS0000009117.V282896.R01.S.doc Version 5.1 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
