CARE HOME ADULTS 18-65
Rosemerryn 2a Cadogan Road Camborne Cornwall TR14 7RS Lead Inspector
Lowenna Harty Unannounced Inspection 13th June 2006 09:30 Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 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.V300024.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 10th February 2006 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 adults with autistic spectrum disorders. Spectrum aims to provide its service users with appropriate support in a domestic style environment in a community setting. Spectrum employs management and care staff to work directly with service users in the home. Senior managers from within the Spectrum organisation visit the home as necessary and provide additional support. The home is a two-storey, detached house, located in the town of Camborne. It is within easy reach of all the towns amenities and is set in spacious grounds, slightly off the street. Service users are provided with single rooms. They have access to a lounge, separate dining room and kitchen. The home has a laundry room, three bathrooms and office accommodation for staff. There are no specific adaptations for people with physical or sensory disabilities and not all parts of the home are wheelchair accessible, but the home has two bedrooms on the ground floor and some adaptations could be made if required. Fees range from £813.00-£7084.00 per week according the home’s manager at the time of the inspection. Service users are charged extra for certain activities, such as massage and trampolines, private chiropody, hair dressing, alcoholic drinks and are expected to pay some contributions towards leisure activities outside of the home. Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an annual key inspection, which took place on 13 June 2006 and was unannounced. It lasted for approximately six hours. Information about the home received by the Commission since the previous inspection was taken into account when planning the inspection. The purpose of the inspection was to ensure that service users’ needs are appropriately met in the home, with particular regard for ensuring good outcomes for them. This involved interviews with them and observation of the daily life and care provided. There was an inspection of the home’s premises and of written documents concerning the care and protection of the service users and the ongoing management of the home. Staff were interviewed and observed in relation to their care practices and there was a discussion with the home’s manager. The principle method used was case tracking. This involves examining the care notes and documents for a select number of residents and following this through with interviews with them and/or their relatives and staff working with them. This provides a useful, in-depth insight as to how residents’ needs are being met in the home. At this inspection, all three of the service users were case tracked. There was evidence of ongoing improvement in care standards at this inspection 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:
Admission to the home is based on a detailed assessment so that service users can be confident it will be suitable for them. They are provided with written information about the home, what it provides and what is expected of them, which is available in translated formats so that they can access it directly, if they wish. Most service users have detailed written care plans, which set out how the home will meet their personal, health and social care needs, including needs relating to their individual backgrounds and culture, age, sex, religion, individual abilities and sexual orientation. These are regularly reviewed and
Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 Page 6 shared with their representatives so that they can be kept informed of their progress in the home. Staff help them to make important decisions about their lives, such as what clothes to wear and how to spend their personal allowances so that they dress appropriately for the weather and enjoy a good quality of life. They are supported and encouraged to take risks to develop their skills, independence and confidence, but in ways which are safe for them and other people. Service users enjoy a very good quality of life in the home. Staff support them to take part in a wide range of activities in the community, including college courses and trips out to places that they enjoy. They are encouraged to go out to a local social club one evening a week and to maintain valued relationships with their friends and families outside of the home. Staff support service users with their personal care so that they look smart and fashionably dressed, which they and their relatives appreciate. They are helped to access a range of NHS healthcare providers, such as doctors, opticians and community nurses so that they maintain good general health and d receive any specialist services they need. Their medicines are safely stored in the home and accurate records are kept when they are given to service users so that there is a reasonable level of protection from medication errors. . Service users and their representatives said that they are safe and well cared for in the home and there is a genuine commitment among the staff team to ensure their welfare and protection from abuse. The home is well located so that service users have both privacy and good access to the local town. It provides them with a comfortable, homely and mainly safe environment, with plenty of individual and communal space. The staff team is selected fairly and on the basis that people employed to work in the home are fit and suitable to work with vulnerable adults in a care setting so that service users and their representatives can have confidence in the people caring for them. The home is well and competently managed for the benefit of the service users. The manager is in the final stages of his application to be formally registered with the Commission so that service users can be confident that he is fit and competent to be in day-to-day charge of the home. Service users appeared to be settled and happy in the home and their relatives and representatives confirmed that they are well placed there. The home’s manager has formal systems in place to review the quality of the service so that service users’ needs and feelings are paramount. Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better:
Service users and/or their representatives should be provided with improved information on the cost of their placements in the home, including clear information on how the contributions they make are calculated so that they are made fully aware of their financial rights and obligations. Not all of the service users currently have written care plans relating to their placement in the home so that they can be clear about why they are there and their needs will be met. More should be done to make them meaningful to those that do have them, such as provision of information in translated formats that they can directly access. They would also benefit from being provided with more detailed and specific goals so that they and their representatives are better informed of their progress and achievements in the home.
Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 Page 8 Not all staff who handle service users’ medication had undertaken any more than basic, in-house induction to enable them to do this. They should be provided with formal training in the safe handling of medicines, so that they and service users can be confident that they are adequately trained to undertake this important aspect of their work safely. Spectrum’s written procedures to guide staff on how to ensure that service users are protected from abuse should be reviewed and updated and the home’s manager should attend multi-agency training on the protection of vulnerable adults to enhance systems already in place to ensure service users’ welfare and best interests. The carpet in the dining room is stained quite badly and should be cleaned or replaced and ventilation in a service users’ bedroom should be improved so that they have a healthier atmosphere in their private accommodation. Of particular concern, is the state of the path on the outside of the building, which is very worn and uneven and had a hole in it, so that service users are protected from risks of falls. The proportion of staff who have formal qualifications should be increased so that service users can have confidence that sufficient numbers of people working with them have been assessed as competent to do so. Staff training records should be improved so that the home’s manager can effectively monitor their training needs and they should be provided with formal supervision, with records kept so that service users can be assured that properly trained and supervised staff care for them at all times. Whilst the home is mainly safe so that the welfare of service users and staff is protected specific risks were noted during the course of the inspection, which should be included in the manager’s risk assessment of the premises and the home’s fire safety risk assessment needs to be reviewed. 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.V300024.R01.S.doc Version 5.2 Page 9 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.V300024.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area is adequate. Service users’ needs are assessed prior to their admission to the home to ensure that it will be suitable for them and they are provided with written statements of the terms and conditions of their placement in the home so that they are informed of their rights and obligations, but this does not include clear information about the cost of their placements or how their individual contributions towards it are calculated. EVIDENCE: The home’s manager said that there had not been any recent or planned changes to the service user group and this was observed at the inspection. There was written assessment information for all three. This was detailed and included clear information on their health, personal and social care needs, including needs relating to their individual abilities, language and communication skills, cultural and ethnic backgrounds, religion, sexual orientation, relationships and age, so that they and their representatives could be confident it would be a suitable placement for them. Service users are provided with written statements of the terms and conditions of their placement, in translated formats, so that they can access the information directly. This is shared with their representatives and relatives. This information does not include the total cost of their placement or a detailed breakdown of how their personal contributions towards the total cost is calculated to provide them with clear information about their welfare rights. Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 Page 11 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 Quality in this outcome area is adequate. Improvements are needed to ensure that service users are consistently provided with care plans that are meaningful to them and provide them with clear goals, so that they and their representatives can monitor their achievements. They are helped to make decisions and take managed risks so that they can develop their skills and independence. EVIDENCE: The current standard care plan format used considers service users’ health, personal and social care needs, including needs relating to their background, culture and ethnicity, individual abilities, age, sex, sexual orientation and religion, but were not in place for all of them. There is clear evidence that they are regularly reviewed, where they are in place and service users’ representatives and relatives confirmed this. Referrals have been made for service users to access speech and Language therapy and independent advocates so that they can either be more directly involved in the care planning process or have input from someone independent to the service, although they are still waiting for these services. They should be provided with more detailed and specific goals as part of their care plans, so that they can
Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 Page 12 monitor their progress and achievements, and be provided with them in alternative formats so that care plans are made as meaningful as possible for them, as they currently have little awareness of them. The manager said that service users have been referred to speech and language therapists via the NHS and an independent advocacy service so that they can be supported to make choices or have representation external to the home, although they have not yet received these services. In the meantime, their care plans address their abilities to make choices independently and staff provided examples of how they assist service users to make appropriate choices such as suitable clothing for the weather and how to budget their personal finances, if they need support with this. Service users have detailed written risk assessments, which their relatives and representatives said are shared with them. These have been improved so that they are more relevant to individual service users and relate to specific activities they engage in so that they can develop their skills and independence in ways that are safe for them and other people. Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 Page 13 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, 13, 15, 16 & 17 Quality in this outcome area is Excellent. Service users access a wide range of activities, in accordance with their individual needs and preferences, so that they develop their skills and independence. They access the local community and are supported to maintain valued relationships with their friends and relatives so that they are not isolated and they enjoy a good quality of life. Their rights and responsibilities are recognised and promoted as far as is practicable and they are well fed so that they stay physically healthy and enjoy their meals. EVIDENCE: At the time of the inspection, service users were engaged in a range of different individual activities and there were sufficient staff to support them to do this. Their individual needs and preferences are considered as part of the assessment and/or care planning process so that they can be provided with activities that are appropriate for them. They have information, in pictorial formats about the different activities available to them so that they can plan and choose what they will do each week with staff. Service users were continuously in and out of the home during the inspection, going to college and on drives and walks in the local community, with staff.
Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 Page 14 Their daily care records confirm that they make use of a wide range of community resources, including local fairs, cafes, pubs and shops. Their relatives confirmed that they lead full, busy and active lives. All three service users attend a social club in the community once a week, so that they have opportunities to meet people from outside of Spectrum. There are records of their contact with their families, including regular visits home, or visits from relatives to them at Rosemerryn, which their relatives confirmed. Needs in relation to their developing personal relationships are considered as part of the ongoing assessment and care planning process, including specific risks. Senior managers from Spectrum provide support and work with external specialist providers with detailed records maintained so that care staff are kept informed of how to support service users appropriately. Service users rights and responsibilities are clearly set out in their individual service users’ guides, in written and translated formats, so that they are informed of what is expected of them The home’s manager has taken steps to help service users to access independent advocacy services, particularly where they do not have close relatives to support them on a regular basis. Service users said that they like the food provided to them at the home and they appeared to enjoy their mealtimes. Staff support them according to their individual needs and abilities and they are able to independently access the kitchen, depending on their individual risk assessments. There are clear records of food provided to service users so that staff can monitor their nutritional intake and encourage them to eat healthily. Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 Page 15 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): 18, 19, 20 & 21 Quality in this outcome area is good. Staff help service users to maintain good personal care so that they look smart and well cared for. They are assisted to access the healthcare services they need so that they can stay well and enjoy their lives. Some improvements are needed to ensure that they are protected from medication errors. Progress is being made to ascertain the wishes of all the service users in the event of their aging, illness or death, so that they can be respected. EVIDENCE: Service uses looked smart and well cared for and staff were observed assisting them with their personal care during the inspection. There are detailed instructions for care staff on how to support service users with their self-care so that they can develop their skills and independence. The relative of one service user remarked on how smart he always appears, and how he appreciates this. The home’s records show that service users are helped to access a range of NHS healthcare providers to maintain good general health and specialist services according to their individual needs. This has had a great impact on the life of one service user, which he and his relatives remarked on during interviews. Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 Page 16 The home has safe arrangements for the storage of medicines and was observed to be safely and properly administered to a service user during the inspection. Staff have clear written guidance and records of medicines administered were clear and up-to-date. The manager has undertaken training in the safe handling of medicines and a small proportion of the home’s staff have attended a brief course run by a pharmacist, but most have only undergone in-house/ induction to the safe handling of medicines so they are not sufficiently trained to ensure that service users are protected as far as possible from medication errors. The home’s manager said that he is in the process of consulting with service users’ relatives and representatives to ascertain their wishes in the event of their aging, serious illness or deaths, so that their wishes can be respected. So far information has been returned on behalf of one of them. Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 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 Quality in this outcome area is good. There are formal and informal systems in place so that service users’ views can be taken into account in the day-to-day running of the home. Service users’ welfare and best interests are protected but some improvements should be made to the formal systems that underpin this. EVIDENCE: Service users, their relatives and representatives said that they are well cared for when interviewed. They are provided with the home’s written complaints procedure in translated formats as part of the home’s service users’ guide, so that they have information on how to make formal complaints if they wish to do so. There have not been any formal complaints made to the home since the previous inspection. Service users said that they feel safe in the home during interviews and they appeared to be happy and comfortable in the home. Care staff are recruited on the basis that they are fit and suitable people to work with vulnerable adults in a care setting. Staff never work in isolation with service users and there appeared to be a strong team spirit among them. Individual staff interviewed during the inspection demonstrated a strong commitment to protecting service users’ welfare. The home has copies of the multi-agency procedures for protecting vulnerable adults from abuse from the local authority and service users’ placing authorities so that staff have information on what they should do if they suspect a service user is being abused, but Spectrum’s internal procedures should be reviewed and updated and the home’s manager should attend multi-agency training so that he can gain familiarity with the ways in which organisations work together locally to protect vulnerable people.
Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 Page 18 Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 Page 19 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, 26 & 30 Quality in this outcome area is adequate. Whilst the home provides mainly suitable accommodation for service users, further improvements are needed to make it safer and more comfortable for them. The home is kept clean and tidy and good hygiene is maintained so that service users and staff are protected from infection risks. EVIDENCE: Service users appeared to be comfortable and happy in the home and their representatives said that it provides them with a good environment. It is well located so that it offers privacy as well as good access to the local town. It is an ordinary, domestic building so that service users live in a noninstitutionalised environment in which they can develop their skills and become more independent. It is well decorated and spacious and furnishing in the living room has improved since the previous inspection. The conservatory is no longer in use because it requires major refurbishment, but service users have sufficient communal space without it. The carpet in the dining room needs to be cleaned or replaced because it appears worn and stained. The outside of the building needs attention, particularly the path at the side of the house, which is very cracked and worn and had a hole in it, covered over by a plank of wood and a concrete brick. This represents a trip hazard, as well as looking unsightly.
Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 Page 20 Service users have individual, comfortably furnished bedrooms, which they are able to personalise according to their own tastes. They have lockable bedroom doors with keys, depending on their individual risk assessments. The manager is in the process of reviewing and revising their risk assessments in this respect. Ventilation in a service users’ bedroom needs to be improved so that they have a healthier atmosphere in their private accommodation. The home appeared clean and tidy throughout at the time of the inspection, which was unannounced. There are systems in place to ensure good hygiene and staff were observed using hygiene equipment provided. There are satisfactory systems in place to manage heavily soiled materials, which may represent an infection risk. Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 Page 21 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 Quality in this outcome area is adequate. Less than half of the staff team are qualified to the level recommended in the National Minimum Standards so that service users can have confidence that people working with them are competent to do so. Staff are recruited fairly, safely and effectively on the basis that they are suitable to work with vulnerable adults in a care setting. They have good access to ongoing training, but organisation of this needs to be improved so that the home’s manager can be sure they all have the training they need to be able to work safely in the home. Staff are well supported but should be provided with more regular, formal supervision so that service users can be assured that they are properly supervised. EVIDENCE: According to the manager and records held in the home, slightly less than the recommended 50 of care staff are qualified to NVQ level 2, although this situation should improve as more staff are due to complete it in the near future. Records in the home indicate that staff are recruited on the basis of fair, safe and effective recruitment policies and practices. Staff interviewed and the manager confirmed this at the time of the inspection. Care staff currently have individual training records and those interviewed during the inspection confirmed that they have good access to training on an ongoing basis, including structured induction training. The manager has not yet
Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 Page 22 completed a whole team training plan, which he should do, particularly in light of the size of the staff team, so that he can monitor staff training needs and ensure a suitable mix of appropriately trained staff is on duty at each shift. Records of individual one-to-one supervision of care staff were out-of-date. The manager said that he plans to improve this, when a recently appointed deputy manager commences work in the home shortly. Staff interviewed said that they felt well supported by the home’s manager. Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 Page 23 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 & 42 Quality in this outcome area is adequate. The home is well managed, for the benefit of the service users living there. Planning and development of the service is based on service users’ needs and views. Further improvements are needed to ensure that the home is safe so that service users are adequately protected from obvious hazards and potential accidents. EVIDENCE: The home’s manager is currently applying to be registered with the Commission. The application is nearing completion and there is sufficient evidence that he is qualified, competent and fit to manage a care service. He said that he is expecting a deputy manager to commence work at the home shortly, which will provide him with the additional management time he needs to undertake further improvements to the home. The home’s manager has completed an annual development plan, which places service users’ at the centre of ongoing planning and development of the home. Service users’ relatives and representatives who were interviewed in the course of the inspection confirmed that they are satisfied with the quality of
Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 Page 24 the service. They are invited to service users’ reviews at regular interviews and provided with opportunities to make their views known. Senior mangers from Spectrum visit the home at least once a month and conduct their own inspections of the service to ensure that it is being well run. Visual inspection and inspection of records held in the home shoed that it is kept mainly safe for service users and staff. Staff were observed using appropriate hygiene and safety equipment and said that they felt safe working in the home. Service users have individual written risk assessments to ensure that risks to them are identified and managed. Environmental and fire safety risk assessments of the home address risks to staff, service users and visitors but some improvements are needed. The environmental risk assessment needs to identify obvious risks such at the worn and cracked path at the side of the house and risks to service users who do not have locks on their bedroom doors so that they can be effectively managed and the home’s fire safety risk assessment is now due for review. Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 Page 25 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 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 2 3 3 X 3 X X 2 X Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 Page 26 Yes 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 YA6 Regulation 15(1) 15(2) Requirement All service users must be provided with written care plans, which they are consulted on, as far as is practicable and which are shared with them. The external areas of the home must be made safe for service users, including external steps and walkways. The date for compliance with this standard has been extended from 01/08/06. It is of concern to the Commission that this requirement remains outstanding. Timescale for action 01/08/06 2. YA24 YA42 13(4) 01/08/06 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. Refer to Standard YA5 Good Practice Recommendations Service users should be provided with clear information about the costs of their placements, including more detailed information on how their personal contributions
DS0000009117.V300024.R01.S.doc Version 5.2 Page 27 Rosemerryn 2. YA6 are calculated. 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. All staff handling medicines should undertake training in how to do this safely. 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. The stained carpet in the dining room should either be cleaned or replaced. Ventilation should be improved in one of the ground floor bedrooms. The proportion of staff qualified to NVQ level 2 should be increased towards achieving the 50 level indicated in the National Minimum Standards. There should be a training plan to cover all the care staff working in the home in addition to individual training plans. Care staff should be provided with more regular individual/ formal supervision, with records maintained. The home’s written risk assessments should address specific risks to service users using external steps and paths, which may present hazards due to falls and the provision/ non-provision of door locks to individual service users’ bedrooms. The fire safety risk assessment should be reviewed. 3. YA6 4. 5. YA20 YA23 6. YA23 7. 8. 9. YA24 YA26 YA32 10. 11. 12. YA35 YA36 YA42 Rosemerryn DS0000009117.V300024.R01.S.doc Version 5.2 Page 28 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
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