Inspection on 19/02/09 for Rosemerryn

This inspection was carried out on 19th February 2009.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rosemerryn 20/11/07

Rosemerryn 22/08/07

Rosemerryn 13/06/06

Rosemerryn 10/02/06

Rosemerryn 06/09/05

Rosemerryn 29/11/04

Rosemerryn 07/05/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Rosemerryn 2a Cadogan Road Camborne Cornwall TR14 7RS     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michael Dennis     Date: 1 9 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Rosemerryn 2a Cadogan Road Camborne Cornwall TR14 7RS 01209610210 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): mail@dcact.org Spectrum Name of registered manager (if applicable) Miss Hayley June Griffin Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximim number of service users that can be accommodated is 3. The registered person may provide the following category of service only: Care home providing personal care only - Code PC to service users of either gender whose primary needs on admission to the home are within the following category: Learning disability (Code LD) Date of last inspection Brief description of the care home 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 Care Homes for Adults (18-65 years) Page 4 of 27 care home 3 Over 65 0 3 Brief description of the care home 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 and dining/ kitchen area. 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.Service users are charged extra for certain activities, such as private chiropody, hair dressing, and are expected to pay some contributions towards leisure activities outside of the home. Only one service user is accommodated at this time. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced key inspection, which took place on 19 February 2009. It lasted for approximately four 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 the needs of people who use the service are appropriately met in the home, with particular regard for ensuring good outcomes for them. There was an inspection of the homes premises and of written documents concerning the care and protection of the people who use the service and the ongoing management of the home. Discussions with staff and observations in relation to their care practices occurred as well as discussions with the homes acting manager. Care Homes for Adults (18-65 years) Page 6 of 27 The principle method used was case tracking. This involves examining the care notes and documents for the single service user. We discussed in detail the care needs of this service user with the manager and area manager. This provided a useful, in-depth insight as to how their needs are being met in the home. At this inspection, one person who uses the service users was case tracked. We were not able to meet the service user as the person was away from the home accompanied by two staff members. What the care home does well: What has improved since the last inspection? What they could do better: The proportion of staff qualified to NVQ level 2 should be increased towards achieving the 80 level indicated in the National Minimum Standards. New fire doors have been installed. The lounge door does not have a handle on it and it shuts by a Yale lock which means that the door automatically locks when it closes. This results in that people who use the service are unable to freely access this communal Care Homes for Adults (18-65 years) Page 8 of 27 area. The Yale lock should be removed and replaced with a normal handle. This is particularly important as access through this door is required at all times as in is part of a fire exit route. The manager informed us that she is arranging for the home to be inspected by the fire authority. We consider this to be a necessity. The fire evacuation plan sites the fire exits to be the front door, window access through the lounge and window access through an upstairs room. Anyone exiting by the upstairs window would find themselves on a sloping roof, which is considered to be unsafe and with no means of descending from this roof to ground floor level. Additional signage is also required. The homes manager is due to submit her application to the Commission for the registered manager post. The complaints procedure should include the contact details of the Department of Adult Social Care. The manager also needs to obtain copies of the multi agency protection of adults and children, from the Cornwall social services departments. The inspector would like to thank the Manager and Area Manager for their kind assistance and cooperation during this inspection. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Statement of purpose has been reviewed and updated so that it accurately reflects the service that Rosemerryn provides for service users and their representatives informationPeople who use the service are assessed prior to their admission so that they can be confident it will meet their health, personal and social care needs, including needs relating to their age, religion, cultural and ethnic backgrounds, abilities, gender and sexual orientation. Evidence: As this service has re-opened to specifically care for one person, The statement of purpose fully reflects the service to be provided. People who use the service and their representatives can therefore have accurate information on what Rosemerryn provides. From documentation inspected it was evident that admissions are made following a full assessment and in consultation with the service user, their family or advocate, and relevant professionals. The complaints procedure included in the statement of purpose should include contact Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: details of the Department of Adult Social Care. Care Homes for Adults (18-65 years) Page 12 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individual care plans fully address the persons health, personal and social care needs, including needs relating to their individual and diverse backgrounds. They are able to take safely managed risks and make important decisions about their lives so that they develop their skills and independence. Evidence: People who use the service their family, advocate and relevant professionals are involved in the development of individual care plans and their subsequent reviews. The reviews record their views so that they are aware of the purpose of their placements in the home and are able to contribute to the ongoing care planning process. The care plan has specific headings to address the individuals health, personal and social care needs, including their diverse needs. Personal Care plans provide service users with specific goals to work towards, and inform and direct staff in how to support the person to achieve this goal to encourage them to fully maximise their skills for independent living. Staff confirmed they were able to understand the care plans and Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: that the detail of how to assist in a particular task allowed consistency of care. People who use the service participate in making decisions about important aspects of their daily lives, according to their individual abilities. People who use the service can choose the level of privacy they wish to enjoy in their private accommodation. People who use the service are able to take managed risks, backed up with written risk assessments and risk management plans, particularly with regard to their engagement in higher risk activities. Service users monies are audited at Spectrum Headquarters and from documentation seen they appeared to be no concerns regarding the management of monies at his time. Care Homes for Adults (18-65 years) Page 14 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to take part in a wide range of activities in and out of the home, which are appropriate to their ages, individual needs, interests and cultural backgrounds so that they develop their skills and confidence. They are supported to maintain valued social and family relationships so that they are not isolated or institutionalised. Evidence: At the time of the inspection, the person who uses was away from the home visiting friends, accompanied by two staff members. Individual needs and preferences are considered as part of the assessment and/or care planning process so that the person can be provided with activities that are appropriate. Opportunities are made available to enable the person to plan what they will do each week with staff. Their daily care records confirm that they make use of a wide range of community resources. Specific Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: interests include cinema, swimming, bodybuilding, crystal hunting, skateboarding and meeting up with friends. These activities are undertaken within a risk management framework. Access to independent advocacy services, particularly where an individual does not have close relatives to support them on a regular basis is available. We were informed that the service user enjoys helping with cooking and agrees a weekly menu in advance. Care Homes for Adults (18-65 years) Page 16 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service personal and healthcare needs are well met so that they are able to live full and active lives in and out of the home. Evidence: Care plans are individualised and address their personal care needs. The home has suitable bathroom facilities so that they can attend to their personal care in private. For people who use the service, their healthcare needs are considered as part of the care planning process and regularly reviewed. Documentation showed that access to external healthcare providers, including specialists, occurs when needed. At present no medication is administered nor held on the premises. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are listened to and respected so that their views, concerns and complaints are taken seriously and acted upon. There are formal and informal systems in place to ensure that they are able to feel safe in the home. Complaints procedures require updating and the home needs to obtain copies of the Cornwall multi agency abuse procedures for both adults and children. Evidence: The home has written procedures to guide staff on what to do if they suspect a person is at risk of abuse. It is important that the home obtains copies of the Cornwall multi agency abuse procedures in respect of both adults and children. There are records to show that staff are recruited on the basis that they are suitable to work with vulnerable adults in a care setting and appropriate checks are made. Residents are not isolated in the home, but take part in a range of activities in the local community and have relationships with people from outside of the home that they can communicate serious concerns to. Spectrum has a whistle blowing policy. The manager has attended the Multi Disciplinary Adult Protection course. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is in the main kept clean and tidy and good hygiene is maintained so that people who use the service and staff are protected from infection risks. The manager needs to review free access to the lounge and safety in the garden area.An inspection by the fire authority is warranted Evidence: People who use the service appeared to be comfortable and happy in the home. 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 they live in a non-institutionalised environment in which they can develop their skills and become more independent. 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. There are satisfactory systems in place to manage heavily soiled materials, which may represent an infection risk, should the occasion arise. The kitchen and lounge area are well equipped to domestic standards and the lounge presented as being comfortable. There is however further scope for improvement to other parts of the building. Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: The conservatory is no longer in use because it requires major refurbishment, but people who use the service have sufficient communal space without it. We have concerns regarding the named fire exits. There are three fire exits in total. One is the front door, which is considered entirely appropriate. The second requires access through the lounge window, which again seems feasible considering the current service user. The lock to the lounge door must be removed as this potentially prevents access to this fire exit route. The third listed exit is through a window upstairs. It is considered possible to exit via this route but once outside people will find themselves on a sloping tiled roof leading to an unsafe plastic roof with no means of accessing the ground below. The manager informed us that she is in the process of contacting the fire authority to request an inspection of the premises. This must be done as a matter of urgency. Additional fire escape signage will also be required. Some of these issues were raised as a recommendation following the last inspection and are now made as a requirement. A room has been specifically provided as an activity base for the service user. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are employed in sufficient numbers at all times. 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 access to ongoing training. Staff are well supported and receive formal supervision. Evidence: The staff rota demonstrates that two staff are on duty from 8am until 10pm at night. Overnight there is one sleeping staff member. Senior staff are on call. Management should keep staffing ratios under regular review to ensure the safety of both the service user and the staff. There are comprehensive risk assessments in place to cover all the activities currently undertaken by the service user. According to the manager and records held in the home, less than the recommended 80 of care staff are qualified to NVQ level 2, although this situation should improve as more staff undertake the qualification. Staff recruitment records inspected evidenced that staff have undergone the necessary Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: clearances before they commenced employment at the home. An induction programme for new staff is implemented. Care staff have individual training records and detailed courses attended and certificates achieved. The manager is in the process of ensuring that all staff receive supervision approximately every 6 weeks. Supervision records confirmed this. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes manager needs to apply to the Commission to be registered so that an assessment of her fitness to provide this role is assessed. The home is mainly well managed for the benefit of people who live there. There are formal and informal systems in place to ensure that views from people who use the service are accounted for in the day-to-day running and ongoing development of the home. There are systems in place to protect those who live, work or visit the home from avoidable harm and injury. Evidence: The manager is Tamsin Burnett who has yet to submit her application to be registered. The previous managers name still appears on the registration certificate. This person should formally notify the Commission of her resignation from this position. Records are stored confidentially and were seen to be well maintained. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: The homes environment in the main appeared safe and there are written individual and environmental risk assessments in place to minimise risks to People who use the service and staff working in the home. Maintenance of the home and its equipment are satisfactory. Policies and procedures were assessed as pertinent and satisfactory. Fire precautions are in need of improvement as listed in the environment section of this report. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 24 23 The fire authority must be consulted with regard to escape roots and general fire safety within the home. Recommendations made to be actioned promptly. Escape routes unsafe 30/03/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 23 The homes manager should obtain copies of the Cornwall multi agency abuse procedures for both children and adults. The complaints procedure should include the contact details of the Department of Adult Social Care. The proportion of staff qualified to NVQ level 2 should be increased towards achieving the 80 level indicated in the National Minimum Standards. The manager should submit her application to the Commission for registration. 2 3 23 32 4 43 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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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