CARE HOME ADULTS 18-65
Rosemerryn 2a Cadogan Road Camborne Cornwall TR14 7RS Lead Inspector
Lowenna Harty Announced 06 September 2005 09:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rosemerryn D52-D04 S9117 Rosemerryn V240533 060905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Rosemerryn Address 2a Cadogan Road Camborne Cornwall TR14 7RS 01209 610210 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Spectrum Care Home 3 Category(ies) of Learning Disability (3) registration, with number of places Rosemerryn D52-D04 S9117 Rosemerryn V240533 060905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: There are no additional conditions of registration. Date of last inspection 29 November 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 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 withing 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 spedific 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. Rosemerryn D52-D04 S9117 Rosemerryn V240533 060905 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place on 6 September 2005 and was announced. It started at 9.30 am and lasted for approximately five and a quarter 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. Overall, care standards in this home have deteriorated, mainly as a result of management changes, which have proved quite disruptive. Whilst this has partly been due to factors beyond the control of the registered provider, it now needs to take swift action to restore good practice in the home. What the service does well: Two service users were out for most of the day at the time of the inspection, attending a placement at a local college although one returned before the end of the inspection and stated that they are satisfied with the care and services they are provided with at the home. The service user who was at home for the day appeared content and there was good interaction between them and the staff working with them. The home’s location is good for service users to access local community resources and transport is provided to enable them to do this. The home has a comfortable lounge with a television and a computer and there was evidence of art and craftwork completed by service users in the home. Service users faith and cultural needs are appropriately considered as part of the assessment process for their placement in the home. Their personal care needs are well met and one went out shopping with a staff member to buy new clothes at the time of the inspection. Service users appeared to be well presented physically. They were fashionably and appropriately dressed. The home has suitable bathroom facilities to enable them to attend to their personal care needs in private. There are written procedures to ensure that staff have information on what to do if they suspect that a service user has been neglected or abused and they
Rosemerryn D52-D04 S9117 Rosemerryn V240533 060905 Stage 4.doc Version 1.40 Page 6 are given training in this. The home has copies of the local authority’s multiagency procedures so that staff know who they should contact and at what stage. The home provides service users with a comfortable, domestic-style environment with plenty of space. All of the service users have well-furnished bedrooms, which they are able to personalise. The internal environment is generally safe, with up-to-date fire and environmental risk assessments in place. There are records to show that all staff have had training in the home’s fire safety procedures. There are records in the home to indicate that senior managers from Spectrum regularly visit the home to oversee its management and there are records of regular staff meetings held at Spectrum’s head office. What has improved since the last inspection? What they could do better:
When the assessment commenced, not all the assessment information relating to a service user was in the home. This was rectified in the course of the inspection, but the information should have been held with them from the start of the placement so that staff working with them would have been better informed of the service users’ needs. Although there were some notes to say that they had visited the home before moving into it, the home’s visitors’ book had not been completed. It is important that all visitors sign in and out to
Rosemerryn D52-D04 S9117 Rosemerryn V240533 060905 Stage 4.doc Version 1.40 Page 7 provide a record and so that staff know who is in the building in case of an emergency. Not all service users had statements of the terms and conditions of their placements in the home and they should be provided with them in formats that are meaningful to them. Where necessary they should be provided with access to independent advocates, particularly when they have communication difficulties to ensure that they are in agreement with their placements in the home. Not all service users had written care plans in respect of their placement in this home. They need these so that they and their relatives can be assured that their health and social care needs will be properly met. Service users with documented healthcare needs, particularly with regard to helping them to develop their communication skills must be helped to access the correct specialist services. Not all service users had up-to-date risk assessments and behavioural management plans relating to their placement in this home or specific activities they may be engaged in whilst there. These need to be drawn up in consultation with them and or their representatives, particularly in situations where it may be necessary to place restrictions on them for their own protection or that of other people. Record keeping and storage needs to be improved. Daily care records need to be completed daily and signed so that staff are aware of how service users are progressing with regard to fulfilling the aims of their care plans and all personal information relating to service users needs to be carefully stored so that there is no risk that their confidentiality will be breached. Service users moving into the home should be provided with continuity in respect of the activities they are engaged with on a day-to-day basis to ensure that they continue to develop their skills and abilities in accordance with written care plans. Service users’ care plans should consider their wishes should they become seriously ill or in the event of their deaths so that these can be respected. The home’s written procedures for the protection of vulnerable adults from neglect, self-harm and abuse should be reviewed and updated, since the current ones were written in 2001. The home’s filing system should be sorted out, as it was not easy for the person in charge on the day of the inspection to locate important policies and procedures such as this one. Staff should have access to multi-agency training the protection of vulnerable adults from abuse so that they gain a clear understanding of how different agencies such as social services departments and the police work together with providers to protect vulnerable people. It would also be useful to have copies of the procedures of local authorities placing service users in the home from outside of the local area so that staff are aware of who they should contact and when if they suspect a service user has been abused. Whilst there have been improvements to the home’s internal environment, there continues to be a smell of damp, this time in one of the service user’s bedrooms. The source needs to be identified so that the odour can be eradicated, as it is very unpleasant. Improvements are still needed to make the outside of the building to make it safe and attractive. This includes making the path at the side of the building safe from tripping hazards, clearing out the
Rosemerryn D52-D04 S9117 Rosemerryn V240533 060905 Stage 4.doc Version 1.40 Page 8 old paint tins and furniture from underneath the conservatory, removing a gate that is currently lying flat at the front of the building and tidying up the bricks and rubble on the far side of the building. Copies of staff training certificates need to be held in the home, partly to provide evidence that they have undergone essential training to make them safe to work with service users but mainly so that managers in the home can be aware of staff training needs when drawing up staffing rotas. It would be useful for the home to have a training plan that clearly sets out what training staff have done and what they need. The numbers of staff qualified to NVQ level 2 should be increased towards achieving the 50 ratio recommended in the National Minimum Standards so that service users and their representatives can be assured that staff have demonstrated their competence to work with vulnerable people in a specialist care setting. Staff should be provided with one-to-one, professional supervision with records kept so that managers, service users and their representatives can be sure that they are well supported and performing their duties correctly to benefit service users. The home’s registered manger has left and the manager appointed to take over from them has been on sick leave, which has caused some disruption to the smooth running of the home, as reflected in the deterioration in care standards found at this inspection. The registered provider must make arrangements to ensure that a suitable manager is in charge of the home on a day-to-day basis and register them with the Commission. 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 D52-D04 S9117 Rosemerryn V240533 060905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Rosemerryn D52-D04 S9117 Rosemerryn V240533 060905 Stage 4.doc Version 1.40 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 standard(s) 2 & 5 Prospective service users’ needs are assessed prior to admission although they would benefit from improvements in this. Not all service users have current contracts or statements of terms and conditions in respect of their placement in the home so that they can be clear about their rights and obligations. EVIDENCE: Upon commencement of the inspection the assessment information relating to the service user whose case was tracked was held at their previous placement although this was brought across during the course of the morning. The assessment information was detailed and provided evidence of appropriate consultation with the service users’ relatives and sponsoring authority, although the service user did not have input from an independent advocate. The service user had been provided with opportunities to visit the home before moving in, according to their care notes, but this was not verified by the home’s visitors’ book. There are clear reasons stated in the service users’ notes to demonstrate how the move should benefit them in the long-term. The home’s service users’ guide also functions as a contract/ statement of terms and conditions for service users but the service user whose case was tracked did not have one. Their most recent contract relates to their previous placement. Rosemerryn D52-D04 S9117 Rosemerryn V240533 060905 Stage 4.doc Version 1.40 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 standard(s) 6, 7, 9 & 10 Service users’ written care plans need improvement to ensure that service users’ needs met. They need to be provided with more opportunities to make decisions over their lives. Written risk assessments need improvement to protect service users’ rights. Storage of information to ensure service users’ confidences are kept needs to be improved. EVIDENCE: The service user whose case was tracked did not have a written care plan in respect of their new placement, which was up-to-date, with clear written goals for the placement. Some recommendations relating to their needs, which had previously been identified in the assessment documentation had not been followed through at the new placement. There was some evidence of service users being assisted to make decisions, for example the service user whose case was tracked was brought to the home on a number of occasions, prior to their admission, to see if it would be suitable for them. Some assistance is provided to enable service users to communicate with staff, where this is needed. There are still several improvements required though, to improve opportunities for service users to make decisions about their lives. One service user’s previous notes indicated that they would benefit from access to professional, skilled input with regard to
Rosemerryn D52-D04 S9117 Rosemerryn V240533 060905 Stage 4.doc Version 1.40 Page 12 developing their communication abilities and this had not been followed up on. Service users who would benefit from it should be provided with information about the home in formats that are meaningful to them before they move in to the home. They should be provided with independent advocates and daily care records to demonstrate how they make decisions on a day-to-day basis should be completed and signed. The written risk assessment for the service user whose case was tracked, related to their previous placement and there was no signature to suggest that restrictions imposed on them for their own welfare had been agreed with them and/or an independent advocate. Written risk assessments should cover specific activities that service users engage in, which may place either them or others at risk so that staff have clear guidance on how best to protect them. The home’s statement of purpose has been updated and now contains a statement on confidentiality to inform prospective service users and key partner agencies on the circumstances under which information may be shared. The home has a lockable office for information storage, with lockable filing cabinets. At the time of the inspection the assessment documentation for the service user whose case was tracked was not located with them, daily care records had not been completed on a daily basis in every case and were not signed. The inspector noted that some archived notes relating to previous service users were being stored in the home’s conservatory at the time of the inspection. This was not sufficiently secure and could have resulted in a breach of confidentiality. Rosemerryn D52-D04 S9117 Rosemerryn V240533 060905 Stage 4.doc Version 1.40 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 standard(s) 12, 13 & 16 Service users need better access to activities outside of the home, which are in keeping with their needs. Service users are assisted appropriately to access and benefit from local community resources. Respect for service users’ rights and communication to them of their responsibilities needs to improve. EVIDENCE: The service user whose case was tracked benefited from the increased individual staff attention available at this home, which is smaller than their previous placement. They indicated that they are content at the home and appeared well settled and relaxed during lunchtime. A staff member was available to provide them with one-to-one assistance during the meal. The other service users were out of the home, attending a local college. There was a lack of continuity for the resident whose case was tracked with regard to their college placement and no formal activities had been set up to replace their previous programme. Care notes lacked detail with regard to their current activities although the service user went out of the home with a staff member during the day to go shopping for new clothes. The home has vehicles to provide transport for service users; there is a spacious lounge with a T.V and
Rosemerryn D52-D04 S9117 Rosemerryn V240533 060905 Stage 4.doc Version 1.40 Page 14 computer for service users’ use. Assessment documentation took account of the cultural and faith needs of the service user whose case was tracked. There are records to demonstrate that service users are assisted to access a variety to local community resources, including a local college and the home is well situated to enable them to reach the local town centre easily. The service user whose case was tracked had no individual care plan or placement contract in respect of their placement at this home to demonstrate that their rights and responsibilities are recognised and incorporated into their daily lives. The same service user should be provided with specialist support to help them to develop their communication skills and independent advocacy to ensure their rights are better protected. Rosemerryn D52-D04 S9117 Rosemerryn V240533 060905 Stage 4.doc Version 1.40 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 standard(s) 18 & 21 Service users receive appropriate assistance with their personal care. They need to be provided with improved consideration of their needs with regard to ageing, illness and death. EVIDENCE: The home now has three bathrooms, all within close proximity of service users’ bedrooms. The transfer notes relating to the service user whose case was tracked provided staff with information on their personal care needs. The service user appeared to be physically well cared for, clean and tidy and a staff member took them out to buy new clothes at the time of this inspection. Some care staff from their previous placement had transferred to the new home with them so that there would be some continuity in respect of addressing their personal support needs. The service user whose case was tracked did not have an up-to-date care plan in place relating to their placement in this home, which set out their needs and preferences in the event of their ageing, serious illness or unexpected death. This issue needs to be addressed sensitively with them, their representatives and an independent advocate so that their wishes are respected as far as possible. Rosemerryn D52-D04 S9117 Rosemerryn V240533 060905 Stage 4.doc Version 1.40 Page 16 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Service users should be better protected from abuse, neglect and self-harm. EVIDENCE: The home has written policies and procedures to guide staff in the event of their suspecting that a service user is being abused, but these are dated 2001 and in need of review. They were not immediately to hand to the person in charge of the home at the time of the inspection because the home’s filing systems need to be improved. Staff had signed a record to indicate that they have read the policies and procedures, which include a section on whistle blowing. All staff have attended internal training organised by Spectrum on the protection of vulnerable adults from abuse but none have attended external multi-agency training and this should be made available to the person in charge of the home. The most recent multi-agency procedures for the protection of vulnerable adults from abuse were available in the home. Procedures from placing authorities, where service users are placed out of their home area should be available to provide staff with additional guidance. Records provide evidence of fair, safe and effective practise with regard to staff recruitment and selection. The service user whose case was tracked appeared content and well settled in the home. The staff member on duty interacted with them appropriately to provide them with the support they needed. Rosemerryn D52-D04 S9117 Rosemerryn V240533 060905 Stage 4.doc Version 1.40 Page 17 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 27 & 30 The home’s physical environment has improved but further improvements are needed to protect service users’ welfare and safety. There are sufficient and suitable bathrooms to meet service users’ needs. The home was clean and hygienic at the time of the inspection. EVIDENCE: There have been some major improvements internally to the home’s environment. The old single bathroom downstairs has been divided to provide service users with two, brand new and very comfortable bathrooms. The kitchen has been modernised, with new worktops and flooring. The home is comfortable and homely inside, with domestic-style furnishing throughout. It is centrally heated and warm. There is suitable security in place to protect service users. The home’s fire safety and environmental risk assessments are completed and up-to-date there are records of ongoing equipment checks and tests and fire drills. The home appeared clean and tidy throughout at the time of the inspection but one of the service users’ bedrooms smelled strongly of damp. The source of this needs to be located and the smell eradicated. The outside of the building still needs to be improved. The path at the side of the house is cracked and uneven and there is a drainage hole in it, covered over with a brick that is a tripping hazard. A metal gate is laid on its side in the
Rosemerryn D52-D04 S9117 Rosemerryn V240533 060905 Stage 4.doc Version 1.40 Page 18 front area of the building and needs to be removed, as it looks unsightly. The home has a conservatory, which is currently disused and kept locked. The area underneath it was cluttered with tins of paint and old furniture and this needs to be cleared. Rosemerryn D52-D04 S9117 Rosemerryn V240533 060905 Stage 4.doc Version 1.40 Page 19 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 35 & 36 Staff have some training but most are not qualified and records of training need improvement. Staff support and supervision arrangements need to be improved to ensure service users’ needs are properly met. EVIDENCE: Records to demonstrate fair, safe and effective recruitment and selection of staff are available in the home. Spectrum has introduced a computerised system for staff records, which is secure and stores copies of staff application forms, interview records, CRB checks and references. There are records to indicate that all staff have undergone induction training at Spectrum’s head office prior to commencing work in the home. Record keeping with regard ongoing staff training needs to improve, as not all staff files held copies of certificates to fully evidence their ongoing training. Only one member of staff is currently qualified to NVQ level 2. There was evidence of monthly visits by senior managers from Spectrum to the home and minutes of regular staff meetings held at Spectrum’s head office, but not of 1:1 supervision of staff. Management arrangements in the home have been seriously disrupted of late, partly as a result of events beyond the control of the registered provider, but service users need to be protected by improved management arrangements for the home pending the appointment of a manager registered with the Commission.
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The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39, 41 & 42 Management of the home needs improvement for the safety and welfare of service users. Systems for consulting with service users on the quality of care need improvement to ensure their views are taken into account. Service users welfare and rights depend on better record keeping. Some improvements are still needed to protect service users’ health and safety. EVIDENCE: There is currently no registered manager in charge of the home on a day-today basis. The home’s previous registered manager has left and the manager who took over was on sick leave. The person in charge of the home on the day of the inspection was mainly based at another service. Disruption in the home’s management is reflected in the deterioration in some standards in the home, such as record keeping. There are records of regular visits by Spectrum’s senior managers to provide some oversight of the running of the home but there needs to be a person in charge on a day-to-day basis to ensure that important tasks are completed.
Rosemerryn D52-D04 S9117 Rosemerryn V240533 060905 Stage 4.doc Version 1.40 Page 22 The service user whose case was tracked should be provided with more opportunities for their views to be ascertained, through the provision of up-todate, written care plans that relate to their placement in this home, assistance with access to support to develop their communication skills and independent advocacy. The home has a lockable office and facilities for the secure storage of confidential information but some confidential files were being stored in the conservatory at the time of the inspection, which to be removed. Daily care records were not fully completed on behalf of the service user whose case was tracked and their care planning documentation needed to be brought up-to-date in respect of their placement at this home. The home’s internal environment has improved with the provision of an additional bathroom and modernisation of the kitchen. Fire safety and environmental risk assessments are up-to-date and all staff have been trained in the home’s fire safety procedures. There was an odour of damp in a service user’s bedroom, which needs to be eradicated, and the home’s exterior needs to be made safe, with particular regard to the pathway at the side of the building and paint tins stored underneath the conservatory. Rosemerryn D52-D04 S9117 Rosemerryn V240533 060905 Stage 4.doc Version 1.40 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 2 x x 2 Standard No 22 23
ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 2 2 x 2 2
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 2 x x 3 x x 2 Standard No 11 12 13 14 15 16 17 x 2 2 x x 2 x Standard No 31 32 33 34 35 36 Score x 2 x x 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Rosemerryn Score 3 x x 2 Standard No 37 38 39 40 41 42 43 Score 1 x 2 x 2 2 x D52-D04 S9117 Rosemerryn V240533 060905 Stage 4.doc Version 1.40 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 2 & 41 5 & 41 Regulation 17(2) 5(1), 5(2) Requirement There must be a record of all visitors to the home, including their names. Each service user must be provided with a service users guide in respect of their placement in the home. Each service user must havewith a written care plan that is drawn up in consultation with them and fully addresses their health and welfare needs. Service users health care needs must be properly addressed, with full records kept, including assitance to access specialist services such as speech and language therapists where necessary. Service users individual risk assessments must be relate to their placement in this home and address specific activities they may be engaged in. Any restrictions necessary for their safety must be agreed with them and/or an independent advocate. All confidential information must be stored securely The source of the smell of damp in a service users bedroom must Timescale for action 15/10/05 30/10/05 3. 6, 16 & 41 15(1) 30/10/05 4. 6, 7 & 16 12(1)(a) 12(3) 13(1)(b) 30/10/05 5. 9 12(2) 12(3) 13(4)(b & c) 30/10/05 6. 7. 10, 16 & 41 12(4)(a) 17(1)(b) 24, 30 & 42 16(2)(k) 23(2)(b) 15/10/05 30/10/05
Page 25 Rosemerryn D52-D04 S9117 Rosemerryn V240533 060905 Stage 4.doc Version 1.40 23(2)(p) 8. 9. 10. 24 & 42 35 37 be identified and the odour eradicated. 13(4)(a-c) The external areas of the home 23(2)(b) must be cleared of rubbish and 23(2)(o) made safe for service users. 17(2) Copies of staff training certificates must be held in the home. 8(1) The registered provider must 8(2) appoint a manager for the home and arrange for them to be registered with the Commission. 30/10/05 30/10/05 10/10/05 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 2 2 & 39 Good Practice Recommendations Assessment information should accompany any service user who is admitted to the home so that new staff working with them have full information about their needs. There should be improved arrangements for consultation with service users, including access to professional support to develop communication skills and independent advocacy. Service users should be given key information, such as their care plans in formats that are meaningul to them. Daily care records should be completed daily and signed There should be improved continuity with regard to activities provided for service users when the move into the home. 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 homes written procedures for the protection of vulnerable adults from abuse should be reviewed and updated. Information, such as policies for the protection of vulnerable adults from abuse should be properly filed and readily accessible to staff. Copies of the procedures for the protection of vulnerable adults from all placing local authorities should be kept in the home Staff should be provided with multi-agency training in the
D52-D04 S9117 Rosemerryn V240533 060905 Stage 4.doc Version 1.40 Page 26 3. 4. 5. 6. 7. 8. 9. 10. 6 10,16 & 41 12 21 23 23 & 41 23 23 & 35 Rosemerryn 11. 12. 13. 35 32 36 protection of vulnearable adults from abuse. A staff training plan should be drawn up so that the manager of the home can readily prioritise staff training. The proportion of staff qualified to NVQ 2 level should be increased towards achieving the 50 level indicated in the National Minimum Standards. Staff should be provided with regular 1:1 supervision with records kept. Rosemerryn D52-D04 S9117 Rosemerryn V240533 060905 Stage 4.doc Version 1.40 Page 27 Commission for Social Care Inspection 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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