Inspection on 12/07/07 for Roseview Home

This inspection was carried out on 12th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Roseview Home 27/07/06

Roseview Home 09/01/06

Roseview Home 13/06/05

Roseview Home 11/11/04

Roseview Home 12/07/04

Roseview Home 23/02/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Roseview Home 26 Bounds Green Road London N11 2QH Lead Inspector Stephen Boyd Key Unannounced Inspection 12th July 2007 09:30 Roseview Home DS0000010752.V336752.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 Roseview Home DS0000010752.V336752.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. Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Roseview Home Address 26 Bounds Green Road London N11 2QH 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) 020 8881 7267 020 8361 5114 Mrs Agatha Annin-Adjei Mrs Angelina Otoo Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th July 2006 Brief Description of the Service: Roseview is a care home registered to provide accommodation and personal care for a maximum of six younger adults with mental disorders. The Homes aims and objectives state that the home: Encourages service users to take part in decision-making processes. Ensures service users have privacy and dignity. Maintains service users personal identity and choice. Involves service users in policy reviews. Ensures service users and staff work together to achieve these goals. The home is a semi - detached, two-storey house that was opened in May 2001. It has six single bedrooms. None of the bedrooms have en-suite facilities. On the ground floor, there are two bedrooms, an office, a kitchen, lounge/diner, a smoking area, a shower room with a toilet and a separate toilet. On the first floor, there are four bedrooms, a phone room and a bathroom with a toilet. There is a small front garden and an attractive larger back garden, which is partly paved and accessible to service users. The home is situated along the busy Bounds Green Road and close to a large selection of restaurants, shops and community facilities. Wood Green Shopping Centre is about a mile away. Bounds Green underground station is within a short walking distance. At the time of the inspection the home was fully occupied with six service users living at Roseview. Inspection reports produced by the Commission of Social Care Inspection (CSCI) are available upon request from the registered manager/provider. The cost of placements is £495 - £535 Following Inspecting for better lives the provider must make information available about the service, including inspection reports, to service users and other stakeholders. Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place in one day in July 2007. I was pleased to meet with the registered manager, Mrs Angelina Otoo. During the inspection three people living at the home were spoken with in private. A member of staff was also spoken with in private. A tour of the premises was undertaken and various records, policies and procedures were perused. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 Page 6 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 Page 7 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 Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The needs of people living at the home have been assessed prior to moving to the home. EVIDENCE: The home has not admitted any new people for a number of years. However, it was clear that those people already living in the home had received full needs assessments prior to moving there. Assessments involve the client and all other interested parties such as relatives. Local social services if they are contracting the care provide copies of their assessment and care plans. Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7, and 9 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have individual plans of care based on a holistic assessment of their needs. People are encouraged to be as independent as possible and make decisions about their lives. Risks are recognised as a part of life and strategies to minimise risks are in place. EVIDENCE: People living at the home were seen to have care plans. Care plans were holistic in their approach to peoples’ needs and had clear strategies identified to meet goals that had been set for individuals. The plans were seen to be regularly evaluated and had the involvement of people living at the home and significant others where able. People living at the home confirmed in conversation with me that they could make decisions about their own lives. For example, how to dress, when to go to bed and get up in the mornings. People were seen to move freely around Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 Page 10 the home and to go to their rooms as they wished. Where people have particular need for assistance this is done as part of care planning and may for example involve helping people to manage their cigarettes by keeping them in the office and giving out a number per day. The home has developed risk assessments for each person living at the home. These identify potential and actual risks for people both inside and outside of the home. Risk assessments were seen to have strategies in place for minimising the risk to people. Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 People who use this service experience good outcomes in this area This judgement has been made using available evidence including a visit to this service. People living at the home are part of the community and have a range of activities they can follow. People are encouraged to maintain appropriate relationships with family and friends. A balance of respecting people’s rights and ensuring their responsibilities are recognised is achieved. People have enjoyable and appropriate food provision. EVIDENCE: People living at the home are quite independent, requiring little in the way of physical care. They are able to follow a number of activities and interests both within and outside of the home. Within the home they can do exercise sessions, bingo, art therapy and cookery as examples. Outside the home, some people attend day centres and colleges for courses such as numeracy and literacy. People use the local library, swimming facilities and of course local shops and cafes. People also help within the home with areas such as Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 Page 12 cleaning and cooking as a means of increasing their abilities to be as independent as possible. Of the six people living at the home, only two have contact with family members. Others have visits from Community nurses or social workers. People are able to decide for themselves if they would wish the services of an independent advocate. People spoken with during the inspection said they were treated well by staff. One stated “ I get a lot of good support.” People are expected to take responsibility for themselves as much as possible. One person was being supported in his desire to move to a more independent setting and was cooking all his own food with some staff assistance. People said they were treated with respect and dignity and this was seen to be the case during the inspection. People living at the home spoken with during the inspection were complimentary regarding the food on offer. One stated that they had “very nice food” Records of food served were kept and showed a variety of food on offer. People living at the home are involved in food preparation where able. Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 People who use this service experience good outcomes in this area. . This judgement has been made using available evidence including a visit to this service. People receive support which is mainly emotional and social in content. Their health needs are recognised and met. The home has appropriate policies and procedures in respect of medication. EVIDENCE: The support needed by people living at the home is indicated in their care plans. One person stated that they “get lots of support from staff” Another indicated that “staff support me well and have good manners” People are quite independent in terms of physical care but rely on a lot of support for their emotional and social needs. To this end, a keyworker system is in operation. There were good records kept of health care appointments that people have. This included appointments with diabetic nurses. G.p’s, Dentists and Chiropodists. Care plans indicate the health needs of people and how these can be met. Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 Page 14 The home operates a monitored dosage system of medicine administration. This was checked on the day of inspection and found to be working appropriately. Medicines were held in a safe and secure manner and staff involved in their administration had received training. At the time of inspection, one person was being helped to self- administer as part of a plan for them to move to a more independent lifestyle. At the previous inspection a number of requirements had been made in relation to medication. These included updating the homes medication policy, having clear guidelines when staff administer PRN medicines, ensuring “tippex” is not used on MAR sheets and ensuring one persons specific dosage of a particular medicine was recorded separately at each administration. These had all been met at the time of this inspection. Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use this service experience adequate outcomes in this area. . This judgement has been made using available evidence including a visit to this service. The home needs to do some work to amend it’s policies and procedures relating to both complaints and the protection of vulnerable adults. EVIDENCE: The home had recorded no complaints by people living there or others since the previous inspection. People spoken to on the day of inspection did not have any complaints or concerns to raise. They felt confident that should they have any issues, these would be taken seriously. The home had a complaints policy and procedure, however, although generally acceptable, it needed to have the name of the registered manager and the address of the new CSCI office in Harrow recorded. The manger, Mrs Otoo advised there had been no protection of vulnerable adults referrals since the previous inspection. The home has a policy on protecting adults from abuse, however this was found to need amendment and addition. For example, there was no reference in the policy to the policy and procedures of the London borough of Haringey. Also, the policy suggested that the home would investigate allegations of abuse, which would not necessarily be appropriate or in line with decisions of strategy meetings. Staff had received training in the protection of vulnerable adults from abuse and the manager was aware of the need to ensure any new staff receive such training. Two requirements are made in respect of the issues identified above. Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 Page 16 Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. The environment of the home would benefit from some redecoration and refurbishment to enhance safety and comfort levels for people living there. EVIDENCE: At the previous inspection in July 2006, some requirements relating to the premises and environment were made. Hand towels were required in the bathrooms and a specific persons bedroom needed to be redecorated. These had been carried out by the time of this inspection. At this inspection some further areas for improvement were noted. There were some potentially hazardous trip areas to the rear of the property and some resurfacing work needed to be carried out. The laundry room floor was also presenting a potential trip hazard and the flooring needed to be sorted out. Some broken furniture in the rear area of the home needed to be disposed of to prevent possible hazards to people. Within the home, bedrooms number four and six were in need of redecoration. At the previous inspection a requirement was Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 Page 18 given to clean the lounge carpet. This had been complied with, but unfortunately the carpet was again found to be stained and dirty in this area and a new flooring is needed for this area and the office to enhance the environment. A requirement to meet all of these issues identified above is given in the report. The home was generally found to be homely in appearance not withstanding the above and there were no offensive odours. Since the previous inspection, a new sofa and some new dining chairs had been purchased. Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has competent and trained staff. Recruitment policies and procedures generally serve to support and protect people. EVIDENCE: At the time of the inspection the home had 50 or more of the care staff with national vocational qualifications in care at level two or above. A requirement made at the previous inspection for staff to undergo mental health awareness training had been carried out. Staff had also undergone a range of other training initiatives relevant to their roles such as food and hygiene, first aid, diabetes awareness, medication, infection control and medication. Staff records seen during the inspection indicated that a generally good process and practice of recruitment was in place. Prospective staff are invited for interview and fill in application forms. If successful, references are taken up along with criminal records bureau checks. Photographic identity is sought and medical declarations of fitness required. A staff member spoken with during the inspection confirmed they had undergone the above procedures and practices. They also said they received regular supervision and were expected Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 Page 20 to attend regular staff meetings. One area of the recruitment process that could be improved is to ensure the homes registered manager is always involved in the interviewing of potential permanent staff for the home. I was advised this is not always the case at the moment. This seems anomalous, given she will be directly responsible for the performance of staff and is best placed to judge how they would fit in with the home and it’s residents. Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is well run. Quality monitoring takes place at regular intervals to seek the views of people living there and those of other stakeholders. The health, safety and welfare of service users are generally well promoted. EVIDENCE: The manager, Mrs Otoo has a background in the caring professions and has completed the registered managers award. The staff member spoken with during the inspection said the manager was very supportive and people living at the home also expressed similar sentiments. It was clear the manager had a good rapport with people living at the home. Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 Page 22 At the previous inspection a requirement was given for the home to obtain the views of stakeholders in relation to the operation of the service and collate the results. This had been achieved by the time of this inspection. The manager was aware that a quality monitoring cycle should take place annually. There were completed risk assessments for areas of the home including one for the laundry, which had been a requirement of the previous inspection. Safety certificates were seen for electrical installation, gas safety and fire safety equipment. Fire drills were seen to take place regularly and checks on the fire alarm and emergency lighting also were seen to take place in the home. This report under standard twenty-four indicates where some remedial work is required to enhance safety for people living and working at the home. Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 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 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 Page 24 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 YA22 Regulation 22 (2) and (6) Requirement The registered provider must amend the complaints policy and procedure in line with advice given under standard twenty two of this report The registered person must ensure that the homes’ policy on the protection of vulnerable adults is re –written in line with the advice given under standard twenty-three of this report. The registered person must ensure the premises are of suitable comfort and safety for people living at the home and to that effect improve the premises as outlined under standard twenty-four of this report. Timescale for action 31/08/07 2. YA23 13 (6) 31/08/07 3. YA24 23 (2) (e and 0) 30/11/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 Page 25 1. YA37 The registered manager should be involved in the interviewing and recruitment of all permanent staff employed at the home Roseview Home DS0000010752.V336752.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Harrow Area Office 4th Floor Aspect Gate 166 College Road Harrow HA1 1BH National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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