Inspection on 10/11/05 for Roseview Residential Home

This inspection was carried out on 10th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Roseview Residential Home 03/07/07

Roseview Residential Home 07/08/06

Roseview Residential Home 28/07/05

Roseview Residential Home 24/01/05

Roseview Residential Home 27/07/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Roseview Residential Home 17 The Limes Avenue London N11 1RE Lead Inspector Jackie Izzard Unannounced Inspection 10 November 2005 10:35 X10015.doc Version 1.40 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 Residential Home DS0000010679.V265388.R01.S.doc Version 5.0 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 Older People. 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 Residential Home DS0000010679.V265388.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Roseview Residential Home Address 17 The Limes Avenue London N11 1RE 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 8368 9195 020 8361 5114 Mrs Agatha Annin-Adjei Mrs Agatha Annin-Adjei Care Home 14 Category(ies) of Dementia - over 65 years of age (14), Old age, registration, with number not falling within any other category (14) of places Roseview Residential Home DS0000010679.V265388.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th July 2005 Brief Description of the Service: The home is owned and managed by Mrs Agatha Annin-Adjei with the support of various members of her family. The registered provider owns another home in Haringey for service users suffering from mental illness. Roseview is registered to provide residential care to 14 older people who may also have dementia. The property is a semi-detached house with a large extension at the rear. The home is situated in a quiet residential street in New Southgate. There are nearby shops and the home is accessible to public transport with Arnos Grove station and buses to Palmers Green nearby. The homes aims are to enable service users to become independent and confident in making choices of their own and to encourage all service users to live a full and active life. Roseview Residential Home DS0000010679.V265388.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was undertaken by two inspectors. They met and spoke to all the people living at Roseview, the two staff who were on duty, the manager and the co-ordinator. Inspectors also looked around the building and examined various records. An anonymous complaint had been made to the CSCI and this was investigated as part of this inspection. Requirements were made and discussed with the manager and co-odinator at the end of the inspection. What the service does well: What has improved since the last inspection? What they could do better: The manager/owner needs to pay closer attention to the temperature of baths and showers that the service users use as this was identified as a problem for the fourth time at this inspection. The shower temperature was measured by inspectors to be 13 degrees above the recommended safe temperature. An immediate requirement was issued to ensure a plumber fits a device to lock the shower temperature at a safe level. At the previous inspection of the home in July 2005, a total of seven requirements were made. These were actions that the manager/owner needed to take to meet national minimum standards of care homes for older people. At this inspection, it was found that two of these requirements had not been met. A third was due to be met by 30 November but the manager said it would not be met by that date and a new timescale was agreed. The two outstanding requirements were to ensure safe water temperatures in baths Roseview Residential Home DS0000010679.V265388.R01.S.doc Version 5.0 Page 6 and showers and to ensure all staff have up to date training in moving and handling people, food hygiene, fire safety and infection control. Inspectors agreed an extended timescale to replace the ground floor hall and dining room carpets as they were informed that the owner intended to redecorate these rooms first. Eleven new requirements were made as a result of this inspection. These were to ensure a constant supply of washing powder and disposable gloves, to ensure all medicines are locked away at all times, to clean one bedroom carpet, ensure heating and hot water are on at all times in cold weather, to provide soap and hand towels in the laundry room, to record a bruise in the person’s records, to ensure everyone has safe footwear, to review staffing levels and inform CSCI of the outcome of the review and to arrange for an Occupational Therapist to assess the home’s bathing facilities and cotsides. 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. Roseview Residential Home DS0000010679.V265388.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Roseview Residential Home DS0000010679.V265388.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Service users’ needs are assessed prior to their admission to the home and they are assured that the home can meet their needs as long as they are able to weight bear (ie stand up for a short period). EVIDENCE: Service users are assessed by the manager or co-ordinator prior to their admission to the home and a written assessment is kept in their file and forms the basis of the care plan. The co-ordinator explained to inspectors that the home has a policy that all service users must be able to weight bear, including those who use a wheelchair. The home does not use a hoist for any service users. Roseview does not provide intermediate care and is not equipped to do so. Roseview Residential Home DS0000010679.V265388.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 Service user’s care needs are recorded in a care plan so that staff are aware of how to meet their needs. Their health needs appear to be met satisfactorily. The service users were not fully protected by the homes’ medication procedures at the time of this inspection and all staff need to be vigilant in locking away all medication to protect vulnerable service users from risk. EVIDENCE: Improvements have been made to care plans since the last inspection. Plans are reviewed monthly to see if service users’ needs have changed. Inspectors recommended that the manager request a case conference meeting for one service user and a review for another as both had some complex needs at the time of this inspection. One service user was wearing slippers which did not fit her and were torn so not suitable to walk in. A requirement is made for the manager to check all service users’ footwear so as to reduce the risk of falls. Some service users were in poor health but there was no evidence that the home were not trying to address their health needs. Some were taking food Roseview Residential Home DS0000010679.V265388.R01.S.doc Version 5.0 Page 10 supplements. Three were currently being visited by the district nurse for specific health problems. Inspectors found a tablet on the floor in the home and therefore a requirement was made that all medication must be locked away at all times. Inspectors were told that the medication belonged to staff member. Other aspects of medication were not assessed at this inspection as this standard was met at the last inspection in July 2005. Roseview Residential Home DS0000010679.V265388.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 Service users said that they were satisfied with the meals offered. EVIDENCE: Inspectors spoke to five service users, staff and the manager about food in the home and inspected the kitchen. There was no cook working and staff were observed to be sharing the cooking duties. Service users said that they liked the food. One said she particularly liked chicken and vegetable pies. The dining room was comfortable and it was noted that a service user set the table for lunch. Roseview Residential Home DS0000010679.V265388.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed at this inspection. EVIDENCE: Both complaints and adult protection matters were assessed in July 2005 and standards found to be met. Staff have been provided with training in adult protection and an allegation of abuse made by a service user against staff was reported by the home and correct adult protection procedures followed. Appropriate measures had been put in place to avoid further allegations against staff. Roseview Residential Home DS0000010679.V265388.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 25, 26 . Service users live in comfortable surroundings which will be improved by planned redecoration and new carpets in specific areas where this is needed. An Occupational Therapist assessment of bathing facilities will also benefit service users. The manager needs to ensure staff have constant easy access to washing powder, soap, hand towels and disposable gloves to ensure service users are fully protected against risk of infection in the home. Service users are placed at risk of scalding by inadequate monitoring of water temperatures and water in a shower being too hot. EVIDENCE: A requirement was made at the last inspection to ensure that the carpets in the dining room and ground floor hallway are cleaned and replaced. These carpets were observed to be stained. The manager said that they had not Roseview Residential Home DS0000010679.V265388.R01.S.doc Version 5.0 Page 14 been replaced yet as she was planning to redecorate these areas first. Inspectors agreed that these carpets must be replaced by 30 January 2006. The manager was asked to obtain an assessment of the home’s bathing facilities by an Occupational Therapist as this has not been done before. She was also asked to seek an assessment of the cotsides used for a number of service users to determine whether these should have buffers to prevent risk of injury. There was no hoist in the home. Two service users use a wheelchair at all times. When asked why there was no hoist, the coordinator and manager said that service users must be able to weight bear or they would not be admitted to the home and that both wheelchair users were able to take their own weight for short periods. After a complaint about inadequate heating, inspectors checked the radiators in all communal rooms and a sample of seven bedrooms. In addition, four service users were asked for their views on the temperature of their bedrooms. One said her room was cold, another said it was “a bit chilly at night”. The other two said their rooms were warm enough. It was noted that four of the seven bedrooms were a little cold and the radiators were tepid. These rooms were much warmer when checked an hour later, indicating that the heating had been turned up. The residents of two bedrooms said they had no hot water, inspectors checked one of these rooms and agreed that the water was cold. The manager said that it took some time for hot water to reach the top floor rooms. Other rooms were suitably heated and the lounge where service users were sitting was very warm. A requirement was made to ensure that there is constant heating and hot water in cold weather. The complainant had also alleged that some service users slept on mattresses on the floor. There was no evidence of this and staff and service users also denied that this ever took place. The lounge, dining room, kitchen and all bedrooms seen were clean and tidy and furnished satisfactorily. There is a very attractive welcoming hairdressing room in the home. Despite previous requirements made to ensure baths and showers are kept at safe temperatures to prevent service users being scalded, inspectors found that the shower temperature was 56 degrees centigrade instead of the recommended 43 degrees. This is of concern and an immediate requirement was made to reduce water temperature to a safe level. In some sinks and bath upstairs the water was cold. The manager was advised to monitor water temperatures regularly. The laundry was inspected. The washing machine had a sluice facility which is needed as a high number of service users have some incontinence. There was no washing powder in the laundry and no soap or hand towels for staff to wash Roseview Residential Home DS0000010679.V265388.R01.S.doc Version 5.0 Page 15 their hands after handling soiled laundry. A requirement was made to ensure constant supply of washing powder, soap and hand towels. A complaint was made to the CSCI that staff did not have access to disposable gloves. Inspectors found that these gloves were in the home but locked in a cupboard. A requirement was therefore made that a supply of disposable gloves be always available in toilets, bathrooms and the laundry room. A requirement was also made to clean the carpet in one bedroom as this had an odour. An inspection of all communal rooms, the kitchen and a selection of bedrooms showed a satisfactory level of hygiene. Roseview Residential Home DS0000010679.V265388.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 30 A review of current staffing levels is needed to ensure there are adequate numbers of staff on duty to meet service users’ needs. Good progress has been made in ensuring staff are appropriately trained to look after service users but further training is planned. This will benefit service users in that the training relates to their health and safety. EVIDENCE: Three service users gave feedback about the two care staff on duty. They said they were both “nice” and one said she loved one of the staff. Staff were seen to be interacting with service users and treating them kindly. There were two care staff on duty when inspectors arrived and the manager and coordinator were working in the office. There was no cook on duty. During the inspection, another staff member arrived to assist. Care staff were sharing the food preparation. Two staff to fourteen service users is adequate as long as additional staff cook and clean. A requirement is made to undertake a review of staffing levels to ensure these are adequate to meet current service users’ needs. The manager was advised to use the Residential Care Forum formulas to calculate staffing levels. It is a requirement for all homes caring for older people that 50 of care staff have NVQ level 2 training or equivalent. Progress is being made with this requirement which will inspected more fully at the next inspection. Roseview Residential Home DS0000010679.V265388.R01.S.doc Version 5.0 Page 17 A requirement that all staff have up to date training in moving and handling, food hygiene, fire safety and infection control is restated as not all staff have received all this training yet. However, the coordinator was able to show inspectors evidence that the home was making good progress with arranging training and the requirement should be fully complied with in the near future. Roseview Residential Home DS0000010679.V265388.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 38 Service users live in a home run by an experienced manager who is familiar with the needs of older people. Staff are currently being trained in health and safety topics. The manager needs to ensure all accidents and/or injuries to service users are recorded and reported as required. EVIDENCE: The registered manager is also the owner of the home. She is experienced at running the home and is supported by members of her family who work with her. Inspectors saw staff food hygiene certificates. A requirement is made to ensure all staff have training in various health and safety topics under standard 30 in this report. Roseview Residential Home DS0000010679.V265388.R01.S.doc Version 5.0 Page 19 One service user had sustained some bruising which was not recorded and a requirement was made to ensure accidents and injuries are recorded. Roseview Residential Home DS0000010679.V265388.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 X X 2 X X 1 2 STAFFING Standard No Score 27 2 28 3 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 2 Roseview Residential Home DS0000010679.V265388.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? yes 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 OP8 Regulation 13(4)(c) Requirement The registered person must ensure that all service users’ footwear is checked for safety to reduce their risk of falling. The registered person must ensure that all staff lock away all medication at all times. The registered person must ensure that the carpets in the dining room and ground floor hallway are cleaned and replaced. This requirement is restated. Previous timescale of 30/11/05 will not be met so has been extended. The registered person must arrange for an occupational therapist to assess the bathing facilities in the home and the cot sides provided to service users for safety and suitability and send a copy of the report to the CSCI. The registered person must ensure that the heating and hot water are on at all times in cold weather. Timescale for action 31/03/06 2. 3 OP9 OP19 13(2) 23(2)(d) 17/11/05 30/01/06 4 23(2)(n) 31/03/06 5 23(2)(p) 12/11/05 Roseview Residential Home DS0000010679.V265388.R01.S.doc Version 5.0 Page 22 6 13 (4)(c) The registered manager must ensure that the shower is fitted with a failsafe thermostatic control that locks the water temperature close to 43 degrees centigrade and send confirmation from the plumber who fits it that this has been completed. This is an immediate requirement. The registered person is required to ensure that water temperatures are maintained close to 43 degrees [previous timescales of 30/9/04 and 28/2/05 and 15/8/05 not met] The registered person must ensure that there is a constant supply of washing powder available in the laundry room. The registered person must ensure that staff have a constant supply of disposable gloves in toilets, bathrooms and the laundry room. The registered person must arrange for the bedroom carpet identified during the inspection to be cleaned or replaced. The registered person must ensure there is a constant supply of soap and hand towels in the laundry room. The registered person must ensure that all staff working in the home have up to date training in moving and handling, food hygiene, fire safety and infection control. This requirement is restated. Previous timescale of 28/10/05 not met. 18/11/05 7 OP26 16(2)(e) 10/12/05 8 OP26 13(3) 10/12/05 9 OP26 23(2)(d) 28/02/06 10 OP26 13(3) 10/12/05 11 OP30 18(1)(c) (i) 31/03/06 Roseview Residential Home DS0000010679.V265388.R01.S.doc Version 5.0 Page 23 12 OP27 18(1)(a) 13 OP38 13 The registered person must review the staffing levels in the home to assess whether more staff are needed on duty and inform the CSCI of the outcome of the review. The registered person must ensure all accidents and /or injuries to service users are recorded and reported. 31/03/06 12/11/05 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 Refer to Standard OP7 Good Practice Recommendations Review meetings should be arranged for two service users who currently have complex needs. Roseview Residential Home DS0000010679.V265388.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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