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Inspection on 28/07/05 for Roseview Residential Home

Also see our care home review for Roseview Residential Home for more information

This inspection was carried out on 28th July 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Roseview is a comfortable and well-maintained home provides a good standard of care and makes every attempt to meet individual service user`s needs. Service users confirmed that they are happy with the care they receive at the home. The inspector observed that there is a good rapport between service users and staff and the recent recruitment of new staff has not adversely affected the quality of care offered by the home. Service users have confidence in the staff and management of the home and the way in which the home is run.

What has improved since the last inspection?

The home has purchased and installed a washing machine with a sluice cycle. The home is now registered with the date protection agency. Medication returned to the pharmacy is clearly recorded. Care plans are reviewed on a monthly basis.

What the care home could do better:

The inspector is concerned that despite requirements at previous inspections the water temperatures in service user bathrooms is dangerously high and puts service users at high risk. Care plans still do not contain information on service user`s history and their social interests. The home caries out pre-admission assessments but these must be dated. Care plans and risk assessments must contain more detailed information on service user`s risks and needs. All staff must receive training in core areas relating to their work such as food hygiene, moving and handling, fire safety, and infection control. The carpets in the dinning room and ground floor hallway must be cleaned and replaced.

CARE HOMES FOR OLDER PEOPLE Roseview Residential Home 17 The Limes Avenue London N11 1RE Lead Inspector Georgia Chimbani Unannounced 28 July 2005 @ 13.15 pm 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 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 G59 S10679 Roseview Residential Home V216787 28.07.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Roseview Residential Home Address 17 The Limes Avenue, London, N11 1RE 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) 020 8368 9195 Mrs Agatha Annin-Adjei Mrs Agatha Annin-Adjei PC - Care Home 14 beds Category(ies) of DE - Dementia - over 65 registration, with number OP - Old age of places Roseview Residential Home G59 S10679 Roseview Residential Home V216787 28.07.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 24 January 2005 Brief Description of the Service: The home is owned and managed by Mrs Agatha Annin–Adjei with support of various members of her family. The registered provider owns another home in Haringey for servce users suffering from mental disorders. Roseview is registered to provide residential care to 14 older people with or without 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 home’s 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 G59 S10679 Roseview Residential Home V216787 28.07.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was three hours and thirty minutes in duration. Present was the registered person Mrs Agatha Annin-Adjei and Ms Mercedes Adusei the Co-ordinator. As part of the inspection process the inspector was able to speak to all fourservice users. Attempts were made to speak to some service users however this was not successful due to the level of their dementia. Feedback on the quality of care offered by the home was very positive. An interview was also held with a relatively new member of staff. They gave an optimistic view on the standard of care offered by the home and the support from management. Six requirements were issued at the last inspection. Four are met and two are restated. A further five requirements are issued bringing the total number of requirements to seven. What the service does well: What has improved since the last inspection? The home has purchased and installed a washing machine with a sluice cycle. The home is now registered with the date protection agency. Medication returned to the pharmacy is clearly recorded. Care plans are reviewed on a monthly basis. Roseview Residential Home G59 S10679 Roseview Residential Home V216787 28.07.05 Stage 4.doc Version 1.40 Page 6 What they could do better: 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 G59 S10679 Roseview Residential Home V216787 28.07.05 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Roseview Residential Home G59 S10679 Roseview Residential Home V216787 28.07.05 Stage 4.doc Version 1.40 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 standard(s) 3 The absence of dates on pre-admission assessments casts doubt on whether service user’s needs have been fully assessed before admission. EVIDENCE: The inspector was informed that three service users have been admitted since the last inspection. The files of all three service users were examined and it was noted that all contained pre-admission assessments from the local authority. Pre-admission assessments are also carried out by the home however these were not dated therefore it was difficult to determine when the assessments were carried out. This is required. Roseview Residential Home G59 S10679 Roseview Residential Home V216787 28.07.05 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9, and 10 The information currently held in care plans and risk assessments is insufficient. It is doubtful whether service user’s needs can be fully met in the absence of comprehensive information on their needs. Service users are satisfied with the level of respect that they are accorded by staff working in the home. EVIDENCE: The care plans and risk assessment documents of the three newest service users to move into the home were examined. There was evidence of monthly reviews and risk assessments had been recently reviewed. Care plans examined contained limited information. For example there was no information on food/dietary preferences, medication, activities and social interests and mental health. Care plan needs were termed “problems.” It was discussed that the use of this term was very negative and implied that service user’s needs were problems. A service user who had made an allegation of abuse had this noted as a “problem” in their care plan and this continued to be reviewed monthly with other care plan needs. Some risk assessments did not contain sufficient information on the risk identified. For instance a service user was described as verbally aggressive and the action to be taken by staff was to encourage them not to be verbally abusive. There were no details on whether Roseview Residential Home G59 S10679 Roseview Residential Home V216787 28.07.05 Stage 4.doc Version 1.40 Page 10 this abuse was directed at staff and or other service users, whether there were any known triggers and various ways in which the service user could be helped to calm down. The registered person must ensure that risk assessments contain detailed information on the identified risks and strategies to minimise them. The home maintains detailed records of health care interventions of service users. Documentation examined revealed that a number of service users had been referred to a dietician and following this medication and supplements had been prescribed. Service users have access to various health care professionals such as GP, dentist, physiotherapist and district nurse. At the previous inspection a requirement was made for records of medication returned to the pharmacist to include the name of the medication. Recent records of medication that had been returned were seen confirming this requirement was met. Interviews with some service user confirmed that they were treated with respect and their privacy and dignity were maintained. One service user emphatically replied, “oh yes” when asked if staff knocked on her bedroom door before entering the room. The inspector observed staff addressing and treating service user with respect during their interactions. Roseview Residential Home G59 S10679 Roseview Residential Home V216787 28.07.05 Stage 4.doc Version 1.40 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 standard(s) 12, 13 and 15 The home has been able to meet individual dietary needs thereby ensuring high levels of service user satisfaction. Service users expressed satisfaction with current activities however their individual interests must be recorded to ensure that all their social interests are catered for. EVIDENCE: A group of four service users were observed playing bingo. The inspector was informed that they were provided with a number of activities such as puzzles and painting and these were considered appropriate to the needs of service users. At the previous inspection the registered person was required to ensure that service users have their history and interests recorded in their care plan. Three care plans examined did not contain this information therefore this requirement is restated. Service users confirmed that there are no restrictions on visitors. The visitor’s book was inspected and it was noted that the home received regular visitors at varying times. The inspection commenced just as service users were completing their meal. Service users interviewed were able to describe what they had for lunch. Feedback on the food offered by the home was positive. Roseview Residential Home G59 S10679 Roseview Residential Home V216787 28.07.05 Stage 4.doc Version 1.40 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 standard(s) 16 and 18 Service users have confidence in the home’s complaints system. Service users are cared for in a safe environment where staff have relevant training to safeguard them from abuse. EVIDENCE: Discussions with a group of service users revealed that they would have no hesitation in approaching management if they had any complaints. Following the last inspection a service user made a complaint about a member of staff. This complaint was treated as an adult protection issue and following investigation was considered to be unsubstantiated. Documentary evidence relating to this adult protection was viewed. The inspector was satisfied that the home had followed the correct procedures. The inspector was informed that following this investigation all staff working in the home had received further adult protection training. A discussion with a member of staff confirmed that they had received this training. This member of staff showed awareness of they different types of abuse and how the training had helped her to understand abuse in relation to the needs of service users. Roseview Residential Home G59 S10679 Roseview Residential Home V216787 28.07.05 Stage 4.doc Version 1.40 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 standard(s) 19, 25 and 26 The home provides a hygienic living environment for service users but their comfort and the standard of decor must be maintained through additional refurbishments. Water temperatures must be regulated to the appropriate levels to reduce the risk of scalding to service users. EVIDENCE: The inspector was able to view the communal areas of the home. No service user rooms were inspected on this occasion. The standard of hygiene was very high and no offensive odours were detected. The home is comfortably furnished and decorated however the carpets in the ground floor hallway and dinning room need to be cleaned and replaced. This was discussed with the registered person who stated that she was aware of this and this would be included on the home’s development plan. The registered person is required to ensure that the carpets in the dinning room and ground floor hallway are cleaned and replaced. At the last inspection a requirement was made for the water temperatures to be maintained close to 43 degrees Celsius. The inspector checked the water temperature in the ground floor bathroom and found it was over 50 degrees Roseview Residential Home G59 S10679 Roseview Residential Home V216787 28.07.05 Stage 4.doc Version 1.40 Page 14 Celsius. This was drawn to the attention of both staff and management. This requirement is restated for the third time. Following a requirement at the last two inspections, the home has now installed a washing machine with a sluice cycle. The sluice option was not apparent through an examination of the washing machine and the instruction manual. However this was confirmed through a telephone discussion with the supplier. Roseview Residential Home G59 S10679 Roseview Residential Home V216787 28.07.05 Stage 4.doc Version 1.40 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 and 30 Rigorous pre-employment checks ensure that staff that have undergone the appropriate level of checks care for service users. There has been some progress in staff training, however, to ensure staff effectiveness in performing their duties, training must be arranged in outstanding areas. EVIDENCE: Three staff files of the most recently recruited members of staff were examined. All files contained an application form, a contract, an enhanced criminal records bureau checks, a recent photograph, a health declaration and two references. Training records for the same members of staff were also examined. Two of the staff had received first aid training and another two had received dementia training. All three staff had no training in moving and handling and infection control. One of the three had received food hygiene and fire safety training in a previous job. 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. Roseview Residential Home G59 S10679 Roseview Residential Home V216787 28.07.05 Stage 4.doc Version 1.40 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 The home has demonstrated it commitment to safeguard service user information by registering with the data protection agency. EVIDENCE: At the previous inspection a requirement was made requiring the registered person to register with the data protection agency. The inspector was shown documentation confirming that the home was now registered. Roseview Residential Home G59 S10679 Roseview Residential Home V216787 28.07.05 Stage 4.doc Version 1.40 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x 1 3 STAFFING Standard No Score 27 x 28 x 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x 3 x Roseview Residential Home G59 S10679 Roseview Residential Home V216787 28.07.05 Stage 4.doc Version 1.40 Page 18 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 3 7 Regulation 14 13(4) Requirement The registered person must ensure that pre-admission assessments are dated. The registered person must ensure that risk assessments contain detailed information on the identified risks and strategies to minimise them. The registered person must ensure that care plans contain detailed information on all aspects of service users needs. The registered person must ensure that all service users have their history and interests recorded in their care plan, including their preferences and capabilities. [previous timescale of 28/2/05 not met] The registered person is required to ensure that the carpets in the dinning room and ground floor hallway are cleaned and replaced. The registered person is required to ensure that water temperatures are maintained close to 43 degrees Celsius. The registered manager must ensure that the home has failsafe, Timescale for action 28/10/05 28/10/05 3. 7 15 28/10/05 4. 12 12(2)(3) 15(1) 28/10/05 5. 19 23(2)(d) 30/11/05 6. 25 13 (4)(c) 15/8/05 Roseview Residential Home G59 S10679 Roseview Residential Home V216787 28.07.05 Stage 4.doc Version 1.40 Page 19 7. 30 18(1)(c) (i) tamper proof; pre set thermostatic mixer valves fitted to bathrooms and showers. [previous timescales of 30/9/04 and 28/2/05 not met] 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. 28/10/05 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. Refer to Standard Good Practice Recommendations Roseview Residential Home G59 S10679 Roseview Residential Home V216787 28.07.05 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 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. Extracts may not be used or reproduced without the express permission of CSCI Roseview Residential Home G59 S10679 Roseview Residential Home V216787 28.07.05 Stage 4.doc Version 1.40 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!