Inspection on 01/06/07 for Roseview Residential Homes

This inspection was carried out on 1st June 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Roseview Residential Homes 10/06/08

Roseview Residential Homes 25/07/06

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 Homes 91-93 Cat Hill East Barnet Hertfordshire EN4 8HP Lead Inspector Susan Shamash Key Unannounced Inspection 1st June 2007 10:20 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 Homes DS0000065993.V336451.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 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 Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Roseview Residential Homes Address 91-93 Cat Hill East Barnet Hertfordshire EN4 8HP 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 Mrs Agatha Annin-Adjei Ms Juliet Mwebe Care Home 10 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (10) of places Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th July 2006 Brief Description of the Service: Roseview is a private residential home owned by Mrs Agatha Annin-Adjei, who also has two other care homes in North London. The home is registered to provide personal care for 10 elderly people including people who have dementia. The home is purpose built, and each person has a single bedroom with en suite facilities. The bedrooms are on three floors and are accessible via shaft lifts. The communal areas include a lounge, a dining room, a kitchen, and a large back garden. The home is located on a busy road and can be accessible by car. The Cockfosters underground station on the Piccadilly line, is a few minutes’ car drive from the home. At the front of the building there is a parking space for staff and visitors’ cars. Information about the home including service users’ guide and the CSCI inspection reports are available from the home by contacting the provider. The weekly fees of the home depend on the assessed needs of people living at the home but currently range from £450.00 to £500.00. Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. I was accompanied by another regulation inspector, Jane Ray, for this key unannounced inspection of the home. At the time of the inspection, one person was on holiday in Ireland with family members, and another was in hospital, so eight people living at the home were in the home. We were able to speak with all of them on this occasion. Discussions were also held with three care staff and the area manager and acting manager. Care plans, staff files and the files of all people living at the home, health and safety documents, rotas, menus and other records maintained at the home were examined. The premises and the facilities of the home were inspected through a guided tour, facilitated by the acting manager. The area manager (who is also the responsible individual) for the home, was also present during the majority of this inspection. What the service does well: The home is clean and the bedrooms are spacious with en suite facilities. Care plans are updated and risk assessments are completed. New people are admitted on the basis of their assessments and the home’s ability to meet their needs. There are various activities which people can choose from and participate in and detailed information is recorded about the life histories of all people living at the home. The varieties of food provided meet the cultural and health needs of the people. One person told my colleague ‘I enjoy the food – I have a good appetite.’ The home has commissioned a general practitioner who regularly visits service users. People living at the home speak highly of the staff support that they receive. One person told me ‘the staff are very kind.’ The home has an ambitious development plan, based on a continuous improvement of services for people living there. Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Contracts need to be completed for all people living at the home and more information needs to be included in care plans about lifestyle choices to ensure that their rights and choices are respected Improved guidelines should be available regarding the support of people who have challenging behaviour to ensure that people living at the home are protected from abuse. An identified carpet needs to be cleaned and hygienic hand drying facilities are needed to protect the health and comfort of people living and working at the home. Further staff members should undertake training in working with people who have dementia, food hygiene and fire safety to ensure that they are able to meet the needs of people living at the home safely and appropriately. A review is needed of the risk assessment for managing the finances of an identified person living at the home to ensure that they are protected from financial abuse as far as possible. It remains required that security procedures in the home must be reviewed to ensure that people are not exposed to unnecessary risks, and more detailed information should be recorded for fire drills. Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 7 Recommendations are made regarding the need to explore religious and community links, making the building easier to navigate for people, further staff training in relevant health care topics, greater staff participation in meetings and obtaining the views of health and social care professionals about the running of the home. 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. The summary of this inspection report can be made available in other formats on request. Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 8 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 Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 and 5. (6 is not applicable as the home does not provide intermediate care). Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The rights of most people living at the home are protected by appropriate contracts. They can be confident that their needs will be assessed to ensure that they can be met on admission to the home and have the opportunity to visit the home to decide whether they wish to live there. EVIDENCE: I inspected the care files of five people living at the home, and found that these included evidence of detailed assessments both by the home and social workers or health professionals. Peoples’ health, personal care, and social care needs are outlined in these assessments including information about their cultural and religious needs. The responsible person stated that all new people’s admission to the home is based on their own assessment as well as information from health and social care professionals. Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 10 She advised that if the home believes that a new person’s needs cannot be met within the home, they would not be admitted. She also advised that prospective residents and their families are invited to visit the home prior to admission so that they can decide whether they wish to live at the home. One person living at the home told my colleague (another regulation inspector) ‘I came to look at the home before I moved in’ others advised that their families had looked at the home for them. Whilst all care files inspected included formats for contracts with the home, not all of these were completed, leaving people living at the home potentially at risk of not having their rights respected. The statement of purpose for the home indicates that people will supported to practice their religions. However it could be further updated to indicate that the home has an equalities and diversity policy that recognises people’s right to be treated with respect whatever their race, religion, ethnicity, sexual orientation or lifestyle choices. Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home benefit from detailed care planning and risk assessments so that their health and social care needs can be met according to their choices as required. Their medication needs are met appropriately and safely and their privacy and dignity is maintained as appropriate . EVIDENCE: Discussions with the responsible person, the manager and an assessment of five care files confirmed that detailed care plans are developed for the people who live at the home. The care plans are detailed and reflect the assessed needs of the people living at the home although further information should be provided about how social, cultural and intellectual needs are met to ensure that holistic care is provided. The files also contained evidence of risk assessments for people living at the home. Areas of possible risk to people were recorded, alongside descriptions of how to minimize the risks. Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 12 It was clear from the files and discussions with the responsible person that the home had consulted peoples’ families and professionals regarding some actions (e.g. use of bed-sides). The home is situated on a road with busy traffic and the issue of people leaving the home without staff noticing them is still an issue, due to problems with the security of the back door. This must be addressed as a priority. The responsible person said that a doctor privately commissioned by the home comes once every two weeks on Wednesdays to see people living at the home. Peoples’ relatives are aware of the days and times when the doctor visits the home. This has enabled families and relatives to see the doctor and represent people living at the home in discussing health related issues. People are weighed monthly and district nurses, dentists, chiropodists and opticians also come to the home to see people and monitor their health needs. Care staff, who were interviewed individually, gave a good description of how they support people with their personal care by respecting their privacy, dignity and choice. Medication is stored in a room on the ground floor. No people living at the home are self-medicating. The medicines and the medication administration record sheets were checked and found to be in order. Staff who administer medication have attended relevant training. Records were also maintained of herbal remedies administered to people living at the home at their personal request or that of their relatives, indicating that their choices are respected with regard to their health care provision as appropriate. Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at the home are encouraged to engage in recreational activities according to their choices and are supported to maintain contacts with families and friends. However they would benefit from further support for their spiritual, intellectual and cultural needs and more contact with the local community. The food provided at the home is enjoyed by people living at the home. EVIDENCE: Each person living at the home had a detailed life history recorded in their care file, providing useful information for care staff about the lives of each person. This is a very positive way of ensuring that staff engage with people as individuals. However although care plans are available for all people living at the home, they did not include sufficient information about the sexuality, social, spiritual and intellectual needs to ensure that holistic care is provided to all people living at the home. Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 14 From the assessment of peoples’ files and from the discussions with people living at the home as well as observations of activities within the home it was noted that people have opportunities to be engaged in various activities including bingo games, stories, cookery, puzzles, music, dance, colouring and drawing, manicures and pedicures, light exercises and reminiscence sessions. One person was reading the day’s newspaper and others were listening to the radio when we arrived at the home. On the day of the inspection people were involved in a cookery session making cakes, and appeared to enjoy this session a good deal. Those people living at the home who wish to, are also encouraged to be involved in home life, with some helping out at drying dishes in the kitchen or bringing their laundry down as appropriate. The responsible person advised that she is still investigating how best to ensure the spiritual needs of people are met. She had spoken to the people who use the service regarding their wishes to practise their religion, but had not yet been able to find representatives from local religious establishments to visit the home. It is recommended that this be further explored. The responsible individual advised that staff occasionally support people to go out to shops and cafés. However records indicated that this does not happen on a regular basis. The responsible individual advised that further trips out for people living at the home were being planned now that the weather is improving. The people living at the home that I spoke with said that their relatives and friends visit them and that they can talk to visitors in private in their bedrooms. One told my colleague ‘My daughter comes to see me a lot and they always make her a cup of tea,’ they also said ‘I enjoy listening to the radio and having a sing song.’ The home’s visitors’ book confirmed that relatives visited the home regularly. There is a telephone point in each bedroom and a pay phone, which can be used in private, is available for all people living at the home. The home has a two weekly rotating menu. The inspection of the menu and discussions with the responsible person confirmed that people have a choice of cooked breakfast and varieties of food for lunch. A cook is employed to prepare the meals. From records and discussions it is evident that the home caters meals that meets people’s beliefs, ethnicity and health needs. All but one of the people spoken to said the food is good and people were supported with eating their meals on the day of the inspection. The staff were observed standing by the side of the people while helping them with the food. During the tour of the premises it was observed that there were fresh fruit and vegetables available within the home as required at the previous inspection. At the previous inspection it was required that no foods be kept past their ‘use by’ date to ensure that people living at the home are not exposed to Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 15 unnecessary risks. No out of date foods were found at the current inspection, and the responsible individual advised that she had introduced a form to be completed daily to ensure that no out of date foods remain at the home. Drinks are provided to people on a regular basis, and water is left out in the dining room area for people to help themselves at other times. Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has satisfactory systems in place to ensure that people’s complaints are taken seriously and that they are protected from abuse. However insufficiently clear guidance regarding ‘restraint’ procedures may potentially place people living at the home at risk. EVIDENCE: People living at the home advised that they can talk to the staff if they have concerns or complaints. The members of staff spoken to were confident in their knowledge to deal with complaints and allegations or suspicions of adult abuse. No complaints had been recorded since the previous inspection. The staff have attended training on the protection of vulnerable adults from abuse and certificates were available to evidence this within staff files. The home has policies and procedures on complaints and adult protection. As required at the previous inspection the responsible person had obtained a copy of the placing authority’s policy on the protection of vulnerable adults from abuse. I was concerned to note that several care plans included reference to the use of ‘restraint’ when necessary for people exhibiting challenging behaviour. Discussion with staff and the responsible individuals indicated that they would not ever use physical restraint on people living at the home. However clearer Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 17 written guidelines and training are needed to ensure that staff are fully aware of non-physical interventions for people with challenging behaviour, and understand how to support them in emergency situations. The use of the word ‘restraint’ in care plans must be clearly explained or removed to ensure that people living at the home are protected from abuse. Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home benefit from a clean, spacious and well-maintained environment. However there is room for improvement in hand-drying facilities at the home to ensure that people are fully protected from the spread of infection. EVIDENCE: This is a new home, which has been operating since March 2006. The building, furniture and fittings are all consequently still new. There are three floors, which can be accessed via a lift. Each person has a spacious bedroom with en suite facilities. The halls and the stairs are wide and bright with natural light. All the areas were clean, tidy on the day of the inspection. People spoken to said that they liked their bedrooms. Toilets and bathrooms were clean and well maintained, however I was concerned to see that cloth towels were provided for people to dry their hands, Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 19 as this presents a potential risk of infection transfer. The responsible individual advised that the use of paper towels was avoided as these are frequently found to block the towels, when people flush them away instead of using the bins provided. Alternatives that are flushable or air dryers may be more appropriate for this, however the use of shared cloth towels must cease. The carpet in one identified room had a faint odour of urine, and this needs to be cleaned thoroughly for the comfort of the person living in this room. Use of a steam cleaner may be necessary. It is recommended that ways of making the building easier to navigate for people with dementia should also be explored e.g. use of colour codes, signage, pictorial formats or photos. Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home benefit from a staff team who are trained and are provided in adequate number to ensure their safety. Appropriate recruitment practices are in place to protect people living at the home from harm. However staff would benefit from further training and confidence to ensure that the needs of people living at the home are fully met. EVIDENCE: The staff rotas indicated that two or three staff are on shift every morning and two in the afternoons. A waking night and an on-call member of staff cover the night shifts. The responsible person’s name was not on the rota but she said she works at the home regularly between 9:00 am and 5:00 pm. Two staff were on maternity leave, and new staff had recently commenced work at the home. A cook also works at the home on weekdays. The people who live at the home spoke positively about the staff. Staff who were spoken to demonstrated their good knowledge and understanding of supporting people in a care home, and were aware of individual people’s preferences, cultural and lifestyle preferences. All the previous inspection it was required that all information and references obtained during recruitment procedures for the home must be verified. Four staff files were inspected, and these included two verified written references Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 21 and evidence of CRB checks as appropriate, with some missing information sent to me shortly after the inspection. The responsible person advised that vacant jobs are advertised through job centres and candidates are employed by completing job application forms and undergoing interviews. All new employees attend induction programmes. The staff sign a document to confirm that they have completed all training areas identified in the induction package. The staff files and the records seen at the home have evidence of the training undertaken by the staff. It was clear from the staff files that most have attended training on adult protection, dementia, manual handling, medication administration, first aid, fire safety, and basic food hygiene as appropriate. However the cook had not yet obtained a basic food hygiene certificate, which is necessary to ensure the safety of people living at the home. More recently recruited staff members also needed to undertake this training, as they are involved in serving and handling food at the home and should also take training in working with people who have dementia and fire safety without delay. It is recommended that all staff continue to receive training in relevant health care topics including tissue viability, care of people who have had strokes and diabetes to ensure that they are prepared for admissions of people with these conditions or if people living at the home develop these heath needs. Records showed that a large proportion of staff have completed an NVQ (national vocational qualification) at Level 2 in Care, as appropriate. Records indicated that staff are supervised on a regular basis including observations of their practice within the home and have regular staff meetings with the manager and responsible individual. Supervision was recorded in great detail including issues for improvement and how these are progressing. Staff that I spoke to confirmed that they had regular supervision sessions and meetings to ensure that they provide people living at the home with a high standard of care. Minutes of staff meetings indicated that these are largely manager-led with few issues or ideas brought forward by the staff team. Observation of staff within the home also indicated that they sometimes lacked the confidence to take decisions themselves and relied on management to tell them what to do, even in relatively straightforward situations. It is recommended that this issue be addressed. Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 22 Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager in post receives support from the responsible individual to ensure that the home is run in the interests of people living at the home. People’s finances are generally safeguarded appropriately and staff are strongly supervised to ensure that the needs of person living at the home are met. However there is room for improvement in some health and safety procedures and security procedures at the home to ensure that people are not placed at risk of harm. EVIDENCE: The home does not have a registered manager but is run by an acting manager who has made an application to the CSCI for registration, and this is Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 24 currently being processed. She is supported by the responsible individual (who is also the area manager). The acting manager has obtained the NVQ level 4 Manager Award as appropriate. Care staff spoken to said the area manager and the acting manager are approachable and supportive. The incident/accident books and residents’ files showed that detailed records are kept of all such incidents with actions in place to prevent their reoccurrence as appropriate to protect people living at the home. Although a high number of incidents were reported, the responsible individual felt that this was largely due to the newness of the home and becoming acquainted with the building, and residents needs. However I was concerned that there had been another incident in which a person had gone missing from the home. The managers advised that there is an alarm system in place on all exit doors, however people wishing to smoke in the back garden, know how to switch this alarm off, and frequently forget to switch it on again, on returning to the house. This potentially places people living at the home at risk, particularly people who are confused and can wonder out from the back door, out to the front of the home, which is situated on a busy road. Security arrangements must be reviewed in the home, in consultation with the local fire prevention office, if necessary. The home does not manage people’s finances. Records and receipts are kept in respect of the personal allowances that come to the home. The home receives and keeps the personal allowances for some people living at the home for spending on toiletries. A pool account has been opened for this purpose as the responsible person has not been able to open individual accounts for people. All transactions in relation to personal allowances are recorded and receipts are kept for auditing. However I was concerned that one person (who presented as mildly confused) was signing for and receiving their personal allowance each week, although it would be difficult for them to take responsibility for looking after this money themselves. It is therefore required that the risk assessment for this person, regarding management of their personal finances, be reviewed and that appropriate action be taken as found necessary, to ensure that they are protected from financial abuse as far as possible. As part of a quality assurance system, the registered person has developed questionnaires for people living at the home and relatives. The responsible person advised that the questionnaires had been sent out to gather information from the people who use the service and from their relatives. Feedback had been obtained and a summary of the finding was available. However other stakeholders such as health and social care professionals had not been consulted although this was required at the previous inspection. Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 25 The findings of the audit were taken forward into an annual development plan for the home, with clear objectives set including purchasing garden furniture (completed) and shower seats for en suite bathrooms, arranging meetings for relatives with expert speakers on dementia (one had been arranged and was a huge success), improving the menu(undertaken), dementia care training and a target of 75 staff trained to NVQ level 2 in care and 50 trained to NVQ level 3. In preparing for the next quality assurance audit for the home, the views of people living at the home, visitors, health and social care professionals need to be sought, in order to ensure appropriate improvements in all areas of the home’s practice for people living at the home. A detailed set of policies and procedures are available for the home including policies regarding equality and diversity. Staff have one to one supervision sessions with the manager or responsible individual regularly including observations of their practice. Detailed records are kept of these meetings. There are also regular staff and resident meetings at the home. It is recommended that greater staff participation be encouraged in staff meetings, so that their views and ideas about the management of the home can be taken into account, in the interests of people living at the home. Work experience students are also supervised to work at the home for periods of two weeks and encouraged to be involved in activities with people living at the home. Appropriate insurance cover was in place for the home. Most of the equipment and the fittings within the home are new, current portable electrical appliances, gas safety and electrical installation certificates were in place as appropriate. Fire safety equipment was being serviced regularly and the fire alarms are tested weekly as appropriate. The cook and other staff members must complete training in food hygiene and fire safety to ensure the health and safety of people living at the home. Detailed risk assessments are available for the home building as appropriate including a detailed fire risk assessment. Although records indicated that regular fire drills are held at the home, and this was confirmed by staff spoken to, records do not specify staff and residents involved in the drills, and any particular issues or lessons to be learned from each drill. This is necessary to ensure that all relevant people are included and that safety practices for people living and working at the home, are improved following each drill. Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 26 Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 27 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 2 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X 3 X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 3 X 2 Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? NO 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 OP2 Regulation 5(1c) Requirement The registered person must ensure that contracts are completed (specifying the rooms occupied) for all remaining people living at the home, to ensure that their rights are protected as far as possible. The registered person must ensure that care plans for all people living at the home include more information around sexuality, social, spiritual and intellectual needs in addition to community contact, to ensure that holistic care is provided to all people living at the home. The registered person must ensure that clear guidelines are recorded and training is provided to staff members regarding support of people living at the home who have challenging behaviour. The use of the word ‘restraint’ in care plans must be clearly explained or removed from care plans to ensure that people living at the home are protected from abuse. The registered person must DS0000065993.V336451.R01.S.doc Timescale for action 03/08/07 2. OP12 16(2mn) 17/08/07 3. OP18 13(7) 20/07/07 4. OP26 16(2j) 13/07/07 Page 29 Roseview Residential Homes Version 5.2 5. OP26 23(2d) 6. OP30 18(1ci) 7. OP35 17(2) Schd 4(9) 8. OP38 18(1ci) 23(4d) ensure that paper towels or a suitable alternative are available in all bathrooms and toilets, for hygienic hand drying to protect the health of people living and working at the home. The registered person must ensure that the identified carpet is cleaned thoroughly. Use of a steam cleaner may be necessary, to ensure the comfort of all people living at the home. The registered person must ensure that all remaining staff members undertake training in working with people who have dementia to ensure that they are able to meet the needs of people living at the home appropriately. The registered person must ensure that the risk assessment for an identified person living at the home is reviewed regarding the management of their personal finances, and that appropriate action is taken as found necessary, to ensure that they are protected from financial abuse as far as possible. The registered person must ensure that the cook and other staff members preparing, handling or serving food, undertake food hygiene training. Evidence must also be provided that all staff members have undertaken fire safety training, to ensure the health and safety of people living at the home. The registered person must, by taking appropriate actions, ensure that people living at the home do not go missing and are not exposed to risks. (Previous timescale of 15/08/06 not fully met). DS0000065993.V336451.R01.S.doc 06/07/07 17/08/07 06/07/07 17/08/07 9. OP38 12(1) 23(2) 13/07/07 Roseview Residential Homes Version 5.2 Page 30 10. OP38 23(4e) A review of security with regard to the back door must be conducted to ensure that people are not placed at risk. The registered person must 20/07/07 ensure that records of fire drills specify staff and residents involved in fire drills, and any particular issues or lessons to be learned from each drill, to ensure that all relevant people are included and that safety practices for people living and working at the home, are improved following each drill. 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 OP1 Good Practice Recommendations It is recommended that the statement of purpose be updated to indicate be further updated to indicate that the home has recognises people’s right to be treated with respect whatever their race, religion, ethnicity, sexual orientation or lifestyle choices. It is recommended that the home further explore church and other religious and community links, so that people living at the home are further integrated into the community. It is recommended that ways of making the building easier to navigate for people with dementia should, be explored e.g. use of colour codes, signage, pictorial formats or photos. It is recommended that all staff continue to receive training in relevant health care topics including tissue viability, care of people who have had strokes and diabetes to ensure that they are prepared for admissions of people with these conditions or if people living at the home develop these heath needs. It is recommended that greater staff participation be encouraged in staff meetings, so that their views and ideas DS0000065993.V336451.R01.S.doc Version 5.2 Page 31 2. OP13 3. OP19 4. OP30 5. OP32 Roseview Residential Homes 6. OP33 about the management of the home can be taken into account, in the interests of people living at the home. In preparing for the next quality assurance audit for the home, the views of people living at the home, visitors, health and social care professionals need to be sought, in order to ensure appropriate improvements in all areas of the home’s practice for people living at the home. Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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. Extracts may not be used or reproduced without the express permission of CSCI Roseview Residential Homes DS0000065993.V336451.R01.S.doc Version 5.2 Page 33 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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