Inspection on 10/06/08 for Roseview Residential Homes

This inspection was carried out on 10th June 2008.

CSCI found this care home to be providing an Good service.

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 01/06/07

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 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Roseview Residential Homes 91-93 Cat Hill East Barnet Hertfordshire EN4 8HP Lead Inspector Brian Bowie Key Unannounced Inspection 18:30 10th June 2008 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.V362556.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.V362556.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 0208 361 5114 info@roseviewcarehomes.co.uk Mrs Agatha Annin-Adjei Mavis Mansa Setsofia Care Home 10 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0) of places Roseview Residential Homes DS0000065993.V362556.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following categories of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old Age, not falling within any other category - Code OP 2. Dementia - Code DE(E) The maximum number of service users who can be accommodated is: 10 1st June 2007 Date of last inspection Brief Description of the Service: Roseview is a private residential home owned by Mrs Agatha Annin-Adjei, who also runs two other care homes in North London. The home opened in 2006. The home is registered to provide personal care for 10 elderly people including people who have dementia. The home is purpose built, and each resident has a single bedroom with en suite facilities. The bedrooms are on three floors. There is a lift available to reach the bedrooms above the ground floor. 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 is close to bus stops. The Cockfosters underground station on the Piccadilly line can be reached by car in a few minutes. At the front of the building there is parking space for staff and visitors’ cars. Information about the home, including the service users’ guide and the CSCI inspection reports, are available from the home by contacting the provider. Copies are also kept in the reception area so that they are available to all visitors. Roseview Residential Homes DS0000065993.V362556.R01.S.doc Version 5.2 Page 5 The fees for the home depend on the assessed needs of people living at the home and at the time of the inspection ranged from £470.00 to £600.00/week. Roseview Residential Homes DS0000065993.V362556.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspection started on June 12th 2008 and finished on June 14th and was unannounced. The inspection began at teatime so that the early evening routines in the home could be observed. The inspection took fifteen hours to complete. The area manager and the manager were both interviewed and assisted with the inspection. The inspection is the annual key inspection and the aim is to look at how well the service is meeting the key National Minimum Standards for Older People. One of the residents showed us around the home. All ten people resident in the home at the time of the inspection were seen. Time was spent with residents in order to get their thoughts and experience of living at Roseview. We also interviewed staff to get their views and comments on the home. Relatives, friends, and care professionals involved with the home provided written and verbal feedback on what they thought about the home. We received seven surveys completed by residents, 2 by health professionals and seven from members of staff. A wide range of records, including care plans, staff files and health & safety documents, were also looked at. The home’s Annual Quality Assurance Assessment also provided considerable detail about the running of Roseview. The overall impression from the inspection was of a home that is providing a good standard of care within a very friendly, homely and supportive environment. This was confirmed by the amount of positive feedback, written and verbal, that was received from residents, relatives and professionals involved with the home. A friend of a resident who had visited the home several times said: ‘The home is extremely well run.’ The inspector would like to thank the residents, staff and relatives for their assistance with the inspection process. What the service does well: Residents feel at home and relaxed at Roseview because staff pay close attention to meeting their individual needs. Residents themselves said they enjoy living at Roseview and are happy with the quality of care they are getting. Relatives and friends were also very positive about the quality of care Roseview Residential Homes DS0000065993.V362556.R01.S.doc Version 5.2 Page 7 in the home and emphasised that they appreciated being able to visit whenever they wanted. Residents benefit from the opportunity to go with staff on a one to one basis to the local shops and community facilities, such as library, cafes and parks. Within the home residents enjoy taking part in a range of activities, such as reminiscence, cooking, exercises and games of various kinds. The management team works closely with other care professionals. As a result the home is able to meet the needs not just of older people with dementia, but people who may have additional mental health needs. The home has an experienced manager, a committed and caring staff team and has been furnished and decorated to a good standard. As a result the residents benefit from living within a supportive, attractive and comfortable living environment. What has improved since the last inspection? What they could do better: No major areas of concern were found at this inspection. A number of recommendations are made to improve care practice further in the home. These included making key documents, such as the statement of purpose and the service user guide as attractive and as accessible as possible to residents. More work is needed to ensure that careplans are as person-centred as possible and fully reflect the life histories and wishes of residents. Consideration should be given to the appointment of an activity organiser who has been specially trained to provide a range of stimulating activities, both inside and outside of the home for people with dementia. It is also recommended that ways are found of making the tables at mealtimes more attractive and that their layout take account of the preferences of the residents sitting there, for example for water to be on the table where appropriate. Roseview Residential Homes DS0000065993.V362556.R01.S.doc Version 5.2 Page 8 Where residents have persistent concerns because of their mental health difficulties it is suggested that a record is kept of these concerns and the action taken by the home to deal with and minimise these issues. In this way it will be clearer to all involved what action has been taken by the home to address these concerns. The home has taken steps to make the living environment as easy as possible for people to find their way around. However further ways to ensure the living environment is as enabling as possible for residents, for example greater use of signage, photos, should be explored. Finally the home could keeps a record of suggestions made by residents that have been followed up and of compliments received so that the home can draw on these examples when completing the annual quality assurance assessment and in key documents such as the statement of purpose and the service user guide. At the conclusion of the inspection the area manager and manager indicated that they were keen to follow up all recommendations made and were committed to a process of continuously raising standards within 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.V362556.R01.S.doc Version 5.2 Page 9 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.V362556.R01.S.doc Version 5.2 Page 10 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): 1,3 (NMS 6 does not apply to this home) People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Detailed information about the home is available so that potential residents and families are able to make an informed decision when considering Roseview as a possible placement. When people move into the home the manager works out what they want and need so that the home is sure it can meet these wishes and needs. EVIDENCE: The statement of purpose and service user guide, were inspected. Both of these documents were clearly written and contained all the necessary information. As a result potential residents and families are able to make an informed decision when considering Roseview as a possible placement. In Roseview Residential Homes DS0000065993.V362556.R01.S.doc Version 5.2 Page 11 order to make these documents attractive and more accessible to residents it is recommended that more use is made of visual material, including photographs so that residents and families have a better idea of what to expect from Roseview. A review on a resident who had recently moved to Roseview had noted: ‘Health professionals informed the resident that they appeared to be much better than when discharged from the hospital and this was attributed to the level of care and support that Roseview care home was providing.’ A resident who had recently moved in said at their review: ‘During the first few weeks I was slightly unsettled, however I am now much more settled and want to stay at Roseview.’ These comments indicate that Roseview assesses and then responds to the needs and wishes of new residents. Four case notes for residents were inspected and these all contained assessments that had been carried out by the home before the person had moved in. Files also contained assessments by other professionals. As a result the home is good at meeting the needs and wishes of new residents. We discussed the current needs of the people living in the home with the care staff and observed the care they were receiving. The staff felt confident that they were meeting the needs of the residents and this was reflected in the care that was observed. Roseview Residential Homes DS0000065993.V362556.R01.S.doc Version 5.2 Page 12 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): 7,8,9,10 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The individual plans of care for each resident reflect the needs and wishes of the resident. Residents benefit from the close attention paid by staff at Roseview to meeting their health needs. The home is good at ensuring there are safe and effective arrangements in place in relation to medication. Staff are good at treating residents with respect EVIDENCE: The records for four residents were looked at and indicated that for each one there was a current plan of care which set out the needs of the resident and how they were to be met by the home, with evidence that these were being reviewed regularly. In addition each file contained an assessment of any areas where there was considered to be any risk to the resident and how these risks were to be dealt with and reduced as far as possible. There is a keyworker Roseview Residential Homes DS0000065993.V362556.R01.S.doc Version 5.2 Page 13 system in place so that members of staff have specific responsibilities in relation to each resident, including updating careplans monthly. As a result residents are having their needs met at the home. This was confirmed by the findings of several reviews which were looked at and which included comments from social workers such as: ‘Roseview is meeting the individual’s needs.’ ‘The placement is suitable and continues to meet the person’s needs.’ As previously required careplans now contain more information about the social, cultural and religious needs of residents so that care provided is holistic. Careplans have become more person-centred so that they now include life histories. It is recommended that further ways are found of making the careplans even more person-centred so that staff have as clear a picture as possible about the individual need and wishes of each resident, including relevant life history information. ‘The Service is very caring.’ ‘Roseview cares well for residents.’ These were the comments of two health professionals involved with the home and indicates the home is responding well to the health needs of residents. Feedback from friends spoken during the inspection was very positive about the commitment of the home to keeping residents as well as possible. The records confirmed that residents see dentists, opticians, chiropodists and district nurses. A GP has been commissioned by the home to provide a regular fortnightly surgery at the home. As a result residents have good access to healthcare and this has contributed to their health needs being responded to earlier and more effectively. The continence advisor is consulted as needed. Specialist input from mental health or psychogeriatric services is obtained when needed. There is a close working relationship with mental health services so that residents with mental health needs are supported appropriately. Staff had also recently attended training on mental health in order to increase their knowledge and competence in this area. The medication administration records were up-to-date and accurate. Staff who administer medication have been trained in how to administer medication safely and effectively so that residents are fully protected in this area. A pharmacist checks quarterly the medication arrangements in the home. In April 2008 they had found that medication arrangements were satisfactory. It was also noted that the timing of administering medication could be adjusted to meet the needs of individual residents, for example having medication later in the morning if the person wanted to get up later. Roseview Residential Homes DS0000065993.V362556.R01.S.doc Version 5.2 Page 14 Throughout the inspection the staff supported residents with their personal care, meals and getting around the home. This was done in a manner that respected the residents’ privacy and dignity. It was observed that the staff were very aware of the mood and comfort of the residents and responded to any signs of distress. One care plan noted how staff support a resident who gets very agitated: ‘Carers calm the resident by speaking to them in a soft and gentle manner.’ Comments from a residents and relatives confirmed that the home is good at treating residents with respect and dignity. This is especially important in relation to residents who have dementia and are therefore particularly vulnerable. Throughout the inspection staff were observed to have a caring approach that enabled people to maintain their dignity. Roseview Residential Homes DS0000065993.V362556.R01.S.doc Version 5.2 Page 15 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): 12,13,14,15 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Roseview is good at making residents feel at home and comfortable and ensuring that their cultural, religious and sexuality needs are met. The home is also good at welcoming and encouraging relatives and friends to be actively involved with the residents at the home. Residents are benefiting from a stimulating range of activities and from having choices about how they lead their life at the home. Residents enjoy healthy and appetising meals with their individual and cultural preferences catered for. EVIDENCE: Staff are good at treating people as individuals, for examples residents’ birthdays are celebrated in the home. The religious wishes of residents are responded to with some going out to church. A priest from the Roman Catholic Roseview Residential Homes DS0000065993.V362556.R01.S.doc Version 5.2 Page 16 Church regularly visits residents at the home. The manager gave examples of how the staff had supported a resident who was gay so that the individual had felt comfortable in the home about their sexuality. During the inspection we observed that this individual was able to be quite open about their sexual orientation. Over the course of the inspection a number of residents went out on a one to one basis with staff to the local shops, library, café and park. Residents commented: ‘It’s very nice to go out. I enjoy going shopping.’ Residents were seen to return from these trips both stimulated and in good spirits. Staffing levels means that residents get out frequently and a record is kept to confirm that people do get out on a regular basis. We observed an activity session involving cooking a cake that really engaged a number of residents. A range of activities is provided in the home, including reminiscence, exercises, board games, bingo, art, and manicure and pedicure sessions. In order to improve further the variety and quality of activities on offer it is recommended that the home recruits an activity organiser who has been specially trained in providing varied and stimulating activities, both group and individual, for people with dementia. Two friends of one of the residents were spoken to and said they appreciated the welcoming atmosphere in the home. These friends had been invited to attend a meeting in the home to discuss the resident’s progress and wellbeing. They said they felt involved with the support being provided by the home. A number of residents had family members visiting regularly or went to visit their relatives. Residents are getting out into the local community on a regular basis and are making use of local facilities, such as shops, library, cafes and parks. Dial-a- Ride, as well as the home’s own vehicle, is used so that people can get out and about. Residents are offered choices in how they spend their time. Some residents preferred to get up later in the morning and have breakfast in their room. They had been provided with a small fridge and would make their own breakfast. One resident had wanted to be able to go out on her own to the local shops. The risks in this situation had been assessed and a plan implemented so that the individual was able to go out on their own which they clearly valued. Meetings are held with the residents so that they can make choices about the meals served in the home and outings they would like. ‘I like the food here- it’s very nice.’ ‘Sometimes the food is a bit bland.’ Roseview Residential Homes DS0000065993.V362556.R01.S.doc Version 5.2 Page 17 There were mixed comments from residents about the meals served. The lunchtime was sampled and found to be tasty with ample portions provided. Table decoration and appearance was basic and uniform. It is recommended that ways are found of making the tables more attractive and that their layout take account of the preferences of the residents sitting there, for example for water to be on the table where appropriate. Staff supported residents who needed assistance at mealtimes. Residents are asked each day for their choices in relation to all meals served. Careplans record any cultural preferences of resident in relation to meals, with religious festivals such as Ramadan being celebrated with appropriate food. In between meals snacks and fresh fruit are available. The cook was interviewed and confirmed that she had a food hygiene certificate. The kitchen had recently been inspected by Environmental Health and awarded four stars indicating a high standard had been achieved. Roseview Residential Homes DS0000065993.V362556.R01.S.doc Version 5.2 Page 18 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): 16,18 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The residents can be confident in the complaints procedures in the home that make sure their concerns are responded to whilst at Roseview. The residents benefit from safeguarding adults procedures that make sure that they are safe and secure whilst at Roseview. EVIDENCE: The home has a complaint procedure so that residents and relatives know how to make a complaint if they are unhappy with any aspect of the home. The complaint book showed that only one complaint had been made since the previous inspection. This had been an adult protection allegation that had been fully investigated and found to be unsubstantiated. Written and verbal feedback from residents was positive about how they feel they are looked after at Roseview. One resident commented: ‘I’ve had no concerns since moving here.’ In some case residents have persistent anxieties and concerns which may be related to their mental health needs. It is recommended in these cases that a record is kept of these persistent concerns and the action taken by the home Roseview Residential Homes DS0000065993.V362556.R01.S.doc Version 5.2 Page 19 to deal with these issues. In this way it will be clearer to all involved what action has been taken by the home to address these concerns. A friend of a resident said that they had been able to raise concerns at a meeting at the home and that these had been positively and constructively responded to by the management team for the home. Care staff have had training in safeguarding adults policies and procedures. At the end of 2007 an allegation had been made which had been followed up by the local authority. The home had followed the appropriate procedures in relation to the safeguarding of adults. The home had a copy of the London Borough of Barnet’s policies and procedures for safeguarding adults. Feedback from residents, friends, and social workers confirmed that residents felt safe and secure at the home. The manager said that the welfare of the residents was her top priority and this was reflected in the care practice seen at the home throughout the inspection. Immediately following the inspection Roseview revised its safeguarding adults policy in order to ensure it is up to date and reflected current terminology and procedures. Roseview Residential Homes DS0000065993.V362556.R01.S.doc Version 5.2 Page 20 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): 19,26 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents at Roseview enjoy an attractive and comfortable living environment that adds considerably to their quality of life, with a high standard of cleanliness and hygiene maintained in the home. EVIDENCE: This is a relatively new home which opened in 2006. The building, furniture and fittings still appear new and attractive. There is a lift so that all floors can be easily accessed by residents. Each person has a spacious bedroom with en suite facilities. The halls and the stairs are wide and bright with good natural light. There is a large and attractive garden at the rear of the property with good views over the surrounding countryside. The garden is well maintained, Roseview Residential Homes DS0000065993.V362556.R01.S.doc Version 5.2 Page 21 with a patio area and garden furniture so that residents can sit outside if they wish. People spoken to said that they liked their bedrooms. All the bedrooms seen contained plenty of personal items, including photos, and had a comfortable and homely feel to them. Residents appear settled and at home in their living environment and this was reflected in the way some would assist with clearing up dishes after meals or sweeping the carpet. Most residents have some degree of dementia so it is important that the environment in the home is as easy and clear as possible for people to move around in. Specialist advice has been obtained in order to ensure the home is as accessible and enabling as possible for the residents. A loop system is in place so that residents with hearing difficulties can hear more easily. Direction signs to toilets have been put up so that residents can make their own way to the toilets more easily. One resident who used to wander into other people’s bedrooms has been helped to find their own room by putting lots of family photos in it. It is recommended that further ways are found to ensure the living environment is as enabling as possible for residents. All the areas were clean, tidy on the day of the inspection. A friend of one of the residents who visits the home regularly commented: ‘The home is always very clean and fresh.’ As previously required air-dryers had been fitted in bathrooms and toilets in place of cloth towels. As a result there is less risk of cross-infection in the home. Roseview Residential Homes DS0000065993.V362556.R01.S.doc Version 5.2 Page 22 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): 27,28,29,30 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by the committed, competent and experienced team of staff at the home. Residents are protected by the home’s rigorous recruitment procedures for new staff. Residents enjoy a good quality of life because staff have the training they need to support people well. EVIDENCE: ‘Staff work hard-they really want to help, and work well as a team.’ This was the comment of one member of staff about the staff team, but was typical of the considerable amount of positive feedback from residents and their relatives about the staff at Roseview. As a result the residents’ experience of the home is of a caring environment where they feel they will be looked after and allowed to make choices. Staffing levels have been increased in order to ensure residents’ needs continue to be met. As a result residents go out regularly into the local community with staff support. The staff rotas indicated that three staff are on shift in the morning and two in the afternoons. A waking night and an on-call member of staff cover the night shifts. A cook and a cleaner also work at the home on weekdays. Staff spoken to had a good Roseview Residential Homes DS0000065993.V362556.R01.S.doc Version 5.2 Page 23 knowledge and understanding of each resident and their needs, and were aware of cultural, religious and sexual issues in relation to residents. A member of staff explained how a minister had been contacted to provide religious support in the home for two of the residents. Consequently residents get the level of support they need whilst at the home. Feedback from residents and relatives was positive about the staff at the home. Nearly all staff have achieved or are undertaking NVQ Level 2 training in caring for older people to improve their skills further. In some cases staff have progressed to NVQ3 and NVQ 4. As a result residents get a good quality of support and care from the staff at the home. The home has its own bank of staff it can draw on to cover staff absent through sickness and leave. The home therefore makes no use of agency staff. As a result residents benefit from having care provided by staff who have got to know them well. Staff files were looked at and contained the information needed to confirm that staff have had the appropriate checks made. Before a new member of staff starts working at the home a new CRB (Criminal Records Bureau) disclosure is obtained. Written references and proof of identification are also obtained. These procedures help to ensure that residents are protected from unsuitable staff. Staff files showed that staff had done training in essential areas, such as food hygiene, health and safety, infection control, administering medication, dementia awareness, first aid and safeguarding adults. New members of staff complete a comprehensive induction programme so that they are well prepared for their caring role and responsibilities. Staff spoken to confirmed that they had attended lots of training. Recently staff had attended training in mental health since residents with more complex mental health needs are being supported at Roseview. As a result residents benefit from support being provided by staff with the required skills to meet their specialised needs. The home has provided more guidance to staff about equality and diversity issues through a new policy and training. As well as religious preferences being responded to, staff are now more away of sexuality issues so that a supportive environment has been promoted for a resident who is gay. Roseview Residential Homes DS0000065993.V362556.R01.S.doc Version 5.2 Page 24 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): 31,33,35,38 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from having the home run by a manager who is very experienced and qualified to manage a care home. The home is good at getting feedback from residents, their families and other key parties so that it is able to continuously raise standards. The home makes sure that residents’ monies are properly looked after. The home has effective health and safety procedures in place so that residents are kept safe and secure at all times whilst living at Roseview. EVIDENCE: Roseview Residential Homes DS0000065993.V362556.R01.S.doc Version 5.2 Page 25 ‘She is always ready to support everyone at their point of need. Mavis is very reliable and supportive.’ This was the comment of one member of staff about the manager, Mavis Setsofia. The manager has considerable experience of working with older people, particularly those with dementia. She has completed the Registered Managers (NVQ 4) Award course for running a care home and is approved by CSCI as the registered manager for Roseview. The manager demonstrated throughout the inspection her knowledge and understanding of the residents’ needs. Residents were seen to interact easily and comfortably with the manager, as well as with other staff. The manager is closely supported by the area manager, Mercedes Adusei, who regularly visits the home and assists with staff supervision. Feedback from friends of one of the residents and social workers was positive about the management team at the home and their commitment to caring for the residents. Written and verbal feedback from residents, relatives and professionals was positive about the home and indicated that they feel able to raise concerns. The home has a quality assurance procedure in order to get the views of all key parties in relation to the home so that ways of improving the service further can be identified. Meetings are held monthly that give residents the opportunity to make suggestions about the running of the home. It is recommended that the home keeps a record of suggestions made by residents that have been followed up and of compliments so that the home can draw on these examples when completing the annual quality assurance assessment and in key documents such as the statement of purpose and the service user guide. In most cases families manage the finances of residents. Where the home is dealing with residents’ monies, in relation to personal items such as toiletries, and shopping items, the records were seen to be accurate and up-to-date. Records are signed by two members of staff to ensure residents’ monies are properly safeguarded. In the case of one resident whose friends were taking on Power of Attorney responsibilities it was seen that the home was working closely and effectively with the people concerned to see that the resident’s best interests were being served. Health and safety and fire safety records were looked at. The home has contracts in place to ensure that key areas are checked regularly and any issued identified. Where action is necessary this had been taken. The home has a comprehensive fire safety risk assessment that had been reviewed in March 2008. Following this action had been taken to deal with all outstanding items. Staff have had training in fire safety. Fire drills are carried out quarterly and had been recorded appropriately. There were no gaps in the Roseview Residential Homes DS0000065993.V362556.R01.S.doc Version 5.2 Page 26 record for the weekly testing of the fire alarm. As a result of these procedures residents are kept safe and secure at Roseview. Roseview Residential Homes DS0000065993.V362556.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 3 x 3 X X x 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 x X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Roseview Residential Homes DS0000065993.V362556.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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP1 OP7 OP14 Good Practice Recommendations The Statement of Purpose and Service User Guide should be made more accessible so that residents are as informed as possible about what to expect from living at Roseview. The care plans should continue to be reviewed to ensure they are as person centred and holistic as possible. In order to improve further the variety and quality of activities on offer it is recommended that the home recruits an activity organiser who has been specially trained in providing varied and stimulating activities, both group and individual, for people with dementia It is recommended that ways are found of making the tables at mealtimes more attractive and that their layout take account of the preferences of the residents sitting there, for example for water to be on the table where appropriate. It is recommended where residents have persistent DS0000065993.V362556.R01.S.doc Version 5.2 Page 29 4 OP15 5 OP16 Roseview Residential Homes 6 OP19 concerns because of their mental health difficulties that a record is kept of these concerns and the action taken by the home to deal with and minimise these issues. In this way it will be clearer to all involved what action has been taken by the home to address these concerns. It is recommended that further ways are found to ensure the living environment is as enabling as possible for residents, for example greater use of signage, photos. It is recommended that the home keep a record of suggestions made by residents that have been followed up and of compliments received so that the home can draw on these examples when completing the annual quality assurance assessment and in key documents such as the statement of purpose and the service user guide. 7 OP33 Roseview Residential Homes DS0000065993.V362556.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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