Inspection on 24/02/06 for Roseville

This inspection was carried out on 24th February 2006.

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

Roseville 01/11/07

Roseville 23/08/06

Roseville 30/11/05

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Roseville Marine Gardens Preston Paignton Devon TQ3 2NT Lead Inspector Annie Foot Unannounced Inspection 24th February 2006 11:15 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 Roseville DS0000065294.V268630.R01.S.doc Version 5.1 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. Roseville DS0000065294.V268630.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Roseville Address Marine Gardens Preston Paignton Devon TQ3 2NT 01278 741279 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) Underhill Care Ltd Mrs Dianne Bradley Care Home 22 Category(ies) of Dementia - over 65 years of age (22), Old age, registration, with number not falling within any other category (22), of places Physical disability over 65 years of age (22) Roseville DS0000065294.V268630.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30 November 2005 Brief Description of the Service: Roseville is a detached property situated in a level residential area, approximately 200 yards from the sea front and quite near to some local shops. The home cares for up to 22 service users aged 65 or over, who may have varying levels of physical and/or mental frailty. The home benefits from having level access to the ground floor, where the communal rooms are situated, and the garden. There is a shaft passenger lift to the first floor. All bedrooms are single rooms, and all have en suite toilet and washbasin facilities. There is a car parking area at the front of the building. Roseville DS0000065294.V268630.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place during the morning and part of the afternoon, on the 24th February 2006. It was the second inspection of the year. The purpose of the inspection was to follow up on requirements and recommendation made at the previous visit and to assess progress in other areas. Requirements and recommendations from the previous inspection had all been addressed and met. The registered manager was on annual leave but on being informed by staff of the inspection came in to the home and was present throughout the inspection. Four care staff were on duty together with the cook and cleaner. The premises are currently fully occupied with 22 residents living at the home. The inspection included discussion with residents and staff, a partial tour of the building and inspection of health & safety, medication, care and other records. The proprietors have owned the home for three months during which time various improvements have been made to the property and equipment at the home. What the service does well: What has improved since the last inspection? The new owners have already put considerable new resources into the home including: Fitting new carpet and curtains in the lounge, installing new washing and drying machines. Purchasing, lifting and specialist equipment for residents; installing new freezers in the kitchen and obtaining a medication Roseville DS0000065294.V268630.R01.S.doc Version 5.1 Page 6 trolley. There is also a new computer in the office to aid organisation and efficiency. A company car has been supplied to provide transport for residents. A new conservatory has arrived which is waiting to be fitted. This will provide a pleasant space for residents to sit, overlooking the gardens. A new health and safety manual is in place and is being worked through by the manager. Medication requiring cold storage is stored in a locked container in the fridge. Uniforms for staff have been introduced. The manager and all staff spoken to were positive in their observations of the new ownership. 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. Roseville DS0000065294.V268630.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Roseville DS0000065294.V268630.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 Residents and potential residents and their families receive clear information, to assist them in making a decision to choose the home. EVIDENCE: All other standards in this section were assessed at the previous inspection were met and were therefore not reassessed on this occasion. The statement of purpose and service user guide has been revised (2/2/06) following changes to the management of the home. The manager is waiting for approval from the owners before distributing new documents. A minor amendment is still needed to insert Room sizes in the statement of purpose. Roseville DS0000065294.V268630.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 9,10 There is a clear care planning system in place to ensure that resident’s needs are met. But the procedure for review of care plans is confused making it difficult for changing needs to be consistently met. The systems for the administration of medicines are clear and consistent ensuring residents medication needs are met. EVIDENCE: A random selection of four care plans were inspected. The process of reviewing and assessments and care plans is confusing. Care plans are developed from the initial assessment. Plans are reviewed but not as frequently as once a month. This was discussed with the manager. Care plans are detailed and are backed up by daily resident reports. Not all files seen included a photo of the individual resident. Since the last inspection a new drugs trolley has been obtained, which has improved the organisation of medication. This is fixed to the wall of the dining room. Medicines requiring cold storage are held in a locked container in the Roseville DS0000065294.V268630.R01.S.doc Version 5.1 Page 10 fridge. This was discussed. It was explained that there was not room for a separate medication fridge. Administration of lunchtime medication was observed. The member staff was competent and clear in explaining the procedures followed. Records were seen to be complete. Two residents self medicate. Controlled drugs are stored in a separate locked cabinet. A CD register is in place. Records are up to date and consistent. All staff who administer medication have received appropriate training. Roseville DS0000065294.V268630.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 Resident’s benefit from an active social programme that meets individual interests, capacity and preferences. EVIDENCE: A positive proactive approach is taken in organising activities for residents. Residents positively participated with activities arranged both in the morning and during the afternoon of the inspection. A reminiscence session was in place as the inspection commenced. Proverbs and old sayings, were being discussed. A glass of sherry is offered before lunch. During the afternoon a game of Bingo took place. Both activities involved the majority of residents. A member of staff has responsibility for arranging the activity programme although other staff will introduce and run the session. Everyone was very positive about the programme and it was clear from interaction that residents enjoy arrangements made. Individual interests are identified at Residents meetings and all suggestions are taken up. Staff also talk with residents to try to identify particular interests. Examples of other activities offered include, music making, singing, physical exercises, talks on local history and the area, various parties, including a cheese and wine party arranged the previous week to which several family members attended. Walks along the sea front are encouraged and supported. At Christmas even more activities were arranged including a Pantomime Roseville DS0000065294.V268630.R01.S.doc Version 5.1 Page 12 performed by the staff. Outside entertainers are invited regularly to the home and photos were seen of residents having great fun at one such session. A peripatetic activity organiser also comes to the home once a week. A lot of effort is put into providing a varied, entertaining and stimulating programme. The manager intends introducing “memory books” for residents to recall past lives and interests. Residents said they choose whether to get involved or not, mostly they do, as it is real point of social contact. Staff said they aim to encourage interaction between the residents. Families are friends are welcomed at any time and residents are encouraged to participate wherever possible with the local community. Staff were observed to knock on doors before entering and were respectful in their communications with residents. Roseville DS0000065294.V268630.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Residents can be confident that complaints and issues of concern will be dealt with appropriately and in a timely manner. EVIDENCE: There is a complaints policy and procedure in place. The complaints procedure is included in the service users guide. There is reference to a timescale in the procedure, and a timescale of 7 days is stated in the policy. A flowchart is used to guide the investigating manager though the process. Staff were able to clarify correct reporting methods should a complaint arise. There have been no complaints within the last twelve months. Roseville DS0000065294.V268630.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Residents are provided with comfortable surroundings. EVIDENCE: A partial tour of the building was made. Environmental requirements from the last inspection had been met. Window restrictors have been fitted to all first floor rooms apart from one room, where the resident has refused a radiator cover and asked for window restrictors to be removed. This request had been complied with and had been recorded but rather briefly. In discussion with the manager it was agreed that further detail will be included on the residents file with the residents signature alongside, to confirm their wishes. Regular reviews of the risk assessment are needed to ensure the residents safety. The manager explained that that the owners have plans to purchase adjoining land to extend the property and its facilities. The manager said there is a maintenance plan in place and that anything needed has been supported and supplied by the owners. Roseville DS0000065294.V268630.R01.S.doc Version 5.1 Page 15 Residents rooms seen vary in size and layout. All contain evidence of personal items and possessions. The home was clean and hygienic on the day of the inspection. There was a mild hint of an unpleasant odour in Room 5 due to the incontinence of the resident. The room is thoroughly cleaned each day. A fire door was seen to be held open with a chair. Once brought to the attention of the manager this was immediately removed. Roseville DS0000065294.V268630.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28 Staff are experienced and competent in their roles. Staffing levels are reviewed to ensure that there are sufficient numbers on duty at all times to meet vulnerable and confused residents needs. Staff receive training and are encouraged to undertake external qualifications to increase their knowledge and understating of older people. EVIDENCE: Four care staff were on duty at the time of the inspection, together with the cook and cleaner. Sufficient staff were on duty to attend to residents needs. The manager explained a recent change in night staff levels, from 2 waking staff at night to one waking and one sleeping. Both the manager and senior staff confirmed that they had authority to bring in other staff should a resident be ill and need more attention. Staffing levels benefit from reviews to ensure that residents needs can be met at all times. Staff were observed in their duties and seen to sensitive and gentle with residents. Staff spoken to all said they enjoyed working at the home. Staff met were competent and skilled in working with older people, some have been employed for several years at the home. They confirmed that they received adequate training to perform their duties. A senior staff member has responsibility for arranging statutory training. There is a key working system in place. Another member of staff has responsibility for coordinating the system. Key working is working well. One member of staff said that they felt that the system helps “residents feel more secure”. Roseville DS0000065294.V268630.R01.S.doc Version 5.1 Page 17 Staff are encouraged to undertake NVQ training and a number have achieved at least Level 2. Roseville DS0000065294.V268630.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35,38 There is an experienced manager at the home, providing clear leadership and guidance to staff. But until the health & safety procedures and mandatory training is fully implemented there is a potential risk to the safety of residents. EVIDENCE: The manager has been in post since August 2005, although previously employed as deputy manager for a year prior to the new appointment. She has nursing qualifications as a RGN and in Health and Social care management. She has worked in the community for most of her previous career and has many years experience of management. The manager is responsible to the registered provider and there are clear lines of accountability within the home. The owners visit the home each week. There is an extensive Quality Assurance Manual in place. Procedures for implementation are in the development stage and more work is needed to complete the process. Roseville DS0000065294.V268630.R01.S.doc Version 5.1 Page 19 Residents meetings have been held in the past, the last one being September 2005. The frequency of meetings will be regularised once the manager is clear about plans for the development of the home. A residents survey was last undertaken in September 2004. There are a range of policies and procedures in place, which are reviewed annually. Resident’s monies are paid into “Roseville Residents Bank Account”. The manager and a senior carer are the named holders of the account. Residents are not named on the account. This practice should be reviewed to ensure residents interests are safeguarded. None of the residents have their own bank accounts. The manager explained the procedure for withdrawal of monies, which are taken out of the account and held in named envelopes for resident’s ease of access. Financial records and receipts for transactions were seen. Although there was a clear record of transactions in place, records were not signed. A double signatory is recommended. Two residents manage their own finances with support from families. A new health and safety manual has been received at the home. The procedures are being developed and have not yet been implemented. Manual handling training is offered to staff, but is out of date. Staff do not receive regular training in fire prevention. Accidents are recorded. Completed incident forms should be stored confidentially in residents’ or separate files. Falls are closely monitored. Health and safety training is offered to new staff at induction. Records were seen. The COSHH file was seen. This is supported by risk assessments. Roseville DS0000065294.V268630.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 x 3 x x x x x 2 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Roseville DS0000065294.V268630.R01.S.doc Version 5.1 Page 21 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. 2. Standard OP7 OP19 Regulation 15 (2) 23 Requirement Care plans must be reviewed at least once a month to reflect changing needs of residents. Staff must be reminded that fire doors must not be held open at any time. All staff must receive fire training at least twice a year. Manual handling training must be provided for all staff. Timescale for action 31/03/06 24/02/06 3. OP38 13 (4) 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Roseville DS0000065294.V268630.R01.S.doc Version 5.1 Page 22 No. 1 2 3 Refer to Standard OP25 OP33 OP35 Good Practice Recommendations A detailed risk assessment and regular monitoring system is needed for Room 22, where radiator covers and window restraints are not fitted. Quality assurance systems need to be developed to take into account the views of residents, families and other interested parties. To ensure that financial records are signed by two people to safeguard residents interests. Roseville DS0000065294.V268630.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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