Inspection on 02/02/06 for Rosewood

This inspection was carried out on 2nd February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rosewood 25/05/06

Rosewood 16/08/05

Rosewood 03/03/05

Rosewood 26/11/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Rosewood 30 Norwood Avenue Southport Merseyside PR9 7EG Lead Inspector Miss Orla Murphy Unannounced Inspection 2nd February 2006 4:00 Rosewood DS0000005392.V282197.R01.S.doc Version 5.1 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 Rosewood DS0000005392.V282197.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 Adults 18-65. 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. Rosewood DS0000005392.V282197.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Rosewood Address 30 Norwood Avenue Southport Merseyside PR9 7EG 01704 509582 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) Speciality Care (Rest Homes) Limited Mr John David Little Care Home 14 Category(ies) of Learning disability (14) registration, with number of places Rosewood DS0000005392.V282197.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Service users to include up to 14 LD Age range of service users is limited to 16 to 25 years Service type is limited to personal care The registered providers, Specialty Care (Rest Homes) Ltd do not rent, sublet or otherwise use or permit the use of the registered accommodation other than to service users or members of staff employed to work at Rosewood. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 16/08/05 5. Date of last inspection Brief Description of the Service: Rosewood provides accommodation and personal care for up to 12 young persons aged 16 - 25 years. A private company, Speciality Care Ltd, owns the home and manages the service. The current acting manager is John Little, who has worked for the company for a number of years. The registered Manager left in 2002.The home is located on a residential Avenue, relatively close to Southport town centre and local shopping / transport facilities. Southport train station is approximately 10 minutes journey by car. The home comprises of two, three storey properties, which are linked internally. Service users accommodation is located on the upper floors. A lift is available but not used. Ample parking is available in front of the property and there is a large garden to the rear. Transport links to Lancashire & Liverpool are good. Rosewood DS0000005392.V282197.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection was unannounced and neither residents nor staff knew the Inspector was coming. The last inspection report was examined and some requirements needed to be followed up on this visit. The Inspection was the second in the home’s required visits, which are 2 inspection visits per year. 2 students and two staff were spoken to at the inspection. One student was “case tracked”. Case tracking means that the Inspector concentrates on the care given and experiences of one or more students to get an idea of what is like to live there and how that person’s needs are being met. Case tracking also shows the inspector where needs aren’t being met. A variety of records (care plans, medical notes, complaints records, assessments, medication sheets, meeting minutes, menus, timetables, staff rotas and significant events) were examined. The bedroom of the student(s) case tracked and communal areas were also examined. What the service does well: What has improved since the last inspection? Rosewood DS0000005392.V282197.R01.S.doc Version 5.1 Page 6 Staff report that posts have been recruited to & numbers have improved. 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. Rosewood DS0000005392.V282197.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rosewood DS0000005392.V282197.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were met at the last inspection. EVIDENCE: These standards were met at the last inspection. Rosewood DS0000005392.V282197.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 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 Students make some decisions in relation to their day-to-day lives but forums to do this are not carried out regularly. EVIDENCE: The home is supposed to have very regular student meetings to address dayto-day issues and make decisions. This inspection was carried out in February 2006 but there have been no student meetings since September 2005 when new students moved in. In the minutes from this meeting, staff informed students of the purpose of the meetings, to come together, discuss group choices regarding activities, menus, and concerns. However, no meetings have been held since then. Two students spoken to said they were expecting meetings but none had been held & they didn’t know why. They thought group meetings were a very good idea. The two students spoken to felt they make reasonable decisions daily regarding their lives with the support from staff and family. But the lack of consultation by the home must be addressed. Rosewood DS0000005392.V282197.R01.S.doc Version 5.1 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 16 & 17. Students are fully involved in appropriate activities of their choice. Rights and responsibilities are encouraged as part of student’s development. Students have a healthy and varied menu, which they plan themselves. EVIDENCE: One student case tracked had a weekly timetable that covered both College and home activities. This was examined and showed she has A wide range of experiences and learning opportunities such as Computers, life skills, drama, catering, basic skills, IT, literacy, communication and personal care. These sessions were recorded and were Cross referenced with plans for sessions and evaluations for their personal Targets. All these documents were seen and were up to date. This student said she really enjoyed all the different sessions. On the evening of the inspection some groups were going out to different community activities. Responsibility is a key part of student’s individual plans. Those seen showed that student’s need to understand their learning goals and the responsibility these give them. The student case tracked was aware of this in terms of her progress. She said “ I need to pass my subjects at college because I want to Rosewood DS0000005392.V282197.R01.S.doc Version 5.1 Page 11 get a job when I leave.” Some students have behaviour agreements where they agree to abide by certain rules to help them address issues they may have and all students abide by an agreement (when they move in) that addresses areas such as bullying, group living, attendance record and behaviour. Students are supposed to chose the menu together though given there have been no meetings where the menu is discussed it is done more on a day to day basis. The menu is in both a written and picture format, which helps students who have difficulty reading. The menu was examined and showed meals were varied and nutritious. All students spoken to said the food was “good”, “fine” and “nice”. Rosewood DS0000005392.V282197.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 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 & 20. Student’s health needs are met. Medication administration systems are satisfactory. EVIDENCE: The student case tracked said staff remind her and support her with health & personal care. This was supported within her individual plan, recording that she needs prompts and encouragement to carry out her own personal care. She said she’d tell staff if she was ill. Daily records seen were mostly detailed in monitoring mood and well being of those case tracked but as at previous inspections, some days were not completed. Doctor/Health appointments/visits were recorded in their files. Discreet references to personal care given were in the daily records and were the same as those written in their assessments. Staff spoken to were very aware of the support needed by the students discussed. Rosewood DS0000005392.V282197.R01.S.doc Version 5.1 Page 13 Rosewood DS0000005392.V282197.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 Students feel able to express concerns and feel listened to but formal opportunities to voice concern are not in place. EVIDENCE: The service has a satisfactory complaints procedure. A pictorial version is available and this is both on display in the home and is issued in the service user guide. The student case tracked and another student spoken to said they knew what to do if they were worried or angry. They both said they would talk to staff, talk to their parents or discuss it at a students meeting. However, student meetings are not being held since September 2005. As these are good forums to discuss concerns or grumbles at an early stage, this is not supporting students to voice concerns/issues. The complaint record was examined and showed there were no complaints made in the home since the last inspection. CSCI has received one direct complaint regarding the service since the last inspection. The complaint concerned care practices, medication, belongings and staff observation. This complaint was upheld in parts and not upheld in others. Rosewood DS0000005392.V282197.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 The home was clean on the day of the inspection. EVIDENCE: All communal and some bedroom areas were seen on the evening of the inspection. All these areas were clean, tidy, comfortable and adequately maintained. Students are responsible for general upkeep of their bedrooms and chores around the house as part of their independent living skills. Rosewood DS0000005392.V282197.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35. The staff team present as competent but some are still working excessive hours concurrently which must have an impact on ability to work effectively. Staff recruitment follows a satisfactory procedure but files were not seen. Staff training could not be assessed, as records are not held in the home. EVIDENCE: The staff rota was examined in detail for a 3-week period. There has been a history of staff working excessive consecutive hours and this was seen as occurring again. It has been raised as a requirement at previous inspections on several occasions but still is occurring. Three staff in particular were noted to be working such hours as 3pm – 10:15 then a waking night, 10:15 – 8 am and back in at 3 pm on the same day. This does not allow for sufficient rest and will render staff unfit & unsafe for duty. This practice must cease for the protection of staff & students. Staff were observed being supportive, respectful and professional with students. Students spoken to all stated that staff were helpful and they listened to them. One student said, “ The staff are ok, nice really”. Records were mostly well completed and staff had kept Individual plans, reviews and targets up to date. Staff are aware of students individual needs and each students goals/targets. The recruitment policy & procedure were examined and found to be satisfactory. Staff files were not accessible on the evening of the inspection. Rosewood DS0000005392.V282197.R01.S.doc Version 5.1 Page 17 However, staff training records, of courses attended and planned training were not available for inspection as they have been previously. Copies of training attended and scheduled training must be held, available for inspection, in the home. Rosewood DS0000005392.V282197.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,41 & 42. The management of the home needs to improve. Students have informal, but immeasurable input into the day-to-day running of the home and give formal feedback annually. Notifications to CSCI are not up to date. Staff consecutive working hours have been excessive previously and continue to be excessive. EVIDENCE: Evidence found on the evening of the inspection indicates the Management of the home is not as effective as it should be. Students have not had the opportunity to be involved in student meetings since September 2005, denying them the opportunity to have a formal voice, make decisions as a group and contribute to the running of the home. Students & families fill out satisfaction questionnaires annually. Staff continue, despite several previous concerns highlighted by the Inspector, to work excessive concurrent hours, putting themselves and students welfare at risk. 5 serious incidents, which should Rosewood DS0000005392.V282197.R01.S.doc Version 5.1 Page 19 have been notified to CSCI by The Manager, have not been, under Regulation 37. Rosewood DS0000005392.V282197.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 Adults 18-65 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 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 1 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 2 X X X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X X X 2 X 2 X 2 2 X Rosewood DS0000005392.V282197.R01.S.doc Version 5.1 Page 21 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 24 Requirement Woodwork & rooms identified must be redecorated and carpets cleaned professionally & if not of a good standard, replaced. Staff working hours & patterns must continue to be monitored. Staff must cease working concurrent shifts as described. Student meetings must be held regularly in line with service procedure. Daily records must be completed & kept up to date. CSCI must be notified of all incidents described under this regulation. Staff training schedules, planed & attended must be available in the home for inspection. Timescale for action 15/04/06 2. 3 4 5 6 7 YA42 YA42 YA7 YA41 YA41 YA35 18 18 12 17 37 18 13/03/06 02/03/06 02/03/06 02/03/06 02/03/06 12/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Rosewood DS0000005392.V282197.R01.S.doc Version 5.1 Page 22 Rosewood DS0000005392.V282197.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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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