Inspection on 16/06/05 for Roshini Care Home

This inspection was carried out on 16th June 2005.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Roshini Care Home 28/09/06

Roshini Care Home 13/02/06

Roshini Care Home 07/12/04

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

CARE HOME ADULTS 18-65 Roshini Care Home 25-26 Villiers Road Southall Middlesex UB1 3BS Lead Inspector Paula Eaton Unannounced 16 June 2005, 11:30 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Roshini Care Home G61-G10 s61849 Roshini v214900 160605 Stage 2.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Roshini Care Home Address 25-26 Villiers Road, Southall, Middlesex UB1 3BS Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8574 0392 020 8574 0392 Mrs Satwinder Birk Mrs Satwinder Birk Care Home 9 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia (7), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (2) Roshini Care Home G61-G10 s61849 Roshini v214900 160605 Stage 2.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Up to two service users may be aged sixty-five years and over. The room that is 10.8 square metres must only be used for respite or other short-term placements not exceeding six months (NMS 25.7) Date of last inspection 7/12/04 Brief Description of the Service: Roshini is a care home that provides personal care for up to nine service users with mental health needs. The home was registered in September 2004. The Registered Provider previously owned a three-bed care home of the same name and has now moved the service to larger premises. Roshini is a house on a quiet residential street in Southall and is owned and managed by Mrs S. Birk. The home is close to local shopping facilities, transport links and other community facilities. There is a large lounge/dining area on the ground floor, two kitchen areas and a small storage room/office. There are three bedrooms on the ground floor and six bedrooms on the first floor. There are two shower rooms on the ground floor and two bathrooms on the first floor. All bedrooms have ensuite facilities. There is an office, shower room and toilet on the second floor. There is space for parking at the front of the building and a garden to the rear. There are out buildings to the rear of the garden that include the laundry facilities for the home. Roshini Care Home G61-G10 s61849 Roshini v214900 160605 Stage 2.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over three and a half hours as part of the annual inspection process. The Registered Provider/Manager assisted with the inspection process. One other member of staff and two service users were spoken to and records, policies and procedures were examined. At the time of the inspection there were only four service users living in the home. What the service does well: What has improved since the last inspection? 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. Roshini Care Home G61-G10 s61849 Roshini v214900 160605 Stage 2.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection Roshini Care Home G61-G10 s61849 Roshini v214900 160605 Stage 2.doc Version 1.30 Page 7 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 standard(s) 2 and 4 Service users needs are assessed prior to admission to ensure the home is able to meet their needs. Service users are given the opportunity to visit the home and have a trial period to ensure the placement meets their needs. EVIDENCE: The pre-admission documentation was examined for two service users. The home carries out a pre-admission assessment that includes information regarding the service users background, any physical needs, mental health needs, social needs, behaviour, medication and assistance needed with daily living. One service user had been admitted since the last inspection. The manager said that all service users visit the home before being admitted. She said that initially service users just visit for a meal and then will stay for an overnight stay and a weekend before admission. Following this a three month trial period takes place. One service user was visiting the home at the time of the inspection and was due to move into the home shortly. There was also evidence of visits to the home in the records viewed. Roshini Care Home G61-G10 s61849 Roshini v214900 160605 Stage 2.doc Version 1.30 Page 8 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 standard(s) 6, 7 and 9 Service users needs and goals are outlined in their care plans. Any limitations on service users choices are explained to them and recorded. Satisfactory individual risk assessments are completed. EVIDENCE: Comprehensive care plans were in place. Areas of need in the care plans viewed included mental health, physical health, personal hygiene, finance, activities and discouraging isolation. These care plans had been reviewed and updated as necessary and had been signed by the service users. Records regarding Care Programme Approach meetings were also viewed and the areas of need and action corresponded with the plans developed by the home. These records were up to date. The manager said that any limitations on decision making are explained to the service users. For example, one service user has diabetes and has a tendency to eat inappropriate foods that could be detrimental to his health. Therefore a decision was made that this service user would not be allowed to keep food in his room so that his diet can be more closely monitored. Individual risk assessments were in place and included areas such as verbal aggression, road safety and risk of financial abuse. These risk assessments had been reviewed Roshini Care Home G61-G10 s61849 Roshini v214900 160605 Stage 2.doc Version 1.30 Page 9 and updated where necessary. A comprehensive risk assessment had also been completed for a trip into Central London that had taken place the day before the inspection. Service users have access to an advocacy worker from MIND who is based at a local day centre. One of the service users showed the Inspector the business card of this individual that they had in their wallet. Roshini Care Home G61-G10 s61849 Roshini v214900 160605 Stage 2.doc Version 1.30 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 standard(s) 12, 13, 15, 16 and 17 Links with the local community are good and individuals living at the home have opportunities to engage in appropriate leisure activities. Service users are encouraged to maintain links with family and friends. Meal provision in the home is good and consideration is given to the individual needs of service users. EVIDENCE: The manager said that one service user is currently being assisted with finding employment in either a florist or a post room. This service user has been completing a course in flower arranging and now feels able to look for employment. One of the service users is quite elderly and prefers to stay at home and knit. She had almost finished making a blanket out of sewn together squares of knitting at the time of the inspection. Another service user had only been living at the home for a short time and staff were working with him to motivate him to participate in activities. A trip to Madame Tussauds had taken place the day before the inspection and the service users who were spoken to said that they enjoyed the trip. Roshini Care Home G61-G10 s61849 Roshini v214900 160605 Stage 2.doc Version 1.30 Page 11 None of the current service users attend a day centre however there is a local day centre that service users can attend if they wish to. The home has an activities programme that includes shopping, visiting the local library, relaxation, gardening, and board games and trips out to use other local amenities such as the cinema and local restaurants. One service user occasionally attends a local temple. The manager said that all service users have freedom passes and are able to use local leisure centres. The manager said that generally the home has a good relationship with neighbours, there had been some difficulties with one neighbour who was unhappy with a service for people with mental health difficulties being so close to his house but this matter had been resolved. The home encourages the service users to maintain contact with their families and friends. Two of the service users have regular weekend contact with their families and one service user does not see her family but is assisted to write to a friend and an aunt. Staff were working with the other service user and his family to try and increase contact and contact had increased to a weekly telephone call at the time of the inspection. The manager said that service users are encouraged to carry out small household tasks such as washing up after meals, assisting with their laundry and cleaning their rooms. One service user was observed assisting with the washing up after lunch. Service users had also been working with staff in the garden planting flowers. Menus for the home were examined, the home has a four weekly rotating menu that includes meals to meet the cultural needs of service users. The lunchtime meal served during the inspection included a pie with potatoes and mixed vegetables and a vegetarian Indian meal made with lentils for one service user. There is a small kitchen area next to the main kitchen that was well stocked with snacks and drinks for service users to help themselves throughout the day. Roshini Care Home G61-G10 s61849 Roshini v214900 160605 Stage 2.doc Version 1.30 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 standard(s) 18, 19 and 20 Service users are supported as required and health care needs are met. The systems in place for the administration of medication are not always adhered to which could put service users at risk. EVIDENCE: The manager said that each service user has a key worker that is involved in developing their care plan. Service users care plans outline the care that service users require and their preferences. Records viewed indicated that service users health care needs are assessed, monitored and met. One service user suffers with diabetes, his diet and blood sugar levels are monitored and appropriate records maintained. Appointment letters for health care appointments were seen on service users files and staff had contacted the local PCT for support for one service user who had told staff that he wished to give up smoking. Appropriate health checks are carried out as required. The medication trolley had been moved since the last inspection so that it is no longer close to the radiator in the room that it is stored in. Medication in the home was generally stored appropriately, however it was noted that some liquid medicines did not have the date of opening on them. Some gaps were also noted in the medication administration record sheets. Appropriate Roshini Care Home G61-G10 s61849 Roshini v214900 160605 Stage 2.doc Version 1.30 Page 13 procedures were in place for the receipt and disposal of medication, the records relating to this were seen and were in order. Roshini Care Home G61-G10 s61849 Roshini v214900 160605 Stage 2.doc Version 1.30 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 standard(s) 23 Adequate systems are in place to protect service users from abuse, neglect and self-harm. EVIDENCE: The home has appropriate policies and procedures in place for the protection of vulnerable adults. There have not been any incidents at the home that have required investigation since the home has been registered. Staff are provided with training on the protection of vulnerable adults. The home manages the personal allowance of some service users. The records for this are maintained with the service users records and service users sign to confirm receipt of any money that is given to them. Roshini Care Home G61-G10 s61849 Roshini v214900 160605 Stage 2.doc Version 1.30 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 standard(s) 24, 26, 28 and 30 Service users live in a safe, clean and comfortable environment. The personal and communal space provided to service users is adequate to meet their needs. EVIDENCE: The home is clean, safe and comfortably furnished. Staff complete a weekly checklist of the home to ascertain if there are any maintenance or cleaning issues that need to be addressed. The service users bedrooms seen were comfortably furnished. There was some personalisation noted but some of the rooms were still a little bare. The manager said that some service users had still not brought belongings from their previous residence to the home. One bedroom was being altered slightly for one service user who was due to move into the home. For example, a shower door was being fitted to replace the curtain that was in place at the service users request and the furniture had been rearranged. There is a small lounge at the front of the house that is used as a relaxation area. There is a library corner with books that are ordered from a local library and there is a selection of videos for service users to watch. There is a larger Roshini Care Home G61-G10 s61849 Roshini v214900 160605 Stage 2.doc Version 1.30 Page 16 lounge/dining area that is used for activities. This area is light and airy and comfortable, however the lounge area would look more homely if the seating provided was more domestic in character. There is a garden to the rear of the house that has seating for service users and outbuildings that include the laundry facilities. The laundry facilities are appropriate for the home. Roshini Care Home G61-G10 s61849 Roshini v214900 160605 Stage 2.doc Version 1.30 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 Levels of staffing were adequate for the numbers of service users living at the home, however systems for recording staff cover in the home were not satisfactory. EVIDENCE: There were adequate numbers of staff on duty at the time of the inspection. The staff rotas were examined and appeared to be in order, however the manager said that sometimes, extra staff might be at the home to assist with activities etc. but that this is not recorded on the rota. Accurate staff rotas must be maintained to record who has been on duty in the home. The level of staffing will need to be increased as more service users are admitted to the home. The manager has an enthusiastic Team Leader who when spoken to appeared to be well motivated and committed to providing a good service for service users. Roshini Care Home G61-G10 s61849 Roshini v214900 160605 Stage 2.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 Systems regarding the assessment of risk need to be improved to ensure that adequate action is being taken to ensure the health and safety of service users. EVIDENCE: This standard was only looked at in part during this inspection and will be more comprehensively covered at the next inspection. A requirement was made at the last inspection regarding the need to carry out work practice risk assessments. This task had not been completed at the time of the inspection. During a discussion the manager was able to demonstrate how potential risks had been assessed but that this had not been recorded. For example, the storage and use of knives had been risk assessed and as a result knives are stored securely. Also for a gardening activity a decision had been made to limit service users from using the lawn mower but this also had not been recorded. Roshini Care Home G61-G10 s61849 Roshini v214900 160605 Stage 2.doc Version 1.30 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x 3 x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x 2 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Roshini Care Home Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x G61-G10 s61849 Roshini v214900 160605 Stage 2.doc Version 1.30 Page 20 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 20 20 Regulation 13(2) 13(2) Requirement Liquid medicines must have the date of opening recorded on them. Medication administration record sheets must be completed at all times and the reason for non administration of medication recorded. The staff rota must accurately reflect the name and number of staff on duty and the hours worked at all times. Risk assessments for the home must be completed(previous time scale of 1/02/05 not met) Timescale for action 16/06/05 16/06/05 3. 33 4. 42 17(2)(3) (a) Schedule 4 (7) 13(4) 1/07/05 1/08/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Roshini Care Home G61-G10 s61849 Roshini v214900 160605 Stage 2.doc Version 1.30 Page 21 Commission for Social Care Inspection Ground Floor 58 Uxbridge Road Ealing, London W5 2ST National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Roshini Care Home G61-G10 s61849 Roshini v214900 160605 Stage 2.doc Version 1.30 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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