Inspection on 26/02/09 for Roshni

This inspection was carried out on 26th February 2009.

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

Roshni 12/07/06

Roshni 09/01/06

Roshni 02/12/04

Roshni 29/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Roshni 19 Reigate Road Worthing West Sussex BN11 5NF     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Beth Tye     Date: 2 6 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Roshni 19 Reigate Road Worthing West Sussex BN11 5NF 01903505793 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Naimabi Oderuth care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users to be accommodated is 16 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category : Dementia (DE) Date of last inspection Brief description of the care home Roshni is a privately owned care establishment providing personal care to 16 residents with dementia in the category of Older Persons. Roshni is a detached three-storey Victorian establishment in Goring, Worthing and is situated approximately a mile from the centre of Worthing with all its amenities and a mile from the sea front. Local shops and public transport is within walking distance. Accommodation is provided in 10 single rooms and three double rooms. Two of the Care Homes for Older People Page 4 of 24 Over 65 0 16 Brief description of the care home single rooms have en-suite facilities. The rooms are arranged on two floors with a lift giving access to all rooms. A lounge and lounge/diner provide the communal space. Mrs Oderuth is the registered provider and manager responsible for the day-to-day management of establishment. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: A visit to the home took place on the 26th February 2009. Prior to the inspection, information held on file was examined including any official documentation relating to the home. On the morning of the inspection, most residents were dressed and socialising with staff in the lounge and conservatory area. During the day the inspector spoke privately to the residents, interviewed two staff and spent some time discussing the service with the manager/owner, Mrs Naimabi Oderuth. Four residents care files were case tracked. Four staff personnel records were examined, alongside Policies and Procedures, Risk assessments, Training files, Medication records and all Health and Safety Records. This was supported by comprehensive administration systems and a committed staff team. This is the first inspection of 2008/2009. This is called a key inspection and will determine the frequency of visits/inspections hereafter. Care Homes for Older People Page 6 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are assessed prior to admission. All residents are provided with up to date information about the service. The Quality of this outcome area is good. Evidence: The manager prior to their admission to the home had assessed all the residents. The local authority funds most residents although one of the residents case-tracked was self-funding. All residents had the Statement of Purpose and Service Users Guide in their rooms and the complaints procedure was included in the Statement of Purpose and Service Users Guide and displayed on the notice board in the hall. All the residents had contracts that gave up-to-date information about the service and responsibilities for this. Care Homes for Older People Page 10 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All residents have care plan in place, ensuring health care needs are met appropriately by staff in the home. Risk assessments and reviews for residents are recorded on files. Medication procedures are adhered to and staff have received dispensing medication training as part of their induction. This promotes good practice when dealing with medication. The quality of this outcome area is good. This judgment was made from available evidence including a visit to the service. Evidence: Four care plans were case tracked and all contained detailed information relating to health and personal care needs of residents. Staff stated this information informed them of individual needs and how to respond to them appropriately. In relation to health and personal care needs, observation and feedback from residents reflected that they are treated with respect by staff, and their privacy and dignity is upheld. Care Homes for Older People Page 11 of 24 Evidence: The inspector found that since the last inspection care plans had been updated with more detailed information relating to health and social care needs of individuals. There are now objectives and actions for each identified need recorded so staff can be clear about their roles and appropriate responses to residents. All plans had been reviewed on a monthly basis and changes recorded in detail. There were risk assessments in place identifying hazards to residents alongside action plans to inform staff how to minimize and manage risk areas. There was evidence on care plans that residents and/or their relatives were involved in the care planning and review processes. Demonstrating that residents have a say in the care they receive at the home. Staff handover at each of the shift changes during the day ensures each staff member is fully aware of the immediate needs of each resident. This information is transferred to daily records in the care plans. All daily care records seen were all up to date and in good order. Any specialist health needs are referred to community-based professionals via the GPs. Correspondence held in individual files supported this. The homes medication procedures ensure safe practice with the handling, administration, storage and disposal of medicines. It is the policy of the home and included in the Statement of Purpose and Service Users Guide that the home take responsibility for medication. Residents are not encouraged to self-medicate or visitors encouraged to bring in homely remedies. The manager refers all health care needs to the general practitioner for medication or advice. Staff who administer the medicines to the residents have been assessed as competent to undertake the procedure. They lead and supervise any trainee in this procedure. On examining MAR charts they were accurate and no gaps noted in recording of administration of medicines. Care Homes for Older People Page 12 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Roshini are able to make the day-to-day decisions about how they want to live their life. There is a range of activities for those who wish to participate and residents are encouraged to maintain contact with all their friends and family, wherever possible. The food is of a good standard and offers a choice of menu. The quality of this outcome area is good. This judgement was made from available evidence including a visit to the service. Evidence: There are currently twelve residents living in the home and care staffing hours ensure staff are able to spend individual time with them. All the staff are well established in the home and know the residents well. This assists them in better understanding individual needs. Visitors are always made welcome and this was confirmed by the visitors book. An activities worker is employed to attend the home once a fortnight. She uses this time to engage residents in one to one activities of specific interest. Care Homes for Older People Page 13 of 24 Evidence: The manager has started to complete social profiles for each resident. The inspector noted that these contain detailed information about the residents history and interests. This enables staff at the home to understand residents needs, interests and preferences. A programme of activities was observed and a list of these was displayed on the notice board in the lounge. Currently, activities are based on residents wishes and abilities. Activities occur each afternoon in the home. Sessions include music and movement, crosswords, word games, reading local articles and ball games. The residents and relatives comments included praise for the home cooked food. The inspector observed the good quality of the home-made meal prepared from fresh ingredients. The menus are changed regularly according to feedback. Where residents prefer an alternative, this is provided. Dietary needs are recorded in the individual care plans and these are taken into consideration when planning meals. Weight charts are present on care plans and the manager also keeps a record of the daily nutritional intake of each resident. Care Homes for Older People Page 14 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has provided residents with information in respect of complaints. Residents and their families are aware of their rights and how to complain. All staff have completed training on adult abuse awareness. The quality of this outcome area is good. This judgement was made from available evidence including a visit to the service. Evidence: The complaints procedure was displayed in the hallway with the Visitors Book and included in the Statement of Purpose and Service Users Guide. The complaints log was examined but there had been no complaints recorded. The staff confirmed that in-house training for Adult Protection Training had been given and the Care Training Consortium would be consolidating this. The West Sussex Multi Agency Guideline was present in the home and staff had signed to say they had read and understood the procedure for responding and reporting abuse. The staff files seen contained the relevant documentation, including Criminal Records Bureau enhanced checks and relevant references. This demonstrates that the home has a robust recruitment procedure which protects the residents welfare. Care Homes for Older People Page 15 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a safe, well-maintained environment and have access to safe and comfortable indoor and outdoor communal facilities. Standards of hygiene and cleanliness are good throughout the home. Records and feedback demonstrate that staff have completed infection control training. The quality of this outcome area is good. This judgement was made from available evidence including a visit to the service. Evidence: The inspector toured the building and examined specialist equipment to ensure residents are safe and enjoy surroundings. The premises is clean and well presented throughout. Records demonstrate that staff have all completed infection control and health and safety training. This ensures the residents are safe and risk of infection is minimized and where possible eliminated. Since the last inspection the manager has purchased new furniture for the dining room and some bedrooms. New curtains have been hung throughout the premises. The indoor communal areas, garden and individual room areas are safe and well arranged to maximize independence without compromising a sense of freedom. Outdoor garden furniture was well placed to encourage the residents to move in and Care Homes for Older People Page 16 of 24 Evidence: out of the secure rear garden. Residents rooms are well decorated according to the residents wishes, furnished and arranged to accommodate the needs of residents. The three double rooms each have screens to protect residents using the wash hand basins and promote privacy and dignity. Two rooms have en suite facilities and the remainder all have wash hand basins. There were prompts throughout the home including photographs in the dining room and on residents bedroom doors to assist in memory recall and promote independence. Radiators are guarded and thermostatic valves in place to restrict water temperatures to safe levels and protect residents from burns and scalds. Provision of a bath-slide, grab rails and raised seating in toilets provide individuals with limited mobility more independence. A call bell is provided in every room so staff are aware and can attend an emergency situation should it arise. Records showed all fire, health and safety checks are regularly undertaken and up to date. All equipment is regularly serviced and certificates held on file. The Registered Provider continue to seek ways to improve the facilities for residents and an on going maintenance plan for the home is in place. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff numbers are sufficient to meet the assessed needs of residents. Recruitment procedures and record keeping are robust to ensure that residents are in safe hands at all times. Staff training includes specialist areas to fully meet residents needs. The quality of this outcome area is good. This judgement was made from available evidence including a visit to the service. Evidence: The inspector observed that the staffing rota, examined in conjunction with care plans, showed that the staffing levels do ensure residents needs can be met at all times. The inspector observed that staff spent quality time with residents and treated them with dignity and respect. Staff were observed responding and communicating appropriately to residents in line with their levels of understanding and ability. The home does not use agency staff and existing staff covers staff absences. The inspector observed that domestic and catering roles are staffed separately on four days of the week with staff having clearly defined roles for these tasks. Staff members, who were spoken with in private, said I like working here, the residents receive an excellent standard of care. Another stated there is good communication between team members. Care Homes for Older People Page 18 of 24 Evidence: All the staff spoken to were clear about their role and responsibilities within the home. Over 50 of the care staff have now obtained training in National Vocational Qualification level 2, to ensure they have the skills and knowledge to do their job in a professional manner. The inspector examined four staff records to ensure consistency of recruitment procedures. Records showed that staff had only been employed following a Protection of Vulnerable Adults check and Criminal Records Bureau clearance. All records were up to date, contained relevant information and were in good order. The staff on duty confirmed that training has been provided in addition to mandatory training staff had completed specialist training appropriate to residents needs. These included Dementia Care and Mental Capacity. Staff records seen on the day confirmed this. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and staff benefit from the leadership and management approach within the home. Supervision for staff is undertaken regularly. Overall the residents welfare is a priority within the home, and this is supported by efficient administration systems. The quality of this outcome area is good. This judgement was made from available evidence including a visit to the service Evidence: The manager has completed the Registered Managers Award and keeps herself up to date with changing legislation and training. This compliments her years of experience in managing Roshni. The Quality Assurance System for 2008 has been completed and was available in the porch for all visitors, relatives and residents representatives to view. Staff, residents and their families are consulted through regular meetings to ensure their views are included and implemented in any decision made on the way the home Care Homes for Older People Page 20 of 24 Evidence: is run. Staff feedback reflected that the management provides a clear sense of leadership and direction. Staff spoken to stated if there are problems the manager is always around to deal with it. And that the management is supportive. This enables staff to seek guidance when needed to ensure residents needs are met appropriately. Residents are encouraged to manage their own finances or if this is not viable and a representative of the resident take on the responsibilities for this. The manager is responsible and is the appointee for one resident who does not have any relatives. The monies held for this resident is well maintained and monitored by the social care worker appointed to oversee this persons care. The two members of staff spoken to, confirmed that supervision is provided at the required intervals and that training needs are identified from this procedure. Records seen confirmed this. Health and safety is maintained through training and servicing of necessary equipment. All equipment checks and servicing is carried out within the safe guidelines. Policies and procedures were in place and are updated on a reguler basis. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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