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Inspection on 10/08/05 for Roslyn House

Also see our care home review for Roslyn House for more information

This inspection was carried out on 10th August 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home has a trained and stable staff team that provides continuity and security for service users. There are regular reviews of care and the home enables people living there to see their relatives regularly. Service users have an active lifestyle and are engaged in regular activities.

What has improved since the last inspection?

A requirement regarding risk assessments has been complied with and the home continues to monitor the needs of service users to ensure appropriate staffing levels are provided at all times.

What the care home could do better:

The home was seen to be organised and records inspected were mainly accurate and up to date. Some records regarding plans of care and incidents must be maintained to ensure current information is available to demonstrate that the home is meeting the service users aspirations, goals and safety needs.

CARE HOME ADULTS 18-65 Roslyn House 68 Molesworth Street Wadebridge Cornwall PL27 7DS Lead Inspector Mike Stokes Unannounced 10 August 2005 08:30 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. Roslyn House D52-D04 S9222 Roslyn House UI V235830 100805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Roslyn House Address 68 Molesworth Street Wadebridge Cornwall PL27 7DS 01208 815849 01208 815618 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) Home Farm Trust Mrs Valerie Goldie Care Home 8 Category(ies) of Learning Disability (LD) registration, with number of places Roslyn House D52-D04 S9222 Roslyn House UI V235830 100805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10 March 2005 Brief Description of the Service: The Home Farm Trust is registered to provide accommodation and personal care for up to 8 persons with a learning disability, in the age range of 18 to 65 years. Roslyn House is a large, three storey and detached building close to the centre of Wadebridge Town. The home is close to community facilities, shops and public transport. The service users bedroom accommodation is provided on the ground and first floors. There is an enclosed, small garden to the front of the building. There is parking to the rear of the building, accessed through a private secure area, which also contains the separate resource centre building owned by the Home Farm Trust. Roslyn House D52-D04 S9222 Roslyn House UI V235830 100805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. I arrived for this unannounced inspection at 8.30 a.m. and the inspection lasted for 3 hours. During this time I was able to observe the early morning routines and procedures, speak to service users, staff and also review records that are required to be maintained at 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. Roslyn House D52-D04 S9222 Roslyn House UI V235830 100805 Stage 4.doc Version 1.40 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 Roslyn House D52-D04 S9222 Roslyn House UI V235830 100805 Stage 4.doc Version 1.40 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) 1,2 and 4. The registered person understands the need for pre-admission assessments and has produced information to assist prospective service users in choosing a home. EVIDENCE: The statement of purpose and service users guide has been completed. 8 service users are now accommodated at Roslyn House and 6 service users have lived with the Home Farm Trust for ten years. The home provides a service users charter of rights and information for service users. Full assessments, home visits and time at Roslyn House were arranged to assist in the process of the admission of a service user on 31.1.05. Roslyn House D52-D04 S9222 Roslyn House UI V235830 100805 Stage 4.doc Version 1.40 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 and 7. Service users are living in a stable and supportive environment. The service users are involved in decisions affecting their lives and enabled to participate in chosen activities. EVIDENCE: Assessment procedures are used to form the initial service users care plan and formal reviews of care occur at 6 monthly intervals. Staff support service users on a day-to-day basis and liaise with other staff about the changing needs of individual service users. The service users have key staff to assist in monitoring and updating the service users care plan. Risk assessments are completed for various aspects of service users needs and activities. Community, leisure and holiday activities are provided with support and supervision according to individual assessments. A discussion occurred with staff on duty regarding a service user that requires 1:1 staffing support. Issues regarding waking at night or early morning and behaviours that may affect other service users were discussed. The records seen did not give sufficient details to monitor these events and a requirement is made to ensure plans of care reflect service users changing needs, appropriate referral to support agencies and planned interventions. Roslyn House D52-D04 S9222 Roslyn House UI V235830 100805 Stage 4.doc Version 1.40 Page 9 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) 11, 12, 14 and 17. The home ensures that service users have access to a range of opportunities for development and leisure activities. The home provides a varied menu and service users exercise choice over what they eat. EVIDENCE: Service users enjoy a range of activities such as swimming, horse riding, walking, Gateway Club, cinema, pub meals and trips to places of interest. The support staff on duty expressed appropriate attitudes in wishing to provide support for service users. The diary recorded the various appointments and activities that service users were involved in. The home supports service users to maintain links with family and friends by providing transport or inviting visitors to the home. Service users maintain regular contact with family members through home visits, telephone contact, letters and cards. Service users have access to a range of educational and social activity at the resource centre and through individual living skills work at the home with staff. Service users were seen to enjoy a variety of cereals, toast, fish and beverages for their breakfast. Staff enabled service users to prepare for their day in an organised, calm and relaxed atmosphere. Roslyn House D52-D04 S9222 Roslyn House UI V235830 100805 Stage 4.doc Version 1.40 Page 10 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. The personal and health care needs of service users are met with evidence of promoting privacy, dignity and good multi disciplinary working taking place. EVIDENCE: Service users are registered with General Practitioners at the Wadebridge and Camel Estuary Practice. Assessments by the home determine that service users do not currently self-medicate. The medication policy and procedures are appropriately maintained. Service users are assisted with their medication needs and the registered person maintains records regarding the ordering and administration of prescribed medication. The medication records, procedures and storage facilities were inspected. The local authority oversees annual reviews with consistently good reports that service users’ needs are met. A 6 monthly review of the service users support plan also occurs. Roslyn House D52-D04 S9222 Roslyn House UI V235830 100805 Stage 4.doc Version 1.40 Page 11 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 The registered person has provided staff with knowledge and understanding of Adult Protection issues that protects service users from abuse. EVIDENCE: The homes policy and residents charter state the complaints procedure and this is presented in a relevant format for service users and for those acting on their behalf. These issues are discussed with service users at the advocacy group at the Resource Centre and in review procedures. Advice regarding various forms of potential abusive situations and procedure are available to staff and are raised during induction training. The policy refers to ‘No Secrets‘ and the need to refer concerns to the Social Services as the ‘lead’ agency. The support staff confirmed that these procedures are discussed at staff meetings. Roslyn House D52-D04 S9222 Roslyn House UI V235830 100805 Stage 4.doc Version 1.40 Page 12 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, 25, 27 and 28. Service users live in a homely, comfortable and safe environment with evidence of maintenance and improvement. EVIDENCE: I sat with service users and staff in the ground floor dining room and lounge areas. The furnishings and fittings are of good quality and service users live in a comfortable and homely environment. The home is in keeping with the local community and offers service users access to local amenities as stated in its aims and objectives. The garden areas have been landscaped. Service users are provided with single room accommodation that are individually decorated and furnished. Toilets and bathrooms are provided in sufficient numbers and offer privacy to the service users. The home has refurbished the first floor bathroom providing a new bath, tiling and redecoration. A ground floor walk in shower is provided to assist service users. Roslyn House D52-D04 S9222 Roslyn House UI V235830 100805 Stage 4.doc Version 1.40 Page 13 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) 31, 32 and 35. The Home Farm Trust is providing competent support staff to provide for the welfare of service users. EVIDENCE: On arrival at this unannounced inspection there were 3 members of staff on duty to provide for service users needs in the home. A discussion with staff confirmed that a stable staff team is available that is providing continuity and a consistent approach to care. The staff team are involved in NVQ training at levels 2 and 3. Other training has been completed in first aid, health and safety and fire precautions. The staff on duty also confirmed that the registered manager discusses work issues and development during supervision meetings. During this visit staff were confident in their Knowledge of the service users needs and presented as confident and organised. The staff were observed to exhibit appropriate skills and attitudes in their interactions with service users. Roslyn House D52-D04 S9222 Roslyn House UI V235830 100805 Stage 4.doc Version 1.40 Page 14 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) 37, 40 and 42. The manager is supported in delivering appropriate services and staff demonstrate an awareness of their roles and responsibilities. EVIDENCE: The registered manager was not on duty during this inspection. The staff expressed their approval of communication systems and the organisation at the home. The members of staff on duty discussed various policies and procedures and the Home Farm Trust provide management manuals. The registered manager has successfully completed the registration process to be responsible for 2 HFT care homes in Wadebridge. An assistant service manager supports the registered manager and other administrative and financial support functions are provided. An assistant service manager completes a monthly report on the conduct of the home and a copy is sent to this Commission. Roslyn House D52-D04 S9222 Roslyn House UI V235830 100805 Stage 4.doc Version 1.40 Page 15 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 3 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 2 3 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x 3 3 x x Standard No 11 12 13 14 15 16 17 3 3 x 3 x x 3 Standard No 31 32 33 34 35 36 Score 3 3 x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Roslyn House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x 3 x 3 x D52-D04 S9222 Roslyn House UI V235830 100805 Stage 4.doc Version 1.40 Page 16 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 6 Regulation 12 and 15 Requirement The registered manager must ensure plans of care reflect service users changing needs, appropriate referral to support agencies and planned interventions. Timescale for action 30/9/05 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 Roslyn House D52-D04 S9222 Roslyn House UI V235830 100805 Stage 4.doc Version 1.40 Page 17 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 Roslyn House D52-D04 S9222 Roslyn House UI V235830 100805 Stage 4.doc Version 1.40 Page 18 - 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. 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