Inspection on 23/10/07 for Roslyn House

This inspection was carried out on 23rd October 2007.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Roslyn House 04/10/06

Roslyn House 15/02/06

Roslyn House 10/08/05

Roslyn House 10/03/05

Roslyn House 17/08/04

Roslyn House 05/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Roslyn House 68 Molesworth Street Wadebridge Cornwall PL27 7DS Lead Inspector Alan Pitts Unannounced Inspection 23rd October 2007 10:00 Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 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 Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 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. Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Roslyn House Address 68 Molesworth Street Wadebridge Cornwall PL27 7DS 01208 815489 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) mo.whittingham@hft.org.uk www.hft.org.uk Home Farm Trust Mrs Muriel Whittingham Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th October 2006 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. Fees range from £513.75 to £1677.81 per week. Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over approximately 6 hours. The inspector met with six residents, four staff, and the registered manager. The inspection included a tour of the premises, discussion, and examination of relevant records. The inspector was also invited to meet with the adjacent resource centre manager and enjoyed a short tour of this HFT managed facility. Overall, this is an established home with a stable, skilled staff team. All the residents have lived at the home for a number of years and enjoy settled relationships with staff and each other. The home is clearly managed with the residents’ best interests at heart. What the service does well: What has improved since the last inspection? What they could do better: HFT have taken steps to introduce a training matrix, inclusive of all staff. This matrix is, as yet, not up to date and does not provide the information it was intended it should. The home’s complaints procedure could be improved. The personnel information for one staff member was not available for inspection, either in ‘hard copy’ at Roslyn House or via the HFT Staff Management System on the intranet. HFT should do more to ensure the ‘seamless’ working of its recording systems. Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 Page 6 More could be done to ascertain the views of others in respect of the quality of the service provided 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. The summary of this inspection report can be made available in other formats on request. Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 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 Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a statement of purpose and service users guide that provides information about the home in an appropriate format. A thorough assessment is carried out for all prospective residents. EVIDENCE: The statement of purpose and service users guide has been completed. Eight residents are accommodated at Roslyn House and six have lived with the Home Farm Trust for 13 years. The most recent admission to the home has lived there for a number of years, and full assessments, home visits and time at Roslyn House were arranged to assist in the process of the last admission. Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of residents, who are involved to the best of their capabilities in decision-making and self-determination. EVIDENCE: The registered manager demonstrated a detailed understanding of the complex range of needs that are presented by residents and the records inspected detailed how the relevant support is provided. The plans of care involved health care issues residents’ aims and aspirations in educational or social interactions. The residents have key staff to assist them in creating ‘Who am I’ information, attend reviews of care, and the monitoring and updating of their care plan. Appropriate daily records are kept. The registered manager is providing appropriate supervision to staff and progress with identified resident goals are regularly discussed. Risk assessments are completed for various aspects of residents needs, capabilities, and activities. Community, leisure and holiday activities are supported. Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 Page 10 A new computerised care documentation system (SPARS) is due to be introduced in the New Year 2008. The system is backed-up, and protected by antivirus software. The system is also password protected, allowing different levels of access according to responsibilities. It would be helpful if HFT could confirm that entries made on the new system will not be able to be altered retrospectively, and that entries will be time and date stamped by the system. Computer training is currently being rolled out to staff. A sample SPARS file was seen. This is a lengthy document requiring significant scrolling up/down the screen to navigate to the point you need. It is suggested that HFT ‘bookmark’ an index at the start of the document (in the nature of lengthy pdf documents) to enable easier navigation via these links. Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A range of social and recreational opportunity is provided in keeping with known preferences and capabilities. Residents engage with the local community, and all have appropriate contact with people important to them. Residents’ rights and capacity as adults is recognised. A balanced diet is provided in conjunction with the adjacent HFT resource centre. EVIDENCE: The residents, registered manager, and care records confirm that residents are involved in a range of appropriate leisure activities and maintain contact with people important to them. The eight residents attend the HFT resource centre during the week. The residents access a range of community activities such as swimming, horse riding, walking, Gateway Club, cinema, pub meals and trips to places of interest. Some of the residents have voluntary or paid work placements. Most of the residents have very frequent contact with family members. Social/recreational activities and work opportunities are recorded in Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 Page 12 individual plans and the Home Farm Trust provides appropriate staff to support these activities. Menus evidence a good choice of light evening meals, the main meal being provided by the HFT resource centre during the week. All staff have a responsibility for meal preparation and have undertaken relevant training. The kitchen is domestic, well equipped and clean. Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personal and health care needs of residents are met with evidence of promoting privacy, dignity and good multi-disciplinary working taking place. EVIDENCE: The care records, and discussion with the registered manager and staff show that the residents’ waking day is flexible, within the parameters of their care plan. Residents are encouraged, or assisted where necessary, to make meaningful choices (e.g. clothes, room décor). The registered manager and support staff ensure that the residents receive health care services as required, and in accordance with the residents’ known preferences. The home maintains good links with other health care professionals. On the day of the inspection the registered manager made arrangements for one resident to see a District Nurse after the resident made this request. Residents are registered with General Practitioners at the Wadebridge and Camel Estuary Practice. The key worker role is responsible for ensuring that the identified needs of residents are monitored and that services, equipment and support is provided as required. Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 Page 14 Residents do not currently self-medicate. Residents 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 are appropriately maintained. The local authority may complete an annual contract review by delegating the annual review of care to the Home Farm Trust, who then report back to the local authority. Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were seen to interact with staff in a relaxed manner. Support staff have a clear understanding of ‘Adult Protection’ issues and procedures that will protect residents from abuse. EVIDENCE: The registered manager understands the appropriate procedures to report issues of concern regarding residents’ welfare. In-house training is provided for staff and the Home Farm Trust have appropriate policy and procedures to support senior staff. The homes’ policy and residents charter includes the complaints procedure and this is presented in a relevant format for residents and for those acting on their behalf. The registered manager has provided all of the residents next of kin with the homes complaints procedure, though this was done some considerable time ago and does not include recent changes to the contact details for relevant agencies such as the Department for Adult Social Care or Commission for Social Care Inspection, nor does it include a statement that complaints will be responded to within 28 days. How to make a complaint or express a concern is discussed with residents 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 Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 Page 16 ‘No Secrets‘ and the need to refer concerns to the Social Services as the ‘lead’ agency. Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home Farm Trust continues to develop the environmental standards. The overall quality of furnishings and fittings is good and residents live in a safe, clean and homely environment. EVIDENCE: The registered manager gave the inspector a guided tour of the home. There is a lounge and separate dining room. The furnishings and fittings are of good quality and residents live in a comfortable and homely domestic environment. The garden areas have been landscaped. Residents are provided with single room accommodation that is individually decorated and furnished, reflecting their preferences and individuality. Toilets and bathrooms are provided in sufficient numbers and ensure privacy. The home was seen to be clean and odour free. The laundry is domestic in nature, but sufficient for the demands placed on it. Hand washing facilities are available throughout the home. Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 Page 18 The home is in keeping with the local community and offers residents access to local amenities as stated in its aims and objectives. Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, 36 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home Farm Trust is providing skilled and experienced support staff to provide for the welfare of residents. Records were not available to establish whether the registered provider is adhering to a robust employment procedure. EVIDENCE: A stable staff team ensures continuity and a consistent approach to care. There are 11 staff, including the registered manager. Eight have NVQ Level 2 or above, as evidenced by the certificates in the personnel files at the home. The training matrix available on the HFT intranet shows that no staff member has achieved this training however, and entries in respect of other training are incomplete. The registered manager confirmed that further training has been planned, such as in first aid. There is never less than a 1:4 staff to resident ratio during the waking day, and this will increase as needs or activities dictate. There is 1 sleep-in staff member available on the premises at night. The residents generally have little in the way of nocturnal care support needs. Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 Page 20 The staff on duty were observed to exhibit appropriate skills and attitudes in their interactions with residents. The inspector asked to see the personnel file of the staff member most recently employed at the home. Neither the personnel file at the home nor the computerised Staff Management System provided the information necessary to demonstrate adherence to a robust employment procedure. The Staff Management System shows some details, such as Criminal Records Bureau checks, but could be better used to provide all the information needed. The training matrix and Staff Management System offer great potential as records, but further thought is needed as to their use. The home is using a National Training Organisation compliant induction programme and a sample was seen. As discussed, on completion the resultant qualification is nationally recognised and as such transferable. The resultant certificate therefore needs to clearly state that the induction includes all the units covered by the National Training Organisation, Skills for Care. Staff are appropriately and regularly supervised with records kept. Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home Farm Trust continues to provide for the safety and welfare of residents. EVIDENCE: The registered manager has completed the Registered Managers Award. The registered manager has worked at the home for some time, being the registered manager for approximately two years. There are clear staff responsibilities and hierarchy both within the home and HFT. The registered manager showed a commitment to resident focused care and lifestyle. There are internal quality assurance tools, such as team meetings and house meetings, but more could be done to ascertain the views of others in respect of the quality of the service provided. Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 Page 22 A review of schedules 3 and 4 showed that the records required to be kept are appropriately maintained. A senior manager supports the registered manager and completes a monthly report on the conduct of the home. The Home Farm Trust provides other administrative and financial support functions to the registered manager. Relevant maintenance and safety records are kept (e.g. fire equipment, insurance). Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 Page 23 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 3 2 3 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 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 Page 24 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 YA34 Regulation 17 Requirement The registered manager must ensure that records required to be kept are available for inspection. Timescale for action 01/12/07 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 YA22 Good Practice Recommendations The registered manager should review and amend the home’s complaints procedure to ensure that it contains: • Contact details for relevant agencies • 28 day deadline for responses • A statement that concerns may be made directly to either Department of Adult Social Care or Commission for Social Care Inspection at any time. The registered manager should make use of quality assurance questionnaires, the content specifically aimed at the target audience (e.g. relatives, visiting professionals), and the summarised, anonymous findings published. 2. YA39 Roslyn House DS0000009222.V349888.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000009222.V349888.R01.S.doc Version 5.2 Page 26 - 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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