Inspection on 30/11/05 for Rosna House Residential Home

This inspection was carried out on 30th November 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rosna House Residential Home 27/02/09

Rosna House Residential Home 27/02/07

Rosna House Residential Home 18/06/05

Rosna House Residential Home 23/02/05

Rosna House Residential Home 30/09/04

Rosna House Residential Home 17/10/03

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

CARE HOME ADULTS 18-65 Rosna House Residential Home 339 Stone Road Stafford Staffordshire ST16 1LB Lead Inspector Mrs Wendy Grainger Announced Inspection 30th November 2005 09:00 Rosna House Residential Home DS0000004997.V261530.R01.S.doc Version 5.0 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 Rosna House Residential Home DS0000004997.V261530.R01.S.doc Version 5.0 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. Rosna House Residential Home DS0000004997.V261530.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Rosna House Residential Home Address 339 Stone Road Stafford Staffordshire ST16 1LB 01785 245696 01785 4974451 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) Rosna House Limited Mr Michael John Huxley Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (8) of places Rosna House Residential Home DS0000004997.V261530.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. MD - REGISTERED FOR 8 - 4 OF WHOM MAY BE OVER THE AGE OF 65 ON ADMISSION 04/07/2005 Date of last inspection Brief Description of the Service: Rosna is a large semi-detached Victorian house located approximately one mile from the town of Stafford. The town can be accessed via the local public transport route from outside the home. The gardens to the home were well maintained; the drive would display colourful baskets and flowers during the summer months. Accommodation for the residents were located on two floors; the first floor can be accessed via the stairs the home did not have a shaft or stair lift. Bedroom accommodation included one shared and six single bedrooms, no en-suite facilities were available; a lounge, dining room, smoking area, bathing and toilet facilities were located on both floors. Rosna provides accommodation and a home for up to eight people with mental health needs. Rosna House Residential Home DS0000004997.V261530.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was completed with the provider, care manager and the residents present at the time. The Commission had been provided with the pre inspection questionnaire from which information will be taken and made as part of the report. No comment cards had been received from residents or families, general practitioner or placement officer. The residents spoken with included two new people, one resident told the inspector that she had settled in well after a transfer from another home. The staff had made her feel very welcome and very happy. The other resident also transferred told the inspector that she was not as settled and would like to look at somewhere else. The care manager will arrange for her to meet with her social worker. Other residents spoken with were very happy with their life style and praised the staff and care manager for their care and support. One visitor was spoken with he was satisfied with the placement of his relative and felt that the home was very good. While the home was comfortable, clean and tidy the decoration was tired and time for the providers to commence redecoration. The documents that were not available on the previous inspection had been reviewed and recreated by the provider/care manager. There had been a large commitment by the people responsible to create documentation. Arrangements were in place for the residents to access specialists pertinent to their particular health needs. What the service does well: Since the last inspection and with the support of the provider and care manager two residents had ceased smoking. The support of the residents continued for all aspects of their life style, independence is encouraged, as are interpersonal skills. Rosna House Residential Home DS0000004997.V261530.R01.S.doc Version 5.0 Page 6 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. Rosna House Residential Home DS0000004997.V261530.R01.S.doc Version 5.0 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 Rosna House Residential Home DS0000004997.V261530.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,4,5 The Statement of Purpose had been reviewed and amended in parts necessary to provide current information to any person enquiring about a placement. The home continued to offer personal care and support in line with the homes registration. EVIDENCE: Two new residents had been admitted to the home since the last inspection. One of them told the inspector that she had been made to feel very welcome and had settled in well. The other resident was less settled, this could be part of her personal problem, arrangements were to be made for her to see her social worker. Each of the new residents were offered a trial visit, one person had refused and the other person was transferred within a short time. Each of the residents were provided with the terms and conditions of the home following the admission and review. Rosna House Residential Home DS0000004997.V261530.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 The care plans provided, ensured that individual’s needs were recognised and addressed. The staff supported resident’s life styles. EVIDENCE: The format of the care plans had been reviewed again this inspection identified that more personal and pertinent information was recorded. This information enabled the staff to support individuals in their chosen life style. Evidenced in the plans seen was that residents had been involved in the new format and had signed the plan and where necessary risk assessment. The home had a communication book for the staff, daily reports were not operational, and incidents and any occurrence would be recorded in the individuals record. Each individual was supported and encouraged to live at a pace and style that suited them. Rosna House Residential Home DS0000004997.V261530.R01.S.doc Version 5.0 Page 10 The inspector was impressed with the work that management had undertaken to complete the risk assessments. The care manager was aware that this record like the care plans would need to be reviewed on a regular basis. Rosna House Residential Home DS0000004997.V261530.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,15,17. Individuals were supported in their chosen life style by the staff and management. The menus were based on choice, provided by the residents. EVIDENCE: The voluntary work in Stafford by one resident continued, day centres/college was also accessed by certain residents. The preferred choice for some residents was that they remained at the home and did not seek employment. Hobbies and interests were supported, the majority of the residents access the local community, and there was limited contact with families. Residents chose to access medical facilities and collect where appropriate prescriptions. Each resident had a routine encouraged to promote independence and a life style that includes simple catering and domestic duties in their personal areas. Rosna House Residential Home DS0000004997.V261530.R01.S.doc Version 5.0 Page 12 The menus in general were improved evidencing the food residents were served. The staff on duty confirmed that she had neglected to write in two of the weeks lunches prepared. The management had reviewed and addressed the issue regarding labelling, food temperatures and food temperatures. Records evidenced for the fridge /freezer records. It is recommended that the staff now commence using the probe and wipes when cooking food. Three residents had beans on toast for lunch, one resident was served his meal in his bedroom. Rosna House Residential Home DS0000004997.V261530.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 21. Arrangements were in place to meet the mental health needs of individuals. The storage of medicines was satisfactory; the concerns were around the different storage containers used in the home and the hand written record sheets. EVIDENCE: Residents were supported in their personal care needs on a daily basis. The staff and the medical profession supported one resident during a recent illness. Residents can access their own general practitioner and any other specialist professional agency. The care manager had addressed the recommendation to date prescribed creams. No resident chooses to self-administer his or her medication. Medication records were current; the inspector had concerns as to the collection of systems used for the containing of medicines. The local pharmacist did not provide a printed MAR sheet, these were hand written. This had been discussed as part of the previous inspection. It was felt that the staff were vulnerable when hand writing the instructions. Rosna House Residential Home DS0000004997.V261530.R01.S.doc Version 5.0 Page 14 Three of the staff had taken a training course in the safe handling of medicines. The home had a home for life philosophy where appropriate in the event of a death occurring. Rosna House Residential Home DS0000004997.V261530.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 23 The homes complaints system was available to any person resident at the home and to visitors. From the system of checking employees and via the training residents were protected from elements of abuse. EVIDENCE: The providers had received no internal complaints; the Commission had received no complaints against the home or care provided. All the present residents had the ability to discuss and raise a complaint with the providers. The home had in place systems as required when employing new staff, this system was checked and found satisfactory. Via the training of NVQ in Care employees were made aware of the various types of abuse that could occur. Rosna House Residential Home DS0000004997.V261530.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29 The home was comfortable, the providers needed to consider redecoration throughout the areas discussed. EVIDENCE: The environment was homely and comfortable; at the time of this inspection the decorating was looking tired and in places needed redecorating. In one of the bedrooms the carpet had a hole near to the new sink unit, this could be a possible hazard. Some of the fire doors would in ineffective in the event of a fire and required adjusting. The previous inspection identified personal residents toiletry items left in the bathrooms. While the residents are independent for their personal hygiene, the COSHH regulations required that hazardous items should be secured (returned to the bedroom) It was recommended that a small lock should be fitted to the laundry door. Only one bedroom was shared at the time the room is for single occupancy. Each of the bedrooms seen displayed numerous personal possessions. The home was maintained in a clean hygienic manner. Rosna House Residential Home DS0000004997.V261530.R01.S.doc Version 5.0 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 36 Residents would be aware of the person on duty from the displayed rota. The staff had regular training to ensure they were aware of residence needs. EVIDENCE: Each of the staff were provided with a job description, the records of employment were checked, the manager was aware that two written references were required. The required checks were evidenced. The care manager had commenced a more formal supervision; he was to create an alternative form for the records to divide them from the training records. On going training ensured that competent staff supported residents. The staffing levels for the support of the residents were satisfactory. At the time of the inspection there were no vacancies for staff. The provider is part of the staff team. Four of the present staff were working towards the completion of NVQ level II in Care. The care manager is waiting for his work towards the Registered Managers Award NVQ IV to be verified. Rosna House Residential Home DS0000004997.V261530.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39,40 41 42 The home is operated to benefit the life style of the residents. There was a relaxed atmosphere and positive interaction between the staff and residents. Policies and procedures were part of the operation of the home. There was a need to tighten up on fire drill to ensure the safety of the residents. EVIDENCE: The home operates with a small group of staff supervised by the care manager and provider. Residents were fully aware that they could approach any person to discuss issues. The care manager had held two residents meetings since the previous inspection ensuring that he had feed back for the quality assurance. It would be very difficult to have written feed back from the relatives/visitors. There was limited if any contact with families. Residents access all the professional agencies independently. Rosna House Residential Home DS0000004997.V261530.R01.S.doc Version 5.0 Page 19 Monies held on behalf of the residents were accurate. The public liability insurance was displayed and current until 25 1 06. There was a need by the care manager to ensure that all the staff were involved in a fire drill before the end of December. Other fire records were satisfactory. Rosna House Residential Home DS0000004997.V261530.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 X X 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 2 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score 3 X 3 X 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Rosna House Residential Home Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score X X 3 3 3 2 X DS0000004997.V261530.R01.S.doc Version 5.0 Page 21 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 Standard YA42 Regulation 23 Timescale for action The registered person shall make 10/12/05 arrangement for the persons employed to receive suitable training in fire prevention. The registered person shall 12/12/05 provide suitable floor coverings, rooms reasonably decorated and a residents call system provided in all parts of the home accessed by the residents. The registered person shall make 10/12/05 suitable arrangements to prevent the spread of infection at the care home. Requirement 2 YA24 16 & 23 3 YA30 13 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 2 3 Refer to Standard YA17 YA24 YA20 Good Practice Recommendations To commence the use of the food probe with records maintained. To fit a small lock to the laundry door to ensure that residents were safe at all times. To approach the pharmacist to review the presentation for DS0000004997.V261530.R01.S.doc Version 5.0 Page 22 Rosna House Residential Home medication and the MAR sheets. Rosna House Residential Home DS0000004997.V261530.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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