Inspection on 14/09/06 for Roundham Court

This inspection was carried out on 14th September 2006.

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.

Other inspections for this house

Roundham Court 26/10/07

Roundham Court 15/02/06

Roundham Court 18/10/05

Roundham Court 01/12/04

Roundham Court 28/07/04

Roundham Court 19/02/04

Roundham Court 08/10/03

Roundham Court 10/09/02

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

CARE HOMES FOR OLDER PEOPLE Roundham Court Roundham Court 22 Cliff Road Paignton Devon TQ4 6DG Lead Inspector Judy Cooper Key Unannounced Inspection 14th September 2006 9:50 X10015.doc Version 1.40 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 Roundham Court DS0000018420.V300375.R02.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 Older People. 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. Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Roundham Court Address Roundham Court 22 Cliff Road Paignton Devon TQ4 6DG 01803 528024 01803 528024 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) Mrs Jill Wakeham Mrs Sally Brazier Mr Trevor Lewis Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Females over the age of 60 may be admitted within the OP category Date of last inspection 15th February 2006 Brief Description of the Service: Roundham Court provides care for up to thirty-five older people. It is a large Victorian house, situated in Paignton near the harbour, set in wellmaintained grounds that overlook Torbay. There is a terraced area to the front and side of the home, which allows residents to have excellent views whilst sitting outside. There is also parking and level access to the Home. The Home has 31 single bedrooms, 29 of which are en-suite, 1 double en-suite bedroom and 2 rooms without an en-suite facility. There is also a dining room, large hall area with seating, office, kitchen, laundry, lounge and a conservatory. There is an assisted bathroom and 2 assisted shower rooms. A shaft lift and wide stairs lead to the first floor. The weekly fees range from £375-£550 at the home. Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on a Thursday between 9.30-5.30 p.m. It was undertaken by two inspectors. Opportunity was taken to observe the general overall care given to residents. The individual care provided for four residents was also followed in specific detail, from the time they were admitted to the home, which involved checking that all elements of their identified care needs were being met appropriately. A tour of the premises, examination of some records and policies, discussions with the owner (who was present for the majority of the inspection), the registered manager, residents and staff all formed part of this inspection. Two visiting District Nurses were also spoken with to obtain their views on the care provided. Staff on duty were also observed, in the course of undertaking their daily duties. Other information about the home, including the receipt of eight completed questionnaires from residents at the home, two staff who work at the home, as well as eight from relatives/visitors to the home has provided further feedback as to how the home performs. This collated information has been used in the overall writing of this report. All required core standards were inspected during the course of this inspection process. What the service does well: Roundham Court continues to provide a comfortable, clean, well-maintained environment, where residents’ care is provided for by a relatively stable and well-trained staff group. The home continues to maintain a welcoming, comfortable atmosphere, where residents are freely able to choose how they spend their time. The owner continues to undertake both routine maintenance and upgrading on a regular basis to allow the home’s environment to be maintained to a high and comfortable standard, which benefits residents by providing a good standard of accommodation overall. The manager remains committed and enthusiastic about his role. Visitors continue to be welcomed and encouraged to the home. Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 6 The staff group continue to endeavour to maintain individual resident choices to facilitate residents being able to pursue their own interests and choice of lifestyle. What has improved since the last inspection? What they could do better: Some good practice issues that will be put into place, following this inspection were agreed. These were agreed after receiving residents’ verbal feedback at the inspection and prior to the inspection in a questionnaire form from both residents as well as other interested parties such as family members. These are as follows: The manager will further ensure that residents are aware of their care plans and are involved as much as they choose to be. This is to allow residents, that wish to, the opportunity to plan for their own care needs in conjunction with the home and so therefore ensure all are agreeable as to the care provided. The manager, along with the home’s cook, will continue to work to improve the choice/variety of meals provided in the home. The manager will also build into the cook’s weekly routine a time when the cook can speak individually to all residents to ascertain individual preferences. Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 7 The owner/manger will endeavour to provide additional staff training to allow the staffing requirement of having 50 percent of trained staff (to NVQ level 2 in care) on duty. The owner/manager will look at the re-distribution of the allocated staff hours throughout the day/week. This is in response to some comments received in respect of some residents and/or their relatives feeling staff were, on occasions, rushed and not always able to meet their needs. The four rooms that necessitate the resident to climb four steps to access the room should be used for physically independent residents only. This is to ensure the occupants of these rooms are able to come and go as they wish. 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. Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. (6 is not applicable to this home) The quality in this outcome area is good. The admission process is managed appropriately and residents and/or their next of kin/advocate are given the necessary information regarding the service prior to admission so that they can make an informed decision. EVIDENCE: Since the last inspection the home has admitted several new residents (some of whom have had a short respite stay at the home). Three such residents’ admission processes were looked at in detail. All of the three residents were spoken with during the inspection. The manager had visited one of the residents prior to their admission to the home, another had personally contacted the home, prior to their admission and in the other two cases family members had been involved in the admission process. The three residents all had a detailed admission procedure. An assessment of need, for all of these residents had been undertaken at the point of admission from which a detailed care plan had later been drawn up. Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 10 The newly admitted residents confirmed that they or their family member had been given access to necessary information including the home’s brochure/statement of purpose. Additional feedback from another resident also confirmed that she had been able to visit the home “before making a decision”. The Court Group, overall, have recently introduced an initial risk assessment based on the admission process. This includes such details as ensuring glasses and other personal necessary items arrive with the resident and that information noted within the previously conducted pre-assessment continues to be valid. It further determines whether there is an additional need to contact other professionals to inform them of the resident’s admission. This is to ensure that the new resident will “feel at home” as quickly as possible and ensures that all required care is made available at the commencement of the stay. The Court Group are also in the process of issuing feedback questionnaires to all newly admitted residents to try to build up a true picture of how each new resident felt and to see if the admission process can be improved on. One such feedback form stated: “the attitude of the staff is excellent and the atmosphere of the home is good”. During the inspection it was noted that another new resident was moving into the home. It was pleasing to note the care and attention given to this resident and her next of kin and the way both were made to feel welcome by the manager. The next of kin was also able to confirm that the manager had been very helpful, during the decision making process, finally enabling the resident to move into the home confident in the knowledge of what the home could provide. The home does not provide intermediate care. Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 The quality in this outcome area is good. Residents receive appropriate care in respect of their health and personal care needs. Residents’ privacy and dignity is mostly upheld and their life style choices are respected. EVIDENCE: Care plans were seen in respect of the four residents (three respite residents and one permanent resident, with the three respite residents’ admission processes having been inspected previously). The care plans examined were thorough and covered all required care needs. The manager should be commended for ensuring those care plans detailing the care of residents staying in the home for a respite stay are also very detailed, as this helps ensure the care these residents receive is also well thought and planned for and that their stay becomes a worthwhile experience. There were appropriate risk assessments in place including a moving and handling assessment, a pressure area risk assessment and a self-medication assessment (where appropriate) for all residents. Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 12 However, some other permanent residents spoken to during the inspection indicated that they were not fully sure of the content of their care plan. This has been a previous issue within the past twelve months, that the management of the home have been working towards and which will be now be continued to ensure all residents are aware of the involvement they can have in their care planning/review process if desired. The home maintains a comprehensive list of any health care visits which ensures all staff are easily able to be aware of what each professional may have prescribed/suggested. During the inspection two District Nurses were spoken with and asked for feedback as to how they felt the home met residents’ needs. Both the District Nurses gave positive feedback and felt that the home gave good care overall and were helpful to them when they visited. Wheelchairs were available if required for transport purposes, as was a mobile hoist. It was noted that for the one permanent resident whose care was inspected in detail the manager had got the resident her own designated wheelchair from Social Services as well as a pressure relieving cushion as her mobility had weakened. This evidences that this resident’s needs were being regularly reviewed and appropriate action taken to meet them as required. The resident herself also stated when spoken with “Anything you want the manager will get if he can. I needed some new teeth and he arranged this for me”. Another respite resident whose care was inspected stated that she found the staff “very kind”. They helped her “get undressed and dressed and she had been comfortable during her stay”. Discussion with the manager confirmed that staff are made aware of the need to use all wheelchairs correctly including ensuring that the foot plates are used at all times. If, for whatever reason, a resident does not wish to use the foot plates the manager confirmed that this would be written down within the individual resident’s care plan along side a risk assessment. The home’s accident recording was noted as being in order with the home’s accidents records seen. The home’s newly upgraded medication cupboard was inspected and the home’s medication procedures and records were noted as being in order with regular medication awareness training provided for the named carers who administer medication. The home’s senior head of care has undertaken an in depth distance learning course in medication awareness and it is this member of staff only that has responsibility for the ordering, receipt and checking of medication into the home. Her attention to detail should be commended as the medication procedures within the home were noted as being very orderly, with the home’s medication being managed very well including the home’s controlled drug polices, which were noted as being followed correctly. Very positive comments were received back from some residents as to the way that the home does manage their medication. Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 13 A medical fridge has also been provided for the storage of insulin or eye drops. The home keeps records of when residents have taken showers or had baths. It was noted that these were filled in with some residents having weekly showers/baths and others more frequent. Although several residents confirmed that they were always offered their shower on a weekly basis, one resident spoken to felt that should they miss their weekly “slot” another one would not be made available and indeed the record of when this resident took a shower highlighted that the resident had not received a shower for a week with no reason being given for this omission. The newly amended key worker system (operational since June 2006) is working very well with some good feedback received from residents who were in the main happy with the key worker allocated and felt comfortable approaching them for help with personal bits and pieces. Staff are responsible for detailing what aspects of individual care has been given and there were records of this which highlighted that staff have taken their key worker role seriously and are trying to enhance residents’ lives through the use of the same. It was however noted during the inspection that on one occasion a staff member entered a resident’s room without knocking on it first, although overall the residents stated that they felt that the staff were respectful towards them and did all that could to help them and they were, in the main, happy with the staff’s approach towards them. In particular the senior head of care and an overseas worker were individually praised by the residents for their caring and efficient manner. Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 The quality in this outcome area is adequate. Residents enjoy a peaceful life at the home, with visitors encouraged and welcomed. Choices are made available to residents regarding their day to day living and these are respected and upheld by the management and staff. Links are encouraged and maintained with the local community. Residents are able to participate in various informal activities, and can take advantage of weekly outings, when offered (which are charged for at £4.00 per outing). The home provides adequate meals. EVIDENCE: It was noted that residents feel they can take advantage of the informality of the home’s routines and consequently choose how they spend their time. Several residents verbally confirmed this and also stated that they and their visitors were quite free to come and go as they wanted. During the inspection it was noted that some residents had chosen to remain in their own rooms, others were socialising together whilst some were enjoying each other’s company. An example of how staff manage diversity to good effect was in the manner with which the home had provided for the care needs of a resident who was on Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 15 a short stay but was also accompanied by his carer, who is his wife (both having been allocated this respite placement through a charitable body). The manager and staff were very aware of the actual resident’s needs but also ensured that needs of the couple were taken into account i.e. offering meals in their own room, ensuring they were given privacy as required, ensuring that care was provided in a discreet and non-obtrusive manner. Good feedback was received from the couple who were thoroughly enjoying their stay at the home. Visitors are welcomed and encouraged and the home’s visitor’s book evidenced many visits from many people at differing times. Feedback from resident’s families stated how welcome they were made and one relative’s comment was: “Always made very welcome with a cup of tea and a smile and either the manager or one of the staff asks after my welfare”. There is normally a weekly outing for residents. There is a charge for these trips of £4.00. The manager is currently in the process of obtaining feedback as to what type of activities residents would enjoy and is looking to amend the current activities programme. Currently two informal activities are arranged on a daily basis. The home does not employ a designated activities organiser. Rather staff are responsible for organising the daily actives and undertake activities as time and staff numbers allow. Currently these are provided in an informal manner, within the home, according to residents’ desires. Detailed records were kept to show what activities have been made available. The manager has also initiated a mobile shop which operates once a week and has proved popular with residents and allows them to be able to purchase small items “in-house”. Some outside entertainment is also brought in on occasions such as clothes parties, visiting musicians etc. Regarding meals served, some residents stated that they felt there was room for some improvement regarding these, in so far as they felt their personal choices and specific dietary needs were not always catered for. Such comments received that evidenced this included: “too much sponge pudding and custard”, “always a new cook and the standard of meals is not as good as it once was”, “not confident that the meals provided cater for specific needs of a diabetic”, “same thing day after day”. One resident also stated that they did not always receive the supper time choice they had made earlier in the day. It was however noted that there was a varied weekly menu made out, with choices available, and that this information was displayed on a notice board within the home’s dining room. It is true that the home has had several changes of cook within the past twelve months and the manager, having himself been originally trained a chef, was Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 16 clearly aware that this has made it more difficult for the home to provide a consistently high standard of meals during this time of change. The most recently appointed cook has been at the home since March 2006. She has a food hygiene certificate and had had past experience in catering. It was unfortunate that on the day of the inspection she was not working within the home, being unexpectedly unavailable. In her place a care staff member, with some experience of cooking was preparing the midday meal. The meal provided was beef stew and dumplings with mashed potato and vegetables. The pudding was fresh melon with a strawberry sauce. The standard of cooking was good, considering this had been an emergency measure, and the majority of residents appeared to enjoy the meal. The more negative comments regarding the overall standard of the meals provided was discussed with the owner and the manager the manager will continue to provide a means to allow all residents the opportunity to be very specific about what they would wish to see on the menu and how exactly they feel the menus/ meals can be improved upon/changed for the better. Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The quality in this outcome area is good. Arrangements for protecting residents and responding to their concerns are satisfactory. EVIDENCE: The Commission has not received any formal complaints in respect of Roundham Court, since the last inspection undertaken in February this year. The home’s complaint policy remains communally displayed within the home’s hallway and is also contained within the home’s statement of purpose. The manger keeps a written record of complaints received internally and of subsequent action taken. This was reflected in resident feedback as most residents spoken with, or who responded to the feedback questionnaires, were clear as to how to complain and felt they could easily approach the manager or senior care manager should they have any cause to. Staff receive vulnerable adult training on a regular basis and there were records kept of when this training was both given and when it needed to be renewed. Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 The quality in this outcome area is excellent. Roundham Court is very comfortable, clean, well maintained and provides a safe standard of accommodation for the residents. EVIDENCE: The tour of the home confirmed that the owner and manager maintain very good environmental standards within the home, which makes Roundham Court a pleasant place to live in. Since the last inspection, the exterior of the home has been repainted, new chairs have been provided in the home’s conservatory and new leather settees provided within the home’s large and pleasant hallway. There are further plans to install additional security lighting to the exterior of the home and the home’s electrical testing of its portable appliances is also due to be undertaken next month. These measures further protect residents living at the home. Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 19 One comment received from both a resident and their visitor was in connection with the home’s front door approach. Due to a small raised edge the resident finds it hard to negotiate her wheelchair in and out of the doorway. This was discussed with the owner at the inspection, who will look at ways of enhancing the access to relieve the problem. Other than this small point the visitor said “they couldn’t fault the home”. Another point regarding the physical aspect of the home that was raised concerned the use of four rooms within the home. As these rooms are approached by four steps it was agreed that from now on only physically independent residents will be offered these rooms. Routine general upgrading continues to take place as required and ensures that the home’s environment is clean, comfortable, welcoming and very well maintained. The manager ensures that the home’s day to day fire precautions are maintained in line with the requirements of the local fire department and it was noted that all the home’s fire doors, seen, were either closed or being held open with the use of an automatic door closure. The home’s fire log was also noted as being in order. An appointed health and safety officer undertakes a monthly visit to Roundham Court, detailing any remedial work that needs to be done to maintain the required environmental standards as well as further ensuring that the home’s fire precautions remain in order. Privacy locks to all residents’ bedroom doors are in place. Each resident had had a room risk assessment undertaken. Hot water regulation is being finalised, with the owner confirming that all hot water outlets servicing the residents’ wash hand basins will be fully regulated by the 29th September 2006. The home presented as very clean and hygienic overall. The laundering needs of the residents are met appropriately with the new improved laundry equipment ensuring that all residents’ laundry needs are undertaken as effectively as possible. Staff receive regular cross infection training as part of the Court Group’s statutory training programme. Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The quality in this outcome area is adequate. Staff cared for residents appropriately and well. The home’s recruitment policies are in order and protect residents. Staff at the home are appropriately trained and mostly employed in adequate numbers so as to meet the residents’ needs. EVIDENCE: On the day of inspection there were thirty residents in the home. The staffing rota was inspected. Normally there are five carers in the morning and five carers during the morning with four in the afternoon/evening. Additionally there is a domestic on duty from 8.00a.m until 2.00p.m during the week and a cook who works 8.00a.m until 2.00p.m Monday to Saturday. However on the day of the inspection both the domestic and the cook were not available for work. Two waking night staff provides night cover. The home also employs a maintenance member of staff to ensure all minor repairs to the building can be undertaken The registered manager works from 8.00a.m until 5.00pm Monday to Saturday as well and his role does involve “hands-on” care as required. Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 21 The manager is sensitive to the fact that not all female residents may want to receive personal care from a male and alternative arrangements are made if this is the case. Staff, on duty, were noted as being well presented and polite towards the residents and there were several positive comments received regarding the manner which staff care for them with several residents stating that they are very kind and considerate. It was pleasing to note that the owner took immediate action in respect of some negative comments received regarding the attitude of one care staff member and the owner later confirmed that this staff member no longer works at the home. Staff spoken to on duty were able to confirm that they had received a lot of in house training since their appointments and were happy to take advantage of the further training opportunities being presented. The home does not currently have its required allocation of 50 of trained staff (NVQ level two in care) with the number being only 25 , but there are plans in hand to address this and several care staff members are due to undertake this training in the near future. Although the staff group remains relatively stable within the home there have been some changes due to staff leaving/moving on. The records for new care staff members, employed since the last inspection, were looked at in detail. The recruitment procedures within the home, including receipt of completed application forms, two written references, an enhanced CRB check were seen to be in order and ensure that there are suitable staff working within the home and that residents are protected. All staff receive regular supervision and annual appraisals to allow them to fully understand their role/performance within the home and there were records of these available. It was pleasing to note that those staff spoken with felt comfortable working at the home felling well-supported and able to approach the manager should they have any concerns. One staff comment card contained the following comment “lovely members of staff and manager. I’m happy to work here” They also voiced the fact that they felt the current staff group was strong and that they were able to support one another. During the inspection it was noted that staff took pride in their role and tried hard to ensure that all residents had a good quality of life, irrespective of need or diversity i.e. it was noted that frailer residents were given choice as a matter of course and were treated with respect. There are regular staff meetings held with minutes kept where issues surrounding any aspects of care are discussed or pans for the future of the home. Information that may be useful to staff, including any training opportunities etc are also made available to all staff. This allows them to have an awareness of all issues surrounding their roles and to feel part of a bigger team. Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 22 However there were also some comments received from residents and their families/advocates that state that they find the staff are “rushed”, “the call bells not always being answered quickly enough”, and “there is a general shortage of staff on occasions”. These comments was fed back to the owner and the manager who will look at the allocation of the current staffing hours and adjust/increase as necessary. Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 The quality in this outcome area is good. The management of the home provides the necessary support to staff and residents to ensure the home is run and managed appropriately. Excellent quality auditing takes place to help ensure that the home is run in the best interests of the residents. The home provides a safe, secure environment where residents’ safety and well-being is maintained. EVIDENCE: The registered manager has been in post for the past year. He was registered with the Commission in June this year. He has completed his NVQ level 4 in care and management and is currently awaiting verification of his NVQ 4 award in management. During the inspection several residents and staff fed back how approachable they found the manager with one comment being: “I think everyone thinks a lot of our manager” and “the manager will always listen to any complaint”. Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 24 The manager maintains the day-to-day management of the home in a satisfactory manner. Records inspected were up to date, concise and contained appropriate information. One aspect to be commended is the manager’s forward thinking and enthusiasm for his role. An example of this is the manner in which he has provided a system to avoid any staff member compiling a resident’s file incorrectly or undertaking an admission incorrectly. To prevent this the manager has independently created “blank proforma” files that staff can follow in his absence which, when then ensures that these are completed correctly and contain all necessary information to allow a resident’s details to be fully recorded. The residents or the residents’ families/advocates mostly deal with any financial matter although the home does hold small amounts as requested by residents or their families. There were detailed records in respect of these and the Court group senior management team undertake a monthly review of all monies held. This ensures residents’ monies are secure. The appointment of the newly created quality audit officer also evidences that the management are working towards ensuring that all of its homes are run in such a way as to be in the best interests of the residents. The officer visits monthly and speaks with the residents and staff and provides a written report of her visit to the manager and a copy is forwarded to the Commission’s office. The manager holds three monthly residents’ and staff meetings with minutes kept. The home obtained “Investors in People” in January 2005. Results of questionnaires are made available to residents and are displayed on their notice board. The home’s annual development plan for 2006/2007 was available is made available to staff and residents. The residents and staff both receive a copy of the newly introduced Court Group newsletter, which allows all to know what is going on within the Court Group generally. The manager and the owner both confirmed that health and safety issues continue to be well managed within the home and records inspected supported this. The manger, in conjunction with the Court Group’s newly appointed health and safety representative, undertakes all required routine health and safety management including fire awareness and ensures all health and safety standards continue to be met. The home’s hot water supply is mostly regulated throughout the home to a safe temperature with the owner confirming that the few outstanding water outlets will be fully regulated by the week ending the 29th September 2006. All hot surfaces are covered or have low surface temperatures and windows are fitted with restrictors. This measure further helps maintain residents’ safety at all times. Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 26 CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 X X 3 Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 28 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 OP7 OP15 OP19 Good Practice Recommendations The manager should ensure that all residents and/or their family/advocate are aware of both the existence and the content of their care plan and of any change made to it. The manager should continue to try to ensure that the menu choices offered meet all individual residents’ expectations. The four rooms that necessitate the resident to climb four steps to access the room should be used for physically independent residents only. This is to ensure the occupants of these rooms are able to come and go as they wish. The owner/manager should continue to make staff training available to allow the home to achieve its target of having 50 percent of the staff working at the home trained to NVQ level two in care and therefore ensure residents are cared for by suitably trained and aware staff. 4 OP30 Roundham Court DS0000018420.V300375.R02.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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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