Inspection on 18/10/05 for Roundham Court

This inspection was carried out on 18th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Roundham Court 26/10/07

Roundham Court 14/09/06

Roundham Court 15/02/06

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 Announced Inspection 18th October 2005 09:30 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.V257159.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 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.V257159.R01.S.doc Version 5.0 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 Vacancy Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Roundham Court DS0000018420.V257159.R01.S.doc Version 5.0 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 1st December 2004 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, set in well-maintained grounds that overlook Torbay. The owners have recently created 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, a dining room, large hall area with seating, office, kitchen, laundry, lounge, conservatory and area for craft work. There is an assisted bathroom and 2 assisted shower rooms. A shaft lift and wide stairs lead to the first floor. Roundham Court DS0000018420.V257159.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over two days. One written feedback form was received, prior to the inspection, from a resident and two were handed back on the day of the inspection. Opportunity was taken, at the inspection, to tour the premises, examine records and policies and talk with both of the owners and the newly appointed home’s manager (not yet registered). A visiting District Nurse and a visiting Occupational Therapist were asked for their feedback as to how they felt the home is operating and some visitors were also asked for their opinions, as to the overall services provided to residents. All, but four, of the current 31 residents were met with during the inspection, as well as the staff on duty, who were also observed, whilst in the course of undertaking their daily duties. This report is therefore based on the findings from these observations. What the service does well: The home’s environment provides residents with a homely, bright, comfortable, very well maintained environment. Residents benefit from a “community spirit” within the home and are encouraged and enabled to socialise with each other, as desired, as well as make individual personal friendships. The management and staff enable residents to maintain links with the nearby local community and visitors are encouraged and welcomed into the home. The result of this is that residents both benefit from companionship with each other, and continue to feel part of the local community. The current staff group, although experiencing a degree of change with some staff moving to other jobs etc, have helped maintain a feeling of stability for the residents, by some long standing staff remaining in post. The current staff are aware of the residents’ individual needs and endeavour to meet them effectively, and the residents themselves confirmed this to be the case. Roundham Court DS0000018420.V257159.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Staffing levels need to be increased, particularly during the afternoons, and at weekends, to ensure that residents’ needs and welfare can be met and upheld. The registered provider must ensure that residents are protected from the risk of fire within the home by maintaining fire precautions in line with those recommended by the local fire and rescue service. All hot water, provided to residents’ facilities within the home, must continue to be regulated to a safe temperature, to ensure that residents are protected from the risk of sustaining a scald. The manager should ensure that those residents, who have chosen to be involved in their care plans reviews be given this opportunity. Roundham Court DS0000018420.V257159.R01.S.doc Version 5.0 Page 7 Residents’ should be further consulted on the home’s menu planning, to allow residents to feel fully involved in ensuring that their individual needs and preferences are known and can be met. Locks should continue to be provided to each resident’s bedroom door to ensure that every resident’s rights to privacy is further enhanced. 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.V257159.R01.S.doc Version 5.0 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.V257159.R01.S.doc Version 5.0 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). The admission process is well managed with residents’ needs explored and known prior to admission to the home. EVIDENCE: The home continues to maintain its statement of purpose and service users’ guide appropriately, with newly updated details, regarding both the recent management and staff changes within the home, currently being incorporated into the guide. By inspecting the records for a random two residents who have recently been admitted to the home, it was noted that a full and detailed admission procedure had been undertaken in both cases, which had ensured that Roundham Court was the appropriate home for both of the residents. One of the two residents was available to discuss their admission process and was able to confirm that they had been made to feel welcome, very comfortable and that their needs were being well met at the home. Roundham Court DS0000018420.V257159.R01.S.doc Version 5.0 Page 10 The other resident whose admission records were inspected was on a respite stay placement. It was noted that there were again full details regarding what care this resident would need. The home does not provide for intermediate care. Roundham Court DS0000018420.V257159.R01.S.doc Version 5.0 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 All residents are looked after well in respect of their health and personal care needs, however some residents, who had requested to be involved in their care planning reviews, had not been consulted and so had been unable to participate in this process and agree what care should be provided. Residents are treated with dignity and respect and their individuality and independence maintained. EVIDENCE: Care plans contain all relevant details appertaining to providing for each individual resident’s care. They were concise and contained necessary details of any medical needs of the resident. The care plans had been regularly reviewed, but not always with the resident as had been requested by the resident. The manager and staff liaise with other professionals as required and, during this inspection, a District Nurse was asked for feedback as to how she felt the home cared for the clinical needs of the residents she visited. The District Nurse gave positive feedback, stating, that in her opinion and from what she Roundham Court DS0000018420.V257159.R01.S.doc Version 5.0 Page 12 observed, the manager and the staff at the home did all they could for the residents and followed any instructions she may give as best as they could. An Occupational Therapist was also visiting a resident at the home (who had recently suffered a stroke), and again verbal feedback was requested from her. She stated that she felt the manager and staff were responsive to her suggestions and worked towards the individual resident’s best interests. The home’s medication storage and administration systems were noted as being in order with medication being administered correctly, by appropriately trained staff, whilst the recording of medications was also in order. Some residents self medicate and the manager stated that he had ensured that these residents are both risk assessed and have a self medication agreement in place between the home and the individual resident concerned, to ensure that each resident involved in self medication is protected as far as the home is able and a sample of these were seen and were noted to be in order. (Following discussion, during this inspection, it was concluded that it would be in the best interests of the staff, concerned with medication administration, to re-locate the medication storage area within the home. This is because the present one does not allow staff to have good, or easy, access to stored medication). Verbal feedback from residents, about the care they received, was positive with several comments stating that the staff are kind and caring and very good at their jobs. Residents were noted as being treated with respect, and their dignity and individuality maintained by the staff during the days the inspection took place. Staff were seen addressing residents by their chosen name, and all residents were well dressed whilst any care needed was noted as being delivered in a professional and sensitive manner. Roundham Court DS0000018420.V257159.R01.S.doc Version 5.0 Page 13 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. Residents enjoy a pleasant and supported lifestyle at the home, which helps them maintain a good quality of life, with visitors welcomed and encouraged. Resident choice is upheld with residents enabled to have some input into the day to day running of the home. Different activities are made available and adequate meals are provided, however residents would benefit from having more consultation with the home’s chef to ensure that they feel confident that their individual preferences and nutritional needs are fully known. EVIDENCE: Staff undertake group activities with residents when time allows. Other organised events are a feature at the home. On the day of inspection an “inhouse” clothes party was taking place. Outside entertainment is also brought in as desired and trips out offered on occasions. The home operates an open visiting policy and the visitor’s book clearly showed that the residents had many visitors at varying times throughout the day and residents stated that their visitors were able to visit at any time and were always welcomed. During the inspection two visitors were spoken with, and both were able to confirm this to be the case. Roundham Court DS0000018420.V257159.R01.S.doc Version 5.0 Page 14 Residents are enabled to have contact with the local community as they so desire and the home has a regular visits from a local clergyman. The routines within the home are flexible to ensure that residents can choose how they spend their time. Some had chosen to spend their time in the communal areas of the home, whilst others had chosen to spend their time in their rooms. Resident meetings are regularly held with the minutes seen, proving that residents are asked for their views and thoughts on the day to day running of the home. The home’s menus were inspected and were seen to be varied and nutritionally well planned, however some residents stated that they wished to have greater consultations with the newly appointed home’s chef to ensure that the menus continue to be to their liking. During the inspection the chef was spoken with and stated he was open to having grater involvement with the residents and, directly following this inspection, the management of the home agreed that a resident’s meeting was to be called to allow this process to happen. The manager is also to review, and amend, the home’s menus in accordance with the resident comments received back. Roundham Court DS0000018420.V257159.R01.S.doc Version 5.0 Page 15 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 Arrangements for protecting residents and responding to their concerns are satisfactory. EVIDENCE: The home’s complaint procedure was clear and was available to all residents. The owners/manager have dealt appropriately with any complaint made (either through CSCI or internally). A recent complaint, made directly to the CSCI, about a discharge of a resident to another home, has not yet been fully concluded. There are appropriate adult protection policies in place, which staff have easy access to and vulnerable adult training is provided, with some more recently appointed staff being given this training immediately following this inspection. Roundham Court DS0000018420.V257159.R01.S.doc Version 5.0 Page 16 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): Roundham Court provides a very comfortable, clean, pleasant, well maintained and warm environment. The registered provider is compromising residents’ safety, by not fully maintaining all fire prevention measures within the home as required. EVIDENCE: Overall the home presented as very comfortable, clean, pleasant and welcoming. The tour of the building evidenced that the register provider continues to undertake any required routine upgrading within the home to ensure that an excellent standard of accommodation is provided throughout. Bedrooms have been personalised as desired and residents can bring in personal items with them if they wish to. The management of the home maintains the day to day home’s fire precautions in line with the requirements of the local fire department, however Roundham Court DS0000018420.V257159.R01.S.doc Version 5.0 Page 17 it was also noted that some resident bedroom doors were being wedged open during the inspection. An immediate requirement notice was issued in respect of this, as resident safety was being compromised by the use of such, and the acting manager did take immediate remedial action before the inspection ended by removing the door wedges. The owners will provide a suitable lock if requested by a resident, but they are not provided as standard on admission. This is documented this within the home’s statement of purpose. The home has an infection control policy and staff were seen to observe routine infection control measures such as using gloves, aprons and disposing of clinical waste appropriately which helps protect residents from the risk of cross infection. Further staff training in infection control is to be made available in the near future. All areas of the home were odour free. Roundham Court DS0000018420.V257159.R01.S.doc Version 5.0 Page 18 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. Staff are not always employed in sufficient numbers to meet the current resident groups’ needs. The home’s recruitment processes were seen to protect residents. Staff training provided, allows the staff the opportunity for further personal development and the ability to increase their skills and awareness in caring for the residents. EVIDENCE: Staffing levels during the afternoons and over the weekend were not seen to be in sufficient numbers to ensure that residents’ needs could always be met. This is because the three carers on duty in the afternoon also have to prepare and deliver afternoon trays as well as supper trays which, for up to 34 residents, can take a considerable amount of time (at the time of inspection there were 31 residents in the home). At weekends the manager is off duty. As his role also incorporates direct care hours as required, when he is not in the home the staff are short of both a manager and of an extra carer if necessary. Residents spoken to did however state that, overall, they felt well looked after, although some did comment that the staff appear to have to work very hard and had less time available to spend with them as previously. Some staff also stated that they felt very pressurised and felt they could not always deliver the care they wished to during the times identified, due to the current staffing levels. Roundham Court DS0000018420.V257159.R01.S.doc Version 5.0 Page 19 Discussion followed with both the owners, as well as the acting manager, and it was concluded that this staffing shortfall would be addressed as soon as possible. Training was well planned and supports the staff in providing for the varied needs of the residents with statutory training and other work related courses being made available, including NVQ training. Two staff files for recently recruited staff were inspected. A full recruitment programme had been carried out in respect of the staff members with application forms, written references etc being available. One of the staff members CRB disclosure had not yet been received back, although the manager stated that it had been applied for, but as it was for the home’s chef and he does not have any current direct contact with residents or work in any unsupervised capacity, his working in the home had been allowed by the owner and the acting manager, prior to the CRB being received back. The manager stated that he had seen the second staff member’s CRB disclosure, and there was a note of the CRB number, which was seen. However the actual disclosure was not available for inspection. Following on from this inspection it was agreed that the acting manager would hold any such disclosures, in the home, until they had been inspected by the CSCI. Roundham Court DS0000018420.V257159.R01.S.doc Version 5.0 Page 20 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 owners are involved in the day to day running of the home, whilst the recent appointment of a new manager within the home has allowed residents to feel more secure and settled. Routine health and safety precautions are maintained appropriately, however by not providing regulation of the hot water temperature to residents’ wash hand basins, residents’ remain at risk from scalding. EVIDENCE: There have been some management changes within the past twelve months. This has been due to the previous long serving manager leaving earlier in the year, and her replacement leaving after only a short time in post. A new acting manager has recently been appointed (July 2005) from within the Court Group, and, as he has previously worked at Roundham Court is Roundham Court DS0000018420.V257159.R01.S.doc Version 5.0 Page 21 familiar with the home. He is to undergo the registered manager’s “fit person” process as required by this Commission, in the near future. Feedback from residents and staff evidenced that they felt positive about this manager’s appointment and felt able to approach him with any worries/concerns. The home operates satisfactory internal quality monitoring systems with residents’ feedback invited as part of the overall process. The owners ensure that a monthly, in depth, quality audit visit is undertaken, where all aspects of the running of the home are examined and reported on, including consultations with the residents. This ensures that all practices within the home are regularly reviewed and that the care provided is of a standard that residents would expect/want. The manager holds monies for some residents in a locked drawer, as agreed/requested by the resident/their family, and there were detailed receipts etc in respect of these. This ensures that those residents that do use this service can be reassured that their monies are being handled and kept appropriately and securely. Routine health and safety issues are well managed within the home with the required records being made available, including fire prevention records, and these were seen to be up to date. All hot surfaces have now been protected throughout the home, which helps ensure residents are protected from sustaining a burn. The owners also stated that all required windows within the home have now been fitted with suitable window restrictors. The home’s hot water supply has not been fully regulated to a safe temperature to residents’ wash hand basins, although the owners stated that this was in hand. It is in place where there are full body submersion bathing facilities. Roundham Court DS0000018420.V257159.R01.S.doc Version 5.0 Page 22 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 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 2 8 3 9 3 10 4 11 N/A 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 2 x x x x x x 3 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 2 x 3 x 3 x x 2 Roundham Court DS0000018420.V257159.R01.S.doc Version 5.0 Page 23 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. 1 Standard OP19 Regulation 23 Requirement Timescale for action 18/10/05 2 OP24 15 3 OP27 18 The registered provider must ensure that the homes’ fire precautions are maintained in accordance with the requirements of the local fire and rescue service. The registered provider must 18/04/06 ensure that all residents hand wash basins are risk assessed and subsequently fitted with valves to provide hot water to 43 degrees Centigrade. The registered provider must 18/11/05 ensure that at all times suitably qualified, competent and experienced persons are working at the home in such numbers as are appropriate for the health and welfare of the service users. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000018420.V257159.R01.S.doc Version 5.0 Page 24 Roundham Court 1 2 3 4 5 Standard OP7 OP15 OP23 OP27 OP31 The manager should involve those residents who have requested that they be so, in the monthly review of their care plan. The manager should ensure residents are more involved in the menu planning processes within the home. The registered provider should continue to provide suitable door locks to individual residents bedrooms to ensure their rights to privacy are enhanced. The manager should ensure that all recruitment details are available, within the home, for inspection including any newly appointed staff’s CRB disclosure. The homes newly appointed manager should apply to this Commission, to undertake the registration process to allow him, if successful, to be the registered manager at the home. Roundham Court DS0000018420.V257159.R01.S.doc Version 5.0 Page 25 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. Extracts may not be used or reproduced without the express permission of CSCI Roundham Court DS0000018420.V257159.R01.S.doc Version 5.0 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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