Inspection on 26/10/07 for Roundham Court

This inspection was carried out on 26th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 but made no statutory requirements on the home.

Other inspections for this house

Roundham Court 14/09/06

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 22 Cliff Road Paignton Devon TQ4 6DG Lead Inspector Douglas Endean Unannounced Inspection 10:00 26th & 30 October 2007 th 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.V343840.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.V343840.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Roundham Court Address 22 Cliff Road Paignton Devon TQ4 6DG 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) 01803 528024 01803 528024 info@thecourtgroup.co.uk Mrs Jill Wakeham Mrs Sally Brazier Mrs Denise Elaine Ellis Care Home 35 Category(ies) of Dementia (35), Old age, not falling within any registration, with number other category (35), Physical disability over 65 of places years of age (23) Roundham Court DS0000018420.V343840.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home providing personal care only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) - maximum number 35 Dementia (Code DE) - maximum number 35 Physical Disability, aged 65 years and over (Code PD (E)) - maximum number 23 2. The maximum number of service users who can be accommodated is 35. 14th September 2006 Date of last inspection Brief Description of the Service: Roundham Court provides care for up to thirty-five older people in a large Victorian house that has been adapted to meet the needs of the people who live in it. It is located on headlands near Paignton Harbour and set in wellmaintained grounds that have magnificent sea views over Torbay. There is a level terraced area at the front and side of the home, which allow residents to sit outside and have excellent views across the bay. The front driveway provides level access to the homes main entrance and widens out to provide several parking spaces. The home has 34 mainly generous sized bedrooms organised as one double and 33 single, of which 31 rooms have en-suite facilities. There is ample lounge and dining space on the ground floor and a staircase that leads to the first floor and mezzanine floor where further bedrooms can be found. There is a shaft lift to the mezzanine floor and chair lift up just 4 steps to the first floor. There is a choice of bathing facilities, shower and bathrooms, in the home. The weekly fees commence at £375. Roundham Court DS0000018420.V343840.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place over two visits, the 26th and 30th October 2007, the first one commencing at 09:30. Over the two visits we met the Registered Manager, Quality Assurance Officer and Registered Provider who were very cooperative during the progress of the inspection. A total of 6 hours were spent at the home to complete the process. In that time we spoke to 4 staff and 4 people who live in the home. As part of the case tracking exercise we looked at 3 sets of records belonging to each of these groups of people and 3 sets of staff records. We also looked around the home going into lounges, the dining room, bedrooms, bathing and toilet facilities, the laundry and the kitchen. The Registered Manager provided the Commission for Social Care Inspection with a complete Annual Quality Assurance Assessment prior to this inspection that gave information about how the home felt they have functioned and what improvements they plan for the future. It also gave information about staffing and maintenance of the home. In addition to this we have received 13 completed Commission for Social Care Inspection survey forms from people who live in the home, 8 from their relatives and 4 from the staff. What the service does well: What has improved since the last inspection? Roundham Court DS0000018420.V343840.R02.S.doc Version 5.2 Page 6 The home has a new and experienced Registered Manager. She has motivated and empowered staff group who feel they are a part of what makes their working environment good, and that this results in good care. There are new and improved record keeping systems in place. 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. The summary of this inspection report can be made available in other formats on request. Roundham Court DS0000018420.V343840.R02.S.doc Version 5.2 Page 7 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.V343840.R02.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standards 1 & 3. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The information that is provided to people who may move into the home, and also to those who live and visit it, is of a high standard. The pre-admission assessment information is comprehensive and well structured. EVIDENCE: In the reception area there is a desk on which the home has displayed a wide variety of valuable information for people who live in the home and those that visit. This included a Statement of Purpose that was well presented and included information about the home, the complaints procedure, a copy of the last Commission for Social Care Inspection report, a sample copy of the homes contract, and the Annual Development Plan. There were also the results of the Roundham Court DS0000018420.V343840.R02.S.doc Version 5.2 Page 9 last quality assurance exercise that provided information about what people felt about the building, the food and their care. Other information was available in booklets and leaflets such as the Office of Fair Trading document “Choosing a Care Home”, and “Responding to abuse in residential day care settings” from Action on elder Abuse. Finally there was a letter that gave information about bringing into the home portable electrical appliances, such as televisions and music centres. It introduced the subject of tests that must be carried out under Health & Safety legislation and the initial cost for testing that is passed onto the individual. The Commission for Social Care Inspection survey for people living in homes asks the question, “Did you receive enough information about this home before you moved in so that you could decide if it was the right place for you?” 13 responses were received. One said “no”, two did not respond to this question and 10 said “yes”. One said, “My family made enquiries but liked Roundham Court best. They brought me to view it for my opinion. As it was initially for respite care, it wasn’t a crucial decision, but I soon felt at home here and chose to stay”. Before there is an agreement to admit a person to the home the Registered Manager ensures that a pre-admission assessment takes place. This is carried out where ever the person resides at the time the referral is received, such as home or hospital. The home is introducing new documentation that is being used through out the group of homes that Roundham Court is a part of. We saw examples of completed assessments in the sample of 3 files we read about people who are now living in the home. The pre-admission information was in the old format that holds comprehensive information about the individuals and their care needs. The comprehensive information included a personal history where this had been available, and details of their needs such as dietary, medication, and mobility, and whither there was to be General Practitioner and District Nurse involvement. The information we saw is to be transcribed into the new format that is colour coded for ease of access to specific areas and all held in one file. In addition to the information that the home has written they had gathered assessments and notes from health and social care professionals who have been involved with people prior to the referral and admission to the home. We felt that this information provide good evidence to support the managers decision to agree to the admission of individuals to the home. As part of the monthly audit practices the Quality Assurance Officer visits the home and reviews many things including records of new admissions to see that the admission process has been followed. Roundham Court DS0000018420.V343840.R02.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standards 7, 8, 9 & 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has good care planning arrangements, which involves the people who live in the home as much as they wish to be involved. Staff treat the people who live in the home with dignity and respect. EVIDENCE: The group of homes to which Roundham Court belongs are replacing the format of the records for people who live in the home with a new set of records that have colour codes sections and references to the standards that are being addressed in the section. There are also prompts so that valuable information is not forgotten when completing a section. We saw both formats of the records in use and found that they held good information about the people they were written about beginning with photographic identification. Information from the pre-admission assessment and health and social care Roundham Court DS0000018420.V343840.R02.S.doc Version 5.2 Page 11 professionals were used to write the initial care plans. There was evidence that the care plans were then reviewed monthly and changes made to the plans where necessary. The care plans were well written and held clear information about problems, and what was to be done to manage the address them. Risk assessments were good and covered both care needs such as falls, pressure area care or continence as well as the persons room environment, identifying any hazards that may be there as a result of the various problems that a person had such as mobility, sight, and confusion. The care plans were sectioned and progressed through the care needs of each individual and signed either by the person they had been written about or their advocate. There was also a signed agreement regarding the level of involvement that the person living in the home, and/or their advocate, would prefer to have, in the reviews of the care plans. Health care professionals, private and National Health Service continue to be involved with people who live in the home. Chiropody is available on a six weekly basis at a present charge of £7. A record of the visits by health care professionals including the Chiropodist, Optician and Dentist are held on a sheet entitled, “Medical Appointments”. The General Practitioner will visit when requested to do so and the records of visits are enhanced with a further record sheet simply entitled, “Doctors Visits”. District Nurses generally have their own records about the care they provide but the home still make a record that will stay at the home. All visits by these health care professionals are carried out within the privacy of the person’s own room. The questionnaires received from people who live in the home showed that the majority of people felt that they received the medical support that they needed. We looked at the way medication is managed within the home. There is a risk assessment for people who wish to self medicate followed by a signed agreement that included the person and their advocate. The medication procurement records are held on each of the administration charts so that the information about medication use follows each person. Medication is stored in a small secure room within the home and held in a purpose built medication trolley that holds the multi dose system that is favoured by the home. The trolley was new to the home as part of their improvement plans, and arrived before the second inspection visit. They also have a small drugs fridge in this room. Staff training includes medication training by an external provider. All staff that administer medication have to have done this training first and evidence of this was seen in staff files and the Annual Quality Assurance Assessment that the home provided before the inspection. We also saw that the home does have reference books to refer to for information about the medication that they are administering. During the inspection people were receiving care and attention from the staff on duty. This was done in the privacy of their own room or in the bathrooms around the home. No one seemed rushed and staff were overheard talking to Roundham Court DS0000018420.V343840.R02.S.doc Version 5.2 Page 12 people in a respectful and friendly manner. The people we spoke to said that the staff looked after their needs well and were always polite and caring. Roundham Court DS0000018420.V343840.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standards 12, 13, 14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides an environment that promotes independence through choice for each of the individuals who live there. The level of activities is good and enjoyed by those who choose to take part. The nutritional needs of the people who live in the home are met through well planned meals, which meet with the satisfaction of most of the people who live in the home. EVIDENCE: During the pre-admission assessment the home gather information about people as individuals. They obtain a brief live history at this time or after admission. This information may come from the person living at the home or their relative’s and friends. They find out what the best method of communication is given people may have a disability that affects their sight, hearing or speech. Their dietary likes, dislikes and medical needs are obtained Roundham Court DS0000018420.V343840.R02.S.doc Version 5.2 Page 14 and if they will need their meal presented in a particular way, i.e. cut up or some parts pureed. They are asked about their own routine such as when they like to get up and go to bed, what they prefer to do with their time, such as join in activities in the communal rooms or spend time in their own room and visit the local town with family and friends. A weekly diary of routine events is written into the new records so that regular events can be supported by the staff that help people prepare for them. People are free to express their individuality in such things as how they decorate their rooms and also in how they might fulfil their religious needs such as attending services at local churches. Visiting can take place at any reasonable time and in any place inside, or outside the home. We saw people being visited and going out to lunch with relatives during the inspection. With the previous information in place the home plan activities such as bus trips, visits to the local theatre, cloths parties in the home, and daily activities in the home. The staff provide daily activities such as quizzes and bingo and there are musical events such as the one that was being tried for the first time during the inspection. A lady came to sing with the people in the home using her guitar. The staff joined in making the afternoon entertaining for those who joined in. We also saw staff spending time with people in conversation about everyday things whilst others went out with family for lunch or a walk around the shops in Paignton town that is a short distance away. The home is in a privileged position having wonder views over Torbay. They have taken advantage of this by making a level patio with railings around it at the side of the home so that people can sit in relative safety and enjoy the view during good weather. There was a lively, comfortable, feel about the home with people doing what pleased them. Pets are allowed in the home if the person wishes to bring one with them when they move in. Half of the people who live in the home responded in the survey to say they always or usually take part in the activities that are arranged. Others did not respond to this question or said why they do not attend, due to disability. One person said they did not know what the activities were. The design of the home allows for people to sit quietly and read in their own room or in the library where large print and audio books are available, or join in conversation with others in the larger communal spaces. People can exercise their choice whatever they choose to do, and the staff encouraged this during our inspection. The menu was on display on the notice board outside the lounge opposite the foot of the stairs. There was also a list of the staff on duty for people to see. The people in the home do have the right to exercise choice over who will provide them with the different level of care they are to have, such as the choice of the gender of staff that are providing personal care. Mealtimes are a welcomed event with most people eating in the very comfortable looking dining room. The cook prepares nutritious meals using his knowledge of the likes and dislikes of individuals along side their nutritional needs as assessed by the staff and health care professionals who have been Roundham Court DS0000018420.V343840.R02.S.doc Version 5.2 Page 15 involved with the people who live in the home. The Registered Manager and Group Trainer have also attended the training entitled, “Eat well for older people” that has helped with planning nutritious meals. We saw fresh produce from local suppliers being used to prepare the main meal. The cook showed how he manages his kitchen to meet the requirements of the Environmental Health Department. He has attended, “Safer Food Better Business” training and showed us good records of how the kitchen is managed. The food that was served was attractive, in good portioned and to individuals liking. People are asked daily what they would like and alternatives were available where some people did not wish to have the planned main meal. Special diets were also produced for individuals such as diabetics. On special occasions the cook also prepares birthday cakes, etc, to celebrate the occasion. We were shown evidence that all the kitchen staff, and 80 of the care staff have at least their basic food hygiene. The kitchen assistant has professional catering skills also. Monthly weights are recorded for every person who lives in the home and this provides some indication of their general health that might change and require a review of the diet they have among other things. The people who live in the home, when asked the question, “Do you like the meals at the home?” replied in the survey form in several ways. Half of the responses were either always or usually with one person writing, “The chef and helpers try to make the meals as varied as possible, and the cooking is excellent”. Five people responded that they sometimes like the food with one saying there was a lack of choice. One person felt that their special diet was unsatisfactory. We spoke to 4 people during the inspection and all said that the food they received was very good. The home does not manage the financial affairs for any of the people who live in the home, but they provide information so that people can make an informed decision about what they should do to safe guard their affairs. Roundham Court DS0000018420.V343840.R02.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standards 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for informing people how to make a complaint and the procedure for handling a complaint are good. The home provides good arrangements for the protection of people from any form of abuse. EVIDENCE: The home has a complaints procedure that is accessible to people who live in the home and those who visit it. A copy is available in the reception area in the statement of purpose a copy of which is given to new referrals who make contact with the home. The procedure is clear and has the contact address of the Commission for Social Care Inspection should a complaint not be resolved to the complainants satisfaction by the home. The Registered Manager keeps a log of complaints and how they are addressed. She also will inform the Commission for Social Care Inspection of issues that may result in a complaint being made. One complaint was managed through the adult protection team since the last inspection. There was insufficient evidence to substantiate the complaint. Roundham Court DS0000018420.V343840.R02.S.doc Version 5.2 Page 17 The Commission for Social Care Inspection survey for people who live in the home showed that 10 of the 13 people who responded knew who to speak to if they had a complaint. One person said that they did not know who to speak to and 1 said that they sometimes know who to speak to, and one did not respond. All the relatives seemed to know how to make a complaint although one did seem to feel that as their relative was self-funding they could not use the Social Services as an avenue to complain. Staff received their training in safeguarding people in two stages, which is delivered by the group trainer. The first stage is at induction using the “NO Secrets” video and we saw evidence that this had occurred when looking at staff files. The second stage was delivered as part of the training package for all staff once the induction period had been completed. The safeguarding people training package was well designed to achieve the purpose of raising staff awareness of abuse and how to report it. The staff also has access to the policies and procedures on the subject that are kept in the manager’s office, including the Local authorities “Alerters Guide”. Staff also receive the General Social Care Council booklet entitled “Code of Conduct” when they commence work. This provides clear information about what there conduct, and that of their employers should be. Staff recruitment checks are commented on in the “Staffing” section of this report. Roundham Court DS0000018420.V343840.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. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standards 19, 20, 21, 22, 24, 25 & 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is in a good location, attractively presented with good quality furniture and fixtures in and ample sized rooms. There is a warm, comfortable, environment that is well maintained. EVIDENCE: The home has good parking within the well kept grounds that is level to its front entrance. It is in a pleasant location with magnificent sea views across Torbay. It is close to Paignton Harbour that is a short walk away. Some shops, restaurants and public houses can be found here. A level walk along the sea front is just beyond the harbour and the town of centre of Paignton is a short distance from the sea front, about a mile from the home. There is a paved Roundham Court DS0000018420.V343840.R02.S.doc Version 5.2 Page 19 patio area with safety railings at the side of the home where people can sit and enjoy the sea view in good weather. The building is well maintained by the maintenance man and people they contract for specialist maintenance of equipment such as the shaft and stair lifts that provide assisted access to the mezzanine and first floors. The large reception area has comfortable seating areas and a fireplace. Doors lead off this area to the wood panelled main lounge that is very comfortably furnished. A second small lounge/library leads to the separate dining room. The dining room also attractive and well furnished with several dining tables allowing for individuals or groups to dine. A number of bedrooms are on the ground floor. All areas seemed to be well lit by natural and artificial lighting. The kitchen is opposite the dining room and the laundry is at the rear of the building. A large staircase provides access to the upper floors where more bedrooms can be found. There is an assisted bathroom and 2 assisted shower rooms in the home. Bedrooms are of good size and all but two have en-suite facilities and thermostatic mixer valves on the wash hand basins. They were personalised to the liking of those who lived in them. All of the service users have a wireless nurse call system for their use that they take with them as they move about the home. The only drawback with the system is that it does not show the location of the individual if they are not in their own room when they use the alarm. The Health & Safety Officer for the group has produced a good risk assessment for the building that was looked at. The assessment is reviewed at the monthly audit carried out by the Quality Assurance Officer. It is also fully reviewed every 8 to 10 weeks by the Health & Safety Officer, and there was proof that this level of review has occurred. We noted that windows above the ground floor were provided with restrictors to reduce the amount that they can open and radiators are guarded. Wash hand basins had thermostatic valves fitted to prevent scalding. A number security system has been put in place at the front door for added safety of those people who have problems with their memory. The home has its own laundry that is located on the ground floor away from any food storage and preparation areas. The washing machine has a sluicing cycle and there is a cloth’s dryer also in the room. Surfaces are washable and there were named storage baskets for people clothing that is returned to them once ironed. Roundham Court DS0000018420.V343840.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. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standards 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home employs sufficient numbers of staff that are appropriately trained to carry out their role in the home. The recruitment procedure is good. The staff are well supported in their role through supervision and good training. EVIDENCE: The Registered Manager provided information about the level of dependency of the people who live in the home. The majority are independent with support for some of their personal care needs. A small number, 7, did need more care with their personal care needs. Only one person required hoisting. We then looked at the staffing arrangements and found them to be adequate for the needs of those who presently live in the home. The skills of the care staff were looked at with regard to the training that they have received and the needs of the people who live in the home. We were told that all the staff have had a comprehensive induction that included an introduction to safeguarding people and practical care skills such as moving and handling. The induction training Roundham Court DS0000018420.V343840.R02.S.doc Version 5.2 Page 21 has been designed to follow the “Common Induction Standards” to meet the Skills for Care objectives. The 3 staff files that were read, and the 4 staff that were spoken to verified that staff did feel they had been prepared for the job they did at the home. The homes provided evidence that 8 care staff had a National Vocational Qualification at level 2 or above, and 6 more are now studying for their National Vocational Qualification. A total of 60 of the care staff have an National Vocational Qualification. The Registered Manager has a National Vocational Qualification at level 4 in care and also the Registered Managers Award. People who live in the home were asked, “Do you receive the care and support you need?” in the Commission for Social Care Inspection survey forms. Of the 13 forms returned 7 said always with one person stating, “The staff are always available to help and are very willing to do so”. A further five said that the staff are usually available whilst 1 said that the care and support varied depending on experience and knowledge with attitudes varying from mild hostility to genuine concern. The same person felt staff were unaware of, or ignored the finer points of bed making and tea making. The relatives survey form asked if staff had the right skills and experience. Four people said they usually had whilst 1 felt that always had saying they were exceptional staff. Another person said that, “Should anyone not be sure they would immediately send for the Doctor or District Nurse”. One return gave no score but did write a reply saying, “Presumably”. There were 4 staff surveys returned to the Commission for Social Care Inspection and all were positive about the homes achievements with 1 stating, “The home is much nicer now we have a new manager and there is a happier atmosphere”. Three staff records were read to see if the recruitment procedure had been followed. Each file had an application form, photographic identification, two references, proof of any training and qualifications, and proof that a Criminal Records Bureau check and POVA First had been done. The records also held notes of the initial recruitment interview, supervision and appraisal records and the completed induction checklist. We spoke to 4 staff during the inspection. Each gave a good account of their experiences in the role they carried out in the home, the training that they had received and their satisfaction with their employment. This rated high by each person. Roundham Court DS0000018420.V343840.R02.S.doc Version 5.2 Page 22 Roundham Court DS0000018420.V343840.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. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standards 31, 33, 35 & 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed with its main objective being to maintain a good quality of life for the people who live in it. The quality assurance methods were excellent, and they show that the home mostly achieves its objectives. EVIDENCE: Roundham Court has a new Registered Manager who completed the Commission for Social Care Inspection processing in August 2007. She has a decade of experience in the care industry and was the Registered Manager for Roundham Court DS0000018420.V343840.R02.S.doc Version 5.2 Page 24 2 years of the home she previously worked at for older people who suffered from dementia. She holds a National Vocational Qualification at level 4 in care and has the Registered Managers Award. She is a capable and confident manager and has the respect of the staff that works along side her at the home. The Quality Assurance methods that are used to establish the homes level of success are very good and the results of surveys are available for anyone to read in the reception area. Questionnaires are used from the point of admission and regularly afterwards for people to comment on their care and surroundings. There are unannounced monthly audits carried out by the Quality Assurance Officer who looks at of the day-to-day running of the home including admission procedure, records and the environment. Quarterly Residents Meetings take place where views are aired and minutes taken and again displayed for people to read. The Health & Safety Officer carries out additional quality assurance checks on the establishment during his regular reviews of the buildings risk assessment. The home does not manage the financial affairs of any of the people who live there. They do offer information and advice leaflets to people who live in the home so that they can make an informed decision about how their affairs will be managed. Safe keeping of small amounts of money is available and some people have small amounts of packet money kept for them. The Registered Manager showed us the method that the home uses to record any money that is held in safekeeping. She also provided clear evidence of how the money is accounted for when things are purchased for individuals on their request, such as hair dressing or newspapers. During the process of this inspection we recognised that the Registered Manager understood the Regulations and national minimum standards and how to achieve them. She also was able to give a good account of the functioning of the home and needs of each of the people who live there. There are good arrangements in place to provide a safe environment for the people who live in the home through risk assessment and active maintenance programs. Good staff training on a regular basis has prepared the staff group to deliver good standards of care. In turn the records kept by Registered Manager about people who live there and also the running of the home were of a high standard. An example of these records is the fire risk assessment that has been completed by a competent person. This is supported by the fire system service records and general checks on alarms, emergency lighting and fire door checks. Roundham Court DS0000018420.V343840.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 CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 3 3 X 4 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 4 Roundham Court DS0000018420.V343840.R02.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? YES 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 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP22 Good Practice Recommendations The call system, which is wireless, would be more effective if it showed the actual location of an individual in the home when they use it. It will identify the person who has pressed it as it shows their room number, but it does not show their location if they are not in their bedroom at the time that they press for assistence Roundham Court DS0000018420.V343840.R02.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Roundham Court DS0000018420.V343840.R02.S.doc Version 5.2 Page 28 - 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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