CARE HOMES FOR OLDER PEOPLE
Roundstone Care Residential Home 18/19 Brooklands Filey North Yorkshire YO14 9BA Lead Inspector
Karen Ritson Unannounced 24 June 2005 11:30 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 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. Roundstone Care Residential Home J04 J53 Roundstone Care S55727 V234824 240605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Roundstone Care Residential Home Address 18/19 Brooklands Filey North Yorkshire YO14 9BA 01723 513334 N/A Roundstone.care@btinternet.com Mrs Margaret Koralewski, Mr Ray Koralewski Telephone number Fax number Email 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 Margaret Koralewski Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Roundstone Care Residential Home J04 J53 Roundstone Care S55727 V234824 240605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 16/11/04 Brief Description of the Service: Roundstone comprises two terraced houses situated a few minutes walk from the centre of the town. It is owned by Mr Ray and Mrs Margaret Koralewski and managed by Mrs Koralewski. The houses have been adapted to provide for a maximum of 13 service users who were accommodated by virtue of age or infirmity. The registered providers can also offer accommodation on a short stay basis. The premises occupy three floors, the top one being the private accommodation of the registered providers and their family. The home has 11 single and one shared bedrooms located on its two lower floors. Two single and the shared bedroom have the advantage of en-suite facilities. There is no passenger lift but a stair lift is fitted to one staircase. The registered providers and their staff provide personal care, an in-house catering service, an in-house laundry service and a cleaning and domestic service. Staffing cover to the home is maintained throughout the 24-hour period each day. Leisure and recreational facilities are offered by the staff in-house and are also available at a number of outside locations. Many of the service users are able to go out with the assistance of staff or relatives. Each service user is registered with a general medical practitioner who addresses their primary health care needs and can access the more specialised health services as required Roundstone Care Residential Home J04 J53 Roundstone Care S55727 V234824 240605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on June 24th 2005 at 11.30 am. The inspection took nine hours, which included preparation, and time for writing the report. The owners Mr and Mrs Koralewski were both available throughout the inspection. Four service users were spoken to during the inspection. Their comments were all positive regarding the care they were offered and are described in more detail inn the main body of the report. A visitor was complimentary about the way in which he was welcomed into the home. He said that this welcome was always the same whenever he called and that he felt the owners were genuinely kind and thoughtful people. What the service does well: What has improved since the last inspection?
The home has redecorated and laid new carpets. The laundry is improved, with a new washing machine and drier and the kitchen is being refurbished. Paperwork, although it contained all required information at the last inspection, has been streamlined and the owners say they can now use this more easily for the benefit of service users. Roundstone Care Residential Home J04 J53 Roundstone Care S55727 V234824 240605 Stage 4.doc Version 1.30 Page 6 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. Roundstone Care Residential Home J04 J53 Roundstone Care S55727 V234824 240605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Roundstone Care Residential Home J04 J53 Roundstone Care S55727 V234824 240605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Service users know their care needs will be met. EVIDENCE: Since taking over ownership of the home, Mr and Mrs Koralewski have created new assessment and care plan documentation. The owners said that their method of capturing information and the production of documents to facilitate effective and responsive care had been work in progress. They have adapted their original assessment format so that is easier to work with. The result is an easy to follow document containing all required areas of care, with risk assessments where necessary. This assessment is then used as the basis for a comprehensive care plan which is regularly reviewed and updated. Assessment and care planning documentation are kept on a case file for each service user. Records detailing routine and other daily activities inform the care plan at the point of review. Documentation is signed and dated by the service user. Service users said they felt the staff understood their care needs very well and that this made them feel secure. A visitor reported that staff were responsive to the changes in his friends’ care needs when she had become more dependant recently.
Roundstone Care Residential Home J04 J53 Roundstone Care S55727 V234824 240605 Stage 4.doc Version 1.30 Page 9 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 standard(s) 7 Service users health is protected and promoted by the care planning process. EVIDENCE: The care plan is based on the assessment. It is comprehensive and informed by the daily notes and staff observations. All areas of care are covered and regularly reviewed, signed and dated. The involvement of health care specialists is recorded where needed and any other external input to care planning. Service users were all complementary about the way in which care was offered. None showed a great deal of interest in the care plan documentation, but were clear that their care needs were met. Roundstone Care Residential Home J04 J53 Roundstone Care S55727 V234824 240605 Stage 4.doc Version 1.30 Page 10 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 standard(s) none of these standards were assessed. EVIDENCE: Roundstone Care Residential Home J04 J53 Roundstone Care S55727 V234824 240605 Stage 4.doc Version 1.30 Page 11 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 standard(s) 16 and 18 The welfare of service users is protected by the homes’ complaint and abuse policies and procedures. EVIDENCE: The complaints procedure was seen. This details how to complain, to whom and gives timescales for any response. A Complaints Register is in operation. Several service users were spoken to and all said they felt confident that any concern would be dealt with quickly and courteously. A visitor said that service users were encouraged to comment upon the way on which care was offered and that people were treated as individuals. This inspection was carried out in response to a complaint from a third party, regarding a previous resident at the home. The complaint has been investigated by CSCI not upheld. The homes’ adult protection policy and procedure was available, this was supported by the multi-agency agreement and protocol based on the Department of Health document “No Secrets”. The registered providers were aware of the requirements and responsibilities placed on them and the actions to be taken should allegations of suspected abuse arise. The home has a whistle blowing policy together with policies on harassment, bullying, challenging behaviour and the use of restraint. A number of other policies and procedures relating to the non-involvement of the registered provider or staff in service users’ financial affairs were also available. All service users said that they found the owners to be kind and helpful and that they felt safe in their care. Roundstone Care Residential Home J04 J53 Roundstone Care S55727 V234824 240605 Stage 4.doc Version 1.30 Page 12 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 standard(s) 19 and 26 Service users live in a well maintained and improving environment. EVIDENCE: Service users said that the home was comfortable and well decorated. All liked their rooms. A tour of the building confirmed that the home had been re decorated, re carpeted and that work had been carried out to improve heating; lighting and the safety of the premises. The kitchen was in the process of being replaced and the laundry had been improved, with a new washing machine and drier. Service users said they had been informed of the plans for the kitchen and were happy to have a reduced choice menu until the new cookers were fitted. Roundstone Care Residential Home J04 J53 Roundstone Care S55727 V234824 240605 Stage 4.doc Version 1.30 Page 13 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed. EVIDENCE: Roundstone Care Residential Home J04 J53 Roundstone Care S55727 V234824 240605 Stage 4.doc Version 1.30 Page 14 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed. EVIDENCE: Roundstone Care Residential Home J04 J53 Roundstone Care S55727 V234824 240605 Stage 4.doc Version 1.30 Page 15 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 4 x x x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x
COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x x Roundstone Care Residential Home J04 J53 Roundstone Care S55727 V234824 240605 Stage 4.doc Version 1.30 Page 16 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 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 Good Practice Recommendations Roundstone Care Residential Home J04 J53 Roundstone Care S55727 V234824 240605 Stage 4.doc Version 1.30 Page 17 Commission for Social Care Inspection York Area Office Unit 4, Triune Court Monks Cross York, YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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