Inspection on 17/11/05 for Roundtrees

This inspection was carried out on 17th November 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 16 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Roundtrees 29/10/08

Roundtrees 15/04/08

Roundtrees 23/10/07

Roundtrees 21/06/06

Roundtrees 26/05/05

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Pennine Camphill

Muston Road (70)

Grayling

The Cornerstone

John Street Nursing Home

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

CARE HOME ADULTS 18-65 Roundtrees Roundtrees 340 Beverley Road Kingston upon Hull East Yorkshire HU5 1LH Lead Inspector Simon Morley Unannounced Inspection 17th November 2005 11:00 Roundtrees DS0000062842.V263657.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Roundtrees DS0000062842.V263657.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Roundtrees DS0000062842.V263657.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Roundtrees Address Roundtrees 340 Beverley Road Kingston upon Hull East Yorkshire HU5 1LH 01482 342404 01482 342404 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) Milewood Healthcare Limited Michael Alexander James Smith Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Roundtrees DS0000062842.V263657.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That the Residential Staffing Forum hours are adhered to. The home should ensure that there is a person on duty at all times with experience in Learning Disability, this condition will be reviewed after three months of registration. That the home do not admit people who have physical disabilities or conditions which affect their mobility. 26th May 2005 Date of last inspection Brief Description of the Service: Roundtrees is one of a number of homes owned by Milewood Healthcare. It is registered to provide personal care and accommodation for up to 9 adults aged 18 to 65, of either gender and with a learning disability. The home is on Beverley Road, a main bus route into the city centre. There is a range of local shops and amenities close by. There is an enclosed rear garden and parking is limited to nearby street parking. On the ground floor is a large lounge and dining room, a kitchen the laundry, office and one rear bedroom. There is no passenger or chair lift and no wheel chair access. Private accommodation is provided in 9 single bedrooms 8 of which are upstairs on the first and second floors. Four have en suite facilities (including a shower). There is also a bathroom with WC, shower room without WC and 2 more WCs all located upstairs. Roundtrees DS0000062842.V263657.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection lasted for 6 hours and included talking to the residents, staff, looking at the home’s records and a tour of the home. Care records were looked at for two resident who were also asked their views of the home. At the time there were five residents living at Roundtrees. Feedback about the home’s performance was given verbally to the manager at the end of the inspection. What the service does well: What has improved since the last inspection? What they could do better: The care planning process must be developed further to ensure that all the needs of a resident are fully assessed and it is clear how they will be met. A written contract / statement of terms and conditions must be agreed with residents at the time they move into the home. The arrangements to support people to self medicate must improve. Roundtrees DS0000062842.V263657.R01.S.doc Version 5.0 Page 6 Residents must be offered a key to the front door or it must be clearly recorded and agreed as to why not. Residents’ responsibilities for housekeeping tasks must be clearly recorded and agreed in their care plans. There must be better records of the food provided to residents. Floors in the communal areas were hard and bare and must be made safe and homely. More staff must achieve the required care qualification and there must be better arrangements for training staff to be competent at their jobs. There must be plans to improve the service based on residents’ views of the home. The home must have a proper maintenance/safety certificate for the gas appliances in the home. 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. Roundtrees DS0000062842.V263657.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Roundtrees DS0000062842.V263657.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5 The home is not doing all that it must prior to and at the point of a new resident moving in to help ensure positive outcomes for their stay. EVIDENCE: Residents spoken to were happy with their care and said that their needs were being met. There were two different types of assessment forms in the records that were repetitive and could be misleading. Some of the assessments had not been signed or dated, it was unclear who had done them and when. The manager reported that assessments were completed prior to admission to ensure that he knows the home can meet some one’s needs. There was no evidence that a ‘statement of terms and conditions’, about living at Roundtrees had been agreed with two of the residents. Roundtrees DS0000062842.V263657.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6. The arrangements for making sure that residents’ have an individual plan (detailing their assessed and changing needs and personal goals) need to improve. EVIDENCE: Residents spoken to were happy with their care and said that their needs were being met. Two sets of care records were examined, neither had a written plan of care for that resident. Staff also confirmed this. In discussion they did have a general awareness of individual needs. This should improve and so too should the quality of care if written, detailed plans of care are completed upon admission. The manager reported that one had recently been completed but had not yet been put in that resident’s care file. Roundtrees DS0000062842.V263657.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Written, detailed individual plans of care based on a thorough assessment in line with the national minimum standards would help to improve the opportunities for residents to follow their chosen lifestyle. EVIDENCE: Residents spoken to said they were happy with their care and the support from staff to be able to lead their own lives. Staff support residents to go out and use local community facilities. This was seen during the day and documented in care records. Residents could have a key to their bedroom but not the front door and are encouraged to do household tasks. There were no risk assessments as to why residents could not have a front door key. The responsibility for household tasks was not clearly recorded or agreed. It was the inspector’s opinion that positive lifestyle outcomes would improve with a better admissions process. From looking at the care records it was evident that a range of information is gathered about each resident at the time they move in. But two residents still did not have a plan of care clearly stating what support they could expect from Roundtrees DS0000062842.V263657.R01.S.doc Version 5.0 Page 11 staff to pursue their ambitions. One had been at the home already for nearly two months, the other for four months. The manager did report that one of these care plans had just been completed. Menus are planned with residents who can also choose something different if they don’t want what is on the menu. Residents said they were happy with the food. The kitchen is kept locked, as residents have been assessed as being at risk if they were to go in on their own. Staff do support residents to use the kitchen in a safe manner. Records are kept when an alternative meal to the menu is cooked. Records of food provided to each resident are not kept. Resident’s weight is monitored for any changes. Staff reported that the menu is planned on what they consider to be a healthy diet based on offering a variety of foods. There has been no more formal input into how the home offers a healthy diet that meets the collective and individual needs of residents. Roundtrees DS0000062842.V263657.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. The quality of care planning and support needs to improve in some areas to ensure the health of residents is fully protected. EVIDENCE: Residents were mainly independent in managing their own personal care. They also said they were happy with how staff treated and helped to look after them. There was evidence in care records of liaising with health professionals to support residents with any health problems. Staff encourage healthy lifestyles with regard to diet, exercise, alcohol and smoking. Without detailed care plans it was unclear how all the health care needs of residents are monitored and appropriate action taken. This was also the case at the last inspection. There had been some improvements to the general arrangements for administering residents’ medication. One resident was being supported to self-medicate. The way in which this was being done was not best practice. There was no detailed risk assessment to help manage any potential risks of self-medicating. Roundtrees DS0000062842.V263657.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 There were good arrangements to ensure that residents’ views are listened to and to keep them free from abuse. EVIDENCE: Residents spoken to had no complaints about the home but felt able to complain if they wanted to. There was a clear procedure for dealing with complaints. None had been made to the home. There were procedures in place for reporting abuse and staff knew what these were. Roundtrees DS0000062842.V263657.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Improvements to the home continue to be made and the home was clean and hygienic. EVIDENCE: The home is close to local amenities and on a major bus route into the city centre, offering a wide choice of leisure and social opportunities for residents. Downstairs the lounge and dining room looked homely and there were plans to modernise the kitchen. The lounge and dining room floors were hard with a linoleum type floor covering. This detracted from the homely feel. It was also a safety issue as the floor is quite hard. This puts residents at risk especially those with epilepsy, a condition common for people with a learning disability. At the time of inspection this was a limited risk as those residents with epilepsy rarely had seizures. There was a rear garden, partly gravelled, with tables and chairs for residents to sit out and enjoy good weather. This overlooked the downstairs rear bedroom, which would restrict privacy. Roundtrees DS0000062842.V263657.R01.S.doc Version 5.0 Page 15 Upstairs, bedrooms were now fully decorated following the addition of en suite facilities (including a shower) to four of them. Residents that had moved in had brought their own belongings and had personalised their bedrooms. The home was seen to be clean and tidy. There is a cleaning rota in place and residents are encouraged to help keep the home clean and tidy. Staff reported that there was no clinical waste and there were adequate laundry facilities – domestic in style that could also be used by residents. Roundtrees DS0000062842.V263657.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35. There were good arrangement for recruiting staff and ensuring there are enough on duty. The arrangements for staff training need to improve??? EVIDENCE: The manager reported that 25 of staff had completed the required care qualification this does not meet the required target of 50 . More staff are working towards the qualification. The staff rotas were examined and the staffing levels meet the recommended guidance. Recruitment records were also examined. It was evident that the necessary checks were made before appointing staff to work in the home. The manager reported that an external training provider is used and once staff have completed a training course they have to complete an assessment. Staff must pass this before getting a certificate for the course. Records looked at for three staff indicated that they had undertaken a range of training but had not yet found out if they have passed. If not the home would have a number of untrained staff working there. One of these staff had started but not yet completed her induction, which was now overdue. It was also unclear if staff new to working with people with a learning disability were receiving the proper induction. Roundtrees DS0000062842.V263657.R01.S.doc Version 5.0 Page 17 Roundtrees DS0000062842.V263657.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Some of the management arrangements need to improve. EVIDENCE: The registered manager is experienced and qualified to run the home. The current manager is also the owner and intends to handover the manager role to allow time to develop his business. The new manager has recently applied to us for registration. The home has yet to establish a quality assurance system. The home was well maintained with the majority of maintenance certificates available, one was missing. Roundtrees DS0000062842.V263657.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X 2 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 2 13 3 14 3 15 X 16 2 17 Standard No 31 32 33 34 35 36 Score X 2 3 3 2 X CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Roundtrees Score 3 2 2 X Standard No 37 38 39 40 41 42 43 Score 3 X 2 X X 2 X DS0000062842.V263657.R01.S.doc Version 5.0 Page 20 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard YA2 YA5 Regulation 17 5 Requirement All records must be signed and dated by the person completing them. Each service user must have an individual written contract or statement of terms and conditions in accordance with NMS 5. All aspects of personal, social and health care needs must be fully assessed and included in the individual plan of care. (Target date of 31/08/05 not met). The care plan must describe the servcies and facilities to be provided by the home and how these will meet the current and future needs and goals of each resident. (Target date of 31/08/05 not met). The care plan must make clear who has agreed to restrictions on choice and freedom, how these restrictions are reviewed and that they are in line with legislation. (Target date of 31/08/05 not met). Timescale for action 31/03/06 31/03/06 3 YA6 14 & 15 31/03/06 4 YA6 14 & 15 31/03/06 5 YA6 14 & 15 31/03/06 Roundtrees DS0000062842.V263657.R01.S.doc Version 5.0 Page 21 6 YA12 14 & 15 7 YA16 14 & 15 8 YA16 14 & 15 9 YA17 17 10 YA19 14 & 15 11 YA20 13 12 YA24 13 13 14 YA32 YA33 18 18 15 YA39 24 Assessments and care palns must accurately details residents’ wishes with regard to finding and keeping appropriate jobs, continuing education or training and / or taking part in valued and fulfilling activities. Residents must be offered a key to the front door in line with a detailed and appropriate risk assessment. Residents’ responsibility for housekeeping tasks must be specified in the Service User Guide and individual care plans. There must be records of the food provided for service users in sufficient detail to enable any one inspecting the record to be able to determine whether the diet is satisfactory. There must be an adeqaute assessment of and care planning for: footcare needs / chiropody, dietary/nutritional needs, dental needs, and safe alcohol levels in realtion to medication. (Target date of 31/08/05 not met). Residents’ support to selfmedicate must be in line with the Royal Pharmaceutical Society guidance. Floors in communal areas must be made safe and homely. (Target date of 31/08/05 not met). 50 of care staff must have achieved the NVQ level 2 in care. All staff must receive the appropriate induction and be trained and competent to do their jobs. There must be an effective quality assurance system based on seeking the views of residents and which provides a measure of success in achieving the aims and objectives of the home. DS0000062842.V263657.R01.S.doc 31/03/06 31/03/06 31/03/06 31/03/06 31/03/06 31/03/06 31/03/06 31/12/05 31/03/06 31/03/06 Roundtrees Version 5.0 Page 22 16 YA42 13 The home must have an up to date Corgi Gas Certificate. 31/01/06 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 Standard Good Practice Recommendations Roundtrees DS0000062842.V263657.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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