Inspection on 21/06/06 for Roundtrees

This inspection was carried out on 21st June 2006.

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

The inspector 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 3 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 17/11/05

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 Key Inspection 21st June 2006 09:30 Roundtrees DS0000062842.V301079.R01.S.doc Version 5.2 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.V301079.R01.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 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.V301079.R01.S.doc Version 5.2 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.V301079.R01.S.doc Version 5.2 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. 17th November 2005 Date of last inspection Brief Description of the Service: Milewood Healthcare own Roundtrees, one of a number of homes the company owns in the area. 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 through lounge and dining room, a kitchen, 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, 4 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. Weekly fees depend on how much care a person needs. There were 5 residents living at Roundtrees at the time of the inspection. Information about the home is available in the hallway and on request. Roundtrees DS0000062842.V301079.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. • • • • • • • The visit to the home lasted from 9.30 until 4.30pm. Three of the residents spent some time chatting to the inspector. One was out and one did not want to talk. Three staff and the deputy manager also talked to the inspector. Records about the care provided, and other records about the running of the home were looked at. Questionnaires about the home were sent to all the residents, staff, two relatives and five healthcare professionals involved in supporting residents. Two were received from residents and three from staff none of the others were returned at the time this report was written. Peoples’ views about the home and what was found during the visit have been used to write this report and make judgements about the quality of care. What the service does well: Residents spoken to said they liked living at Roundtrees and were well looked after. They like the staff who help them do the things they want. Staff spoken to were enthusiastic and liked working at the home. They are well supported by the manager and it is a friendly place to work. Roundtrees DS0000062842.V301079.R01.S.doc Version 5.2 Page 6 Residents’ needs are assessed well and there are good care plans that tell staff what support each person needs. Staff help and encourage residents to be as independent as possible whilst also looking out for their safety. Residents have plenty of opportunities to go out and are free to spend time in the privacy of their own rooms. These have been personalised and decorated making them very individual. Residents liked the food provided, are well fed and encouraged to eat a healthy diet. Staff do most of the cooking but residents can help in the kitchen if they want to and cook their own food if able. Staffing levels were good and this helped residents to do as much as they wanted. Roundtrees DS0000062842.V301079.R01.S.doc Version 5.2 Page 7 Residents are able to say what they think about the home and staff listen to their views. Roundtrees is comfortable to live in, clean, tidy, safe and well maintained. What has improved since the last inspection? A new good quality kitchen has been installed replacing the old worn out one and it makes the kitchen a more homely place to be in. There was a small, dedicated room for storing the medication and procedures had improved helping ensure residents get the right medication on time. Roundtrees DS0000062842.V301079.R01.S.doc Version 5.2 Page 8 Individual care plans and the quality of care records had improved which helps to ensure that all the residents get all the care they need. Staff have undertaken a range of training helping them to be more competent at their job. What they could do better: This is what must be done to meet the national minimum standards: There must be an individual written contract or statement of terms that is agreed with each resident as part of the process of moving into the home. The contents of this must include what is required by the minimum standard. Roundtrees DS0000062842.V301079.R01.S.doc Version 5.2 Page 9 Two written references as well as all other employment checks must be obtained before new staff start to work in the home, to make sure they are suitable to work there. Staff new to working with people with learning disabilities must complete required training about this type of work within 6 weeks of starting work at the home. • • This is what the home have been asked to do as good practice recommendations: • • 50 of care staff should have achieved the required care qualification. There should be an annual development plan for the home based on improving the quality of care for residents. 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.V301079.R01.S.doc Version 5.2 Page 10 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.V301079.R01.S.doc Version 5.2 Page 11 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): Standards 2 and 5. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There were some good arrangements for helping residents move into the home and assuring them they will be looked after. This would improve by ensuring residents receive a written contract in a form they understand at the time they move in. EVIDENCE: Returned questionnaires indicated that residents had a choice of whether to move into Roundtrees and they had information about the home to help them decide. They said they liked it at the home and were well looked after. Care records contained a range of information about the needs of each person and how they would be looked after. This is essential information for staff so that they know what support each person needs. There was a new personal health assessment and action plan. As well as basic health needs this also included individual lifestyle issues such as alcohol, drugs, sex education and sexuality. People living at the home are also asked if there are any cultural or religious practices that are important to them and that they want to carry on. Roundtrees DS0000062842.V301079.R01.S.doc Version 5.2 Page 12 All records seen were signed and dated which was an improvement since the last inspection. One person had still not got an agreed contract or statement of terms and conditions that explained what the fees are, what would be provided for that and what may cost extra. These must be agreed at the time some one moves in to help them know what to expect. This was an issue at the last inspection. Copies of these contracts were available and some residents had signed them. The contents of these did not match what is needed to meet the minimum standard. Roundtrees DS0000062842.V301079.R01.S.doc Version 5.2 Page 13 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): Standards 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good arrangements for planning the care people need that allows them to take risks and make decisions about their own lives. EVIDENCE: Residents said they liked the staff and felt supported by them to lead their lives. They also said that they could make decisions about what they do during the day, in the evenings and at weekends. Throughout the day staff were seen to help residents make decisions and go about their daily lives. Care records included individual care plans for each resident. These provide good information about what support each person needs whilst living at the home. The plans are agreed and regularly reviewed with residents. Roundtrees DS0000062842.V301079.R01.S.doc Version 5.2 Page 14 Thought has been given to the potential harm to residents from any aspect of their lives e.g. going out alone, having your own front door or room key, cooking in the kitchen are but a few. Residents are supported to lead independent lifestyles and staff try to keep risks to a minimum. Roundtrees DS0000062842.V301079.R01.S.doc Version 5.2 Page 15 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): Standards 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were good arrangements for helping people follow their chosen lifestyles. EVIDENCE: Support was provided to residents throughout the day in a variety of ways so they could do what they wanted. One resident was out at college all day and goes four times a week. Another resident was hoping to start art classes. One resident was in and out on his own choosing to do his own thing. One resident was planning a trip to a friend’s birthday party and two went out to lunch. The home has a large car to take people out in. When asked what was nice about the home one resident replied ‘The free lifts!’ Roundtrees DS0000062842.V301079.R01.S.doc Version 5.2 Page 16 One of the residents regularly attends a local church. Staff use the information gathered about each resident (including their hobbies, interests and food preferences), to help them spend their lives as they wish. Throughout the day staff were seen talking to and spending time with residents. But residents can also go off to their rooms and staff respect their privacy. Residents, with support from staff, cook, do their laundry and help keep the house clean. Incentives are also on offer to help encourage residents with these tasks. There is no obligation to do so and staff will undertake these tasks. Residents said the food was good and menus are planned with them. Records were kept of food provided. Staff knew residents’ likes and dislikes. There was a large bowl of fresh fruit on the dining table for people to help themselves to. The kitchen is locked to help keep residents safe. But staff and residents were in and out all day making frequent drinks and sandwiches for lunch. Some residents like to help more in the kitchen and do some cooking as well. Roundtrees DS0000062842.V301079.R01.S.doc Version 5.2 Page 17 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): Standards 18, 19, 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were good arrangements for supporting people with their personal and healthcare. EVIDENCE: Residents said that staff treat them well and they were happy with their care. Residents were fairly able, so support with personal care was mainly by discreet prompting from staff. There were good records of residents’ health needs and how they were being helped. Staff had supported residents to use local health services and got support from specialist health workers for people with learning disabilities if needed. This means that residents receive regular health checks, eyesight and hearing tests, see the dentist and get help with things like epilepsy and how to control anger. If able to do so, residents can take responsibility for their medication. Staff usually administer medication though. Staff are trained to do this, the Roundtrees DS0000062842.V301079.R01.S.doc Version 5.2 Page 18 medication was well stored and there were good records showing that residents get their medication on time. Roundtrees DS0000062842.V301079.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were good arrangements for ensuring that residents are listened to and feel free from harm. EVIDENCE: Residents said they knew who to talk to if they were not happy and wanted to complain. They also said that staff listen to them and help them with any problems. During the day staff were seen to have time to listen to what residents had to say. There were two complaints since the last inspection from residents about each other. There are times that residents have fallen out to the point of hitting each other. Staff are trained in how to deal with these situations and good records are kept of what happens. This does not happen very often. Staff were knowledgeable about what is considered to be abuse and how to report it to make sure no one suffers from it. Roundtrees DS0000062842.V301079.R01.S.doc Version 5.2 Page 20 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): Standards 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable environment that is well kept. EVIDENCE: Residents liked their bedrooms, which they had personalised with their own possessions. They could also choose which of the unused rooms to live in and how it would be decorated. There was a constant programme of improvements. The new kitchen was just about finished and a big improvement on the old one. Staff followed hygienic food practices when cooking in the kitchen to prevent any food poisoning. The home was clean and tidy. Roundtrees DS0000062842.V301079.R01.S.doc Version 5.2 Page 21 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): Standards 31, 32, 33, 34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels and some of the training arrangements are good. Recruitment checks and arranging training for staff new to working with people with learning disabilities must improve. EVIDENCE: Staff were clear about their role and the aims of the home. They worked in ways to promote people’s individuality and chosen lifestyle. Staffing levels met the recommended guidance. Most staff had or were working towards the required care qualification that demonstrates they are competent at their job. Not all the required checks had been made on two of the new staff started since the last inspection. In both cases only one written reference had been obtained instead of two. All checks must be made before staff work in the home to help ensure they are suitable to work there. Staff are trained to do their jobs well. New staff though, do not always start the required training on time. This was an issue at the last inspection as well. Roundtrees DS0000062842.V301079.R01.S.doc Version 5.2 Page 22 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): Standards 37, 39, 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good management arrangements of the home. EVIDENCE: Staff all said they like working at the home and get good support from the manager. The manager is registered with the Commission and is qualified and competent to run the home. The administration and management of the home had improved and was more organised helping to improve the lives of the residents living there. As well as day-to-day interaction with staff, residents and their relatives can say what they think about the home through regular satisfaction surveys. There are regular management checks on the running of the home as well to make sure that people are cared for well. Roundtrees DS0000062842.V301079.R01.S.doc Version 5.2 Page 23 There was no written information available about how the home will continually try and develop. It was recommended that some type of annual statement be written down that says how the home will develop in the future. The home was well maintained and maintenance certificates were available for inspection. Roundtrees DS0000062842.V301079.R01.S.doc Version 5.2 Page 24 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 Standard No Score 1 X 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Roundtrees DS0000062842.V301079.R01.S.doc Version 5.2 Page 25 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. 1 Standard YA5 Regulation 5 Requirement Each service user must have an individual written contract or statement of terms and conditions in accordance with NMS 5. (Previous target date of 31/03/06 not met). Timescale for action 16/10/06 2 YA34 19 3 YA35 18 Two written references as well as 16/10/06 all other employment checks must be obtained before new staff start to work in the home. Staff new to working with people 16/10/06 with learning disabilities must complete the LDAF induction within 6 weeks of starting work. (Previous target date of 31/03/06 not met). 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 YA32 Good Practice Recommendations 50 of care staff should have achieved the NVQ level 2 in care. DS0000062842.V301079.R01.S.doc Version 5.2 Page 26 Roundtrees 2 YA39 There should be an annual development plan for the home based on the aims and outcomes for residents. Roundtrees DS0000062842.V301079.R01.S.doc Version 5.2 Page 27 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. Extracts may not be used or reproduced without the express permission of CSCI Roundtrees DS0000062842.V301079.R01.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!