Inspection on 26/05/05 for Roundtrees

This inspection was carried out on 26th May 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Roundtrees 29/10/08

Roundtrees 15/04/08

Roundtrees 23/10/07

Roundtrees 21/06/06

Roundtrees 17/11/05

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 340 Beverley Road Kingston upon Hull HU5 1LH Lead Inspector Simon Morley Unannounced 26 May and 6th June 2005 th 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 J54_s62842_Roundtrees_v226688_260505_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Roundtrees Address 340 Beverley Road Kingston upon Hull HU5 1LH 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) 01482 342404 01482 342404 Milewood Healthcare Limited Michael Alexander James Smith Care Home 9 Category(ies) of LD Learning disability (9) registration, with number of places Roundtrees J54_s62842_Roundtrees_v226688_260505_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the Residential Staffing Forum hours are adhered to. 2. The home should ensure that there is a person on duty at all times with experience in Learning Disability, this condition reviewed after three months of registration. 3. That the home do not admit people who have physical disabilities or conditions which affect their mobility. Date of last inspection This was the first inspection of the service. Brief Description of the Service: Roundtrees is one of a number of homes owned by Milewood Healthcare. It is registered to provide persoanl care and accomodation 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 are 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 kithcen the laundry, office and one rear bedroom. There is no passenger or chair lift and no wheel chair access. Private accomodation is provided in 9 single bedrooms 8 of which are uptsairs on the first and second floors. There is also a bathroom with WC, shower room without WC and 2 more WCs all located upstairs. Roundtrees J54_s62842_Roundtrees_v226688_260505_Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out in response to an anonymous complaint. The complaint was about the attitude of the manager, poor staff recruitment checks, ongoing building work and the effect this was having on the resident living there. At the time of inspection a large part of the home was closed off due to ongoing decorating and plumbing. Only one resident was living at the home whilst this was going on. The inspection lasted about 5 hours on the first day and involved talking to staff, the resident, a brief tour of the home and looking at some records. The manager was away on holiday but a deputy manager from another home (owned by the same company) was ‘standing-in’ until he came back. A second visit was made to see the parts of the home that were closed off on the first day. What the service does well: What has improved since the last inspection? This service was first registered on 18th February 2005 and this was its first inspection. There was ongoing work e.g. plumbing and decorating to the interior of the home to generally improve the home. Four bedrooms were having en-suite shower rooms (with basin and WC) fitted at the time inspection. Roundtrees J54_s62842_Roundtrees_v226688_260505_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. Roundtrees J54_s62842_Roundtrees_v226688_260505_Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Roundtrees J54_s62842_Roundtrees_v226688_260505_Stage 4.doc Version 1.30 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 standard(s) 2. The home had gathered a range of information about the residents needs but some needs were not clearly identified and planned for, to the benefit of the resident. EVIDENCE: Care records inspected showed that the home had a range of information about the resident’s needs. Staff spoken to were able to talk about some of the resident’s needs but also said that certain things e.g. the resident’s benefits were sorted out by the manager. Some care needs had not been fully assessed or planned for – these are detailed in the sections on ‘Individual Needs and Choices’ and Personal and Healthcare Support. The resident was reluctant to talk to the inspector and when he did it was not about his care needs. Roundtrees J54_s62842_Roundtrees_v226688_260505_Stage 4.doc Version 1.30 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 standard(s) 6, 7 and 9. Individual needs and choices are promoted within a restricted environment, which limits the freedom of individuals to make some choices. The restrictions were there to reduce risk of harm and encourage socially acceptable behaviour. EVIDENCE: Staff spoken to were aware of what care to provide but the written individual plan of care was brief. It did not cover all the required areas of personal, social and health care needs. The focus of care was encouraging personal care and socially acceptable behaviour. There were guidelines in place for staff to help them deal with any challenging behaviour – verbal and physical aggression. At times staff have restricted a service user’s access to cigarettes and the community for poor behaviour. Access to the community is also restricted to being escorted by one or two members of staff, the front door is locked with a key. This would also affect other residents who may move into the home. Roundtrees J54_s62842_Roundtrees_v226688_260505_Stage 4.doc Version 1.30 Page 10 These restrictions had the signed agreement of the resident and the manager. It was not clear if any one else had been involved or how they are reviewed. Within these limits the resident was able to make his own choices e.g. when to get up, go to bed, what to eat, to spend time in his room. Care needs regarding education, training, occupation, income, leisure and social activities were not properly identified. There were no clear, short or long term goals for the resident to achieve in life. Staff did report that improvements would be made to how the care is planned but relied on the manager to do so. The home assesses the risks to residents including their medication, safety in the kitchen, their mobility, safety outdoors. Steps are then taken to reduce the risk of an accident happening. Roundtrees J54_s62842_Roundtrees_v226688_260505_Stage 4.doc Version 1.30 Page 11 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 standard(s) None of the lifestyle outcomes were assessed on this occasion. EVIDENCE: Roundtrees J54_s62842_Roundtrees_v226688_260505_Stage 4.doc Version 1.30 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 standard(s) 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: The resident was registered with local health services and supported to access them by staff and have necessary health checks. This was confirmed by talking to staff and looking at care records. Staff were encouraging a healthy lifestyle e.g. healthy diet, exercise, low alcohol consumption and a reduction in smoking. In other areas there needed to be some improvements. There was evidence that some health care needs e.g. foot care needs / chiropody, specific dietary / nutritional needs, dental care, safe alcohol levels in relation to medication, had not been properly planned for. The correct procedures for storing and administering medication were not being followed and this also puts residents’ health at risk. Staff, including senior staff designated to administer medication were only receiving their training on the day of inspection. Roundtrees J54_s62842_Roundtrees_v226688_260505_Stage 4.doc Version 1.30 Page 13 Roundtrees J54_s62842_Roundtrees_v226688_260505_Stage 4.doc Version 1.30 Page 14 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 standard(s) None of the ‘concerns, complaints and protection’ outcomes were assessed on this occasion. EVIDENCE: Roundtrees J54_s62842_Roundtrees_v226688_260505_Stage 4.doc Version 1.30 Page 15 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 standard(s) 24. Ongoing improvements to the building at the time of inspection did not create a homely and comfortable environment. 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 but the lounge floor was hard wood with no coverings, the dining room floor had a linoleum cover but was still quite hard. Floors were bare and detracted from the homely feel. The hardness of the floor would also put residents at risk especially those with epilepsy, a condition common for people with a learning disability. Staff spoken to were not aware if these areas were going to have carpets. The deputy manager did report there was a new carpet for the hallway. 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 J54_s62842_Roundtrees_v226688_260505_Stage 4.doc Version 1.30 Page 16 Upstairs, access was limited to a small part of the first floor only as there was maintenance and decorating work taking place throughout the rest of the upstairs. The deputy manager reported that en-suite facilities were being put in the bedrooms as part of this work. No other residents would be able to move in until this work is complete and has the required safety approval. On the second visit the inspector was able to see that 4 bedrooms were having ensuite facilities installed and all bedrooms were being decorated. There was a bathroom with overhead shower used by the resident living there. When asked about the home the resident chose to change the topic of conversation. Roundtrees J54_s62842_Roundtrees_v226688_260505_Stage 4.doc Version 1.30 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 and 35. The evidence available at the time of inspection did not guarantee that recruitment practices and staff training adequately protected residents or ensured their needs would be met. EVIDENCE: Staff were spoken to about the checks that were required to be made before they started to work at the home. They said the necessary checks had been made but the homes records were not available for inspection to be able to support this. Training records were available and showed that some staff had not received required training. A letter was left at the home for the owner to put this right or further enforcement action will be taken. One member of staff did say he had done more training but it had not been recorded. The deputy manager said she would get the records up to date to clearly see who needed what training. Staff responsible for resident’s medication were only being trained at the time of inspection. Roundtrees J54_s62842_Roundtrees_v226688_260505_Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 There was a good style of management that had helped to create a team of staff who were enthusiastic about their jobs. EVIDENCE: All staff spoken to said they liked the manager, that he was friendly, approachable, supportive and had a good way with the residents. Roundtrees J54_s62842_Roundtrees_v226688_260505_Stage 4.doc Version 1.30 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 2 x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x x Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score x x x 2 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Roundtrees Score x 2 2 x Standard No 37 38 39 40 41 42 43 Score x 3 x x x x x J54_s62842_Roundtrees_v226688_260505_Stage 4.doc Version 1.30 Page 20 NA 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 6 Regulation 15 Requirement All aspects of personal, social and health care needs must be fully assessed and included in the individual plan of care. 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. 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. There must be an adeqaute assessment of and care records for: footcare needs / chiropody, dietary/nutritional needs, dental needs, and safe alcohol levels in realtion to medication. Residents consent must be obtained for staff to administer their medication. Records must be kept of all medicines received, administered and disposed of. There must be a list of staff designated to administer medication and they must be Timescale for action 31st August 2005. 31st August 2005. 2. 6 15 3. 6 15 31st August 2005. 4. 19 14 and 15 31st August 2005. 5. 6. 7. 20 20 20 12 and 13 12, 13 and 17 12, 13 and 18 31st August 2005. 31st August 2005. 31st August 2005. Page 21 Roundtrees J54_s62842_Roundtrees_v226688_260505_Stage 4.doc Version 1.30 appropriately trained. 8. 20 13 and 17 Two staff should check and sign the instructions for administrating medication when writing them onto the MAR chart. Floors in communal areas must be made safe and homely. The registered person must give notice in writing to the Commisision about the alterations being made to the home. Residents must not be accomodated in parts of the home that have been altered without approval of the Commission and safety approval from Building Control and the Fire Authority. Records required by regulation 17 must be kept upto date and be available for insepction at all times. The registered person must provide evidence that staff have been trained in the following areas: fire safety, basic food hygiene, first aid, health and safety; or provide a detailed training rpogramme of how this will be achieved. The registered person must provide evidence that an appropriate induction covering: the homes policies and procedures, the Skills for Care induction requirements or the Learning Disability Award Framework accredited induction training has been completed by all staff; or provide a detailed training programme of how this will be achieved. 31st August 2005 31st August 2005. Immediate 9. 10. 24 24 13 and 16 39 11. 24 12 and 13 Immediate 12. 34 and 35 17 31st August 2005. Immediate 13. 35 18 14. 35 18 Immediate 15. Roundtrees J54_s62842_Roundtrees_v226688_260505_Stage 4.doc Version 1.30 Page 22 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 Roundtrees J54_s62842_Roundtrees_v226688_260505_Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 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 J54_s62842_Roundtrees_v226688_260505_Stage 4.doc Version 1.30 Page 24 - 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!