Inspection on 18/08/05 for Roxburgh House

This inspection was carried out on 18th August 2005.

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 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

Roxburgh House 27/01/09

Roxburgh House 11/02/08

Roxburgh House 29/08/07

Roxburgh House 03/01/07

Roxburgh House 12/01/06

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Roxburgh House 29 Roxburgh Road Westgate-on-sea Kent CT8 8RX Lead Inspector Brenda Pears Announced 18/08/05 at 09:30hrs 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. Roxburgh House H56-H05 S62994 Roxburgh Hse V237374 180805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Roxburgh House Address 29 Roxburgh Road, Westgate-on-sea, Kent. CT8 8RX 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) 0207 639 1421 Discovery Care Ltd Mrs June Veronica Farley Registered Care Home 22 Category(ies) of Older Persons registration, with number of places Roxburgh House H56-H05 S62994 Roxburgh Hse V237374 180805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: The Home provides care and support for 22 older people including some people with physical disabilities. The Home is a large property that is situated in a small, slightly privately sectioned area, close to local shops and is within walking distance of the sea front. The frontage of the Home is on level ground and gives access for wheelchair users. This paved frontage area has seating arranged for service users to enjoy during good weather. There is also ample on street parking available. Roxburgh House H56-H05 S62994 Roxburgh Hse V237374 180805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection and the inspection consisted of speaking with the proprietor, registered manager, staff members and service users. The methods of inspecting the home included checking records, tracking service user care plans, examining staff files, discussions with service users, observations and a tour of the building. The inspection focussed on the requirements from the last inspection and key standards. As part of the pre-inspection process, residents and relatives were consulted for their views of the home. The service users and families returned their comment cards, providing valuable feedback about the home, which helped in the planning of this inspection. The home was found to be clean and service users were cheery, friendly and waiting to speak to the inspector. Service users were fully included in this inspection and were relaxed and laughing with staff. Some were in their rooms as this is their choice and staff support them if they wish to have meals in their rooms. The home continues to improve the environment through continued redecoration. Rooms are decorated to a high standard and present a warm and welcoming environment. Service users stated they are well cared for and staff are always there when support is needed. What the service does well: Ensures decoration is renewed on a regular basis to provide a well maintained environment. Provides a relaxed and happy environment with service users being at the centre of care provision. Supports service users to enjoy and be part of the local community. Maintains contact with family/advocates to keep them fully informed and to forge good relationships. Roxburgh House H56-H05 S62994 Roxburgh Hse V237374 180805 stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? 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. Roxburgh House H56-H05 S62994 Roxburgh Hse V237374 180805 stage 4.doc Version 1.40 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 Roxburgh House H56-H05 S62994 Roxburgh Hse V237374 180805 stage 4.doc Version 1.40 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) 3,4,5 All new admissions are undertaken following a pre admission assessment. Visits are undertaken and encouraged prior to a decision being made about entering the home. EVIDENCE: The admission process and assessments have been thoroughly carried out and full care plans developed. Files contain information to support service users in an appropriate way and to help goals to be met. Staff observe and discuss needs with service users and/or family/advocates as necessary. This assessment enables the home to ensure they are able to meet individual needs and also provides initial contact between service user and staff. Roxburgh House H56-H05 S62994 Roxburgh Hse V237374 180805 stage 4.doc Version 1.40 Page 9 Prospective service users are able to visit and stay for short periods prior to deciding to remain in the Home. A new service user is able to stay in the home and discuss if the placement is appropriate and suitable over the initial weeks of a stay, providing valuable information to support a decision regarding moving into the home. Roxburgh House H56-H05 S62994 Roxburgh Hse V237374 180805 stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 Care plans clearly set out the health needs of service users and these are being met through contact with health care teams. Care plans are in need of review and must continue to be reviewed on a regular basis. Personal and social care needs are set out in care plans and fully supported by the home. Appropriate policy and procedures are needed to deal with returned medication. Service users are treated with respect and the right to privacy is upheld. EVIDENCE: Care plans clearly set out the health and social needs of service users and any health care appointments are fully recorded on records. If needs change or any follow up action is required this is clearly recorded with a red star for the Roxburgh House H56-H05 S62994 Roxburgh Hse V237374 180805 stage 4.doc Version 1.40 Page 11 next shift to follow through and to alert the manager of any changes. Staff on duty and the length of each shift is clearly recorded on morning and afternoon shift records, entries are informative and signed and dated. A new area for care plans to be completed has been developed to give staff a quiet area to complete records. Discussions were undertaken regarding the review of care plans as files are currently not up to date. Due to a change of ownership and some staff shortages files have not been reviewed regularly. Following some staff recruitment and developing the role of the registered manager files are now to be regularly reviewed. Some medication has been duplicated by the pharmacy and an appropriate policy and procedure needs to be in place to ensure safe handling of medication is undertaken when it needs to be returned to the pharmacy. Discussions with service users and questionnaires received confirm that social and personal care needs are being met. Service users stated they are happy and well cared for and have choice of how they spend each day. Observations and questionnaires received also confirm that dignity and privacy is respected. Roxburgh House H56-H05 S62994 Roxburgh Hse V237374 180805 stage 4.doc Version 1.40 Page 12 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) 12,13,14,15 All aspects of service user needs are met by the home and family, friends or advocates are encouraged to maintain contact. Choice and autonomy are supported and encouraged. A variety of meals are offered at all times and special choices, needs or diets are catered for. EVIDENCE: Friends and family are encouraged to visit and are also invited to various events undertaken in the home. Walks are easily enjoyed when staffing permits with shops and the sea front very near the home. Service users were being dealt with in an appropriate way and with due consideration for choice and dignity at this time. Service users are able to sit out in the sunshine as tables, chairs and parasols are placed in the front garden area. One service user stated she loves to sit out as she can watch what is going on locally and chat to people passing by. The kitchen is kept in an organised manner and is very clean, a gold award has been given for this year. The chef offers a variety of meals and also is aware Roxburgh House H56-H05 S62994 Roxburgh Hse V237374 180805 stage 4.doc Version 1.40 Page 13 of what is enjoyed by service users. There is always an alternative meal if required, salad if a hot meal is not wanted and snacks are available at any time of the day or night. The dining area is relaxed, brightly decorated and is more in line with a bistro than a dining room. This provides a very pleasant environment, choice of seating areas for service users and accommodates discussion or a quiet corner for eating. Roxburgh House H56-H05 S62994 Roxburgh Hse V237374 180805 stage 4.doc Version 1.40 Page 14 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) Although not directly inspected, there are policies and procedures in place regarding abuse and complaints. EVIDENCE: Previous inspections have confirmed that abuse and complaints procedures are available in the home. Files containing these are now clearly labelled and accessible for all staff. This supports the safety of service users and good practice is underpinned for staff. Roxburgh House H56-H05 S62994 Roxburgh Hse V237374 180805 stage 4.doc Version 1.40 Page 15 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) 19,23,24,25,26 The standard of the environment within the home is very good, providing service users with an attractive, comfortable and homely place to live. The external area is well maintained and colourful. The home was clean and pleasant at the time of the inspection EVIDENCE: The home was found to be clean, bright, free from odours and with a welcoming and relaxed atmosphere at the time of this inspection. The building and service user rooms are maintained in a good state of repair. Rooms are individual and comfortably furnished with bedside lights available. Some rooms have been redecorated with matching linen and curtains. This enables service users to feel their room is individual and is set out to meet individual needs. Wash basins and commodes have a privacy screen that provides dignity and privacy for service users. Some residents were seen to be comfortably seated Roxburgh House H56-H05 S62994 Roxburgh Hse V237374 180805 stage 4.doc Version 1.40 Page 16 either in their own rooms or the lounge area and enjoying conversation, television or knitting, supporting choice and independence. Roxburgh House H56-H05 S62994 Roxburgh Hse V237374 180805 stage 4.doc Version 1.40 Page 17 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) 27,29,30 The recruitment and induction processes, to date, have not always been thorough enough to protect service users. There is a training matrix in place but staff training is not currently up to date. EVIDENCE: In the main, recruitment would normally be appropriate, however, this has not been the case over the last few months. A new member of staff started work without the appropriate CRB checks in place and without a full induction. While this is not common practice in the home, this does not ensure the full protection of service users or support good practice. The registered manager explained that this occurred in one instance during a particularly difficult time and would not happen again. All other staff files seen at this time contained appropriate checks, references and an induction programme. While staff are trained and competent to undertake their role, core refresher training has not been undertaken recently. This has unfortunately lapsed due to change of ownership. Discussions regarding training were undertaken with the new proprietor and the registered manager who stated that refresher training is currently being addressed. Roxburgh House H56-H05 S62994 Roxburgh Hse V237374 180805 stage 4.doc Version 1.40 Page 18 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) 31,32,33,38 The registered manager is fit and able to undertake her duties in the home. Service users benefit from a safe environment and well run home and the systems of consultation are good. EVIDENCE: The Registered Manager has many years of experience with the current service user group and works in an inclusive and open manner. Residents appeared to be comfortable and happy when speaking with the manager and the proprietor during this inspection. Service users and questionnaires confirm the manager is caring and supportive. Service users confirmed that consultation is undertaken regularly. The staff group and service users were observed to be relaxed and confident when dealing with management at this inspection. Roxburgh House H56-H05 S62994 Roxburgh Hse V237374 180805 stage 4.doc Version 1.40 Page 19 The home provides a safe environment with radiators being covered, restrictors on hot water, COSHH items secured appropriately and records are securely stored. Staff had a good awareness and knowledge of service user needs and were seen to be supporting people in a considerate and appropriate manner. Discussions and comments received all confirm that family/visitors/advocates are welcomed and are included in the daily routines of the home. This supports service users to feel the home is their own, to have control over their lives and to feel that their views are heard and regarded as being important. Roxburgh House H56-H05 S62994 Roxburgh Hse V237374 180805 stage 4.doc Version 1.40 Page 20 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 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 3 x 3 x x x 3 Roxburgh House H56-H05 S62994 Roxburgh Hse V237374 180805 stage 4.doc Version 1.40 Page 21 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 OP 7 OP 9 Regulation 15 13 Requirement Care plans must be regularly reviewed, dated and signed. A policy and procedure to be developed to cover the safe handling of medication that needs to be returned. Recruitment and induction to be undertaken totally in line with the National Minimum Standards. Timescale for action 3011/05 31/10/05 3. OP 29 18 With all new staff from 18/08/05 4. 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 Roxburgh House H56-H05 S62994 Roxburgh Hse V237374 180805 stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent. TN23 1HU 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 Roxburgh House H56-H05 S62994 Roxburgh Hse V237374 180805 stage 4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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