Inspection on 29/08/07 for Roxburgh House
Also see our care home review for Roxburgh House for more information
This inspection was carried out on 29th August 2007.
CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 but made no statutory requirements on the home.
Other inspections for this house
What follows are excerpts from this inspection report. For more information read the full report on the next tab.
What the care home does well
Residents have a choice of food and the meals are well presented. Several residents expressed that the food is good. Contacts with families, friends and advocates are encouraged. Residents expressed that they are comfortable to approach any of the staff if they have a problem or request. Bedrooms are individualised with residents` own personal possessions. The majority of staff have achieved a qualification in care. Residents said that the staff are nice and are usually available to help them when they need it.
What has improved since the last inspection?
Five staff have attended training on adult protection since the last inspection. Staff on duty at the visits indicated good awareness of issues that might indicate abuse and were clearly committed to ensuring that residents` best interests are protected. A number of staff had attended recent training on infection control that should help to develop their skills in this area and provide extra protection for residents and themselves. However, management need to take further action in this area to ensure safety see next section.A new wide screen television has been provided in the main lounge and residents expressed that the picture quality is good and they enjoy watching it. One bedroom has been redecorated since the last inspection and provides a pleasant environment. A new `wet room` shower facility is being created, which when completed will provide more choice for residents. Radiator guards have been delivered and there are plans to fit them by the winter to address the risk of burns from radiator surfaces. However, this was identified at the last inspection as necessary to ensure the safety and well being of residents in all areas. The guards should be fitted in priority according to assessed risk.
What the care home could do better:
The current management structure is not sufficiently effective. Although this home has some strengths, weaknesses have been identified at this inspection that could adversely affect residents` welfare. The home sets out the level of care and service provided in its statement of purpose and service users` guide. However, it was not meeting some of its stated aims, for example, to deliver quality care via personalised "holisitic" care plans, which evidence in this report suggests is not always happeneing. Both documents could therefore mislead prospective residents. The documents also contain some factual inaccuracies that need reviewing and updating. Assessments carried out prior to admission are not sufficiently thorough and do not demonstrate if the home can meet the person`s needs. This places them at risk of their care needs not being fully met. Although each resident has a plan of care to provide the basis for the care to be delivered, some care plans were not at the home. Therefore the quality of care provided to residents is dependent upon staff carrying information in their heads, or passing it on verbally. Discussion with staff indicated that they do understand residents` care needs, but some of the information in the care plans seen did not fully support this, posing the risk of inconsistent care being delivered to residents. Practices for managing medications in the home were mainly appropriate. A couple of improvements were identified for the safe administration of medications and to protect residents` welfare at all times. These were to ensure that all staff that administer medications have received appropriate medication training and that a dedicated drugs refrigerator is provided.There were a number of maintenance and safety issues that were discussed with Mr Isiakpere. There needs to be a system in place to ensure that such issues are dealt with promptly to safeguard residents and staff. There has been a change to the home`s smoking policy to comply with the new smoke free regulations. Smokers now have to smoke outside. However, this has not been made clear in the statement of purpose and service users` guide so that residents who smoke know what is expected. The home has some specialist disability equipment to maximise independence for people with physical disabilities. However, some adaptations are necessary to ensure that people in wheelchairs can access all communal areas without the need for staff assistance, for example the step into the sun lounge. Any specialist equipment, such as mobile hoists, must be maintained in good working order. Suitable arrangements must be in place to prevent the spread of infection within the home. This must include procedures for dealing with soiled articles and bodily waste in a safe way that protects residents and staff. Appropriate hand drying facilities also need to be provided. A review of staffing levels must be carried out and there must be sufficient staff on duty to meet residents` needs, taking account of the layout of the home. Structured induction and ongoing staff training must be provided to give them the necessary skills and knowledge to deliver the appropriate care to residents and ensure residents are safe. Staff should receive appropriate supervision. Robust quality assurance systems need to be in place, to ensure that the home is run in the best interests of the residents. This must include monthly monitoring visits by a responsible person of the organisation, to review the quality of care provided and ensure acceptable standards are maintained in all areas of the home. All working practices must ensure the safety and welfare of residents and staff. Action needed includes: to carry out regular staff fire safety training and drills; to ensure sufficient staff are trained in moving and handling and food hygiene.