Inspection on 08/06/05 for The Roan Rest Home

This inspection was carried out on 8th June 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Roan Rest Home 27/06/08

The Roan Rest Home 02/07/07

The Roan Rest Home 23/05/06

The Roan Rest Home 22/11/05

The Roan Rest Home 13/10/04

The Roan Rest Home 25/05/04

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 The Roan Rest Home 27/29 Pembroke Crescent Hove East Sussex BN3 5DF Lead Inspector Penny Bailey Unannounced 8 June 2005 10:30 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 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. The Roan Rest Home H59-H10 S14253 The Roan Rest Home V216479 150504 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service The Roan Rest Home Address 27/29 Pembroke Crescent Hove East Sussex BN3 5DF 01273 772927 01273 738260 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) Mr Joginder Singh Vig Mrs Beant Kaur Vig Mrs Beant Kaur Vig Mr Balbir Roy Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (OP) 19 of places The Roan Rest Home H59-H10 S14253 The Roan Rest Home V216479 150504 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of service users accommodated must not exceed nineteen (19). 2. The service users accommodated will be aged sixty-five (65) years and over on admission. Date of last inspection 13 October 2004 Brief Description of the Service: The Roan Rest Home is a care home providing personal care and accommodation for up to nineteen older people. The home is owned by Mr and Mrs Vig, who have four other homes in East Sussex. The Roan is situated in a residential area of Hove, within close walking distance of the library and there are local shops and transport links nearby. Accommodation is provided over three floors in a large property that has been converted from two houses. A passenger lift enables residents to access all parts of the home. However, there are short flights of stairs to mezzanine levels that place some limitations on residents with mobility problems. The home provides seventeen single rooms, eleven of which are en-suite, and one shared en-suite room. There is an attractive lounge/dining area on the ground floor, and a quiet lounge on the first floor. There is a pleasant garden, with access to residents, at the rear of the building. The Roan Rest Home H59-H10 S14253 The Roan Rest Home V216479 150504 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over five hours, forming part of the annual inspection programme for this home. A tour of the home took place, and the Inspector spoke with six residents of the eighteen currently accommodated, and two members of staff. Staff and care records, menus and documentation relating to health and safety were examined. A discussion with the Registered Manager took place around progress since the last inspection. The focus of the inspection was on the quality of life for people who live at the home. In order that a balanced and thorough view of the home is maintained, this inspection report should to be read in conjunction with the previous inspection reports. The Inspector would like to thank the residents, staff and management for their hospitality and assistance during the inspection. What the service does well: What has improved since the last inspection? The administration of residents care records has improved with evidence of more regular review. Any areas of concern noted during previous inspections have been addressed, and action is in place to ensure that those areas not yet fully met are done so in the near future. The Roan Rest Home H59-H10 S14253 The Roan Rest Home V216479 150504 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Roan Rest Home H59-H10 S14253 The Roan Rest Home V216479 150504 Stage 4.doc Version 1.20 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 The Roan Rest Home H59-H10 S14253 The Roan Rest Home V216479 150504 Stage 4.doc Version 1.20 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) 1, 2, 3 & 5 Information has been produced in booklet form that gives a clear picture of the service offered. This information needs to be given to people preferably before they move in so that they can make a proper choice about where they wish to live. Prospective residents are assessed before they move in to ensure that the home is able to offer the care needed. EVIDENCE: The home provides detailed information for residents within a Service User Guide, regarding the services offered. The Service User Guide contains most of the information detailed in Standard 1 but needs to include views of people living in the home and contact details for relevant health and social care agencies. One resident who spoke with the Inspector did not recall being provided with a Service User Guide, and did not have a copy within their room. The Manager, where possible, visits people either at home or in hospital to tell them about The Roan Rest Home, and make an assessment to ensure that The Roan Rest Home H59-H10 S14253 The Roan Rest Home V216479 150504 Stage 4.doc Version 1.20 Page 9 their care needs can be met. Residents are only accommodated if the home is satisfied that they can meet their needs. Information about their needs is gathered from a variety of sources including the resident, their representative and health care professionals. The needs assessment then forms the basis for each residents plan of care. Prospective residents or their relatives are able to visit the home and talk to people living there before deciding whether they wish to live in The Roan, and residents are admitted for a months trial period to ensure that they are satisfied with the placement. On admission residents receive a Contract of terms and conditions, that provides information on what they may wish to know about the home, including the amount of fees they will need to pay. The Roan Rest Home H59-H10 S14253 The Roan Rest Home V216479 150504 Stage 4.doc Version 1.20 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, 10 & 11 The home was found to be meeting residents’ health and general needs and the Manager and staff were aware of what additional support was required. Care-plans provided a good overall picture of each resident’s needs, however, staff must ensure that an assessment is completed, and care plans updated whenever a residents needs change. EVIDENCE: Four individual plans of care were inspected. These comprised of many documents including risk and needs assessments, basic information, daily notes and a plan of care. Care plans were seen to have been reviewed on a monthly basis, however, a care plan had not been fully updated or completed for one resident after they had returned from a hospital stay. Residents’ physical needs are closely monitored and the home calls in specialist services when necessary. Residents confirmed that visits from the G.P. or District Nurse were arranged promptly when required. Residents confirmed that they could see friends and other visitors in their rooms and that staff were polite and considerate. There is also a quiet lounge on the first floor that is available for residents and their visitors if required. All residents currently occupy single rooms. Residents felt that they were treated The Roan Rest Home H59-H10 S14253 The Roan Rest Home V216479 150504 Stage 4.doc Version 1.20 Page 11 with respect, and their right to privacy upheld. Bedroom doors are fitted with locks, and staff were observed knocking on bedroom doors before entering. The Manager and staff spoke of the support they had received in the past from Health Care professionals during the care of residents who were receiving palliative care. Resident’s relatives are supported to stay at the home during their last days, and it is the home’s policy to care for residents until their death with the support of the District Nurses, G.P. and Palliative care team unless medical reasons prevent this. The home does not currently have policies and procedures in place to guide staff on caring for those who are dying. The Roan Rest Home H59-H10 S14253 The Roan Rest Home V216479 150504 Stage 4.doc Version 1.20 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 Flexible routines are part of the daily practice at the home, and residents are supported to continue with the activities they enjoy. Dietary needs are well catered for with a balanced and varied selection of food available that meets resident’s tastes and choices. EVIDENCE: Residents are supported to attend the church services of their choice, and to continue with activities that they enjoyed prior to entering the home. An Activities Coordinator visits the home and provides activities on a group or individual basis. However, two residents commented that group activities mainly include playing Bingo or cards, and felt that these had become boring after the first few times of participating. Regular residents meetings are not currently held in the home, and the possibility of this being a forum for residents to express their preferences or suggestions for activities was discussed with the Manager. Entertainers are also booked to visit the home, and parties are arranged whenever it is a resident’s special birthday. Residents stated that there is flexibility in daily routines regarding meal times, going to bed, rising and bathing. Residents are encouraged to remain as independent as possible and maintain control over all aspects of their daily lives. During the inspection residents were observed to move around the home freely, choosing which rooms to be in and what level of company they wanted The Roan Rest Home H59-H10 S14253 The Roan Rest Home V216479 150504 Stage 4.doc Version 1.20 Page 13 to enjoy. All of the residents who spoke with the Inspector commented that the food provided was very good. The Roan Rest Home H59-H10 S14253 The Roan Rest Home V216479 150504 Stage 4.doc Version 1.20 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) 16 & 17 The home operates in an open manner and has not had a formal complaint since the last inspection. All residents and visitors are made aware of how to complain or raise concerns, with information provided in the home’s Service User Guide. EVIDENCE: The home has an accessible complaints procedure for residents, their representative and staff to follow should they be unhappy with any aspect of the service. There was no record of any complaint made to the home over the last year. One complaint was received by CSCI since the last inspection, this was found to be partially substantiated, and steps had been taken by the home to address the concerns raised. Residents are supported to participate in the political process, and information on contacting advocacy services can be provided by the home if required. The Roan Rest Home H59-H10 S14253 The Roan Rest Home V216479 150504 Stage 4.doc Version 1.20 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, 20, 21, 22, 23, 24, 25 & 26 The home provides pleasant accommodation for residents, and all rooms were noted to be personalised. The home ensures that service users private accommodation is equipped to provide comfort and privacy and to meet the assessed needs of those residing in the room. EVIDENCE: The home is well located in relation to the local community and amenities, and was warm, accessible and well-maintained on the day of the inspection. Bedrooms were observed to have been individualised by residents, and are provided with domestic style furniture and fittings of a good standard, together with bedding, carpeting and curtains. All bedrooms are currently used for single occupancy, but one room is available for shared occupancy if required. Bedroom doors have an appropriate lock fitted to enable residents to lock their rooms if desired. The majority of rooms have en-suite facilities. Assisted bathing facilities are also provided. The Roan Rest Home H59-H10 S14253 The Roan Rest Home V216479 150504 Stage 4.doc Version 1.20 Page 16 Grab rails, and a range of equipment and adaptations are provided to support residents in moving safely around the home. Call bells are provided in each room, those tested were in working order. A good standard of cleanliness was noted throughout, and the home was free from offensive odours. Residents felt that their clothes were suitably laundered, and all residents clothing was noted to have been laundered to a good standard. It was noted by the Inspector that there were no hand washing facilities available in a first floor w.c., and a requirement has been made to address this. Communal toiletries, such as soap and bubble bath were seen in some bathrooms, and the Manager was asked to remove these. Communal space is provided in a pleasant lounge dining area, with views of the garden. There is also a quiet lounge on the first floor. Seating is provided in the garden at the rear of the home, and there are small patio areas by the front door where residents can also sit out if desired. The Roan Rest Home H59-H10 S14253 The Roan Rest Home V216479 150504 Stage 4.doc Version 1.20 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, 28 & 30 There is a core group of staff who have worked at the home for many years and who make a positive contribution to the quality of life of residents. Staff training is continuing on a regular basis, and staff are knowledgeable regarding the conditions and treatment of the needs of the residents within their care. However, it is recommended that staff attend annual training on safe lifting and handling practices. EVIDENCE: All residents consulted spoke positively about staff at the home. Duty rotas showed that three care staff are employed during the morning shift, two care staff during the afternoon, and one waking care staff at night. The joint Managers and senior care staff are on-call throughout the night if required, and live within a short distance of the home. Training records were viewed and showed that staff have attended a range of training that included lifting and handling, first aid, fire safety, basic hygiene and the protection of vulnerable adults. Not all carers had attended annual updates on safe lifting and handling practices. The Manager reported that further training on this topic is planned in the near future. One member of staff has completed both the NVQ Level 2 and 3 in care, and a second member of staff has completed the NVQ Level 2, two members of staff are also due to commence this training in the near future. The Roan Rest Home H59-H10 S14253 The Roan Rest Home V216479 150504 Stage 4.doc Version 1.20 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, 34, 35, 37 & 38 There is a friendly atmosphere in the home both for residents and staff. Adequate health and safety measures are in place. The home is run with the emphasis on the safety and well-being of the residents, and was found to be conducted in an open and friendly manner. EVIDENCE: The Manager, Mrs Vig, has owned and run the home for a number of years, and demonstrated an in-depth knowledge of the needs and preferences of each resident. The home is also jointly managed by Mr Roy. Staff receive training on basic health and safety topics, and there is a policies and procedures manual which is readily available to staff, designed to guide them in their work with residents. Policies and procedures had not been reviewed, and the Manager was asked to address this. Some policies and procedures were not in place, including procedures for fire drills and the evacuation of residents should The Roan Rest Home H59-H10 S14253 The Roan Rest Home V216479 150504 Stage 4.doc Version 1.20 Page 19 a fire occur. A fire risk assessment of the home was unavailable for inspection, and the Manager was asked to address this as a matter of priority. Systems for the inspection of fire safety alarms, equipment and emergency lights are in place, and up to date. A health and safety audit is carried out at the home annually, and the Manager reported that requirements made during the previous audit had been addressed. The home does not have a formal annual development plan, however rooms are redecorated as they become vacant, and electrical equipment is replaced or repaired as soon as this is required. It was noted that the floor and floor covering in the first and second floor bathrooms were uneven and could present a trip hazard, and that an electrical cupboard was not fitted with a lock, although warning signs were in place. A requirement has been made to the Manager to ensure that risk assessments of these areas are carried out. The Roan Rest Home H59-H10 S14253 The Roan Rest Home V216479 150504 Stage 4.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 3 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x 3 x x 3 3 x 3 2 The Roan Rest Home H59-H10 S14253 The Roan Rest Home V216479 150504 Stage 4.doc Version 1.20 Page 21 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. Standard 1 Regulation 5 (2) Requirement That the homes Statement of Purpose and Service User Guide are reviewed at least annually and updated if required, and provided to each resident. That each time a change of care is identified, or a particular need is assessed, that this information is written in the care plan and reflects all of the residents physical, psychological and social needs. That strategies are developed for consulting service users about the programme of activities provided in the home. That a means of enabling staff and service users to cleanse their hands is provided in the first floor communal toilet. That the Fire risk assessment is completed, reviewed frequently, records significant findings and the action taken to ensure adequate fire safety precautions in the home. That policies and procedures are developed to guide staff when evacuating service users in the event of a fire. The Roan Rest Home H59-H10 S14253 The Roan Rest Home V216479 150504 Stage 4.doc Version 1.20 Page 22 Timescale for action With immediate effect. With immediate effect. 2. 7 15 (2) 3. 12 16 (2) (n) With immediate effect. With immediate effect. With immediate effect. 4. 26 13 (3) 5. 38 13(4)(c) 6. 38 13 (4) (a) That a risk assessment is completed of the electrical cupboard door and first floor bathroom floor, and steps taken to ensure safety if required. With immediate effect. 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 11 Good Practice Recommendations That policies and procedures are developed to provide guidance for staff on caring for a service user who is dying, and procedures to be followed when a service user is transferred to hospital. That toiletries are used only for individual service users, and that any communally used toiletries are removed from bathrooms. That staff attend annual updates on safe lifting and handling practices. That the Registered Manage undertakes an NVQ Level 4 in management by 2005. 2. 3. 4. 26 30 31 The Roan Rest Home H59-H10 S14253 The Roan Rest Home V216479 150504 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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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