Care Home: Rockny House

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What the care home does well Rockny House is a happy, friendly home, and there is evidence of mutual respect and consideration between staff and the people they support, which is also extended to visitors. A warm welcome is given, and the atmosphere throughout the home was calm and relaxed. Detailed information about the home is provided for prospective residents and their relatives, in an appropriate format, if necessary, and it is reviewed regularly, to enable the right decisions to be made about future care arrangements. The procedures relating to the assessment and admission of people who may want to live at the home are in place, to ensure that the needs of prospective residents are identified, and to enable staff to determine if they can be cared for appropriately at the home. The commitment of the management and staff to the provision of person centred care is commendable. `We focus on the clients and everything else follows`, is how it is described. Residents are involved in making decisions about their lives, both within and outside the home, their independence is promoted at all times, and they are supported appropriately with risk assessments. Opportunities are available for residents to do the things they enjoy, and the activities in which they are involved are many and varied, and these also increase their life skills and confidence. The arrangements for purchasing and preparing food give service users more choice about their meals and mealtimes and greater involvement in the running of the home. The care that is provided at the home revolves around the people who live there, and the family and friends of each resident are also supported and their involvement with the home is encouraged. Advocacy services are available to ensure that everyone is able to freely express their views to an independent person. A high standard of personal and health care is provided for each person living at the home, and the staff work well with other professionals and agencies with obvious benefit to residents. The needs of everyone are regularly reviewed. The policies and procedures relating to the administration of medication and the training provided for staff, help to ensure that residents are protected. A satisfactory complaints procedure is in place and is circulated to everyone involved with the home, to enable them to voice any concerns. The policies and procedures regarding the protection of vulnerable people from abuse, and the training provided for staff, ensure that the people who live at the home are safeguarded. Residents live in a homely, comfortable and safe environment, where their privacy and dignity is respected, and their independence promoted, and with their personal possessions around them. The building and equipment is well maintained, the house is nicely decorated, and provides good facilities and a pleasant place in which to live and work. Residents benefit from the satisfactory employment procedures that are implemented at the home and they are supported by an effective staff team who appropriately trained and supervised. The experience of the manager helps to ensure that the best interests of residents are promoted, and that they benefit from living in a well run home. The records and documents at the home are maintained to a high standard, and kept safely, which ensures a well-organised service. What has improved since the last inspection? There is an ongoing commitment from everyone involved at the home to maintain and develop the service. The care planning procedures are reviewed regularly and the process is adapted to suit needs of the people who live at the home. The ongoing training programme and the supervision provided for staff should ensure an effective and competent workforce, which will benefit the people they support. The Annual Quality Assurance Assessment (AQAA) for the home has been completed and submitted to the Commission, and this document helps to show the way the home measures how well it meets the needs of the people who live there. What the care home could do better: A more detailed record could be maintained, of comments made about the service, specifically any compliments received, to give a more balanced view of what people think about the home. The further development of the quality assurance system to include the auditing and publishing of the results of the surveys and questionnaires that are distributed, would ensure compliance with the National Minimum Standards, and enable the management to measure their success in achieving their stated aims and objectives. CARE HOME ADULTS 18-65 Rockny House 25 Birmingham Road Kidderminster Worcestershire DY10 2BX Lead Inspector Rachel McGorman Draft - Key Unannounced Inspection 19 November 2007 10:00 Rockny House DS0000044977.V353270.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 Rockny House DS0000044977.V353270.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. Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rockny House Address 25 Birmingham Road Kidderminster Worcestershire DY10 2BX 01562 864067 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) catsg1971@aol.com Mrs Anna Giannini Caterina Giannini Caterina Giannini Care Home 10 Category(ies) of Learning disability (10), Learning disability over registration, with number 65 years of age (2) of places Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service is primarily for people with a learning disability, but the home may also accommodate people with an associated physical disability. The home may also accommodate a maximum of two people with an associated mental disorder. 16th January 2007 Date of last inspection Brief Description of the Service: Rockny House is registered to provide residential care for up to 10 adults who have a learning disability, and who may also have a physical disability, and for 2 people who may have an associated mental disorder. Two of the service users are over 65 years of age, although they remain active. The premises is a large, detached, Victorian house, which has been extended and upgraded to provide a high standard of accommodation. Situated in a residential area of Kidderminster, it is on a bus route and also within walking distance of the town centre, where there is a range of amenities and facilities. The stated aim of the home is to provide 24 hour support for service users, who are encouraged to be as independent as possible and to achieve their maximum potential. The range of fees varies between £336 and £370 per week. Mrs Anna Giannini and her daughter Ms Caterina Giannini are the registered providers, and Caterina is the registered care manager. Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of this routine key inspection, was to monitor the care provided at the home, to assess how well the service meets the needs of the people who live there, in relation to the stated aims and objectives, and to follow up previous requirements and recommendations. Preparation for the inspection included looking at previous reports, obtaining an Annual Quality Assurance Assessment (AQAA) from the management of the home and analysing the contents, and considering the various contacts made with the home since the last inspection. The visit to the service was unannounced and took a total of 3 hours. The inspector spent some time with the people living at the home, discussing with them what it is like living at the home, what they like to spend their time doing, where they went on holiday and where they have been recently. Observation of the interactions of the residents with the people who support them was very positive, and the relationships were seen at all times to be very kind and considerate, and supportive and respectful. During conversations with staff, comments were made about what it is like working at the home, how it is organised and how they support the people who live there. In addition the opportunities for training and the supervision they are given in doing their work was also discussed. The care plan of one resident was inspected in detail for case tracking purposes, and was found to contain extensive records relating to every aspect of their life. The contents were discussed with the acting manager, and also the way in which the plan was being implemented. A tour of the house was undertaken, and the records kept in respect of the maintenance of equipment, and safe working practices were also seen, including the fire log and the accident book. Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 6 What the service does well: Rockny House is a happy, friendly home, and there is evidence of mutual respect and consideration between staff and the people they support, which is also extended to visitors. A warm welcome is given, and the atmosphere throughout the home was calm and relaxed. Detailed information about the home is provided for prospective residents and their relatives, in an appropriate format, if necessary, and it is reviewed regularly, to enable the right decisions to be made about future care arrangements. The procedures relating to the assessment and admission of people who may want to live at the home are in place, to ensure that the needs of prospective residents are identified, and to enable staff to determine if they can be cared for appropriately at the home. The commitment of the management and staff to the provision of person centred care is commendable. ‘We focus on the clients and everything else follows’, is how it is described. Residents are involved in making decisions about their lives, both within and outside the home, their independence is promoted at all times, and they are supported appropriately with risk assessments. Opportunities are available for residents to do the things they enjoy, and the activities in which they are involved are many and varied, and these also increase their life skills and confidence. The arrangements for purchasing and preparing food give service users more choice about their meals and mealtimes and greater involvement in the running of the home. The care that is provided at the home revolves around the people who live there, and the family and friends of each resident are also supported and their involvement with the home is encouraged. Advocacy services are available to ensure that everyone is able to freely express their views to an independent person. A high standard of personal and health care is provided for each person living at the home, and the staff work well with other professionals and agencies with obvious benefit to residents. The needs of everyone are regularly reviewed. The policies and procedures relating to the administration of medication and the training provided for staff, help to ensure that residents are protected. A satisfactory complaints procedure is in place and is circulated to everyone involved with the home, to enable them to voice any concerns. Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 7 The policies and procedures regarding the protection of vulnerable people from abuse, and the training provided for staff, ensure that the people who live at the home are safeguarded. Residents live in a homely, comfortable and safe environment, where their privacy and dignity is respected, and their independence promoted, and with their personal possessions around them. The building and equipment is well maintained, the house is nicely decorated, and provides good facilities and a pleasant place in which to live and work. Residents benefit from the satisfactory employment procedures that are implemented at the home and they are supported by an effective staff team who appropriately trained and supervised. The experience of the manager helps to ensure that the best interests of residents are promoted, and that they benefit from living in a well run home. The records and documents at the home are maintained to a high standard, and kept safely, which ensures a well-organised service. What has improved since the last inspection? There is an ongoing commitment from everyone involved at the home to maintain and develop the service. The care planning procedures are reviewed regularly and the process is adapted to suit needs of the people who live at the home. The ongoing training programme and the supervision provided for staff should ensure an effective and competent workforce, which will benefit the people they support. The Annual Quality Assurance Assessment (AQAA) for the home has been completed and submitted to the Commission, and this document helps to show the way the home measures how well it meets the needs of the people who live there. Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 8 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. The summary of this inspection report can be made available in other formats on request. Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 9 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 Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 4 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The information provided for prospective service users helps them to make decisions about their future care needs. The assessment and admission procedures are both detailed and thorough to ensure that the home is able to provide the care that is needed, and also to help people to know if the home will be suitable for them. Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 11 EVIDENCE: A Statement of Purpose and a Service Users Guide have been produced by the management of the home, and are available in a suitable format for everyone. They provide detailed information for prospective residents and their families, about the services and facilities that are available at the home. A resident was admitted to the home recently, and the procedure that had been followed was discussed in detail with the registered manager who explained, that the process had included extensive assessment of the prospective resident by staff from the home, and a Community Care Assessment was also completed by the social worker. A gradual introduction was made to the home following the initial referral, and admission was agreed on a trial basis initially, to give them the opportunity to decide if they like living at the home. The placement was not successful on this occasion although the procedures had been followed thoroughly, the manager said, but the home had not been aware that the new resident would challenge the service to the extent that they did, and cause so much disruption for the other people living at the home. Some of the residents said that when they first came to the home they had visited several times and stayed for tea before deciding to live there, although it was quite a long time ago now, so they couldn’t remember it very well. Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The plan of care is based on the initial assessment, which clearly identifies the assessed needs of each person, and how these will be met. The way in which the person centred approach to the care of each resident is implemented, helps to ensure that all the decisions made revolve round the people who live at the home. Residents are helped to take part safely in the various activities of daily living and to enjoy new opportunities. Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 13 EVIDENCE: Care planning is well developed at the home, and those seen detailed the specific needs of each person and how these are to be met. They are based on the initial assessment undertaken at the time of admission, and the content of the plan is reviewed regularly, to ensure that it accurately reflects the care that is provided. The care plans are very informative, give a clear picture of the resident, and show that life at the home revolves around the people who live there. Observation of the relationship between the staff and the people they support, and talking with residents, also provided good evidence of the person centred approach that is taken at the home. The care plan of one person was seen, and was very comprehensive. The specific areas of need are identified, and details recorded as to how these are to be met. The long-term and short-term goals are included, and any changes are monitored and recorded. Additional information for one resident was found in a memory folder, containing many photographs to assist with the recall of events and the people involved in their life. A ‘Life-Plan’ is developed with each individual, and as a result everyone is helped, as much as possible, to live the life they choose. The mutual respect and consideration observed within the group of people at home at the time of the visit, creates a positive and stimulating environment that everyone appeared to be enjoying. They were very keen to relate the things they liked doing, and the places they liked going to, and many comments from residents said how wonderful the staff are, and how happy they are to be living at Rockny House. Risk assessments are completed, in relation to the premises, to the activities undertaken, and any restrictions imposed, and also in respect of every aspect of the life of everyone living at the home, and these are reviewed regularly. The management of the risks encountered every day, and also when doing something more unusual, encourages residents to be more independent, and to take greater responsibility for what they do, the registered manager said. Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents help to plan their lives. Each person takes part in various activities, both within and outside the home, and they are able to choose what they want to do and when, which helps to ensure that their rights are respected. The opportunities made available to residents, and their regular contact with family and friends, enables them to live as full and satisfying a life as possible. There is a flexible approach to the provision of a healthy diet, and service users are encouraged to decide what to eat and when. Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 15 EVIDENCE: Residents are constantly encouraged and supported by staff to be as independent as possible, to achieve individual goals, and to develop and maintain various life skills, by doing general household chores, and helping with food shopping and preparation. One person particularly likes to bake a cake, and others enjoy pottering in the garden during the summer months. There are hanging baskets and flower tubs for planting and tending, and other people like to just sit in the fresh air. One resident said how lovely the garden is in the summer and that she likes to be out there all the time. The registered manager explained that people living at the home are enabled to follow an ‘ordinary’ life style as far as possible, by using the same facilities as other members of the community, and being involved in a range of leisure activities. They do various things in the local community such as swimming, browsing around markets, and going to the cinema, and a record is kept in the individual plan of care. A visit to the pantomime in January has been arranged, and this is a regular spot on the calendar that is always looked forward to and very much enjoyed by everyone. Several people were already talking about it. An individual programme of activities is arranged with each person that acknowledges their preferences, and the daily routines revolve around their personal choice. If they decide they don’t want to do something or to go somewhere, then they don’t have to. The wishes of every individual are respected and recorded. One resident decided when she reached the age of 60, that she didn’t want to go to work anymore, and so she retired. Several people attend day centres during the week, and a resident who loves trains, often goes out independently and will spend time at the railway station train spotting. This person is also interested in wrist-watches, and spends many hours taking them apart and repairing them. Some people said they like to go into town for shopping, and may then call in at the local pub for lunch on the way home, while some people said they prefer to stay quietly at home, where there is a variety of past-times available. These include, knitting and sewing, doing jigsaw puzzles, playing board games or cards, playing bingo, listening to music, watching TV or playing a video/DVD. Everybody was having a cup of tea after lunch, when the inspector arrived, and then everyone decided what to do during the afternoon. One person did some drawing, a couple of people had some knitting on the go, another resident did word search competitions and made frequent cups of tea for anyone who wanted one, some people watched a quiz show on TV, and there were lots of other things going on most of the time. The inspector was proudly shown a jigsaw puzzle that one resident had completed. Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 16 Holidays are arranged for people who like to go away, and they had recently returned from a few days in Blackpool, which judging by the experiences that were excitedly recounted was a great success. The records showed that there had been several outings arranged during the summer and these included the sea-life centre and the safari park, which everyone was thrilled about. The majority of residents have family with whom they are in regular contact, and arrangements are made to visit them whenever possible. An advocate is involved with any resident without family contact, and also with other residents when requested. The care manager confirmed that there are no specific visiting times and the involvement of family and friends is actively encouraged. Visitors are made very welcome at Rockny House and they are usually enjoyed by everyone, as part of the family life of the home, although residents can meet with people in private, if they wish. The arrangements regarding the provision of food reflect the individual likes and dislikes of each person, and menus are planned with them. General food stocks for the home are purchased on the internet and delivered each week, but incidental food shopping is done with the assistance of residents, who all said how lovely food is, and that they were able to have what they wanted. Several people said that the occasional ‘take-away’ was also very much enjoyed. Everybody has some involvement with meals from preparing the vegetables, helping with the cooking, laying and clearing the tables, and doing the washing up, and they were all very keen to talk about what they did. Rockny House DS0000044977.V353270.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19, 20 & 21 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care that is provided at the home revolves around the people who live there, and their individual needs are understood and met in an appropriate way. The manner in which support is provided by staff helps to ensure that the rights of residents are respected, when meeting their personal and health care needs. The health of each person is promoted and they are protected, by the high standards maintained when giving medication. The illness and recent death of a resident was managed with sensitivity and respect, which helped everyone to cope as well as possible with the situation. Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 18 EVIDENCE: The personal and healthcare needs of residents are well documented, and there is evidence in their individual files to show how staff understand and respond to them in an appropriate way. Personal care is provided in privacy. Reviews are undertaken regularly with all service users to determine their specific needs. Health Action Plans are in place for each person, and these are completed to a high standard. They are taken by residents when attending the doctors surgery or for hospital appointments The independence and dignity of each individual is promoted, and a relaxed and flexible approach maintained towards their personal care needs. Residents said they are happy with the support they get and can ask for help if needed. The healthcare of each individual is closely monitored, and additional specialist support and advice is sought from the primary health care team, and other health professionals, when necessary. The records show that each person living in the home receives the individual attention they need, and everyone is supported by staff to attend for routine dental and eye appointments, and also for chiropody treatment, although this is more limited unless special treatment is required, therefore staff attend to peoples nails regularly. Well person checks are also undertaken The care plans contain detailed information on general health matters, and provide a clear picture of the health care needs and any treatment given. They also show how well staff monitor these, which helps to ensure that appropriate care is provided. Medication arrangements at the home are satisfactory, and residents are protected by the policies and procedures that are in place. A Monitored Dosage System is in use, and the Medication Administration Records have been completed appropriately. A profile has also been developed to include the side effects of each medicine, and a photograph of the service user is attached. The local Pharmacist undertakes a regular check to ensure that the correct procedures are being followed, and staff confirmed that training has also been provided for them. The recent death of a resident who had lived at the home for many years was discussed, and had been coped with very well by everyone, although several people said they still missed their friend. Appropriate support had been provided to the hospital, to the family, to the staff at the home and to the residents by the management of the home, which had helped everyone through a very difficult time. Rockny House DS0000044977.V353270.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express any concerns, through an effective complaints procedure. Staff know what they should do to protect residents from all forms of abuse. EVIDENCE: A clear procedure for investigating complaints has been developed, in a suitable format, and any issues are dealt with immediately. There have been no complaints about the service during the past year, but neither were there any compliments recorded in the log book, although letters of appreciation were seen. The care manager was again encouraged to record all comments made about the home and the care provided, to give a more balanced view of the service. A suggestion box, is available, and everyone is encouraged to make use of it. Policies and procedures for protecting residents have been produced, and an appropriate procedure is in place relating to all forms of abuse. The records confirmed that abuse awareness was included in the induction training, and that further training has also been provided on the Protection of Vulnerable Adults. Discussions with staff confirmed this and showed that they have a clear understanding of the issues. Rockny House DS0000044977.V353270.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25 & 30 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises are suitable for their purpose. They are comfortable and clean, and ensure as far as possible that the safety and wellbeing of the residents is promoted. The standard of the accommodation is good. The décor and furnishings are well maintained, and provide people with an attractive and homely place to live. The location of the house is convenient to local services and facilities, and the layout provides adequate communal space for the needs of each individual. The maintenance programme and the ongoing development of the premises and facilities helps to enhance the quality of life for the people who live there. Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 21 EVIDENCE: Rockny House is a large, imposing, Victorian style property, which has been sensitively developed and upgraded, and is being maintained to a high standard. The house has been completely redecorated over the last few years, and new hot water and central heating systems installed. A new laundry has also been provided, which has improved facilities at the home. The office is situated off the main lounge, and the sleeping in room is located on the first floor. Three bedrooms rooms have en suite facilities, and a shower room and toilet for the use of another three residents, has been provided on the first floor. These changes have created additional communal space for the people who live at the home and have also improved facilities for staff. Further improvements to the property are underway at present; the roof and guttering have been replaced, the outside of the property is being repainted, and a new driveway is being laid. Planning permission has also been granted for future development of the property. There are a total of 8 single bedrooms and a double room, which two friends have made a positive choice to share. Every bedroom is tastefully decorated and furnished to a high standard, and reflects the individuality of the people who live there, and who are each encouraged to personalise their rooms. The need for aids and adaptations are minimal, but these would be provided should the need arise. One person requires the use of a wheel chair, if walking any distance, and this is serviced regularly to ensure their safety. The home is clean and fresh and staff confirmed they are familiar with the procedures regarding to the control of infection, and that they have been given training in health and safety matters. There are no outstanding requirements following the most recent visit of the Environmental Health Officer. Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34, 35 & 36 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an experienced and competent team of staff, who are able to ensure that the needs of the people living at the home can be effectively met. Appropriate recruitment procedures ensure that residents are supported and protected by the staff who are employed. The supervision provided and the training programme available to staff ensures that they are effective in their work, and therefore able to provide appropriate care and support to residents. Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 23 EVIDENCE: There is an experienced and stable staff team working at the home, and there are few changes in the group, which provides a consistent approach for residents. Observation and comments from residents provide evidence of a team that is effective with the people they support, fully committed to their caring role and supportive to the management of the home. The stability of the staff group at the home has obvious benefits for residents, who said how kind the staff are, and that they help them to do many of the things they want to. One service user when asked if the staff treated her well said, ‘of course they do’. Another person commented, ‘ I wouldn’t want to move from here.’ A deputy is also employed to assist the manager in running the home, and she is now doing the Registered Managers Award. The recruitment and selection procedures that are in place are satisfactory. The file of one member of staff was seen, and the correct procedures had been followed, and appropriate documentation recorded, including evidence of Criminal Record Bureau (CRB) checks, written references, a birth certificate and passport as proof of identity, and qualifications. There is a training programme in place for staff that includes both mandatory and specialist care related areas. These include abuse awareness, the person centred approach to care, continence management, communication, coping with aggression, risk assessment and confidentiality. All staff have completed the Protection of Vulnerable Adults (POVA) and dementia awareness training. An individual training and development assessment and profile has been implemented for all staff. The NVQ (National Vocational Qualification) training Levels 2 & 3 in Care is also provided, and all staff are expected to undertake this, to ensure that they have the competence and skills to do their work, and that residents are supported by a well trained team. Formal supervision sessions, which include an annual appraisal, are regularly provided for all care staff by the manager, with a record of the content of the discussion maintained in the staff files. During conversations with staff, they confirmed that a training programme was in place, and that they are given opportunities to attend the various training courses, and that regular supervision is also provided. Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 & 42 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Satisfactory management arrangements at the home ensure that residents and staff benefit from a well run home. The rights of residents are safeguarded by the effective policies and procedures, together with appropriate records that are maintained at the home. The quality assurance system needs to be fully implemented, and the results of surveys audited, to confirm that the aims and objectives of the home are being met. The health, safety and welfare of residents and staff is promoted and protected in respect of all safe working practices Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 25 EVIDENCE: Mrs Anna Giannini and her daughter Ms Caterina Giannini are the Registered Providers. Caterina is also the Registered Care Manager, and has completed the Registered Manager’s Award in both management and care, and is also an NVQ Assessor. The manager seeks the advice of other professionals at an early stage if a problem arises. There is evidence of a clear sense of direction and strong leadership in the management approach within the home, and the positive interactions observed between staff and the people they support are pleasing to observe. A quality monitoring system for measuring the success of the home in achieving the stated aims and objectives has been introduced, and continues to be developed, although it is not yet fully operational. The results need to be audited and published annually, and a copy submitted to the Commission. The Annual Quality Assurance Assessment (AQAA) has also been produced by the management of the home and submitted to the Commission. The policies and procedures at Rockny House, are reviewed regularly, and updated when necessary, and staff support service users in understanding those relevant to them. Contracts are in place for the servicing and maintenance of equipment at the home, and the records are well maintained with all the appropriate certificates available. The member of staff with responsibility for this area of work, confirmed that everything was in good working order. Notifications are made under Regulation 37, which requires reports to be sent to the Commission of death, illness or other events in the home. The accident records were also seen to be in order. The Fire Log Book was seen, and appropriate checks have been undertaken with the required frequency. The Fire Risk Assessment has been reviewed and updated recently. Fire awareness training is provided for staff, and fire practices and evacuation are undertaken regularly. Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 26 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 3 2 3 3 X 4 3 5 X 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 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 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 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 2 X X 3 X Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action 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. 2. Refer to Standard YA22 YA39 Good Practice Recommendations All comments, concerns and compliments made about the service should be recorded Further development of the quality assurance system should be undertaken Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Worcester Local Office The Coach House John Comyn Drive Perdiswell Park Droitwich Road Worcester, WR3 7NW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Rockny House DS0000044977.V353270.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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