Care Home: Roland Residential Care Homes Ltd

What the care home does well There are many positive aspects to the service. The manager provides strong leadership and leads by example. Care provision is well considered with emphasis being placed on providing a quality service for people. The service is well run with good attention to detail resulting in a smoothly operating service with staff enthusiastic about their work. Care planning is particularly good with some excellent examples of care plans which have comprehensive information about people, their needs and how care is to be delivered. People using the service are well known to staff who are able to provide a good individual service for each. There is a caring attitude. A good example being the fact that one person who is in hospital is visited each week by staff. Positive feedback was received from relatives. One said that, "they do everything that`s possible", for her relatives. The relative also said that she felt there were a lot of staff and that they always, "keep me informed if there is a problem". There are some good examples of involving people in the day-to-day running of the time. People are encouraged to raise concerns. They have been assisted to choose the furnishings for their bedrooms and there are regular meetings. Staff have also been proactive in making sure that health care is obtained. Recruitment is sound with new staff being introduced to the work through a detailed induction process. Staff are then supported to obtain NVQ and other qualifications. There is a confidence amongst the staff team. A very pleasant environment is provided with staff and the people using the service proud of it. The home has been well maintained and a comfortable, attractive home has been created. One relative said that the home is, "homely, bright and clean". Good administrative systems are in place. The home`s office is well organised with records kept neatly and up to date. There are ordered records covering required areas such as health and safety, fire safety and finance. The deputy manager is due to apply to CSCI for registration early in 2008. He has worked at the service since it opened and is well placed to now take on more responsibility. What has improved since the last inspection? The service is well run and already providing a good standard of care. Having said that, there have been improvements. One example is that of the introduction of a new staff induction process. There is a detailed written record kept of staff induction which includes the requirement for staff to have an induction when working in any of the four Roland homes. The new process involves more time with staff and more opportunities for making sure staff are proficient. Other improvements include the purchase of new furnishings. What the care home could do better: No requirements or recommendations have been given. The main issue facing the service is the need to make sure that the deputy manager transfers to the registered manager post efficiently. However, this change has been planned for well and the likelihood of any difficulties is slim. Overall, the approach taken by the registered manager promotes selfassessment and an early resolution to arising issues. For example, there is a three monthly health and safety audit which is carried out by a manager of another service. And there is a focus on involving people using the service and getting things right for them. These initiatives should mean that where possible problems arise they can be successfully managed CARE HOME ADULTS 18-65 Roland Residential Care Homes Ltd 6 Old Park Ridings Winchmore Hill London N21 2EU Lead Inspector Duncan Paterson Key Unannounced Inspection 11th December 2007 10:00 Roland Residential Care Homes Ltd DS0000067023.V354784.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 Roland Residential Care Homes Ltd DS0000067023.V354784.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. Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Roland Residential Care Homes Ltd Address 6 Old Park Ridings Winchmore Hill London N21 2EU 02083642534 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) luckydroland@aol.com Roland Residential Care Homes Ltd Mrs Nilmarnie Gaithri Ranetunge Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd October 2006 Brief Description of the Service: 6 Old Park Ridings is a home registered to provide accommodation and personal care for a maximum of five younger adults with a diagnosis of mental disorder. The home was registered on 24th March 2006 and is one of four residential care homes belonging to Roland Residential Care Homes Limited, a company owned by Mr and Mrs Ranetunge. The home is a large, substantial three-storey house. On the ground floor there is a lounge with an attached conservatory leading to a large and pleasant garden; a kitchen/diner; three service user bedrooms and a toilet/shower room. The home’s laundry facilities are accommodated in a separate wooden building in the garden. On the first floor there are five service user bedrooms two with en-suite facilities and a bathroom containing a jacuzzi and a toilet. On the second floor there are two bedrooms, one with a toilet and one with a shower/toilet and the staff office. The home is located in a residential area near to Winchmore Hill. Public transport, local shops and other community facilities are within a short walking distance of the home. The home currently charges from £650 - £950 per week depending on the assessed needs of the service user. Information, including the contents of CSCI reports will be made available to service users and other stakeholders when they become available. The main aim and objective of the home is to support people who are experiencing mental health problems by enabling them to become involved in the local community and amenities. Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place on 11 December 2007. The inspection involved speaking with the people using the service, the staff on duty, the manager and deputy manager. The manager is Mrs Ranetunge who is also an owner of the business. Care managers and relatives were spoken with on the telephone after the inspection. A standard form, the Annual Quality Assurance Assessment (AQAA), was returned to CSCI by the manager. This was taken into consideration. The inspection also involved the case tracking of three people’s care, the assessment of a range of the home’s records, procedures and forms as well as observation and a tour of the premises. What the service does well: There are many positive aspects to the service. The manager provides strong leadership and leads by example. Care provision is well considered with emphasis being placed on providing a quality service for people. The service is well run with good attention to detail resulting in a smoothly operating service with staff enthusiastic about their work. Care planning is particularly good with some excellent examples of care plans which have comprehensive information about people, their needs and how care is to be delivered. People using the service are well known to staff who are able to provide a good individual service for each. There is a caring attitude. A good example being the fact that one person who is in hospital is visited each week by staff. Positive feedback was received from relatives. One said that, “they do everything that’s possible”, for her relatives. The relative also said that she felt there were a lot of staff and that they always, “keep me informed if there is a problem”. There are some good examples of involving people in the day-to-day running of the time. People are encouraged to raise concerns. They have been assisted to choose the furnishings for their bedrooms and there are regular meetings. Staff have also been proactive in making sure that health care is obtained. Recruitment is sound with new staff being introduced to the work through a detailed induction process. Staff are then supported to obtain NVQ and other qualifications. There is a confidence amongst the staff team. A very pleasant environment is provided with staff and the people using the service proud of it. The home has been well maintained and a comfortable, attractive home has been created. One relative said that the home is, “homely, bright and clean”. Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 6 Good administrative systems are in place. The home’s office is well organised with records kept neatly and up to date. There are ordered records covering required areas such as health and safety, fire safety and finance. The deputy manager is due to apply to CSCI for registration early in 2008. He has worked at the service since it opened and is well placed to now take on more responsibility. 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. The summary of this inspection report can be made available in other formats on request. Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 123&5 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. There is a clear guide informing people about the service. The manager and staff have been able to make sure that assessments are obtained and used to inform care plans which set out people’s needs in detail. Staff have been able to provide god quality care that is appreciated by people as well as their relatives. EVIDENCE: I used the CSCI case tracking method throughout this inspection to assess the quality of the service. This involved selecting three people using the service and looking in detail at their care plans and other records held in the home. It also involved talking with people using the service about the care provided as well as talking with staff, the manager and relatives and care managers where possible. This allowed me to reach an overall judgement about the quality of the service provided. I was shown the statement of purpose which has recently been revised. It is one document covering all four of the Roland care homes with a separate section for each home. The statement of purpose covers all the required areas with one minor exception. The names of the registered managers need to be included. The registered manager undertook to do that. The statement of Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 9 purpose is clear and easy to read and provides a useful guide to the service. The aims and objectives are clearly set out. I looked in detail at three of the individual files for the people using the service. I could see that detailed assessment information had been obtained from referring local authorities. I could also see that the manager and staff had been successful in taking this information and using it to form care plans to plan the care provided. I was able to speak with one relative during the inspection. He was visiting the home that day. He told me that the care provided was, “practically faultless” and that his relative was much better living at this home than she had been for 30 years. Another relative told me that she wished that, “every home was like this one”. A visiting social worker, whom I was able to speak with, was also positive about the care provided. She told me that she found the service to be of a good standard with people well looked after. In addition, through my observations and discussions with the manager and staff I was able to note that staff were placing emphasis and investing time in encouraging the people using the service to eat healthily, to take exercise and to take pride in a pleasant and welcoming environment. It was clear to me that the manager and staff were informed about people’s needs and worked well to not only meet them but try to work with people to develop them. On the three files I looked at I saw copies of contracts from both the provider and the relevant local authority. These contracts set out the fee level and the arrangements for care. Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 10 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 8 9 10 People who use this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. The care provided is well planned, supports people using the service and allows them to enjoy a good quality of life. Care provision is well considered and planned and regularly reviewed. There is good attention to detail and confident staff resulting in a good quality service for people. EVIDENCE: Using the case tracking method I looked in detail at the care plans for three of the people using the service. I could see that the care plans had detailed aims for each person. These were set out clearly in typed plans which provided extensive details of the needs of that person and how the needs were to be addressed. These plans were linked to regular reviews which also set out clearly whether the aims had been achieved. They were also linked to local authority and Care Programme Approach reviews, where relevant. I noted that the commentary and the aims for each person were individualised and that they had retained an impact and up to date feel even after a number of reviews. This was endorsed through the comments from relatives who felt that the people using the service had improved since coming to the home as Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 11 well as comments from the manager and staff who were able to speak confidently and openly about their approach to care provision. I observed that there was a confidence about the approach taken by the manager and staff. The staff on duty to whom I spoke, including a new member of staff, told me that they felt supported and not worried about some of the demanding parts of the work, such as managing challenging behaviour. This was endorsed by a comment from a relative who told me that, “staff knew how to approach (his relative) and o the right thing”. I spoke with the people using the service. They told me that they were free to do whatever they wished and in fact were encouraged and assisted to do things by the staff. For example, one person said that staff assisted her to go to a local art group. There is a keyworker system and one of the staff told me that she went out shopping with the person she had responsibility for. I saw that there were records kept on individual files about the arrangements for finances. Receipts for expenditure as well as records of bank statements were neatly kept on file as well. I was told that the people using the service controlled their money generally with the service assisting by looking after some money as well as keeping the financial paperwork in order. I was shown how staff look after people’s money as well as the records for this. These were well ordered and accurate. I was shown written records of meetings held for the people using the service. I could see that these meetings were held regularly and that detailed notes were being kept for them. I saw reference to a number of day-to-day matters such as food provision where meals had been discussed with people. I saw risk assessments on each person’s individual file. The style followed was to have each risk separately assessed so that each person may have a number of risk assessments covering each aspect of life. The assessments were comprehensive and provided well thought out guidance for staff about each aspect of people’s lives. Care plans and other sensitive information are kept securely in the home’s office. Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 12 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): 11 12 13 14 15 16 & 17 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People using the service benefit from an approach which encourages and supports them to take up opportunities for activities in the community. Daily activity plans are used to plan community and individual activities on an individual basis. Positive and healthy lifestyles are encouraged. EVIDENCE: I was shown daily living plans for the people whose care I case tracked. The plans I saw were varied involving activities such as shopping, swimming, external groups as well as activities within the home such as preparing meals. During the inspection two of the people using the service went out to take up activities and I was told that people using another service run by the Roland group came to the home for lunch. There are opportunities for contact with people living in the other homes and many of the people using the service have friends living in the other homes. Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 13 The people using the service are part of the local community. They use the local shops and community facilities with staff assisting where needed. For example, the staff can use their keyworking time to assist people to go out into the community. Relationships with families are encouraged. One of the relatives to whom I spoke said that he visited often and took his relative out. Staff have assisted with sustaining relationships where it has been difficult to contact relatives. I could see that thought had been invested into how to assist people to develop daily routines. For example, there were set times for when individuals were given the opportunity to prepare their own meals. This was recorded in care plans. Similarly, on one individual’s care plan there were details about the actions staff were to take to manage the side effects of medication. The aim was to minimise the impact on the individual’s lifestyle. I also noted that there was similar input including an emphasis on healthy eating and the encouragement of individuals to take exercise. I looked at the records of food provided and was also shown a 31 day menu which was in use. The menu provided lots of variety of meals provided and was balanced by the fact that individuals prepared their own meals on a regular basis. The menus shown to me were traditional in nature but I could see from the records of meetings with the people using the service that they had been changed after feedback from them. In addition, there is scope for individual diversity including religion. For example, separate food storage arrangements are in place for one person. Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 14 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 People who use this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. A thorough approach has been taken to personal care and health care provision. This has resulting in positive relations with health care professionals and good attention to detail in making sure that people have access and receive relevant health care. A proactive approach has been taken with people benefiting accordingly. EVIDENCE: I saw that care plans provided a range of aims and goals about each aspect of people’s lives, including the provision of personal care. The individual aims were described in great detail in the plans. They were later reviewed so as to assess progress. Individual people were given the opportunity for input and a say in how the care was provided. The people to whom I spoke were complimentary about the staff. They told me that they liked them and found them helpful. The keyworking system helps as each person has a member of staff to whom they can talk to and ask fro assistance as needed. I could see that there were good relations with health care professionals. I was shown positive letters and responses about the service from a number of health and other professionals. Typically, people at the service have a psychiatrist as well as a care co-ordinator involved in their care and I saw Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 15 records of the input from these professionals on individual files. In addition, I saw extensive records of the input of other health care professionals such as audiologists and chiropodists. Each file had records of the input, where relevant of these type of professionals. There were also records of preventative health care including GP appointments and work undertaken by the deputy manager to secure NHS dental treatment for people. The overall impression was of good attention to detail in obtaining health care for people as well as the keeping of detailed records. Good record keeping was evident in all aspects of the running of this service. I inspected the medication arrangements including the records of administration and storage. The administration records were neat and ordered with no gaps. There was a clear audit trail from receipt into the home to administration and return to pharmacy, if required. Back copies of medication administration records (MAR) were retained on individual files. Daily temperature records were kept of the storage cabinet and the cabinet itself was clean, neat and tidy. The system used is a blister pack system with each medicine kept in a date order blister pack. I was shown a review form that had been completed when the supplying pharmacy visited to check the storage arrangements. No recommendations had been made. One controlled drug was in use. I obtained relevant advice form the CSCI Pharmacy inspector about the storage and recording needed for this type of medicine. I then provided this advice to the deputy manager. No change to the storage or recording was required. Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 16 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 this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The complaints system allows people using the service to raise maters of concern easily. It also makes sure that all complaints are thoroughly investigated. The Safeguarding Adults arrangements are suitable with training available for staff as well as the space required to discuss arising matters. EVIDENCE: I was shown the complaints records. These contained records of seven complaints that had been made since the last inspection of 3 October 2006. The records were detailed and outlined the complaint, the investigation and the outcome. It was clear that the registered manager took all complaints seriously and there was evidence that all the complaints had been investigated thoroughly. The practice at this service is to have available a book for people using the service where they can record complaints. This may have lead to a larger number of complaints than other similar settings. Also, many of the complaints were not substantiated. However, such a practice also means that people have another outlet or opportunity to have a say in the running of the service and therefore it can be seen as an example of good practice. I was shown the home’s Safeguarding Adults policy and procedure. This is a relatively brief document but it sets out the main points and provides staff with instructions as to the action to take following allegations or incidents of abuse. Reference is made to the local authority taking the lead role. I was also shown the training brief for staff training on Safeguarding Adults. This was a detailed piece of work with lots of information provided as well as Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 17 space for staff to discuss arising maters. I was told that the approach taken for training was for the managers within the organisation to go on Safeguarding Adults training and then to return to the individual homes and to train staff there. Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 18 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 26 27 28 29 & 30 People who use this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people using the service are provided with a large, attractive and well maintained home with lots of comfortable communal space. People like the facilities and relatives and others feel that the size adds to people’s quality of life. Bedrooms are nicely decorated and include furnishings chosen by the people living there. EVIDENCE: Very comfortable and attractive facilities are provided. The care home is in a large semi-detached house which has been kept in good condition. The home opened in the spring of 2006 after a refit so as to provide a building suitable for use as a care home. The building retains some attractive features such as large rooms, an elegant lounge and kitchen /dining room and large windows. There is a large garden to the rear. When I arrived staff were cleaning the home and it was clear that cleanliness and keeping the home well maintained was part of the day-to-day activity at the service. A visiting relative as well as a visiting social worker and staff mentioned the physical standards as a positive feature. The people using the service also Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 19 mentioned the size of the home and the comfortableness of it as a positive feature. I spent some time in the lounge speaking with people using the service and it was indeed pleasant to spent time there. I was given a tour of the building by the manager and deputy manager. I was able to see a number of the bedrooms including some which are not currently in use. These were all well arranged, homely and comfortable furnished. I was told that the staff had taken the people using the service to a large local furniture store in order to choose furnishings and décor for their bedrooms. The furnishings were attractive. This is a good example of participation for the people using the service. There are ten bedrooms in total although the service is only registered currently for five people. The manager told me that planning permission has been applied for to raise the number of people who can live at the home. Should that be successful then the plan is to apply to CSCI for registration for a larger number of people. Planning permission was originally refused but the process is ongoing. The lounge is large and comfortable and provides a relaxing place for people to rest and socialise. There is a large kitchen /dining room which also provides a large space for people to spend time and eat meals. There is a heated conservatory which provides additional communal space for people. None of the current people living at the service have physical disabilities and there are no specific adaptations for people such as a shaft lift or mobile hoists. Laundry facilities are contained within a garden outhouse. Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 20 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): 31 32 33 34 35 & 36 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People using the service benefit from the careful consideration that has been given to all aspects of staffing. This consideration has resulted in thorough recruitment, a comprehensive induction for new staff and support for staff to obtain NVQ and other care qualifications. EVIDENCE: The staffing arrangements were discussed with the manager and deputy manager. I also held discussions with staff and inspected the home’s recruitment, training and supervision records. I was shown the staff rota. During the day there are two staff on duty in addition to the manager. In the evening one member of staff is on duty and a sleep in service is provided at night. I was told that this can be changed should the needs of people using the service increase. The current arrangements are adequate. There have been very few notifiable incidents which might indicate a need for a higher number of staff on duty. The practice is for staff to be assigned to one specific Roland care home but they may also complete shifts in one of the other homes. There are four home sin total in the group. Therefore, on the day of the inspection, one of the staff members on duty told me that she spent most of her working week at a Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 21 different care home. The advantage of this is that staff can have experience of all the care homes and therefore act as an experienced person if needed at short notice to cover shifts in a different home. I was shown details of an induction that is carried out at each care home to provide staff with specific information about each home. The manager told me that the roles of staff were carefully assessed and monitored. For example, induction for new staff may be extended if needed. Another example was the management of this service. The plan was for the deputy manager to apply to CSCI for registration as the manager. This would allow the current manager to fully concentrate on overall management of the four care homes in the group. The manager wanted to be sure that the time was right for such an application and had carefully monitored it. The plan is to apply for registration early in 2008. I inspected a sample of four staff files. I could see from my inspection that staff had been recruited thoroughly. The files were neatly kept and provided evidence that CRB checks had been carried out, that identification had been obtained and that there were two references on file. Each file also contained copies of regular supervision sessions as well as copies of training certificates. Many of the staff have NVQ qualifications and I was told that newer staff were to start NVQs in early 2008. I was also told that managers within the group were being supported to undertake more advanced qualifications. Training records were kept individually but also via the regular health and safety monitoring records. These records assessed the service for completion of staff training in areas such as fire safety, first aid and health and safety. I could see that the emphasis on training was to concentrate on induction, mandatory training such as first aid and food hygiene and then qualifications such as NVQs. Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 22 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 38 39 40 41 42 &43 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Current management arrangements are strong with effective leadership shown by the registered manager. The forthcoming change of manager has been carefully planned with safeguards built in. Effective tools such as the quality assurance initiatives as well as a thorough approach to maintenance and health and safety result in a well run and safe service for people. EVIDENCE: There is soon to be a change of the registered manager. As discussed above, the current registered manager, who also owns the business with her husband, plans to step down as the registered manager of this service in order to be freed to concentrate on the overall management of the Roland group of care homes. I was advised that the plan is for the current deputy of the service to apply to CSCI for registration as the manager in early 2008. The deputy Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 23 manager has been trained and supervised since the home opened in the spring of 2006. Such a change will have an impact on the service. However, the current manager will still retain overall management responsibility for the group as a whole and will be carrying out regular visits so any potential adverse impact will be limited. In addition, the deputy has served a lengthy period of induction and knows the service and the people using it well. There will also be support from other managers in the group. The ethos and philosophy of care is clear. The registered manager spoke about the approach taken. It was clear from the records kept and the positive feedback received from people using the service and others that the ethos followed is to provide quality care for people that encourages them to develop and lead a good quality of life. I was shown quality assurance questionnaires which had been recently returned to the service. This is part of a regular quality assurance exercise. There were also a number of letters from health care professionals and others as described earlier in the report. Also included in the quality assurance initiatives followed are the three monthly health and safety monitoring visits. These cover a wide range of matters including health and safety matters as well as training and are usually carried out by other managers within the group. I was shown records of the servicing and maintenance of the home’s installations and equipment. These included fire safety checks. These were all up to date and well ordered and again provided evidence of a thorough approach having been taken to record keeping. Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 24 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 3 4 X 5 3 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 4 25 4 26 3 27 3 28 4 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 3 3 3 3 3 3 3 Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 25 No 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. 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. Refer to Standard Good Practice Recommendations Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 Roland Residential Care Homes Ltd DS0000067023.V354784.R01.S.doc Version 5.2 Page 27 - 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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