Care Home: Rose House

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What the care home does well The home is well managed and has a welcoming atmosphere. The service is small and flexible and is run in the best interest of the service users, who are involved with the daily running of the home. Equality & Diversity issues are given a high priority within the home and staff recruitment procedures are robust. Care plan and risk assessments are comprehensive and informative. Service users’ health needs are given a high priority. Rose House DS0000027891.V375499.R01.S.doc Version 5.2 The service does not employ any domestic staff and care staff have responsibility for the cleaning. All areas of the house were clean, tidy and free from any odours throughout. One service user commented, “I like living here, the people are very nice”. What has improved since the last inspection? There has been an improvement in the daily records, which now correlate with the individual’s care plan. All parts of the home are in a good state of repair with redecoration and refurbishment having taken place in most areas of the home. Staff are now not working excessive hours which s to the benefit of the service users. What the care home could do better: The proprietor/manager needs to ensure that all complaints are recorded in the complaints log. It would be good practice for all or part of the service user’s care plan and the menus to be produced in a pictorial format Key inspection report CARE HOME ADULTS 18-65 Rose House 63 Wigton Road Harold Hill Romford Essex RM3 9HB Lead Inspector Julie Legg Unannounced Inspection 20 -21st July 2009 01:00 th Rose House DS0000027891.V375499.R01.S.doc Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Rose House DS0000027891.V375499.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Rose House DS0000027891.V375499.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rose House Address 63 Wigton Road Harold Hill Romford Essex RM3 9HB 01708 349212 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) rosehouseinfo@aol.com Mrs Michelle Paddit Macadangdang Care Home 4 Category(ies) of Learning disability (4), Mental disorder, registration, with number excluding learning disability or dementia (1) of places Rose House DS0000027891.V375499.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD Mental Disorder, excluding Learning Disability or Dementia - Code MD (maximum number of places: 1) The maximum number of service users who can be accommodated is: 4 23rd July 2007 2. Date of last inspection Brief Description of the Service: Rose House is a private owned care home, which is registered for four people with learning disabilities and mental disorder. The home is situated in a residential area of Harold Hill and is undistinguishable from other houses in the road. On the ground floor there is a kitchen/diner, a separate lounge, a toilet and utility room and a conservatory, which the manager uses as her office. Upstairs on the first floor there are three bedrooms and a bathroom/toilet that also has a walk-in shower. The home has recently had a loft conversion and there is now a fourth bedroom with an en-suite toilet and shower. The home is close to the local shops and a leisure centre and Romford shopping centre and the cinema are a short bus ride. The home is run as a family type home, which aims to promote independence and choice and to assist service users with developing daily living skills. All four service users attend day services, clubs and other leisure activities within the community. The Statement of Purpose is available to all service users and relatives. All of the service users have been given a Service User Guide. Rose House DS0000027891.V375499.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key unannounced inspection took place over one day. The inspection was undertaken by Julie Legg the lead inspector. Discussions took place with the senior support worker (the proprietor/manager is currently on maternity leave) and another member of staff. The senior support worker was available throughout the inspection and was given feedback at the end of the visit. The inspection process also included information contained in the Annual Quality Assurance Assessment (AQAA) and other records held at the home. A tour of the home was undertaken during which all parts of the home including service users’ bedrooms. We were able to talk to one of the service users and observe the well-being of another. A health professional and a social care professional were also contacted for their views on Rose House. We case tracked two of the service users. We contacted a health and social care professional but neither responded before the completion of the inspection report. We have previously been advised by the manager that the people living at the home are referred to as ‘service users’. This is reflected accordingly throughout this report. We would like to thank the staff and service users for their input during this inspection. What the service does well: The home is well managed and has a welcoming atmosphere. The service is small and flexible and is run in the best interest of the service users, who are involved with the daily running of the home. Equality & Diversity issues are given a high priority within the home and staff recruitment procedures are robust. Care plan and risk assessments are comprehensive and informative. Service users’ health needs are given a high priority. Rose House DS0000027891.V375499.R01.S.doc Version 5.2 Page 6 The service does not employ any domestic staff and care staff have responsibility for the cleaning. All areas of the house were clean, tidy and free from any odours throughout. One service user commented, “I like living here, the people are very nice”. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Rose House DS0000027891.V375499.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 Rose House DS0000027891.V375499.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 3 People using 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. Prospective service users and their families have the information they need to enable them to make an informed decision as to whether the home is right for them and they can be confident that the service is able to meet their assessed needs. EVIDENCE: The Statement of Purpose and the Service User Guide are informative and assist prospective service users to know what the home is like and what services they can offer. It clearly sets out the objectives and philosophy of the service. All of the service users have received a copy of the Service User Guide. Most of the current service users have lived at the home for some considerable time however there has been an admission since the last inspection. It is the procedure of the home to ensure that any new service users are appropriately assessed prior to admission. The funding authority and health professionals provide assessments as well as the home carrying out their own assessment. Further information is gathered from the prospective service user and their families if appropriate. Rose House DS0000027891.V375499.R01.S.doc Version 5.2 Page 9 The admission process is designed around the needs of the prospective service user. They are encouraged to make several visits to the home and possibly an overnight stay (if appropriate) this is to ensure that they like the home and to meet the other service users. This transition period also allows staff to get to know the prospective service user and to know whether they can meet their needs. Rose House DS0000027891.V375499.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 People using 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. Service users’ health, personal and social care needs are set out in individual care plans and risk assessments which ensure their needs are appropriately met. Service users are supported to make decisions about their lives and to maximise their independence. EVIDENCE: Individual files were available for each of the service users. Files contained up to date care plans and risk assessments. The care plans that were seen were person centred and looks at all areas of the service user’s life. They include reference to equality and diversity and address any needs identified in a person centred way. The care plans cover areas including: personal care, communication difficulties, home care skills, communication difficulties, health, religious and dietary needs. The service has a key worker system which allows Rose House DS0000027891.V375499.R01.S.doc Version 5.2 Page 11 staff to work on a one-to-one basis and contribute to the service user’s care plan. The care plans are written in plain language and easy for staff to understand which ensures continuity of care. However it would be beneficial to the service users if all or part of the care plan could be provided in a pictorial format. This is Recommendation 1 There was evidence that care plans are being reviewed/ evaluated and updated to reflect service users’ changing needs. Each service user has their own progress note book and these were examined alongside the care plans. The progress notes reflect the day to day activities of the service users and their involvement in the life of the home. They are involved in menu planning, shopping trips and general household tasks i.e. making a cup of tea, keeping their bedrooms tidy, washing up and setting the table. Service users are also consulted on activities within the home and in the community; all of the service users attend either day services or various classes and clubs within the community as well as leisure activities and church services. Risk assessments were in place for each of the service users and there was evidence that these are being regularly reviewed and updated. They evidenced that service users are being supported to experience ordinary living within a safe environment. The risk assessments identified risks for service users and detailed actions to keep any such identified risks to a minimum. Where there are limitations the decisions have been taken with the agreement of the person or their representative and are accurately recorded. There is a focus on maintaining and promoting independence whenever possible and staff were observed providing service users with support, assistance and information but were respectful of the individual’s right to make decisions. Rose House DS0000027891.V375499.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): This is what people staying in this care home experience: 11,12,13,14,15,16 and 17 People using 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. Service users are actively encouraged and supported to participate in appropriate relationships and social and leisure activities within the community. Service users’ rights are respected and they are supported to take responsibility for their actions. EVIDENCE: Each service user has a planned activity programme, which takes into account their individual preferences, experiences, age and capabilities (related to their disability. Service users are individually and collectively involved in determining the type of activities they wish to participate in. Service users’ meetings are regularly held and from viewing the minutes it was apparent that activities and other house matters are discussed. There is a wide range of leisure/social activities for service users to engage in the community. Some of Rose House DS0000027891.V375499.R01.S.doc Version 5.2 Page 13 the service users attend specialist day services and others attend sensory art, line dancing, music & movement and arts & craft. All of the services users are supported to participate in leisure activities i.e. clubs, swimming, cinema, shopping and some of the service users are supported to attend their chosen place of worship. The religion of the service users is documented in their care plans; two of the service users do not practice their faith and did not do so prior to living at Rose House. This is clearly documented as having been explored with the families and the funding authorities. All of the service users are going to Wales for their annual holiday and two of the service users are going on a ‘spa’ break. These activities are accessed in a variety of ways; some of the service users access public transport (independently), others use local authority transport and taxis. All of the service users are encouraged and supported to have contact with their families and friends. One of the service users is able to visit her family independently and other service users are supported to visit their families and to keep in telephone contact. One of the service users has a friend who visits her at Rose House. There are no set ‘house’ rules and service users were observed to go about the home freely. During the inspection two of the service users were at the cinema and the other two service users were watching the television and assisting with making a cup of tea. Service users are given the option as to whether they hold the key to their bedroom door. Some of the service users exercise this choice and keep their bedroom locked when unattended. Staff have the overall responsibility for the cleaning of the home, however some of the service users are able to participate at varying levels, to keeping their bedrooms tidy, assisting with their laundry, laying the table for meals and making cups of tea. The home does not employ a cook and care staff shop, prepare and cook all of the meals. These tasks are carried out with the involvement of the service users again at varying levels. On the day of the inspection there were more than adequate quantities of food available, including fresh fruit/vegetables, meat and fish. Drinks and snacks are also available during the day. One of the service users assist with the monthly/weekly shopping. However one of the service users commented on the frequency of rice on the menu (this is an issue that had been previously raised by the service user) and on looking at the menu, rice was frequently being offered i.e. fried fish, steamed vegetables and rice. The service user said that she would prefer chips with fried fish rather than rice. We fed this back to the person in charge, who will discuss this with the proprietor/manager. Consideration should be given to allowing service users to have more involvement and influence in the menu planning and take into account individual likes/dislikes. It would be good practice if the menus were also produced in a pictorial format. This is Recommendation 2 Rose House DS0000027891.V375499.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 People using 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. Service users receive personal support in the way they prefer and their physical and emotional needs are met. There are clear medication policies and procedures for staff to follow, so as to ensure that services are safeguarded with regard to their medication. EVIDENCE: Care plans and service users’ progress notes were examined and discussed with the person in charge. The care plans clearly identify health and personal care needs and how these needs should be met. The service users require encouragement and prompting and some require assistance with their personal care. Some service users prefer to bath and others prefer to shower. Service Rose House DS0000027891.V375499.R01.S.doc Version 5.2 Page 15 users were seen to be dressed in clothes that were appropriate for the time of year and which suited their personalities. Service users that were spoken to confirmed that they were happy with the support they received. Service users have a choice in relation to same gender care preferences when receiving personal care and their care plans set out how their personal support is to be provided. All of the care plans that were examined clearly recorded referrals to specialist heath care professionals: psychologist, psychiatry, speech & language therapist as well as the community learning disability team. Regular appointments to the optician, dentist, chiropodist, diabetic nurse, well women clinic, and GP appointments are also attended. Staff are very observant and alert to changes in individuals’ behaviour and mood and they understand how they should respond and the action required. Care plans detail specific behavioural interventions, particularly in relation to behaviour that challenges. There are policies and procedures for the administration, recording and storage of medication. Staff have received medication training and there is a list of staff (with signatures) that are competent in the administration of medication. Medication Administration records (MAR) charts and the medication cupboard were checked during the inspection and found to be correct. Two of the service users’ medication was audited and the amount given and the amount remaining reconciled with the MAR charts. The Community Pharmacist also undertakes medication checks. Rose House DS0000027891.V375499.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People using 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 manager and staff make every effort to ensure that service users’ views are listened to and acted upon. There are the necessary policies and procedures in place and staff have received the appropriate training to ensure the safety of the service users. EVIDENCE: The home has a written complaints policy and procedure which is also produced in pictorial format that is more easily accessible to this service user group. A copy of the procedure has been made available to all of the service users. Service user that was spoken to was aware of the complaints procedure and informed us that she had made a complaint. She had been satisfied with the way her complaint had been dealt with and the outcome. Staff that were spoken to were aware of the complaints procedure and how to deal with any complaints or concerns that were made to them. The complaints log was looked at and this indicated that complaints and concerns were mostly being logged and details of the investigation and actions taken were evidenced. However the complaint that the service user told us about was not logged in the complaints book but there was evidence in the daily logs, the dairy and the minutes of the service users’ meeting that this matter had been dealt with. The manager must ensure that all complaints and concerns are recorded in the complaints log. This is Requirement 1 Rose House DS0000027891.V375499.R01.S.doc Version 5.2 Page 17 The Care Quality Commission has not received any complaints or safeguarding referrals since the last inspection. The service has Safeguarding Adults policies and procedures; these include the local authority (London Borough of Havering) policy and procedure. The staff that were spoken to were informed on recognising abuse and what actions they needed to take. Staff files indicated that most of the staff have attended Safeguarding Adults training and newly appointed staff will be undertaking this training in the next couple of months. This subject is also covered in new staffs’ induction programme and when undertaking formal qualification i.e. NVQ 2/3. There are policies and procedures for dealing with violence and aggression as well as physical intervention and restraint. Training around these areas have taken place and there was evidence that some of the staff have attended training in the Mental Capacity Act and the Deprivation of Liberty. The proprietor/manager needs to ensure that all members of staff attend training in these important areas. Rose House DS0000027891.V375499.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27 and 30 People using 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. Service users live in a homely and comfortable environment. Some improvements have been made since the last inspection so that the living environment is more appropriate for the particular lifestyle and needs of the people living there. EVIDENCE: The home is in keeping with other properties in the road. A tour of the home was undertaken and this included the service users’ bedrooms. The home is furnished in a homely fashion and was clean. Tidy and free from any offensive odours. On the ground floor there is a kitchen/diner, a separate lounge, a cloakroom, utility room and a conservatory that is used as the manager’s office and sleeping-in room for staff. On the first floor there are three bedrooms and Rose House DS0000027891.V375499.R01.S.doc Version 5.2 Page 19 a bathroom which has a bath and a walk-in shower. The loft has undergone a conversion and offers a bedroom and en-suite shower and toilet. The kitchen/diner has had a new floor laid and the lounge now has curtains at the window as well as some ornaments; this has given the lounge a more homely feel. The frayed stair carpet has been replaced as has the window on the top of the stair landing. The garden is looking tidier and there was ample garden furniture; this is now a pleasant area for service users to use. The four bedrooms are of a good size; three of the bedrooms were appropriately furnished and decorated and were personalised with pictures, family photographs, ornaments, televisions and cuddly toys. The remaining bedroom is furnished and decorated in a way that meets the behaviours of that service user. All of the bedrooms have been refurbished with new curtains and bed linen. Rose House DS0000027891.V375499.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34 and 35 People who use this service receive good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels are satisfactory and service users are supported by qualified staff that have the skills to meet their individual needs. Staff recruitment procedures are robust and this provides safeguards for service users. EVIDENCE: Staff rotas were inspected and they correlated with the staff on duty. There were sufficient staff on duty to meet the needs of the service users. There are at least two staff on duty however staffing levels increase when supporting services users to access day services and other leisure facilities. There is one member of staff sleeping in at night. There is good staff retention within the home and permanent members of staff cover any absences; this ensures continuity of care to the service users. Staff spoke about ‘working well as a team and they cover the rota between them’. Rose House DS0000027891.V375499.R01.S.doc Version 5.2 Page 21 The home has clear recruitment policies and procedures that have recently been reviewed and updated. Four of the staff files were looked at and showed that appropriate recruitment procedures had taken place; a completed application form, two written references, copies of qualifications, proof of identity and permission to work. Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks had been undertaken. Staff confirmed that they had a face-to-face interview and that references and checks had been carried out prior to them commencing at the home. One of the service users participated in the most recent recruitment interviews. She told the inspector that she really enjoyed taking part and was able to tell the applicant about the home. All members of staff have a training profile where training that has been undertaken is recorded and future training needs are identified. All staff undertake an induction programme and during the past twelve months staff have attended training in the following areas: fire awareness, food & hygiene, medication in the care home, mental health awareness, principles of care, deprivation of liberty and safeguard awareness, diabetes awareness, infection control, Mental Capacity Act, positive restraint techniques and learning disability. All of the staff are qualified to National Vocational Qualification (NVQ) 2or above; some of the staff are completing NVQ 3 and three of the staff are undertaking the NVQ 4. Rose House DS0000027891.V375499.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 People using 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 is well managed and service users’ health, safety and welfare are promoted and protected. Service users can be confident that their views underpin the review and development of the service. EVIDENCE: The registered proprietor/manager has extensive knowledge and experience of working with people with learning disabilities and associated mental health needs. The manager has good people skills and understands the importance of person centred care and effective outcomes for people who use the service. Rose House DS0000027891.V375499.R01.S.doc Version 5.2 Page 23 The home is able to show that the service does provide ‘value for money’ as the cost of care is comparable with similar homes and there is good staff retention which gives continuity of care. This is a small home; the needs of the service users are well known to the manager and staff who are able to provide a flexible and person centred service. The manager and staff work continuously to improve the service; there is a strong focus on equality and diversity issues and promotes human rights, particularly in the areas of dignity, respect and fairness. There is also a focus on person centred thinking, with service users shaping service delivery. The manager and staff liaise closely with relatives and other professionals. Service users’ meetings take place and all are encouraged to have an input into these meetings. Minutes are kept and it was recorded when one of the service users complained about the content of a meal. The proprietor/manager is currently undertaking a review of the service where information will be gathered from service users, relatives and health and social care professionals. From this an annual development plan will be completed reflecting the comments and views of the surveys. The standards that relate to health & safety were also well managed and information was readily available. Fridge and freezer temperatures are taken and recorded daily and food was appropriately stored in the refrigerator and freezer. The Annual Quality Assurance Assessment showed that maintenance of all equipment is up to date and all have been checked within the past year. There was written evidence that fire drills are regularly taking place and this was also confirmed by a service user. There were also risk assessments that had taken into account the routines of the home. Rose House DS0000027891.V375499.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 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X 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 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Version 5.2 Page 25 Rose House DS0000027891.V375499.R01.S.doc 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. 1. Standard YA22 Regulation 22 Requirement The registered person must ensure that all complaints are recorded in the complaint log. Timescale for action 30/09/09 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 YA6 YA17 Good Practice Recommendations It would be good practice for all or part of the care plan to be could be produced in a pictorial format. It would be good practice for the menu to be produced in a pictorial format. Rose House DS0000027891.V375499.R01.S.doc Version 5.2 Page 26 Care Quality Commission London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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