Care Home: Roseate House Residential Care Home

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What the care home does well The home obtains good information about people`s needs before they are admitted to the home. The care plans provide staff with clear guidelines on how each person`s care and support should be delivered. The staff make every effort to ensure people are involved in making choices and decisions about their lives. The staff work hard to provide a comfortable and pleasant place for people to live. They encourage people to make decisions about how they would like to spend their time and offer them new experiences. The people living in the home are supported to go on holiday and they are encouraged to access facilities in the local community. People are supported to keep in touch with family and friends and visitors are always welcome in the home. The staff are well trained to meet people`s needs and to protect them from harm. There are good systems in place to ensure people are listened to, including relatives and staff. This helps ensure a good service is offered and is in the best interests of the people living at Roseate House. What has improved since the last inspection? A specialist bath has been provided to meet the needs of some of the people living in the home. Bedrooms have been redecorated according to each person`s taste. What the care home could do better: The registered provider should ensure monthly visits are made to ensure standards are being met and recommend any improvements which may be necessary. The menus should record all choices that are available. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Roseate House Residential Care Home Marden Crescent Cullercoats Tyne And Wear NE26 2EE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Anne Brown     Date: 0 9 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Roseate House Residential Care Home Marden Crescent Cullercoats Tyne And Wear NE26 2EE 01912518194 01912518194 susan.keeney@nhs.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Northumberland, Tyne & Wear NHS Trust care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 6 The number of persons for whom residential accommodation with board and care is provided at any one time shall not exceed 6 men or women Date of last inspection Brief description of the care home Roseate House is a purpose built bungalow providing residential care for six people with severe learning disabilities. The home does not provide nursing care. The accommodation consists of six single bedrooms, two lounges and a dining room. The home has a variety of aids and adaptations to meet the individual needs of the service users who have physical disabilities. There is a large bathroom with an assisted bath and a separate large shower and w.c. There is a large garden to the rear of the premises and ample car parking facilities. The home is situated in Cullercoats and is close to local shops, pubs and metro stations. Whitley Bay and the sea front are nearby. The fees are £1108.41p per week. Information about the home and inspection reports are readily available. Care Homes for Adults (18-65 years) Page 4 of 28 Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. How the inspection was carried out Care Homes for Adults (18-65 years) Page 6 of 28 Before the visit we looked at:Information we have received since the last key inspection on 11th July 2007. How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service, staff and other professionals. The visit: An unannounced visit was made on 9th June 2009. During the visit we: Talked with people who use the service, staff and the manager. Looked at information about the people who use the service and how well their needs are met. Looked at other records that must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last inspection. We sent surveys to the home to issue to people who live in the home, members of staff and health professionals. We told the manager what we found. What the care home does well: 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 set out 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. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good information about the home is available and thorough assessments are carried out to help ensure individual needs can be met. Evidence: The Statement of Purpose and the Service Users Guide both contain the full range of information required. This helps people decide if the home is able to meet their needs. These documents are available in various formats, for example easy read, braille, audio and large print. The home carries out a thorough pre-admission assessment. This includes obtaining the Care Management Assessment and, where applicable, information is sought from carers, relatives and relevant health care professionals. Copies are available on the individual case files so staff can refer to these to help ensure individual needs are met. No new admissions have taken place since the last inspection but there was evidence on the case files to show that individual needs are re-assessed on a regular basis Care Homes for Adults (18-65 years) Page 10 of 28 Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is good information available to the staff to help them deliver care according to individual preferences and people are encouraged to make decisions on all aspects of their lives. Evidence: The care plans give clear guidelines to staff about how care and support should be delivered. People are encouraged to be involved in their care plan as much as possible so they can be supported accordingly to their own preference. The care plans are evaluated by the staff on a monthly basis and reviewed every six months. All interested parties are invited to attend the review. The staff support people to take calculated risks to enhance their lifestyles. Risk assessments are in place and these are reviewed on a regular basis. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: Detailed guidelines which have been completed by relevant professionals, are in place to help staff meet the individual needs of the people living in the home. The staff encourage people to make decisions and provide them information so they can make an informed choice, e.g. how to spend their time, where to go on holiday, menus etc. Meetings are held on a regular basis to discuss all aspects of life in the home and peoples views are taken into consideration as far as possible. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this 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 people living in the home are encouraged to mix with people in the local community and are well supported to participate in activities of their choice. Evidence: Each person living in the home chooses how they spend their time and what activities they wish to participate in. This information is recorded in the daily reports. People attend courses at a local college. On the day of the inspection one person returned from a cookery course where he had made soup which he enjoyed for his lunch. An enabler is on duty during the week to support the staff to escort people to various activities and venues of their choice. The people living in the home enjoy going out for lunch, shopping and visiting local Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: places of interest. One person had recently been to a circus and staff are now planning a day out on a train for another person. People have enjoyed holidays to Haggerston Castle, Blackpool and Keswick. The staff support people to visit and keep in touch with their relatives. Visitors are made welcome in the home at any time. One person was looking forward to her father visiting later in the week. Advocates have been sought for two people who do not receive visitors. Routines were relaxed and the staff on duty were interacting with the people living in the home and were respecting their privacy and dignity. People are encouraged to become involved in household tasks according to their capabilities. The staff confirmed that menus are discussed regularly with the people in the home and their favourite meals are included. People are asked to choose a meal from the picture menu book if they do not want the meal displayed on the menu. Fresh fruit and vegetables are served in the home and drinks and snacks are provided whenever people wanted them. Special diets are catered for and advice is sought from a dietician whenever necessary. The menu stated that juice must be served at mealtimes and tea should be served after the meal. The choice of drinks available at suppertime are not displayed on the menu. The manager confirmed that a choice of drinks is available at all times. The people living in the home are also given opportunities to eat out at local pubs and cafes. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this 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 living in the home are given personal support when they need it and staff monitor and promote their health to maintain their well-being. Evidence: Each person living in the home have individual health care plans. The manager and staff evaluate these on a monthly basis. The health and welfare of people living in the home is constantly monitored by the staff. If there are any concerns about someones health appropriate action is taken. A GP visited during the inspection to visit someone who had a suspected chest infection. Details of health checks, hospital appointments, visits to GP, dentist, optician etc. are recorded on the individual case files. There are clear guidelines to inform the staff how each persons care and personal support should be delivered. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: The manager confirmed that the staff have been provided with specialist training to meet the individual needs of the people living in the home. The medication records were up to date and appropriately signed. An audit of the medication system is carried out in the home every month. The manager confirmed that the pharmacist carries out a quarterly audit. Competency assessments are carried out for all staff annually. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are properly dealt with and training in adult protection has been provided for the staff, which helps to protect people from abuse. Evidence: The home has an appropriate procedure for dealing with complaints. A complaints book is maintained to record any complaints and the outcome of the investigation. No complaints have been received since the last inspection. The complaints procedure is available in various formats, e.g. easy read, audio, large print. The home has a Tell Us policy which supports people living in the home to make a complaint if necessary. There is a whistle blowing procedure and the staff were confident to use this if they observed any bad practice. All staff have received training on safeguarding vulnerable adults and the various forms of abuse. The people living in the home are unable to manage their own finances so their Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: personal allowances are held by the home. All transactions are fully recorded. Receipts are kept for any purchases made and two staff signatures are recorded. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this 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 clean and comfortable and provides people with a pleasant place to live. Bedrooms reflect the individual tastes of the people who live there. Evidence: The home is comfortable and pleasantly decorated and provides people with a nice environment to live in. Each person has their own bedroom which is decorated to their taste. The rooms are personalised and reflects the interests and hobbies of each individual. All bedrooms have been redecorated since the last inspection. The communal areas are clean and comfortable and provide sufficient space for people to enjoy. The gardens are secure and well maintained. There are sufficient bathrooms and showers throughout the premises. A specialist bath has recently been purchased to meet the needs of some people living in the home. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: The staff receive infection control training as part of the mandatory training programme. Protective clothing is ready available and liquid soap and paper towels are provided to prevent the spread of infection. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient staff employed in the home who are well trained to meet the individual needs of the people who live there. Evidence: The staffing rotas showed there were sufficient staff on duty to meet the needs of the people living in the home. The manager confirmed that during the week four home support workers were on duty as well as an enabler. At weekends four home support workers are on duty. There are training programmes in place to ensure staff receive mandatory health and safety training and specialist training to meet individual needs. The manager confirmed that training has been booked for some staff on conflict resolution, break away techniques, medications and safehandling. She is also in the process of booking training for all staff on epilepsy and the Mental Health Act. All staff have achieved a National Vocational Qualification (NVQ) Level 2 and four staff are in the processing of completing Level 4. The manager confirmed that criminal record bureau checks and two written references Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: are obtained before people are employed in the home. This helps to protect the people living in the home. Supervision sessions are carried out with all staff at appropriate intervals and the notes are recorded. The staff felt they were well supported and trained. The staff on duty were well aware of the individual needs of the people they were caring for and good relationships were evident. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this 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 culture and systems in the home help to ensure that the service is led by the needs and wishes of the people living there, and protects them from harm. Evidence: The manager has experience in working with adults with learning disabilities and will be applying to become registered with the Commission. The staff on duty confirmed that regular meetings are held to discuss any issues that arise and to ensure the home is run in the best interests of the people living there. Minutes of the meetings were available for inspection. There are comprehensive policies and procedures in place to safeguard the rights and best interests of the people living in the home. The routines in the home are flexible and revolve around the needs of the individuals living there. Staff felt they were able to spend more one to one time with people and Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: meet their individual needs and help them access preferred activities. There is a quality assurance system and the manager seeks the views of relatives and other interested parties. She also confirmed that staff at head office carry out regular audits within the home to ensure standards are met. These visits had not been carried out on a monthly basis since the last inspection, to help ensure that the people who live there get the care they need and their health, safety and welfare is promoted. The records showed that fire drills are carried out and fire equipment is checked on a regular basis. The staff receive regular health and safety training. The staff on duty confirmed that they receive health and safety training to help protect the safety of themselves and the people living in the home. No unsafe practices were noted during the inspection. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 39 26 The registered provider must ensure monthly visits are made to monitor standards and produce a written report. This will help ensure standards continue to be met and peoples opinions are taken into consideratiom. 31/08/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 17 Menus should display the full range of drinks which are available in the home. This will help ensure people are fully aware of their choices. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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