Care Home: Rosecroft Care Ltd

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What the care home does well Residents are encouraged and supported to make choices about their daily routines and what they want to do with their lives. They are helped to develop their daily living skills and social skills, so that they can live their lives as independently as they can, knowing that staff are there to offer encouragement and support when they need it. They have the opportunity to have time with their key worker. That is a staff member that they have been linked to that they can rely on to provide support. This helps to make sure that they can talk about their worries. Staff are good listeners and make sure that any thing raised is acted upon. Service users are supported to go out into the community and pursue chosen leisure activities. Staff make sure that residents receive good healthcare. The home is well managed with residents best interests at the heart of whatever they do. What has improved since the last inspection? At our last inspection we saw that the home had established excellent standards and there were no areas identified for improvement. They have developed facilities for service users, such as the increasingly productive vegetable garden. We were informed that the home`s vehicle has been replaced with a mini bus with integral hoist for a wheelchair, thus increasing opportunity and flexibility for outings. What the care home could do better: It is the providers stated intention to continue to consolidate and improve the service provided by Rosecroft Ltd. We found from discussion and records that a programme of self assessment, review and development is well established. Key inspection report Care homes for adults (18-65 years) Name: Address: Rosecroft Care Ltd 71 Meehan Road Greatstone New Romney Kent TN28 8NZ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Geoffrey Senior     Date: 3 0 1 0 2 0 0 9 This is a review of 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. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 25 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 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 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. 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 Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: Rosecroft Care Ltd 71 Meehan Road Greatstone New Romney Kent TN28 8NZ 01797361601 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Rosecroft Care Limited care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 5 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category:Learning disability (LD) Date of last inspection Brief description of the care home Rosecroft is registered as a Care Home for up to 5 adults with a learning disability. Rosecroft Ltd is the Registered Provider and Ms. L. Ulph is the registered manager. According to its Aims and Objectives, the Home provides care for adults with a learning disability and challenging behaviour in an environment that respects individuality and promotes the development of service users potential and self-esteem. Service users are supported by a committed, well trained and well informed staff group. Rosecroft is a detached chalet bungalow situated in a residential area of Greatstone, a short walk away from the local amenities and the beach. 5 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 25 Brief description of the care home The reported fee structure is within the range £850 - £1100 per week. Care Homes for Adults (18-65 years) Page 5 of 25 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: three star excellent 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: This report takes into account information gathered since the last key inspection on 13.02.2007 and includes a visit to the home. The visit to the service was an unannounced Key Inspection which took place over one day. We arrived at 11.15 am on 30.10.2009 and stayed for about four hours. The homes Registered Manager, Deputy, members of staff and two of the service users were involved in the inspection. We observed how staff interacted with service users during the day when offering care support. We looked at some of the service users individual support plans and risk assessments. We also looked at and discussed the staff recruitment and training records and quality assurance arrangements. We received the homes annual quality assurance assessment, known as an AQAA for short. This is a document that all homes have to send us once a year to tell us how they think they are meeting the national standards, how they have improved in the previous year, what they aim to do and lets us know when they have completed important environmental safety checks. Care Homes for Adults (18-65 years) Page 6 of 25 We were also able to talk with family members of two of the service users. Their responses were noted and contribute to this report. Care Homes for Adults (18-65 years) Page 7 of 25 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 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 25 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 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are interested in living at Rosecroft will have a thorough assessment to make sure this is the right home for them. Staff will have the right skills to support people living at the home meet their needs. There is good information about the home to help people decide about moving in. Evidence: People can learn about the home from the service users guide that tells them all about it and what to expect if they decide to move in. Each resident may have their own copy that is written in a way that they can understand. The guide is written in simple words and has pictures and photographs of various areas inside the home and the garden, to make it meaningful. It tells the person lots of things, for example, about the staff, what support they can expect, their rights, things that they are responsible for and it explains about the home routines. We spoke with the providers and staff on duty and found that they clearly understood the importance of getting as much accurate information as possible prior to admission.The service user assessments in place brought together the work and Care Homes for Adults (18-65 years) Page 10 of 25 Evidence: support plans from previous placements, resource centres as well as care and health professionals. We saw that, as far as possible, wishes and feelings had been noted and supported and, where there were behaviours that were difficult to support, guidelines were in place. People are offered the opportunity to visit the home, prior to admission, to meet and spend time wth the people who live there and the staff. They can also look around the home and their bedroom and find out about what sort of lifestyle they coud expect to experience if they choose to move in. Care Homes for Adults (18-65 years) Page 11 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from having their own individual plan of care that shows their assessed needs and wishes. Staff, families and service users work together to make sure these are met. Service users are encouraged and enabled to make their own decisions and communicate their preferences. Evidence: Staff have got to know each person well and have found out and recorded what support they need and how they like it to be offered. Some routines have been established and guidelines have been written in the support plans so that every one is doing the same thing. We looked at two of the files and saw that they were person centred. They reflected, as far as possible, the service users involvement and covered areas that are important to to the individual. Things such as daily routines, things they need reminding about, where they need encouragement and where support is needed. Religious and cultural needs are noted to make sure any related things are known, and plans are put in place to make sure the persons wishes are respected. We saw from the records and were told by staff, that the support plans are regularly up dated Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: as people develop and their needs change. The parents of two of the service users told us how the home keeps them informed of progress and will always consult them before making any major changes to the way they provide care and support. The support plans contain thorough risk assessments. These are seen by the home as ways of supporting people to do things safely rather than as a reason to stop something. Care Homes for Adults (18-65 years) Page 13 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from being supported to live fulfilling lifestyles within the home and the wider community. They are helped to take part in activities that enrich their lives and widen their experience. Service users are helped to stay in touch with their family and friends. A good variety of balanced meals are available to the service users. Evidence: Staff told us that people were active in the home and were always out and about doing various things that interest them. There are various activities scheduled for inside and outside the house.The weekly planner is used so that people know who is doing what and the levels of support that are needed. We saw one service user decorating cakes in readiness for the halloween party and noted staff patiently guiding and giving choices rather than doing it for him. Another came in from an outside activity whilst others were with staff fetching another service user from a home visit. Communication between the staff and service users was easy going and informal. Care Homes for Adults (18-65 years) Page 14 of 25 Evidence: Differing forms of communication were used so that everyone was included in the interactions and could communicate their opinions and choices. People are helped to keep in touch with members of their family. Family and friends are welcome to call. We spoke with two of the service users family and they confirmed that staff, in particular key workers, contact them to tell them how things are going. they also said that the home always asks them for their comments and opinions whenever a review is due or when there are any changes in circumstances. We noted a number of comments from parents of service users. We were told that the home is sensitive to the needs of people as individuals, makes family feel that they are listened to and their opinions count, the service user has never been happier and that moving to Rosecroft was the best thing that could have happened for X. The group of service users have all lived at the home for some time and the staff have got to know their food preferences and dislikes. One service user confirmed that the food is good and they always have plenty to eat. Support workers do most of the cooking but everyone is encouraged to do their bit to help. There is a weekly menu plan but this can be changed if people want something different. Care Homes for Adults (18-65 years) Page 15 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the home have their health and personal care support needs thoroughly assessed. Staff support is based on knowledge of the individuals and their condition. Systems are in place for the safe storage and administration of medications. Evidence: The home has conducted personal and health care assessments and have clear support plans based on the identified needs. The staff confirmed that they have clear guidelines on the maintenance of privacy and dignity when offering support. Specialist support is used when necessary and recommendation from these sources is followed. Keyworkers compile a monthly, well being sheet for each service user. These monitor and update how health care needs are being met and are discussed at staff handovers and meetings to inform any necessary changes. One parent said that she is kept up to date with all health care issues and feed back from any specialist appointments. She was particularly pleased that the service user is consistently accompanied by the same member of staff who knows her well. Another parent commented that he is regularly asked for his opinions and his experience was used at the last medication review. Staff reported that even though there are some quite complex support needs Care Homes for Adults (18-65 years) Page 16 of 25 Evidence: everything is done to ensure these do not get in the way of the individual having an ordinary lifestyle. We looked at the storage arrangements and records for medication. These were satisfactory and up to date. Staff who are involved with medication receive training and have their competency assessed by the provider. We were told that service user self management of medications is regularly considered but currently the risk assessments indicate that the home needs to continue the management. Care Homes for Adults (18-65 years) Page 17 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are supported to make a complaint or express a concern. The management and staff make sure that any concerns are listened to and sorted out. Systems are in place to protect service users from the risk of harm. Evidence: The home has a well written complaints procedure that is available to service users, staff, family and visitors. There are copies in symbol and Makaton format that are explained to the service users when they first arrive. Service users are helped to say if they are unhappy, worried or have any concerns. They have regular one to one talk times with their keyworker and the providers are either on duty or pop in most days. We saw instances where staff stopped what they were doing to listen to what the service user wanted to say and always responded. Staff have attended courses to widen their awareness of issues such as, protecting vulnerable people, managing challenging behaviours and deprivation of liberty safeguards. The home does not get involved in service user personal finances. They arrange for these to be dealt with by the parents or local authority. Parents commented that they have never had cause for concern or complaint and thay felt that the staff were very sensitive to the service users needs. Care Homes for Adults (18-65 years) Page 18 of 25 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. Service users benefit from living in a home that is well maintained, clean and comfortably furnished. The furnishings and layout provide a homely environment. Evidence: The house is a homely place and appears clean and tidy. There is little to indicate that it is a registered care home either inside or out. Fixtures, fittings and flooring is kept in good condition. Service users have their own room that is furnished according to their needs and preferences. We were invited to look at some of the rooms and saw that they had been personalised to reflect the individuals interests and lifestyle. Service users can access all areas of the house and garden without restriction. The enclosed garden is well maintained, with service user involvement, and has equipment for leisure and relaxation. Care Homes for Adults (18-65 years) Page 19 of 25 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. Service users can be assured that there will be sufficient staff on duty at all times to support them and that they are competent and properly trained. The homes recruitment procedure protect the service users from the risk of harm. Evidence: The homes recruitment procedure includes the completion of safety and identity checks required for care homes. New staff have an induction and probation period, overseen by the management, until they are deemed competent to work unsupervised. Staff we spoke with were clear about their role and responsibilities and said that staffing levels may often be increased so that there are enough staff available to support people to do different things. A good range of training is available to staff. We looked at the records and saw that training is arranged to meet the needs of the individuals in the home. Communication skills have been identified as needing to play an important part in the training programme. We were also informed that, of the nine staff, three have attained NVQ at level 3 and five have level 2. Staff meetings are held to discuss what is going well and what needs to be improved. Staff have one to one supervision sessions with the providers or the deputy manager to discuss and appraise personal development and performance. Care Homes for Adults (18-65 years) Page 20 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from living in a well managed home where their best interests are safeguarded and their health and safety are promoted and protected. Service users and their representatives can be sure that their views are listened to and may affect changes introduced for their benefit. Evidence: Ms. Ulph has twenty years experience as a registered manager and provider manager in the field of residential care. She has attained an NVQ4 and registered Managers Award and has maintained her Nurse qualification. The AQAA was well completed and covered all the things we asked for. It helped in the planning of our visit and areas we tested were confirmed as being accurate. The open door style of leadership encourages a good level of consultation and communication. One service users parent praised the providers as having a positive attitude and outlook and dedication second to none. Another felt that his views and opinions are often sought and considered by the management when reviewing and planning the future development of the service. The staff spoken with said that they feel valued and that they, and the service users, as far as possible, are consulted and have the Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: opportunity to be involved in the daily running of the home and planning individual lifestyles. Ther are regular staff and service user meetings to discuss matters as they arise. The AQAA indicated that the safety and maintenance checks are satisfactory and up to date. The providers confirmed that repairs and reparation are carried out without delay. Care Homes for Adults (18-65 years) Page 22 of 25 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 23 of 25 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 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 Care Homes for Adults (18-65 years) Page 24 of 25 Helpline: 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. Care Homes for Adults (18-65 years) Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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