Care Home: Rosefern Residential Home

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What the care home does well Rosefern offers a comfortable home with a good level of care for people who live there. The home is good at assessing needs, and only offers a place when it can be sure these can be met. A detailed written plan of care is prepared, based on the assessment. The home is good at assessing what risks there may be for the people living there and planning to make sure these are minimised. As needs may often change, these plans are kept under regular review. The home is good at involving people in decision made about the way in which care is offered. One person said: `They ask me what I want to do and if I want a bath.` The home is particularly good at ensuring people are kept safe. Health care professionals are consulted for advice on how to provide the best care. One health care professional said: `The staff know the needs of people well. They always seem to listen and act on advice given.` The staff place people at the centre of all planning for care. This is evident in the way people are supported with their daily lives, their health care needs, the way their medication is handled, in how they are consulted about their lives and in how content they say they are to live at Rosefern. What has improved since the last inspection? The way in which information is gathered to plan care for people is now more detailed and the plans of care are better informed, leading to good care. What the care home could do better: The manager has identified a need to improve the quality assurance system so that new survey forms can be widely used and the results used to make the service better for those living at the home. This has yet to be fully put into place. The manager also plans to adopt a framework of training specifically focused upon the needs of service users with a learning disability. This also has yet to be put into place. CARE HOME ADULTS 18-65 Rosefern Residential Home 2 Seamer Road Scarborough North Yorkshire YO12 4DT Lead Inspector Karen Ritson Key Unannounced Inspection 19th February 2008 09:30 Rosefern Residential Home DS0000070588.V360190.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rosefern Residential Home DS0000070588.V360190.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rosefern Residential Home DS0000070588.V360190.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosefern Residential Home Address 2 Seamer Road Scarborough North Yorkshire YO12 4DT 01723 378431 01723 368716 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) None Autism Plus Limited Ms Emma Jayne Whiteside Care Home 12 Category(ies) of Learning disability (11), Old age, not falling registration, with number within any other category (1) of places Rosefern Residential Home DS0000070588.V360190.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category 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: Old age, not falling within any other category - Code OP; Learning disability - Code LD. The maximum number of service users who can be accommodated is: 12 2. Date of last inspection Brief Description of the Service: Rosefern is a care home providing personal care and accommodation for thirteen people with learning disabilities, some of who may be over the age of 65. The home is located on the main Scarborough to York Road, approximately half a mile from the centre of Scarborough and is close to shops, supermarkets, pubs and other amenities including public transport. The home consists of two semi-detached houses, which have been converted into one home. Chiropody, hairdressing and transport such as taxis are not included in the fees. Latest CSCI reports can be viewed at the home by request. Rosefern Residential Home DS0000070588.V360190.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. The inspection for this service took 12 hours. This includes time spent gathering information and examining documentation before and after an unannounced site visit and in writing the report. The site visit took place on 19/02/08 between 09:30am and 2pm. Information for this inspection was gathered from the following: • • • • • • • • • • A tour of the premises Observations of care throughout the day of the site visit. Speaking with people living at the home. Speaking with staff on duty at the home. Case tracking service users on the day of the site visit. Looking at information provided in the Annual Quality Assurance Self Assessment form. (AQAA) Notifications sent to the commission from the home since the last inspection. Examining policies, procedures and records kept at the home. Examining information regarding the home on the file kept by CSCI. Considering comments made by relatives, health care and social services staff. All key standards were looked at during this inspection. The manager was not on duty however staff were present throughout the day of the site visit and assisted wherever possible. What the service does well: Rosefern offers a comfortable home with a good level of care for people who live there. The home is good at assessing needs, and only offers a place when it can be sure these can be met. A detailed written plan of care is prepared, based on the assessment. The home is good at assessing what risks there may be for the people living there and planning to make sure these are minimised. As needs may often change, these plans are kept under regular review. The home is good at involving people in decision made about the way in which care is offered. One person said: ’They ask me what I want to do and if I want a bath.’ The home is particularly good at ensuring people are kept safe. Health care professionals are consulted for advice on how to provide the best care. One health care professional said: ‘The staff know the needs of people well. They always seem to listen and act on advice given.’ Rosefern Residential Home DS0000070588.V360190.R01.S.doc Version 5.2 Page 6 The staff place people at the centre of all planning for care. This is evident in the way people are supported with their daily lives, their health care needs, the way their medication is handled, in how they are consulted about their lives and in how content they say they are to live at Rosefern. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Rosefern Residential Home DS0000070588.V360190.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 Rosefern Residential Home DS0000070588.V360190.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. People who use the service experience good quality outcomes in this area. They and their representatives have the information needed to choose a home, which will meet their needs. Their needs are well assessed. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Each person has a needs assessment with risk assessments for relevant areas of care. A new system is being put in place now the home is under new ownership and each person has an updated profile. The assessment focuses upon an index of skills, which includes all areas of daily living. Areas where assistance is required are clearly highlighted. Each person has a detailed health assessment also. A pre admission form is also completed which allows the home to consider whether the needs of each person can be met before offering a place. People said that the home knew what help they needed. One person said: ‘I’ve been here for a long time and they know me very well. They know what I need help with and they help me do my clothes and go out.’ Staff said they felt confident that the needs of people living at the home were regularly re assessed. One person had moved from the home recently because the home could no longer offer the care required whilst also offering the Rosefern Residential Home DS0000070588.V360190.R01.S.doc Version 5.2 Page 9 correct care to others. People said the atmosphere was better now and had heard reports that the person had settled well in another home. The assessment considers the required assistance from health care professionals and the needs and wishes of the person, family members or others involved in the care. This ensures that the person and the network of people important to that person have all been consulted and creates the best opportunity for current and anticipated care needs to be met. Rosefern Residential Home DS0000070588.V360190.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. People who use the service experience good quality outcomes in this area. They are involved in decisions about their lives, and play an active role in planning the care and support they receive. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The manager develops a plan of care in consultation with each person living at the home. This includes every area of each person’s life and considers current and anticipated care needs where necessary. There are procedures for example, for those people who may have challenging behaviour or who may be at particular risk due lack of awareness of dangers either in the home or in the community. These focus on positive behaviour, strengths and capacity. Diary notes show when these strategies have been used. The daily recording method has altered. Staff now fill in a daily working journal which includes detailed handover sheets and provides a good basis for continuity of care. The plans are regularly updated in consultation with the person, health care professionals and others who have an interest in the wellbeing of the person. Rosefern Residential Home DS0000070588.V360190.R01.S.doc Version 5.2 Page 11 The home has a key worker system, which provides each individual with a specific person who knows his or her needs particularly well. Having said this, all staff said they had got to know the people well as this is a small home and the core group of staff have remained the same for a number of years. People know who is involved in their care and they are consulted about health care and other professional support. They have access to advocacy if they wish and are helped to understand medical conditions or the need for medical interventions. All choices are recorded. People are encouraged to live as full as life as possible, according to their choice, where risks are identified and minimised. When asked if she was able to do the things she liked one person said: ‘Yes, I like them they help allsorts of ways and we go to the park.’ A Health Care professional commented that staff at Rosefern know the people who live there very well. The staff telephone whenever there is an issue requiring advice and in her experience they act appropriately on what is suggested. Rosefern Residential Home DS0000070588.V360190.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): 12, 13, 15, 16 and 17. People who use the service experience good quality outcomes in this area. They are able to make choices about their life style, and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individual’s expectations. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The staff help people take part in fulfilling activities and education as appropriate. Evidence for this was seen on care plans and in daily notes. People said they had opportunities to go out most days if they wished and that they were helped to pursue their interests. Daily activities include visiting Brook Lea a day centre nearby, Elders street day centre, shopping trips, visiting the hairdresser, outings to the pub and concerts. Several people went to Skegness last year and the staff are preparing another holiday this year after consulting with people about where Rosefern Residential Home DS0000070588.V360190.R01.S.doc Version 5.2 Page 13 they would like to go. One person was looking forward to two friends calling for tea on the day of inspection. Family and friends are encouraged to visit and people are assisted to keep in contact with those who are important to them. Staff were clearly very knowledgeable about the leisure preferences of each person and were enthusiastic about assisting them to live a full and interesting life. One person said: ’I like it when my sister comes.’ Those who have capacity are encouraged to become involved in the daily routines of living such as cleaning, shopping and laundry. People said that their privacy was respected and that staff would always knock on the door and would not come in if entry were refused, unless there was a problem. All the people spoken to said they enjoyed the meals, that they were involved in choosing menus and that they would help with shopping sometimes. Menus showed that individual preferences were taken into consideration and that a good balance had been achieved between choice and best nutrition. Daily journal notes showed that people are also offered the opportunity to go out to cafes and restaurants. Rosefern Residential Home DS0000070588.V360190.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. People who use the service experience good quality outcomes in this area. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Staff were observed offering care in a way which supported people according to their particular needs and in line with what was written in the care plan, for example at meal times. The specialist support required was written into care plans and daily journal notes showed when this had been offered. Daily routines could be flexible within the risk assessment framework in the care plan. File notes showed that people chose their own clothes, toiletries and hairdressing. Care plans and daily notes also showed that people were supported to have their healthcare needs met. Medication is kept stored, administered and is returned according to policy and procedure. Records for two people were checked and were correct. Staff who administer medication have received training in safe handling of medication Rosefern Residential Home DS0000070588.V360190.R01.S.doc Version 5.2 Page 15 and are all in the process of updating their training with Selby college. This approach protects service users health. Rosefern Residential Home DS0000070588.V360190.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. People who use the service experience good quality outcomes in this area. Their complaints are listened to and acted on, they are consulted about their care and their safety is well protected. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The home has a suitable complaints procedure and policy. People said the staff would listen to them if they had any complaint and would do something about it. The staff said they took complaints seriously and that all complaints are investigated. However, there have been no complaints since the last inspection. Staff have received training in keeping people and themselves safe. They have received training on dealing with challenging behaviour both generally and specific to individual care needs. A staff member said: ‘After several episodes of challenging behaviour from one person the staff had extra training on non violent interventions, to protect the person and ourselves.’ Rosefern Residential Home DS0000070588.V360190.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. People who use the service experience good quality outcomes in this area. The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The home is clean and well decorated. A new toilet has been installed on the first floor and new flooring has been fitted in the lounge, the lounge has also been redecorated since the last inspection. Rooms are individually decorated to people’s taste. People said they liked their rooms, and had been involved in planning and choosing decoration. There are plans to incorporate the previous owner’s flat into the main home which would provide more communal space. The laundry provision remains unchanged and continues to meet the needs of those living at the home. Rosefern Residential Home DS0000070588.V360190.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. People who use the service experience good quality outcomes in this area. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service. They are well recruited. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Staff are well recruited according to policy and procedure. All staff receive detailed induction and foundation training in which health, safety and protection are emphasised. Fewer than 50 of staff have achieved NVQ at level 2 or above, however, training in specific areas of care has taken place for challenging behaviour and abuse awareness. Staff said that Autism plus were planning more training to update foundation areas and to introduce the learning disability award framework Service users commented that the staff were supportive. One service user said: ‘They know all about what I need.’ Rosefern Residential Home DS0000070588.V360190.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. People who use the service experience good quality outcomes in this area. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The manager has achieved NVQ Level 4 in care and management and is fully qualified to run the home. Staff said she was approachable and supportive. Service users said they liked her and it was clear that she related well to all. She has a strong belief in transparency and openness in her management style and operates from a client centred perspective. The home continues to develop its quality assurance system. No questionnaires had been completed since the home had changed ownership, Rosefern Residential Home DS0000070588.V360190.R01.S.doc Version 5.2 Page 20 but the manager has developed a new survey form using advice from a speech and language therapist to produce accessible language incorporating the use of symbols. People said that the staff often asked their opinion about how the home ran and they had a say in day to day activities. People are protected by the health and safety management systems in the home. Several documents were examined, were up to date and in order. This ensures that the home is well run by a manager who has a solid grasp of business planning and progressive care. Rosefern Residential Home DS0000070588.V360190.R01.S.doc Version 5.2 Page 21 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 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 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 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 2 x x 3 x Rosefern Residential Home DS0000070588.V360190.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NA STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA39 Good Practice Recommendations The quality assurance system should be developed to widely survey people living at the home, relatives and others involved and interested in the care provided. Results of surveys should be published and acted upon to improve the service. The manager should introduce training using the learning disability award framework for staff. 2 YA35 Rosefern Residential Home DS0000070588.V360190.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rosefern Residential Home DS0000070588.V360190.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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