Care Home: Roseview Home

What the care home does well Residents said that staff were kind and treat them well. Feedback from the residents was positive. One resident said, "They look after us by giving us medication, food, making sure we`re washed and have nice clothes to wear, we have our laundry done, helping us to do little things to enhance our independence." Another resident said, "they treat me lovely here." Residents are encouraged to be as independent as possible but are also offered the support they need on a day to day basis. They said they are happy in the home. What has improved since the last inspection? At the last inspection of Roseview, three requirements were made. All three requirements have been acted on. The complaints procedure and the policy and procedure for protecting vulnerable adults have both been improved so that they are easy to understand. Improvements have been made to the building. Some flooring has been replaced and two bedrooms redecorated. The house has been well maintained by the provider, Mrs Annin-Adjei. From discussions with the area manager, we consider that the service provided to residents is improving and changing regularly to meet their changing needs. For example, residents currently do not have access to sharp knives for safety reasons. Staff responded quickly to this changed need. A recent trip to a restaurant was enjoyed and transport was provided so that people who find it difficult to go out could be supported to go. What the care home could do better: As a result of this inspection, six requirements have been made. These are actions that the registered provider needs to take in order to comply with the Care Homes Regulations, National Minimum Standards for care homes for adults and to improve the health and safety and quality of service for the six people living there. These requirements are as follows; the home`s statement of purpose document must be updated as the staffing information is no longer correct. This document states that there are two staff on each shift, whereas inspection of staff rotas showed that this has been reduced to one staff at weekends and also between 5 p.m. and 10 p.m. Monday to Fridays. It is important that this document is up to date as placing authorities should be informed of changes to staffing levels. The provider needs to make sure there is a constant supply of basic food items and that these do not run out. This is to make sure that residents can always make a hot drink and have their breakfast in the morning. A requirement was also made that the provider must immediately stop allowing any staff member to work unsupervised until all the checks have been carried out to make sure that staff are suitable to work in a care home, which includes their criminal records bureau disclosure and two references. The reason for this requirement is that a new member of staff had worked alone in the home before a criminal records disclosure had been received. Thiscould put residents at risk. A requirement is also made to review the home`s recruitment procedure to ensure that a thorough recruitment practice is being carried out at all times, for the safety of residents. The home has had no registered manager since the previous manager left in January 2008, therefore a requirement is made that an application for registration is submitted by a manager within five months of this inspection. CARE HOME ADULTS 18-65 Roseview Home 26 Bounds Green Road London N11 2QH Lead Inspector Jackie Izzard Unannounced Inspection 8th July 2008 09:00 Roseview Home DS0000010752.V367018.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 Roseview Home DS0000010752.V367018.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. Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Roseview Home Address 26 Bounds Green Road London N11 2QH 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) 020 8881 7267 020 8361 5114 Mrs Agatha Annin-Adjei No registered manager Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th July 2007 Brief Description of the Service: Roseview is a care home registered to provide accommodation and personal care for a maximum of six adults with mental ill health. The Homes aims and objectives state that the home: encourages service users to take part in decision-making processes. ensures service users have privacy and dignity. maintains service users personal identity and choice. involves service users in policy reviews. ensures service users and staff work together to achieve these goals. The home is a semi - detached, two-storey house which opened in May 2001. It has six single bedrooms. None of the bedrooms have en-suite facilities. On the ground floor, there are two bedrooms, an office, a kitchen, lounge/diner, a smoking area, a shower room with a toilet and a separate toilet. On the first floor, there are four bedrooms, a phone room and a bathroom with a toilet. There is a small front garden and an attractive larger back garden, which is partly paved. The home is situated along the busy Bounds Green Road and close to a large selection of cafes, shops and community facilities. Wood Green Shopping Centre is a short bus ride away. Bounds Green underground station and Bowes Park rail station are within a short walking distance. At the time of the inspection the home was fully occupied with three men and three women living at Roseview. The owner of the home runs two other care homes in North London. Inspection reports produced by the Commission of Social Care Inspection (CSCI) are available upon request from the registered manager/provider. The cost of placements is £495 - £535 per week. Following Inspecting for better lives the provider must make information available about the service, including inspection reports, to people living at the home and other stakeholders. Roseview Home DS0000010752.V367018.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 two stars. This means the people who use this service experience good quality outcomes. This inspection took place on 8 July 2008 and lasted one day. The home had no prior notice of the inspection. During the day, we spent time in the office with the area manager, who is currently acting as manager for the home. We spent time looking at records, staff and resident files and discussing the service provided. As part of the inspection, we looked at the homes self-assessment (annual quality assurance assessment) which was sent to the Commission for Social Care Inspection in 2007. The information in this document was compared with our findings on the day of the inspection. We also looked around the building to check if it was clean and safe and spent time talking to staff and to people living at the home. At the beginning of the inspection we spoke with three residents in the lounge. We later spoke privately with two care staff and with two residents. One resident did not want to speak to us and another we met briefly before he went out for the day. The other four were happy to talk to us and give their views on this home. We also spoke with one resident’s care manager on the phone to hear his views on the service provided to that resident. What the service does well: Residents said that staff were kind and treat them well. Feedback from the residents was positive. One resident said, “They look after us by giving us medication, food, making sure we’re washed and have nice clothes to wear, we have our laundry done, helping us to do little things to enhance our independence.” Another resident said, “they treat me lovely here.” Residents are encouraged to be as independent as possible but are also offered the support they need on a day to day basis. They said they are happy in the home. Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: As a result of this inspection, six requirements have been made. These are actions that the registered provider needs to take in order to comply with the Care Homes Regulations, National Minimum Standards for care homes for adults and to improve the health and safety and quality of service for the six people living there. These requirements are as follows; the home’s statement of purpose document must be updated as the staffing information is no longer correct. This document states that there are two staff on each shift, whereas inspection of staff rotas showed that this has been reduced to one staff at weekends and also between 5 p.m. and 10 p.m. Monday to Fridays. It is important that this document is up to date as placing authorities should be informed of changes to staffing levels. The provider needs to make sure there is a constant supply of basic food items and that these do not run out. This is to make sure that residents can always make a hot drink and have their breakfast in the morning. A requirement was also made that the provider must immediately stop allowing any staff member to work unsupervised until all the checks have been carried out to make sure that staff are suitable to work in a care home, which includes their criminal records bureau disclosure and two references. The reason for this requirement is that a new member of staff had worked alone in the home before a criminal records disclosure had been received. This Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 7 could put residents at risk. A requirement is also made to review the home’s recruitment procedure to ensure that a thorough recruitment practice is being carried out at all times, for the safety of residents. The home has had no registered manager since the previous manager left in January 2008, therefore a requirement is made that an application for registration is submitted by a manager within five months of this inspection. 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. Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 8 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 Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 9 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): 1, 2, 4 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents’ individual needs and aspirations are assessed and they are able to visit the home before they make a decision to move in. Current written information about staffing levels is inaccurate and so prevents people making an informed choice about moving to the home. EVIDENCE: One new person has moved into the home in the last year. This person’s assessment was inspected. It was evident that this person’s needs had been assessed to ensure that his/her needs could be met at this home. This resident said that s/he was happy at this home. The home’s self assessment (AQAA) states that potential residents can visit before moving into the home and that residents were given a copy of the statement of purpose for the home and service user guide. The area manager confirmed that the new resident had visited the home before deciding to move in. The Statement of Purpose was not up-to-date in that the staffing information was not correct. At the time of writing the document staffing levels were two staff at all times. Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 10 At weekends and evenings there is one staff on duty and a requirement is made to ensure the Statement of Purpose reflects the current staffing. The reason for this is that placing authorities may request the Statement of Purpose to help them decide if this home is an appropriate placement for a potential resident so it is important that the information is up-to-date. The service user guide was not inspected on this occasion. Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 11 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, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are encouraged to be as independent as possible and make decisions about their lives. Risks are recognised as a part of life and strategies to minimise risks are in place. Where there are restrictions in place, these are appropriate and for the safety and well-being of vulnerable residents. EVIDENCE: We looked at the care records for three residents. This included the resident who had most recently moved to the home, a female resident and a male resident. The three residents’ care plans, risk assessments and reviews were inspected in detail. These were also discussed with the area manager. Care plans showed individuals’ needs. We spoke with two of the three residents concerned. Both these residents said they were satisfied that their needs were being met and it was clear from the risk assessments and the discussion with the area manager that the risks for these people were well-known and managed by staff. Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 12 We spoke with one resident’s care manager who was in regular contact with the resident and was also satisfied that the placement was meeting this person’s needs. One resident said, “ They look after us by giving us medication, food, making sure we’re washed and have nice clothes to wear, we have our laundry done, helping us to do little things to enhance our independence.” There were documents in one resident’s file which expressed his/her changing needs regarding requesting staff support to give up smoking. It was evident that staff were responding to the changing requests of the resident in a positive way, by respecting his/her decisions. There were some restrictions in place for residents’ safety, to reduce the risk of self harm and suicide. These restrictions were discussed with the area manager and appeared to be appropriate to protect people from their own assessed risks of self harm. Records show that one resident had requested a restriction for his/her own safety. Staff had acted on this without delay. At the same time, people are encouraged to be independent and go out alone where they are able to. Two residents said they were encouraged to make their own decisions. A suggestions book has been introduced to encourage residents to be involved in the running of the home. This was used by residents. Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 13 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, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home are part of the community and are encouraged to maintain appropriate relationships with family and friends. A balance of respecting people’s rights and ensuring their responsibilities are recognised is achieved. People are eating the kind of food they like. EVIDENCE: To assess these standards, we spoke with four residents, two staff and the area manager and inspected records; care plans, records of activities and menus. There was an activity programme in the home where staff involve residents in activities such as board games, Bingo and cooking. Residents also follow their own interests. One resident said she enjoyed drawing and had a desk to sit at and draw in her room. Some of this person’s drawings were displayed in the Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 14 home for others to enjoy. Three of the four residents we spoke to said they liked television, music, going to shops and cafes. One said s/he found it difficult to go out but had recently been on trip to a local restaurant with the other residents and staff. Two residents told us about this trip and said they had really enjoyed it and planned to go again. The area manager said that she had used a minibus to drive residents to the restaurant. One resident said s/he liked to go to local cafes for a cup of tea. Four of the six residents were able to go out independently and do their own shopping. We were told that one person was supported by staff to go out for safety reasons and another preferred to stay in. Staff and another resident bought the items this person requested from local shops. One person attends a daycentre locally a few times a week. People are able to make their own decisions and choices about how to fill their time. Two residents said that staff did not force them to do anything and respected their wishes when they did not want to join a planned activity or when they wanted to be alone in their room. People are supported to maintain relationships with friends and family members. One resident said, “they welcome your visitors.” Residents were well aware of their rights and there was written evidence that they exercised their rights. One person had decided to become a vegan for a period of time and this was catered for by staff. Two residents were well informed about the role of the Commission for Social Care Inspection and knew how to contact us which is very positive. Residents were encouraged to be independent as much as they were able within the home. One resident said that staff encouraged her to be more independent while still respecting her decisions not to be independent in certain areas. One said s/he was aware of his/her rights and responsibilities and was able to give examples of where his/her behaviour could impact on the others living in the home and what s/he could do to respect the rights of others. To assess the diet offered, we spoke with three residents about the food, inspected the food in the home on arrival at 9am, read three weeks’ records of food eaten and discussed food with the area manager. The three residents all said they liked the food. One said, “the food is lovely.” Detailed records are kept of food eaten so that staff can monitor individual residents’ diets. Residents said they eat what they like. Records showed that this is not always the healthiest food as there was chips, corned beef, sausage rolls and take away meals recorded but residents said this is what they wanted. We asked one resident if s/he would like to see more food on the menu reflecting his/her cultural background. This resident said that s/he liked English food. Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 15 One person’s food records showed that s/he was not eating well. This was a symptom of his/her mental health. Staff were keeping a record of this person’s weight and offering supplements when meals were missed to try to ensure the resident was taking adequate nutrition. At 9am on the day of the inspection, there was a limited supply of some foods, for example, bread, and there was no coffee or milk in the house. A resident said that everybody made their own breakfast and could choose what they had. There was also no fruit or juice to drink. The area manager said that food is bought in bulk and stored at another home owned by the company and brought down to this home on a regular basis. She said that more food would arrive later in the morning, which it did. The area manager said that the second member of staff on duty was late so the staff member in the home had not been able to go to the shop. As soon as the second staff arrived, milk was purchased. One resident had expressed disappointment that s/he had not been able to have tea and cereal for breakfast. A requirement is made to ensure that there is always a supply of basic food items so that supplies do not run out. Lunch is cooked by staff as well as a light meal in the evening. A resident said there are always at least two choices of meal every day and that one resident is vegetarian, and this person’s needs are catered for at every meal. Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive personal support in the way they want it and can be assured that their health needs will be met. Evidence that staff are trained is needed to confirm people are protected by safe medication practices in the home. EVIDENCE: Three residents’ health records were inspected and compared to the information in their assessment and care plans. The home keeps separate files for appointments with opticians, dentists, chiropodist and other professionals and when somebody has a physical health need there was clear evidence that they were seeing appropriate professionals. Each resident’s weight is regularly monitored so that action can be taken if there are concerns about the weight gain or weight loss. One person was recorded as refusing all dental and optical checks. This was well documented. Where residents needed staff assistance with personal care , such as having a shower, this was documented. Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 17 Medication Administration Records (MAR sheets) were inspected for three residents over a five week period from 1 June to 8 July. The records were complete as required. Records showed all six staff employed give medication. Evidence that they have been trained to give medication was requested but was not available for inspection. The area manager showed confirmation that medication training had take place in May 2008 but there was no record of which staff attended and certificates had not yet been received. A requirement is made that evidence that staff have been trained and are competent to administer medication be forwarded to the Commission as untrained staff are not allowed to give medication. None of the residents were able to manage their own medication. Two residents were asked about the standard of personal care and both said that they received the care they needed and were happy with the way staff supported them. There are staff of both genders so residents can choose where appropriate who assists them with personal care. Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by a complaints procedure and an adult protection policy. Their views are listened to and they feel safe in the home. EVIDENCE: Two requirements were made at the last inspection in July 2007 to amend the home’s complaints procedure and safeguarding adults procedure. Both of these procedures have been amended. We saw that the home has an appropriate policy for responding to any suspicion of abuse and also the Haringey Council guidelines are present in the home for staff to refer to. The area manager said that all staff have attended training in safeguarding adults. We did not check this on this occasion. The home’s AQAA said there had been no complaints in the last year and the area manager confirmed this. One resident said that they are able to make complaints and raise concerns. Records showed residents had raised a concern about a member of staff. It is positive that they feel able to voice their concerns. The area manager explained how the situation had been dealt with. One resident was clear on how to complain and how to involve his/her placing authority and the Commission if s/he had concerns about any abuse taking place in this home. This is very positive. Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 19 Another resident expressed some concerns about staff which were clearly a symptom of his/her illness. Observation of staff interaction with the resident showed that staff were very supportive of this resident and interacted very positively to make the resident feel secure. Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 20 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, 26, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents of this home are provided with a safe, homely environment to live in which is well maintained and promotes their independence. EVIDENCE: We looked at all six of the single bedrooms in the home. Bedrooms were personalised with residents’ belongings, for example pictures, plants and personal books and photographs. The majority of residents have their own kettle and facilities for making a hot drink and some also have their own fridge. Two residents pointed this out and obviously appreciated being able to have this independence. Some had their own television and two residents said that they like to watch television in their room. There was evidence that individual needs were met. One resident had his/her own specialist bed. Another had a desk and chair at which to draw. One had plants. Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 21 Three residents showed us their rooms and all three said they were happy with their room and did not need anything. We looked at the other bedrooms with the area manager. There were three toilets in the home. One toilet has a domestic toilet seat and the other two have all raised seat for people with disabilities. The area manager said that residents are happy with this. There is one bath and one shower. The home has a back garden which is maintained to a satisfactory standard. The home was clean and tidy. The lounge was adequately furnished and decorated. Magazines, books and television were provided in the lounge. The kitchen was clean and safer food guidelines are being adhered to. There are adequate laundry facilities. The home is fitted with appropriate fire doors, but some were quite heavy and one was not closing properly as the door closure device needed adjusting. The area manager said that these would be adjusted straightaway. Requirements made at the last inspection about the building have been met. Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 22 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, 35, 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from good relationships with staff, but they are not protected by the home’s recruitment practices which may put them at risk. EVIDENCE: From examination of staff rotas and information from the area manager and residents, staffing levels were noted to be two staff on duty in the daytime until 5 p.m. then one staff between 5 and 10 p.m on weekdays. At weekends there is one member of staff on duty throughout the day. At night there are two staff on duty, one of whom is awake and the other asleep. Residents said that staff are always willing to chat with them and make a cup of tea if they needed support during the night. The area manager said that she had used a recognised formula for assessing the staffing requirements and that these staffing levels were sufficient to meet the needs of the current residents. Two residents gave us feedback about staff. Both said that staff treated them well and were supportive of their individual needs. One said, “they treat us lovely here.” Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 23 The senior staff member on duty clearly had a positive relationship with all the residents and we observed him interacting positively with them as individuals. The area manager also interacted positively with residents, one of whom said, “she is really good. She always gets us anything we need.” We assessed recruitment practice in the home by inspecting the files of all six staff members employed. This was to see if there was a thorough recruitment process in place to ensure staff are properly vetted for their suitability to work in a care home. Three of the six staff had been recently employed. A requirement is made to review the recruitment procedure as some concerns about staff references were found. One staff member had a last employer reference written by a referee who was clearly not the last employer. We asked the area manager to investigate this, which she did during the day of the inspection. Two staff members employed had little or no previous experience of working in a care home or with people with mental health problems. The rota showed one new member of staff, who had commenced employment in the home one week before this inspection, had worked four shifts alone in sole charge of the home plus waking night duties. This person did not have a current criminal records bureau disclosure. It is a requirement that a care home provider obtains this disclosure before allowing any person to have unsupervised access to residents in the care home. Allowing people to have unsupervised access to residents before they have been properly vetted to ensure they are suitable to work with vulnerable adults is a practice that puts residents at risk. Therefore an immediate requirement was issued that the provider immediately stop allowing any staff member to work unsupervised until all the required checks on their suitability are received in the home. The area manager agreed to stop this immediately on the day of the inspection. We looked at staff training records available, discussed training with the area manager and also with two staff members individually. A number of training certificates were not available for inspection and the area manager was advised to ensure that all certificates should be present in the home as evidence that staff had attended training. The area manager said that three staff had NVQ level2 training but two had no certificate available in the home as evidence of this. We looked at the supervision records for five of the six staff members. One of the five had not yet received supervision as she had only been employed for six days. The others had regular recorded supervision sessions. This is good practice as it helps to ensure staff know how to do their job. We did not ask to see annual appraisals on this occasion. Staff meetings are held on to a monthly basis and records kept meeting to remind staff of decisions made. Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 24 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and safety of residents is promoted. They would benefit from a suitable manager being employed to run the home. EVIDENCE: The registered manager of the home left in January 2008 and the Commission were notified of this in March 2008. The area manager has been acting as manager of this home since that time. She is qualified and experienced to do so but is not based full time at the home because of her area management duties. The provider has not been successful so far in recruiting a new manager. A requirement is made that the provider submits an application to the Commission for a new manager to be registered within five months of this inspection. Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 25 50 of the staff team are new but a resident told us that this has not affected residents adversely. There was a residents’ suggestions book in place to encourage residents to be involved in decisions about the home. This had been used. Two resident said that they felt involved and consulted about day to day decisions in the home. The home has a history of compliance with requirements from inspections. A sample of health and safety records were inspected. We saw that the home’s insurance is up to date and that electrical appliances and fire equipment have been inspected for safety this year. Fire drills are held every three months and recorded. Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 26 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 2 2 3 3 X 4 3 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 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 1 35 x 36 3 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 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 3 X X 3 x Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 27 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA1 Regulation 6 Requirement The registered person must ensure that the home’s Statement of Purpose contains up-to-date and accurate information about staffing in the home so that residents and placing authorities are informed about changes to staffing levels. The registered person must ensure that there is always a supply of basic foods such as bread and milk as may reasonably be required by residents. The registered person must provide evidence that all staff who administer medication have had appropriate training to do so. This is to protect residents from risk of errors in medication. The registered person must review and update the current recruitment procedure and practice, to minimise the risks to residents of unsuitable people being employed. The registered person must immediately cease allowing any staff member to work unsupervised until all the DS0000010752.V367018.R01.S.doc Timescale for action 30/08/08 2 YA17 16(2)(i) 31/07/08 3 YA20 13(2) 18(1)(c) 30/08/08 4 YA34 19 schedule 2 30/08/08 5 YA34 19 09/07/08 Roseview Home Version 5.2 Page 28 required checks (enhanced CRB disclosure and two verified references) are received in the home. This is for the protection of residents. This is an immediate requirement. The registered person must ensure that an application for a suitable manager to be registered is received by the Commission. 6 YA37 8 08/12/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Roseview Home DS0000010752.V367018.R01.S.doc Version 5.2 Page 30 - 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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