Care Home: Roseview Residential Home

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What the care home does well The home had a relaxed and friendly atmosphere. There is a good rapport between residents and staff. People who use the service are treated with respect and their dignity and privacy is valued and upheld. People who use the service were positive about the food at the home and that they were offered a varied choice of menu. Staff demonstrated a good knowledge of residents needs and consequently an individualised service is promoted. Residents have good access to health care professionals. The home makes sure that people`s needs are assessed before they move in so that people know the home will be able to meet their needs. Residents of the home feel that the staff are kind and polite and support them properly. There are a variety of activities available to residents and people have a say in how the home is run. What has improved since the last inspection? Eleven requirements and one good practice recommendation were made at the last inspection. The registered person has now complied with all of these requirements. The home now carries out a more detailed pre assessment of peoples` needs so that prospective residents to the home can be reassured that the home will be able to meet all their needs. Care plans are now more detailed and cover the social, cultural and spiritual needs of residents. Care plans are now being signed by the resident to indicate that they agree with their initial plan of care that the home has designed for them.The provision of activities has improved so that people who use the service have more of a choice about what they would like to do. This includes going out of the home on a regular basis. Residents` placements are being regularly reviewed so that they can say if they are still happy being at the home. Cleaning staff have now been employed by the home so that care staff have more time to be with residents. A particular staff member, identified at the last inspection, now has two written references on their file. A full time manager has now been employed so the staff can be better supported and supervised. The electrical installation of the home has been inspected to ensure the home is safe for both staff and residents. Fire drills for staff are now being carried out at night so they are confident about what action to take if a fire occurs at night. The home`s fire risk assessment has been reviewed so that any potential risks to people`s safety can be highlighted and steps can be taken to reduce any risks. What the care home could do better: Five new requirements have been issued as a result of this inspection. The home`s statement of purpose must be reviewed so that people who have dementia and a mental health problem, as a secondary issue, can be assured that the home will be able to meet all their needs. Residents must be consulted about their plan of care so that staff know the person is still happy with how they are being supported. In order that recruitment procedures are more robust, all references should include a company stamp or letter headed paper to further confirm their authenticity and all CRB disclosures must have the name of the home as the person`s employer. The way the home manages residents` finances must be more detailed to ensure that residents and their relatives know how much money is being held by the home on their behalf. Four good practice recommendations have been issued as a result of this inspection. The registered person could improve the quality assurance systems in the home by implementing "Dementia mapping" so staff can assess if the service is meeting the needs of people with dementia. Staff could improve the quality and variety of activities provided for people with dementia by developing "Life histories". This means the staff have an understanding of what the residents was like and interested in before they came to stay at the home. The television in the lounge is very small and people who use the service could benefit from a larger television being purchased by the home. Staff retention could improve if the organisation developed incentives for staff to stay at the home such as paying for some of the staff training. CARE HOMES FOR OLDER PEOPLE Roseview Residential Home 17 The Limes Avenue London N11 1RE Lead Inspector Mr David Hastings Unannounced Inspection 30th July 2008 10:00 X10015.doc Version 1.40 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 Residential Home DS0000010679.V369335.R05.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 Older People. 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 Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Roseview Residential Home Address 17 The Limes Avenue London N11 1RE 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 8368 9195 020 8361 5114 Mrs Agatha Annin-Adjei Elsada Golding Care Home 14 Category(ies) of Dementia - over 65 years of age (14), Old age, registration, with number not falling within any other category (14) of places Roseview Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd July 2007 Brief Description of the Service: Roseview is a care home registered to provide personal care for a maximum of fourteen older people who may either have problems associated with old age or dementia. A number of people who have dementia also have mental health problems as a secondary condition. The registered provider of the home is Mrs Agatha Annin-Adjei. The registered provider also owns other care homes in the North London area of Haringey and Barnet. The aims of the home are to enable service users to be as independent as possible and to enable them to be as confident as possible in making choices of their own. It also aims to encourage all service users to live a full and active life. The home is a large semi-detached house with an extension at the rear. The fourteen single bedrooms are located across the ground and first floors of the home. None of the bedrooms have en suite facilities. The home has a lift. There are three lounges and a dining room on the ground floor. The laundry and kitchen are also on the ground floor. There are a total of five communal toilets, two communal bathrooms and a walk in shower. The office and remaining bedrooms are on the first floor. The home is situated in a residential street in New Southgate. There are restaurants, shops and transport facilities within walking distance of the home. Arnos Grove underground station is a short walk from the home. The fees charged by the home range from £470 - £600 each week. The provider must make information about the service available (including reports) to service users and other stakeholders. Roseview Residential Home DS0000010679.V369335.R05.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 stars. This means the people who use this service experience good quality outcomes. This Key Unannounced inspection took place on Wednesday 30th July 2008 and was completed on the same day. The inspection lasted seven hours. We spoke with five staff on duty during the inspection and we spoke with nine residents of the home. We observed the interactions between staff and residents. We inspected the building and examined various care records as well as a number of policies and procedures. We met with the registered manager, the registered provider and the area manager who were all present on the day of the inspection. What the service does well: What has improved since the last inspection? Eleven requirements and one good practice recommendation were made at the last inspection. The registered person has now complied with all of these requirements. The home now carries out a more detailed pre assessment of peoples’ needs so that prospective residents to the home can be reassured that the home will be able to meet all their needs. Care plans are now more detailed and cover the social, cultural and spiritual needs of residents. Care plans are now being signed by the resident to indicate that they agree with their initial plan of care that the home has designed for them. Roseview Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 6 The provision of activities has improved so that people who use the service have more of a choice about what they would like to do. This includes going out of the home on a regular basis. Residents’ placements are being regularly reviewed so that they can say if they are still happy being at the home. Cleaning staff have now been employed by the home so that care staff have more time to be with residents. A particular staff member, identified at the last inspection, now has two written references on their file. A full time manager has now been employed so the staff can be better supported and supervised. The electrical installation of the home has been inspected to ensure the home is safe for both staff and residents. Fire drills for staff are now being carried out at night so they are confident about what action to take if a fire occurs at night. The home’s fire risk assessment has been reviewed so that any potential risks to people’s safety can be highlighted and steps can be taken to reduce any risks. What they could do better: Five new requirements have been issued as a result of this inspection. The home’s statement of purpose must be reviewed so that people who have dementia and a mental health problem, as a secondary issue, can be assured that the home will be able to meet all their needs. Residents must be consulted about their plan of care so that staff know the person is still happy with how they are being supported. In order that recruitment procedures are more robust, all references should include a company stamp or letter headed paper to further confirm their authenticity and all CRB disclosures must have the name of the home as the person’s employer. The way the home manages residents’ finances must be more detailed to ensure that residents and their relatives know how much money is being held by the home on their behalf. Four good practice recommendations have been issued as a result of this inspection. The registered person could improve the quality assurance systems in the home by implementing “Dementia mapping” so staff can assess if the service is meeting the needs of people with dementia. Staff could improve the quality and variety of activities provided for people with dementia by developing “Life histories”. This means the staff have an understanding of what the residents was like and interested in before they came to stay at the home. The television in the lounge is very small and people who use the service could benefit from a larger television being purchased by the home. Staff retention could improve if the organisation developed incentives for staff to stay at the home such as paying for some of the staff training. Roseview Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 7 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 Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Roseview Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 (6 not applicable) People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Prospective residents have good information about the home in order to make an informed choice about where to live. 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 and the support they need. EVIDENCE: We examined the home’s “Statement of purpose” and “Service user guide”. These documents describe the aims and objectives of the home and the facilities available to people coming into the home. These documents also inform social workers looking for placements for people. These documents contained clear information to prospective residents about what services are available as well as the aims and objectives of the home. Roseview Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 10 There was a clear statement that people from different backgrounds and cultures are encouraged by the home. The manager was able to describe how the needs of people from different backgrounds and cultures can be met at the home including appropriate diets and religious observance. A number of residents at the home who have dementia also have other secondary mental health issues. It is important that the home gives clear information to prospective residents about how the home will meet these secondary needs. A requirement has been issued that the home’s statement of purpose includes this information. Pre admission assessments were examined for three people who are now living at the home. The information was satisfactory and clearly outlined each person’ s individual needs. There were also detailed assessments from the local authority to assist the home in their own pre admission assessments. The format that the home uses for the initial assessments has been revised as a result of a requirement given at the last inspection. The new format contains all the requirements of this Standard including details of the person’s physical, mental, social, financial, cultural and spiritual needs. There was evidence that these identified needs were also being recorded in each person’s individual care plan. People also have a review of their placement 4-6 weeks after being in the home. This means that people have the opportunity to decide if the home is right for them. Roseview Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 9 and 10 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Care plans clearly set out residents’ health, personal and social care needs so that staff know how best to support everyone at the home. Residents have good access to health care professionals and they are treated with respect. Residents get the medication they require, at the right times and by appropriately trained staff. EVIDENCE: Five care plans were examined. Each plan addressed the person’s care needs including their physical, emotional and social needs. Each plan gave clear instructions to staff about how best to care for each person. All plans examined had been signed by the resident or their representative. These were two requirements made at the last inspection, that have now both been complied with. Each individual has a number of “Goals of care”. These detail the different outcomes the care plan is designed for. For example, one of the residents who had recently moved into the home had a goal of care that they would feel settled and safe at the home. Instructions for staff included introducing the Roseview Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 12 individual to other residents and answering any questions the person had about the home. Each goal of care also detailed the potential risks faced in achieving this goal. Each goal of care was being regularly reviewed along with the risk assessment and any changes in needs were being recorded. Although care plans were being reviewed, there was little evidence that residents had been involved in the review of their plans. Although all the people we spoke with said they were generally happy with their care, it is important that people are given an opportunity to decide if they want changes to their plan of care. A requirement has been issued that people are consulted about their care and the quality of the care they receive on a regular basis when their care plan is being reviewed. Visits by health care professionals such as doctors, district nurses, chiropodists, dentists and opticians were being recorded. These showed that people had good access to these professionals. Residents we spoke with also confirmed this. We met the doctor who was visiting on the day of the inspection. He told us that there was good communication with staff at the home. One person told us, “If you are ill you see the doctor straight away”. Satisfactory records were examined in relation to the receipt, storage, administration and disposal of medication. Records indicated that staff have undertaken medication training and only qualified staff administer medication at the home. Each person’s medication chart has a picture of them attached to it so that staff can double check who is receiving the right medication. On the day of the inspection we observed staff administering medication, which they did professionally and in line with the home’s policies and procedures. We saw a number of examples of supportive staff interactions with people and staff were able to describe to us how they ensure the privacy of people they support. We saw staff knocking on resident’s bedroom doors before entering. People we spoke with told us that the staff were respectful and kind towards them. One resident told us, “They are never rude to me”. Roseview Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home provides varied activities for people who use the service in order to keep them suitably occupied and engaged. Visitors to the home are encouraged and welcomed. Residents are able to exercise choice and control over their lives. The home provides people with a wholesome appealing balanced diet. EVIDENCE: A requirement was issued at the last inspection that sufficient social and therapeutic activities are provided for people who use the service. The area manager told us that the staffing levels at the home have increased and staff now have more time to spend with residents. Records are being maintained of how each resident spends their day. Records we examined indicated that people at the home go out on a regular basis. Recently the home closed for an afternoon and all the residents and staff went to a local restaurant for a meal. People told us they enjoyed this very much. People who use the service go out shopping with staff and on the day of the inspection one resident was going swimming with a member of staff. A number of residents at the home attend church services on a regular basis. Staff were Roseview Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 14 able to describe how they keep residents suitably occupied and engaged. We saw staff sitting and chatting with residents, which everyone was clearly enjoying. The area manager told us that an activities coordinator was being employed shortly to run activities two days a week. We also observed some residents helping out around the home. A good practice recommendation was also issued that activities take place both in the morning and in the afternoon. We saw that this is now taking place. This means that people are now more engaged with what’s going on at the home. A resident we spoke with said that some people were often sleeping in chairs in the lounge. This may be the resident’s choice but it may be that staff are finding it difficult to engage with people with more advanced dementia. The area manager told us that it was a challenge for care staff to keep residents with more advanced dementia occupied. To ensure that people with dementia are being kept suitably occupied and engaged a good practice recommendation has been issued that “Life histories” are developed for all residents. This means that staff have the opportunity to find out what the resident was like before they came to the home. This could provide staff with more information about suitable activities for each person. The television in the lounge was very small and a good practice recommendation has been issued that the home purchase a larger television so all residents can see it clearly. The home has an open visiting policy and visitors are encouraged at any reasonable time. We did not see any visitors during the inspection but the manager told us that relatives and friends visit the home regularly. The visitors’ book we examined confirmed this. There are regular residents’ meetings and people told us they have a say in how the home is run. For example we saw that people are consulted about activities and the menus in the home. One resident said, “We make our own decisions”. Staff we interviewed were able to give us practical examples of how they offer choice to people living at the home. Records were being maintained in relation to what time each person likes to get up and go to bed. The kitchen was inspected. Fridge and freezer temperatures were being recorded and there were sufficient amounts of fresh fruit and vegetables available. The home provides fresh fruit to all residents each morning. The cook was interviewed and had a good knowledge of individual resident’s dietary needs and preferences. A birthday cake is purchased for residents’ birthdays. The meals we saw on the day of the inspection looked and smelt appetising. People who use the service confirmed that the food was good at the home and Roseview Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 15 that they always get enough to eat. One person commented that the food was, “Very good, really”. Another person told us the food was, “Not too bad”. During lunchtime staff were sitting with residents providing discreet assistance when required. Roseview Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Complaints are taken seriously and responded to in a professional manner. People at the home are protected from abuse by clear policies and procedures and by an appropriately trained staff team. EVIDENCE: The home has satisfactory policies and procedures in relation to complaints and the protection of residents from abuse. No complaints have been received by the home since the last inspection. Previous complaints recorded, had been dealt with appropriately and in line with the home’s complaints procedure. Residents we spoke with said they had no complaints about the service but were clear that they would say something if they had a concern. One resident said, “I’ve got no direct complaints”. The Commission received an anonymous complaint last year regarding the standard of food provided by the home, infection control procedures and the poor treatment of both staff and residents. The Commission undertook an investigation regarding this complaint. The allegations of the complaint were not upheld. A requirement was issued at the last inspection regarding a resident who did not wish to stay at the home. The manager told us that this resident has since moved to another home owned by the organisation and was much happier now. Two residents we spoke to said they would prefer to be living on their Roseview Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 17 own but had been told that this would be unsafe for them. From discussion with the management and examination of case notes it appears that these residents have little insight into their condition and would be at risk if not supported in a residential setting. We saw evidence that these residents are able to express their views freely and are able to go out of the home with staff supervision. We also saw evidence that these residents were being supported by outside mental health professionals. Staff were able to describe how vulnerable people could be at risk of abuse in a residential care setting. All staff interviewed were clear of their responsibility to report any suspicions of abuse to the appropriate authorities. Residents that we spoke to said they felt safe and well supported at the home. One resident said, “They look after you”. Records indicated that staff have undertaken training in the protection of vulnerable people. All the staff we interviewed, including the cook, confirmed that they had attended adult protection training. Roseview Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is safe, clean and maintained and decorated to a good standard. EVIDENCE: We toured the home and met with a number of residents in their rooms. The general maintenance and decoration of the home is very good. There is a maintenance book to record any problems so the maintenance person knows what needs fixing around the home. Peoples’ bedrooms were nicely decorated and contained resident’s personal possessions. Some residents have a key to their room. There is one main lounge which most residents choice to sit in. There is also another small lounge, which is rarely used. There is also a well maintained garden and we saw a number of residents sitting out with staff during the inspection. We also looked at the bathroom and toilet facilities in the home. Roseview Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 19 We saw the laundry area, which has satisfactory equipment including facilities for sluicing bedding and clothes as required. All toilets and bathrooms contained anti-bacterial soap and were being fitted with hand dryers to limit the risk of cross infection. Mandatory training in infection control is also provided for staff. People we spoke with said the home was clean and there were no offensive odours present on the days of the inspection. One person told us, “The home is always clean”. We examined records in relation to the maintenance of the home including lift maintenance, which were all up to date. As a result of a requirement made at the last inspection domestic staff have been employed at the home. This means that care staff have more time to be with residents. Roseview Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The staff at the home work hard to meet the needs of the residents and are provided with good training opportunities to further enhance their knowledge and skills. Recruitment practices are sufficiently detailed in order to protect residents at the home. EVIDENCE: The staffing levels at the home have been increased since the last inspection. We were told that this was due to the increasing dependency levels of residents at the home. People who use the service told us they were happy with the staff at the home and we saw good interactions between staff and residents. On the day of the inspection there appeared to be enough staff to meet the needs of the residents. Staffing rotas seen matched the names of the staff on duty that day. One person told us, “90 are very good”. Another resident said, “You get the help you need”. Staff we interviewed had a good understanding of the needs of the residents at the home. Two of the ten care staff have completed their NVQ level 2 or equivalent. We were informed that six more staff have registered to take this course. Roseview Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 21 Staff were positive about the training offered by the home and records and certificates seen indicated that staff are attending the appropriate training they need to support people properly and safely. This training included medication, mental health training, dementia care, moving and handling, adult protection and infection control. Staff are expected to pay for these courses and some staff said this was quite expensive. The area manager said this was because some staff leave the home after they have received the training to go to other jobs. It is important that the home encourages staff retention to ensure a consistent service. A good practice recommendation has been issued that the procedures for staff training be reviewed and ways of encouraging staff to remain at the home, such as paying for some courses, be explored. Six staff files were examined from staff recently employed by the home. We checked these files to see if the home’s recruitment procedures were being followed so that residents are protected from unsuitable staff working at the home. The files examined contained all the information needed to protect residents including two written references, proof of identity and criminal record checks. One staff file contained a CRB disclosure but the name of the employer was listed as the umbrella body the home uses to process disclosures. This is not satisfactory as all CRB disclosures must have the name of the current employer recorded. The area manager said this was an oversight and the date of the disclosure did match the date the person was employed at the home. A requirement relating to this issue has been made in the relevant section of this report. Some references did not include a company staff or letter headed paper from the referee. This would further confirm the authenticity of the references and a requirement has been issued relating to this matter. Roseview Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The registered manager is working hard to improve the quality of care provided at the home. Residents have opportunities to have a say in how the home is run. Residents’ financial interests are being safeguarded. The health and safety of residents and staff are being promoted and protected. EVIDENCE: A requirement was made at the last inspection that the home must employ a full time manager. We met with the newly recruited manager who had been working at the home for some time in another role. The registered manager, Ms Elsada Golding, has completed the Registered Managers’ Award and told us she is currently undertaking the NVQ level 4 in a care. Residents and staff we Roseview Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 23 spoke to were positive about the manager. One staff member said the manager was, “Approachable”. The home undertakes yearly quality assurance surveys for residents and their representatives. The results of these surveys are then published and made available to all interested parties. An action plan is then developed to address the issues raised as a result of the feedback. The home is visited regularly by the area manager and registered provider who provide written reports to the home manager detailing areas for improvement. As mentioned previously there are monthly residents’ meetings where residents can comment on the running of the home. It would be useful if the minutes of residents’ meetings also contained information from the manager about how any comments and suggestions will be acted upon. A good practice recommendation has been issued relating this matter. To further enhance the quality monitoring at the home a good practice recommendation has been issued that the management explore the use of “Dementia Care Mapping”. This is an observational tool that can monitor for signs of wellbeing in those residents with cognitive impairment. This should ensure that the staff at the home can assess whether they are providing a good level of care and support for those people who have dementia and may not be able to express their opinions verbally. The home holds small amounts of money on behalf of residents. Residents’ finances are either dealt with by the placing authority or the resident’s family. If a resident requires any money the home requests this from either the placing authority or from the family. Clear and accurate records were seen in relation to money being obtained by the placing authority including clear audit trails and receipts. Money received from relatives was not being satisfactorily recorded. The manager was able to explain the procedure and no financial irregularities were found, however the system was complicated and could present a risk of financial mismanagement. A requirement has been made that the procedures for dealing with residents’ money received from their relatives are reviewed and detailed records of any transactions must be accurately recorded. A satisfactory and up to date electrical installation certificate was examined. This was a requirement from the last inspection that has now been complied with. Records indicated that staff undertake fire drill every three months. Fire drills are also undertaken at night on a regular basis. A fire risk assessment has been recently carried out and potential fire risks have been highlighted and measures put in place to limit these identified risks. These were two requirements from the last inspection that have now been complied with. Roseview Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 24 We examined satisfactory records in relation to other health and safety issues including gas safety and Legionella control. Staff training records indicated that staff are undertaking the required health and safety training in order to protect both residents and staff. Roseview Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 3 Roseview Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No 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 OP1 Regulation 4(1) b Requirement The registered person must ensure that the home’s statement of purpose includes clear information regarding how the home will meet the needs of people who have mental health problems as a secondary condition to dementia. This should ensure that people moving into the home can be assured that their mental health needs will be met. The registered person must ensure that residents or their representatives are consulted about their care and are given the opportunity to comment on the quality of the care each time their care plans are reviewed. This is to ensure that people have a say in how they would like their care to be delivered. The registered provider must ensure that all staff working at the home have a satisfactory CRB disclosure that has the name of the home as their employer. Timescale for action 01/10/08 2. OP7 15(2) c 01/09/08 3. OP29 19(1) b 01/10/08 Roseview Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 27 4. OP29 19(1) c 5. OP35 16(2) l The registered person must ensure that all professional references include a company stamp or letter headed paper to further confirm its authenticity. The registered person must ensure that the procedures for dealing with residents’ money received from their relatives are reviewed and detailed records of any transactions must be accurately recorded. This should ensure that the risk of mismanagement of residents’ finances is reduced. 01/09/08 01/09/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP12 Good Practice Recommendations The registered person should ensure that “Life histories” are developed for all people with dementia so staff have the opportunity to find out what the resident was like before they came to the home. This could provide staff with more information about suitable activities for each person. The registered person should ensure that the small television in the main lounge is replaced with a larger one so that all residents are able to see it clearly. The registered person should ensure that the procedures for staff training are reviewed and ways of encouraging staff retention, such as paying for some courses, are explored. The registered person should explore ways that “Dementia Mapping” could be used as part of the home’s quality monitoring systems. 2. 3. OP12 OP30 4. OP33 Roseview Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 28 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 Residential Home DS0000010679.V369335.R05.S.doc Version 5.2 Page 29 - 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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