Care Home: Roseville House

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What the care home does well The manager and his staff like to find out what people living in the home like to do and try to make sure that they can do it and they find out what they like to eat and try to make sure that is what they get If a someone is ill they make sure that they get the right treatment. If someone needs medicines or creams they will make sure they get them. If a someone doesn`t like something they can complain to the manager or his managers and they will look at the problem very carefully. The home is clean and well decorated. The staff are cheerful friendly and helpful and encourage people to enjoy themselves but also try to make sure that they are safe and well looked after. The manager is also cheerful friendly and helpful and does all of the things that help the staff to do their job. What has improved since the last inspection? There were no requirements or recommendations made as a result of the last inspection. What the care home could do better: No requirements have been made as a result of this inspection. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Roseville House New Street Wem Shropshire SY4 5AB     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michael Moloney     Date: 0 6 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Roseville House New Street Wem Shropshire SY4 5AB 01939235163 Telephone number: Fax number: Email address: Provider web address: alan@adelphicareservices.co.uk Name of registered provider(s): Name of registered manager (if applicable) Alan Frank Jones Type of registration: Number of places registered: Adelphi Care Services Limited care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The home may accommodate five persons with learning disabilities including one young person under the age of eighteen years. Date of last inspection Brief description of the care home Roseville is a large adapted family home registered with the Commission of Social Care Inspection to provide care and accommodation for up to 5 adults. Service users living at the home have severe learning disabilities and additional needs associated with autism, epilepsy and behaviours that can be challenging. The home is situated in the market town of Wem approximately 12 miles north of Shrewsbury, close to all the towns community facilities and located in close proximity to another of the organisations residential homes. The Registered Provider is Adelphi Care Services Ltd and the Registered Manager is Alan Jones. Further information is available form the homes service user guide which can be made available in a range of formats. The fees are currently £54,000 to £100,000 per year. 5 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 26 Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: A range of evidence was used to make judgements about this service. This includes: information from the provider which included a self assessment document that they are required by law to complete, records kept in the home, medication records, discussions with the staff team, tour of the premises, previous inspection reports and talking with as well as observing the care experienced by people using the service. Care Homes for Adults (18-65 years) Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 26 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may wish to live at this home and their representatives have the information needed to decide if it will meet their needs. They have a contract which clearly tells them about the service the will receive. Evidence: Nobody new have gone to live at the home since the last inspection. The information available to two of the people who already live there was looked at and this was seen to include easily read versions of the homes Statement of Purpose, the Service User Guide and the contract between themselves and Adelphi Care who own the service. Care Homes for Adults (18-65 years) Page 9 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are involved in decisions about their lives and play an active role in planning the care and support they receive. Evidence: The care records for two of the people who live in this home were looked at and were seen to contain information about the reviews of their care that had taken place in the last twelve months. The records reviewed were of their likes, dislikes as well as those about how they could be kept safe in a variety of situations. When talking with the staff they also confirmed that they had been involved in these reviews. Behaviour management plans had also been reviewed as part of this process and could be seen in the individuals files. The people who live in this home come from a variety of ethnic backgrounds and in each of the documents arrangements were referred to that would meet individuals Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: needs in such matters as food and worship. Talking to the staff showed that they are very aware of the individuals needs and the managers explained that the observations recorded by the staff are used when reviewing the needs of each individual. Observing some of the people who live in this home and looking at their records it is clear that if they did not like something they would show it very clearly. Care Homes for Adults (18-65 years) Page 11 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in this home are able to make choices about their life style and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individuals expectations. Evidence: The records of two of the people who live at the home were looked at. They were both seen to have detailed care plans and Person Centred plans that contained the likes, dislikes and wishes of each individual. Talking to the staff and the manager confirmed that these had been developed by observing which activities the person liked or disliked or asking other people such as friends or relatives for input. Each individual person was also asked and they were able to respond in different ways depending on their communication skills. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: Copies of these plans were seen in each persons bedroom and the manager explained that they were used to explain what activities were to take place. He also explained that some of the plans had been laminated otherwise they did not last long because of wear and tear. Daily activity sheets were also seen in each persons file and looking at these showed that activities take place that are to the liking of the person concerned. During the inspection it was seen that activity summary sheet for each of the daily activities was marked as completed by the staff giving a quick reference when checking that people were taking part in the activities that they either enjoyed or needed. These same daily sheets were seen to contain records of what each person had eaten. Checking these records against individual Person Centred Plans showed that people are being offered food that they are known to enjoy and meet their cultural needs. The records also said what name each person liked to be known as. Throughout the inspection staff were seen to treat everyone with dignity and respect and explained what they were doing as they did it. The people that they were talking to gave the impression that they were used to this and expected it. The home was seen to have three vehicles that were available to transport people to the activities or appointments that had been arranged for them. These were shared with a nearby sister home. Care Homes for Adults (18-65 years) Page 13 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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. Evidence: The records looked at showed when each person had either visited or been visited by a healthcare professional, what for and what the outcome was. The arrangements for the storage and administration of peoples medication were looked at. Storage was seen to be appropriate and records correctly maintained. Storage is within a purpose designed cabinet secured within a small locked storeroom. No controlled drugs were found to be kept at the home. Staff said that they receive training in the safe handling of medication before they are allowed to give them to people and their records confirmed this. Care Homes for Adults (18-65 years) Page 14 of 26 Care Homes for Adults (18-65 years) Page 15 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although the people who live in this home may have difficulty expressing themselves they are able to express their concerns and have access to a robust, transparent and effective complaints procedures, are protected from abuse by transparent policies and procedures and have their rights protected. Evidence: Since the last inspection there have been five issues referred by this home through the local authority Adult Protection procedures. It was seen that they had followed those procedures and had fully co-operated with them. Observing their representatives and reading the formal minutes of the meetings as well as by talking to other members of the management team who did not attend the meetings showed that they had reported information accurately and in a transparent manner. The home had openly reported any failings in their own internal procedures and had outlined the measures that they had intended to take so as to reduce the possibility of a recurrence. Talking to the staff in the home and looking at their records showed that these measures had been put in place. The home was seen to have a complaints procedure in place that was also available in Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: a format that would be easier for the people who live in this home to understand. No formal complaints had been received. Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe, well maintained and comfortable environment, which encourages independence. Evidence: This house is situated near to the centre of Wem in north Shropshire. It has a private and secure garden which can be used by the people who live in this home. The house was undergoing considerable restoration at the time of the visit. Work was seen being carried out on the roof and a new kitchen. Various facilities such as the laundry and the managers office had already been relocated and the manager explained that when the structural work had been completed the whole house would be redecorated. Risk assessments were seen to have been carried out to ensure that the people who live in the home remain safe during this work and plans were being considered that would ensure that if the work may upset individuals they would not be present when it takes place. One bedroom needed to have work done to open up windows and the final part of the job had been put on hold until suitable arrangements for the person who Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: lives in that room could be considered and made. The home has three distinct communal rooms enabling the residents to have a choice of area in which to relax or eat as well as giving the staff more options if managing any challenging behaviours. There is also a craft room in the grounds of the home that is also in the process of being refurbished. All residents have their own bedrooms, each being furnished and decorated to suite the taste and needs of its occupant. All bedrooms were on the first floor. The homes laundry area is fully equipped to make sure that peoples clothes, bedclothes, towels etc. are kept clean and the staff confirmed that they had received training in infection control. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support the people who live there, in line with their terms and conditions and to support the smooth running of the service. Evidence: At the time of the inspection there were 5 staff on duty as well as the manager. Talking to the staff on duty and looking at the rota showed that this is the usual throughout the day with extra staff being made available as necessary and with two staff sleeping in at night. One member of staff had only just started working at the home and he was able describe what training he had been offered and undertaken. Another member of staff was able to describe his induction as well as foundation training and the mandatory safety training that is necessary for someone working in this type of establishment. All of the staff spoken to said that they have access to a good range of professional training that is chosen to meet the identified needs of the people who live in the home. This was confirmed by looking at the training records. Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: By talking with the staff and looking at their records it was also possible to establish that over 50 of the staff team had achieved at least National Vocational Qualification level 2 with a number of them exceeding this. Recruitment files were seen to contain all of the evidence that shows that the home has a safe and transparent recruitment procedure which includes all of the background checks that identify whether or not someone is suitable to work with vulnerable people. Most staff records are kept at the companys head office at Merrington however these were brought to the home so that they could be looked at during the inspection. Although this arrangement does not fully comply with the Care Homes Regulations 2001 it is acceptable as long as identification photographs are kept both on the personnel records and at the home. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. Evidence: Talking with the manager showed that he had completed his Registered Managers Award. This is a qualification that is considered to be appropriate for someone who manages a service of this type. He also said that he receives professional supervision from his manager on a regular basis. This was confirmed by his manager. The law says that a senior member of the owners staff must carry out formal inspections of the home every month. These visits were shown to have been taking place by looking at the records, talking with the manager, his staff as well as the manager who caries out such visits. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: A variety of records were seen that showed that safety issues are constantly monitored. Records of such things as fridge freezer temperatures, fire equipment tests, gas safety tests, hot water temperatures and portable appliance testing were seen to have been maintained. Hazardous materials were seen to have been stored in a locked cupboard. Staff records also showed that the mandatory training that is necessary to keep the service users safe has been taking place. This includes training in such things as food hygiene, fire prevention and infection control. Staff spoken to confirmed that these records were accurate. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!