Care Home: Rosina Gardens

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What the care home does well It provides a safe comfortable environment in well presented and modern accommodation. The three residents all said how pleased they were to have been admitted to Rosina Gardens and each seems to have experienced some improvement in their lives in the short time they have lived there. The administration in the new service is well organised. We met some of the staff and it is evident that they have been selected for there knowledge and experience of people with mental health problems and appeared kind and caring in the attitude and approach to residents. What has improved since the last inspection? Not applicable. New registration. What the care home could do better: Some elements of the environment cannot be further enhanced since they are restricted by space or location; such as bedrooms with frosted windows giving no outward view, two bedrooms are not ensuite, bedrooms on the top floor have restricted head room. As all facilities have now been registered with the Commission it will be for each prospective resident to decide if these limitations will influence their decision to live here. At the time of inspection the home was still experiencing `snagging` problems such as faulty thermostats and water-flow to bath and showers. Some minor damage was also evident in the kitchen with a handle broken on a drawer; we also advised the purchase of a digital thermometer (in addition to the existing oven one) and we noted the use of a wedge to hold open the kitchen door and this poses a fire safety risk. The garden was in some disarray as bushes were being pruned or removed and also a new wooden smoking/activity room was being built. The manager must ensure the safety of residents, and staff during these works. We notethat both the front and back garden are joined with no fence between the two Alice homes Nos. 851 and 849 Brighton Road. Although the Statement of Purpose has already been noted by the Commission we found in practice that the home will provide more than rehabilitation for residents aiming to move on so we suggest the aims and objectives are refined to reflect intended practice. CARE HOME ADULTS 18-65 Rosina Gardens Rosina Gardens 849 Brighton Road Purley Surrey CR8 2BL Lead Inspector Michael Williams Unannounced Inspection 17th March 2009 09:45 Rosina Gardens DS0000072868.V374609.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 Rosina Gardens DS0000072868.V374609.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. Rosina Gardens DS0000072868.V374609.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosina Gardens Address Rosina Gardens 849 Brighton Road Purley Surrey CR8 2BL 0208660 9006 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) Ms Alice Manteaw-Dankyi Ms Roseline Modupe Saint-James Care Home 13 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (13) of places Rosina Gardens DS0000072868.V374609.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following category of service only: Care Home only Code PC To residents of the following gender: Female Whose primary care needs on admission to the home are within the following category Mental Disorder - Code MD 2. The maximum number of residents who can be accommodated is: Not applicable 13 Date of last inspection Brief Description of the Service: Rosina Gardens is situated to the South of Croydon in Purley on A23 and it is near transport, shops and leisure facilities. It is a large detached house recently converted to a good standard and was extended to accommodate 13 female residents. The stated aims of the service are to provide rehabilitation to most residents, who will move on to more independent accommodation when ready to do so. In some cases residents will live in Rosina Gardens but may not increase their independence through rehabilitation and may require 24 hour support for several years. The accommodation is on three floors and comprises 13 single bedrooms most have ensuite facilities including toilet and shower. Two do not have these facilities. Although the bedrooms are very well furnished to modern standards some bedrooms are limited as to space and view. Prospective residents will therefore need to decide if such a bedroom will meet their needs. The care home has the usual facilities including a large lounge, a smaller meeting room, a dining room and kitchen; the laundry is very small. In addition to the ensuite facilities there are other baths and shower rooms. There is a large office to the front of the building and outside there is parking to the front, a garden to the rear in which a general purpose activity/smoking room is being built. The care home was registered on 5th November 2008 and so ownership was confirmed at that time to be Mrs Alice Manteaw-Dankyi who owns several similar care homes in the area, they are known as the ‘Alice Group’ of homes. Fees as March £650, additional charges made be agreed by negotiation for extra care when indicated by formal assessment. Rosina Gardens DS0000072868.V374609.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This inspection included a visit to the new service Rosina Gardens. We met with the person in charge and the General Manager plus other staff. We also spoke to the service users, in this service they prefer to be called ‘residents’. There were no family visitors present during our visit but we circulated questionnaires to visitors and to professional agencies through the home. We also took account of any information we have received at the time of, and following registration in November 2008 and this includes the AQAA form, their Annual Quality Assurance Assessment. What the service does well: What has improved since the last inspection? What they could do better: Some elements of the environment cannot be further enhanced since they are restricted by space or location; such as bedrooms with frosted windows giving no outward view, two bedrooms are not ensuite, bedrooms on the top floor have restricted head room. As all facilities have now been registered with the Commission it will be for each prospective resident to decide if these limitations will influence their decision to live here. At the time of inspection the home was still experiencing ’snagging’ problems such as faulty thermostats and water-flow to bath and showers. Some minor damage was also evident in the kitchen with a handle broken on a drawer; we also advised the purchase of a digital thermometer (in addition to the existing oven one) and we noted the use of a wedge to hold open the kitchen door and this poses a fire safety risk. The garden was in some disarray as bushes were being pruned or removed and also a new wooden smoking/activity room was being built. The manager must ensure the safety of residents, and staff during these works. We note Rosina Gardens DS0000072868.V374609.R01.S.doc Version 5.2 Page 6 that both the front and back garden are joined with no fence between the two Alice homes Nos. 851 and 849 Brighton Road. Although the Statement of Purpose has already been noted by the Commission we found in practice that the home will provide more than rehabilitation for residents aiming to move on so we suggest the aims and objectives are refined to reflect intended practice. 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. Rosina Gardens DS0000072868.V374609.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rosina Gardens DS0000072868.V374609.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 1, 2, 3, 4: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents can be assured the home will arrange suitable assessments, it will provide relevant information and give ample opportunity for a trial period. EVIDENCE: In order to assess this section of the report we took note of the relevant details in the home’s Annual Quality Assurance Assessment form which tells us that the service will undertake “Comprehensive needs assessment of all prospective residents. This includes assessments of needs for the accommodation and personal support; risk assessment and management; rehabilitation programmes and treatment; cultural and faith needs; education/training. In general prospective residents individual needs and aspirations are assessed. All our assessments are undertaken by the home’s Manager, who prior to the assessment will obtain copies of the following from the care coordinator: medical and psychiatric and social history reports, CPA (the mental health services ‘Care Programme Approach’) and risk assessments. Prospective residents will also be given the opportunity to visit the home and go through a process of interaction with other residents, have meals in the home, and try overnight leaves, including a weekend”. During our visit in March we confirmed this to be the case, residents had visited and met with staff and other residents; assessments and care plans were in place for all three residents and they confirmed that their admissions had been well planned from their point of view. The information to be given to residents needs refinement to advise about bedrooms limitations and about long term rehabilitation. Rosina Gardens DS0000072868.V374609.R01.S.doc Version 5.2 Page 9 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): NMS 6, 7 and 9: Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. Residents can be assured that the home will develop care plans, with some proviso about the initial care planning, and will assist residents to make choices and will support appropriate risk taking. EVIDENCE: To assess this section of the report we read a sample case files and spoke to residents and checked other documentation in order to ‘track’ the quality of care planning provided by Rosina Gardens. The home promises to “Involving residents in formulating individual care plans based on the assessment of the residents needs. Included in the care plans are the residents personal goals, expectations, needs and wants. Residents capabilities, any arrangements for specialist input and treatments are also included in the care plan. Action plans to address needs, strategies for managing any challenging behaviours and risks identified are formulated. Care plans are regularly reviewed. Residents will be supported and encouraged to make decisions about their lives. Care staff in their role as key-workers provide information and support to help residents make their own decisions. Residents will be supported in managing their own finances where needed. Staff will Rosina Gardens DS0000072868.V374609.R01.S.doc Version 5.2 Page 10 support residents to take risks as part of the independent lifestyle. Residents will be given guidance and training in personal risk taking and safety”. We found the documentation to support these claims to be quite good. In addition to the information and assessments provided by external agencies, such as the mental health team, the home has its own assessment forms and care planning documents. So the staff have enough information to provide the care required by residents. We did find however that the initial and only care plan we were shown in one instance was rather limited. This initial plan aims to assess needs and risks. Since the home was already provided with very detailed information about a range of needs and risks prior to admission then more comprehensive, if interim, plans could have been drawn up. This is important if specific risks, such as challenging behaviour, have been drawn to the attention of the service. In particular there is need for contingency planning for things don’t go according to the plan, for example if a resident refuses support and guidance. Staff thought other plans may have been drawn up but they were not located by the staff on duty and so were of little value in assessing whether this standard was fully met and of course were not available for use by staff on duty that day. We were also advised that more detailed care plans would be drawn up after the first review. Staff assured us that they support residents to make choices and decisions about all aspects of their lives. This will include matters of hygiene, meals, activities, contact with the wider community and with family and friends and contact with professional agencies. We saw evidence about how this works in practice with residents who need support at meals times so as to encourage good nutrition. The resident we ‘case-tracked’ confirmed that in the few weeks she had been at the home she has settled in well and eating a better diet. Although we find initial care planning in one instance limited the staff on duty were in fact well informed about the residents and knew of the care needs and associated risks, how to manage them and who to contact if problems arose and so this section can be assessed as providing good outcomes for residents. Staff were less clear about the actual conditions of residents and their status under the Mental Health Act and this is a matter dealt with under the staffing section. Rosina Gardens DS0000072868.V374609.R01.S.doc Version 5.2 Page 11 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): NMS 12 to 17: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents will be able to experience a lifestyle, including social, educational, nutritional and personal relationships, that is relevant to their needs. EVIDENCE: The home states, “We, at Rosina Gardens, have plans to encourage and support residents to follow their particular interests and hobbies and to participate in outside activities, by providing information about local facilities and activities and supporting residents to use these facilities. We will also encourage residents to exercise their rights to vote. We actively oppose discrimination and we will encourage residents to engage in cultural and religious pursuits”. The homes’ statement continues, “We will respect residents rights and privacy and encourage independence, freedom of choice, privacy and dignity by always knocking and waiting to be invited before entering residents rooms, by addressing residents by their preferred name and by ensuring that residents receive and open their own mail. We will support residents, who are capable, to prepare their own meals and ensure that mealtimes are kept flexible and suit the residents activities and schedules. We will also encourage residents to pursue activities of interest and encourage and support them to achieve their life expectations/goals as much as possible. We Rosina Gardens DS0000072868.V374609.R01.S.doc Version 5.2 Page 12 will be supporting our residents who are capable to gain voluntary employment to promote confidence and reduce boredom”. To assess to what extend this new service is meeting those aims we met with residents and staff, reviewed documentation and observed day to day life in the home. This is newly registered service that is providing a homely and comfortable setting for residents. They tell us that they are happy with the lifestyle they are leading which involves looking after their own rooms, helping with domestic chores, preparing meals and shopping as example of rehabilitation. They have told us that they are keeping in touch with family and friends and these social contacts are welcomed into the home when they visit. Specific examples of activities including use of leisure centre for swimming and dance/exercise. It is not unusual for residents in this type of care home to still enjoy smoking and spend a lot of time in the home relaxing and watching television; it will be for the placing authorities and care coordinators to assess whether residents’ needs are being met as fully as planned for. Rosina Gardens DS0000072868.V374609.R01.S.doc Version 5.2 Page 13 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): NMS 18, 19 and 20: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate health and personal care can be provided in this care home. EVIDENCE: Whilst there have been no recent review of residents since their admission the residents themselves say that Rosina gardens is meeting their needs and have spoken making progress already. Their case files which we checked indicate that they are registered with a local doctor, they know who the staff of the mental health team supporting them and they are supported in matters such as dental and optician appointments. Residents tell us that the are quite happy with the way these things have been arranged. The Home states, “Staff will be following the policies and procedures regarding the ordering, storage, disposal and the administration of medication. Medicines will always be administered by trained staff. Staff will record all decisions on residents medication in their care plans, monitor residents who are on medication and report any concerns to the person in charge(the manager), and a medical/psychiatric review will be arranged as required. Staff will have good knowledge on the storage and recording of medication and also adequate knowledge and understanding of the legislation regarding the administration, ordering, storage and disposal of drugs. Medication training has been arranged for all care staff. We, the Commission, checked the arrangements for medication in some detail to ensure safe practices and procedures are in place and this was the case. Rosina Gardens DS0000072868.V374609.R01.S.doc Version 5.2 Page 14 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): NMS 22 and 23: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Concerns, complaints and protection procedures are in place to safeguard residents. EVIDENCE: The home has in its statement of purpose and in their AQAA given an undertaking to listen to residents and to protect them from harm. They state, “We (Rosina Gardens) will listen to residents complaints and respond to them and we will keep records of all complaints made and the actions taken. We will investigate and respond to complaints within 28 days. We will ensure that residents/relatives are aware of the complaints procedure and are enable to make complaints. We will ensure that minor issues do not escalate into major problems. We will also ensure that complaints made are dealt with promptly, within 28 days and we will also ensure that all concerned are kept informed about any developments”. To this end the home has a complaints procedure giving advice to residents and this is contained in both the Residents’ Guide and Statement of Purpose. No complaints have arisen we were told when we visited and so none have been recorded in their records. The AQAA makes no reference to the protection of vulnerable adults, now called the ‘Safeguarding’ procedures. We were told that the home has yet to acquire a copy of the local authority’s guidance on safeguarding but the home does have its own procedures which, quite correctly, advise staff to refer safeguarding issues to the relevant authorities including social services and the Commission. So such referrals have been made since the home start admitting residents. The home is recommended to get a copy of local authority safeguarding procedures. Rosina Gardens DS0000072868.V374609.R01.S.doc Version 5.2 Page 15 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): NMS 24, 25, 27 and 30: Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. This home will provide a safe and comfortable setting in which to live, subject to the proviso that some bedrooms have limitations. EVIDENCE: This care home was, once a small hotel, was thoroughly refurbished and modernised for registration as care home in November 2008. There are 13 single bedrooms. Furniture and fittings are to a high standard and the hone has a bright welcoming atmosphere. Additional facilities in the form of wooden summer-house is being built in the garden The gardens, front and back and now open up to both care home owned by Mrs Dankyi at numbers 849 and 851 Brighton Road but there is no internal connection between the two separately registered services. Not all bedrooms have ensuite facilities but most do have a toilet and shower ensuite. Some bedrooms overlook the neighbours and therefore have opaque windows, which means these bedrooms have no view. Some bedrooms, on the top floor also have slopping ceiling and this restricts the amount of usual floor space in these bedrooms. We viewed most bedrooms and found them to be well presented with most of the items in listed in the Standards including bed ad bedding, storage space and chairs. Not all bedrooms have desk or suitable Rosina Gardens DS0000072868.V374609.R01.S.doc Version 5.2 Page 16 surface for residents to use for their personal possessions. None that we saw had a lockable facility for residents to keep possessions safe. Prospective residents will need to made aware of these shortcomings but in general the rooms are very furnished. As a new building there are still faults with some systems, for example the bath water was very hot, in excess of 50oC. Since we are told the current residents can run a bath safely and independently this is not an immediate hazard but the thermostatic valves need to be properly maintained and re-set. Similarly the water supply to showers on the upper floors was cold and with a poor flow and so these also need correcting. We saw a wedge in use to hold open the kitchen door, this was removed by the person in charge when we pointed it out to her. If this door needs to be held open temporarily when carrying trays then a suitable magnetic door holder should be considered. Minor damage such as a broken drawer handle also need to be noted and attended to promptly if the current high standards of décor are to be maintained. The home was clean, fresh and free of offensive odour and suitable arrangements for washing laundering and storage of chemical and control of infection are in place. Rosina Gardens DS0000072868.V374609.R01.S.doc Version 5.2 Page 17 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): NMS 32, 34 and 35: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staffing arrangements in this home appear suitable to meet needs of residents and to keep them safe and well supported. EVIDENCE: At the time of our visit in March 2009 there were just three residents and but staffing levels are in pace for a larger group as more residents are admitted. There was on duty the manager but she left to deal with matters outside the home so for the duration of our inspection visit there was a senior carer in charge, and the General manager arrived to assist her; there were two carers and a cleaner also on duty. We are advised that this was meeting the needs of the small group of residents. The person in charge advises us the she is undertaking NVQ at level 4 and this is commendable. This member of staff also confirmed the recruitment arrangements the home include application forms, references, police check and health checks and interviews. The General Manager further confirmed that safe recruitment practice was in place and that all staff working in the home had been suitably checked including police (CRB) checks. The Manager was unable to provide us with details of staffing in her AQAA form since recruitment was underway for the new service when she completed the form. The home has decided to employ a cleaner and this means care staff will not be occupied by domestic chores and this is also commendable. Although the Rosina Gardens DS0000072868.V374609.R01.S.doc Version 5.2 Page 18 home does not have administrator the General Manager is able to give support in this area of work and this allows the staff and the home’s manager to dedicate more of their time for the residents. The home has a ‘key-worker’ system already in place (a key worker is a carer who takes an overview of the care being provided and acts as a communication link for agencies). We spoke to care staff about their role in supporting residents. Whilst we found that staff had some knowledge of ‘their’ allocated resident they were not as well informed as one might expect for example, their previous work history or their diagnosis. We also found staff were not clear about the legal status of residents in respect of the Mental Health Act. Since this is a home specialising in adults with mental health problems staff should be more aware of residents’ conditions and legal status because it may affect the way in which they are supported by the home. Key workers in particular should be up to date with residents’ current status since orders under the Mental Health Act, will have very precise time limits that residents should be made aware of. Rosina Gardens DS0000072868.V374609.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 37, 39, 41 and 42: Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. Resident can be assured that this is well managed service. EVIDENCE: This service was registered in November 2008 and Ms R. Saint-James was also registered as the Manager. Therefore the premises, the services to be provided and the management were at that time assessed as ‘fit’ for registration. The manager has yet to complete her management in care qualification but she already has 10 years experience in the field and has other qualifications including nurse training in mental health (RMN). We conducted our initial assessment of this new service in March 2009 and so the home has yet to build a track-record of management but our first inspection was very positive. The residents were all very positive about all aspect of the service; the food, the staff, the environment and their daily lives. So outcomes for the residents are already proving very positive. We did not receive back, at the time of compiling the report, any of the questionnaires we circulated so we do not at Rosina Gardens DS0000072868.V374609.R01.S.doc Version 5.2 Page 20 this stage know where other agencies, such the mental health team or the commissioning body, have reviewed placements. During our visit we checked a wide range of documentation including the visitors’ book, case files and staff records, accidents, complaints, owners’ visits (Regulation 26), resident money records, fire safety and kitchen records. All appeared in order and suitable recording systems are in place and relevant safety and maintenance checks are underway. The home a ‘health and safety’ manual to record risk assessments, for example fire safety risk assessments, and to maintain safety certificates so that they can be up dated routinely and promptly. We conclude that this is well run home with the safety and comfort of residents seen as central to the running of the home. Rosina Gardens DS0000072868.V374609.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 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 3 26 2 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X 3 3 X Rosina Gardens DS0000072868.V374609.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NA STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA1 Good Practice Recommendations Information: It is recommended that the statement of purpose be refined so as to reflect the type and range of services to be provided in with particular reference to short and long term rehabilitation. This is so as to reflect current practice in the home. Information: it is recommended that the resident guide be amended provided about the accommodation and facilities with particular regard to bedroom facilities and limitations. This is so that prospective residents can make an informed choice about whether to be admitted to any particular room and to gauge whether or not it will meet their needs and expectations. Care planning: Initial Care Plans need to reflect the information provided at, or prior to admission. This is so that they reflect the information provided, including care needs and risks. This is so that the initial care plans reflect known needs and risks. 2 YA1 3 YA6 Rosina Gardens DS0000072868.V374609.R01.S.doc Version 5.2 Page 23 4 YA23 5 YA24 6 YA24 7 YA26 8 YA35 9 YA37 Safeguarding guidance: It is recommended the home acquire a copy of the local authority’s guidance on referring safeguarding issues. This is so that the home can ensure they follow correct procedures in safeguarding residents. Water: it is recommended that the home monitor and maintain water supplies to baths and showers. This is to ensure the safety of residents by ensure an adequate and safe supply of water to baths and showers. Thermometer: It is recommended that the home acquire a suitable digital thermometer. This is so that temperatures including food storage and water temperatures can be effectively monitored at suitable intervals. Bedrooms: it is recommended that the home review all bedrooms to ensure they contain, so far as is practical all furniture and fittings advised in National Minimum Standard 26. Staff training: It is recommended that staff receive further training in mental health conditions and mental law commensurate with the conditions and legal status of residents. This is so that staff are aware of the health of the residents and are aware of their legal status in the home. Manager’s Qualification: it is recommended that the manager complete the relevant manager’s qualification without unreasonable delay. This is so as to comply with standard 37. Rosina Gardens DS0000072868.V374609.R01.S.doc Version 5.2 Page 24 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 Rosina Gardens DS0000072868.V374609.R01.S.doc Version 5.2 Page 25 - 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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