Care Home: The Roan Rest Home

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What the care home does well The Roan Rest HomeDS0000014253.V375748.R01.S.docVersion 5.2Care plans provide clear guidance for staff on how to meet the needs of individuals. Care staff demonstrated an understanding of the individual needs of residents and was attentive to them on the day of the site visit. Residents are provided with opportunities to involve themselves in activities if they wish. Resident`s routines are to their own choice and preference. Residents` choice and preferences are catered for with meals. Visitors are welcomed at the home. The home employs a stable and committed team of staff who know, understand and respect the needs of the people who live there. Low turnover of staff helps assist in promoting continuity of care. There are systems in place to ensure residents feel free to air their views and know that action will be taken where needed. Residents live in a homely environment and are provided with comfortable communal facilities. Some comments received from residents were: `I am looked after perfectly by a superb team who make it the perfect home for me`, `I was so happy here, I came back`, `It`s the best home in the world` and ` General care and conditions very good.` Two resident surveys identified in what the home does well commented `everything`. What has improved since the last inspection? Work has been done to ensure compliance with the three requirements made at the last inspection. Handwritten prescriptions provide clearer information to ensure staff and residents are safeguarded, a new controlled drugs cabinet has been purchased and installed and the Registered Manager is undertaking a management course to ensure resident live in a home which is run and managed by a qualified person and are protected by the effective leadership. The AQAA identifies areas that they have improved in the last 12 months and some examples given as changes they have made as a result of listening to residents are: menu planning to provide more choice and variety of foods including more fruit and vegetables, sitting and listening to residents regarding the layout of their rooms and involve them in the way their room is decorated and to encourage staff to listen and make time for residents. Further changes they are planning to make as a result of listening to people are to arrange more outings which resident can assist in choosing and plan, to encourage residents to use the outdoor area more and to further involve residents in the gardening and planting their own bulbs. What the care home could do better: Whilst residents currently residing at the home have their needs met, the home must ensure a comprehensive pre admission assessment is undertaken to identify all health, social and welfare needs to ensure all needs can be metThe Roan Rest HomeDS0000014253.V375748.R01.S.doc Version 5.2 with the services and facilities provided at the home, this includes taking into account the layout of the services. Further evidence needs to be provided on how individual choices have been made and where restrictions may have been imposed, risk assessments need identify why this is so. i.e. self-medicating. Any minor shortfalls noted at this site visit, of which no requirement or recommendation has been made have been highlighted throughout the report of which management confirmed they will address or has already been identified in the AQAA as their plans for improvement in the next 12 months. The AQAA received from the home evidences that the home is working to improve the quality of the service provided at Roan Rest Home. It provides us with information on areas that have been improved in the last twelve months and what their plans for improvement are within the next twelve months. Feedback from residents and staff when asked what the home could do better, identified the majority thought nothing else. Some identified that more outings could be provided, weather permitting. Key inspection report CARE HOMES FOR OLDER PEOPLE The Roan Rest Home 27/29 Pembroke Crescent Hove East Sussex BN3 5DF Lead Inspector Jennie Williams Key Unannounced Inspection 5th June 2009 10:50 DS0000014253.V375748.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. The Roan Rest Home DS0000014253.V375748.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address The Roan Rest Home DS0000014253.V375748.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Roan Rest Home Address 27/29 Pembroke Crescent Hove East Sussex BN3 5DF 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) 01273 772927 01273 738260 Roan@vigcare.co.uk Mr Joginder Singh Vig Mrs Beant Kaur Vig Mrs Beant Kaur Vig Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (0) of places The Roan Rest Home DS0000014253.V375748.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 19. Date of last inspection 27th June 2008 Brief Description of the Service: The Roan Rest Home is a residential care home providing social and personal care for up to nineteen older people. There are four rooms allocated to provide intermediate care. The home is owned by Mr and Mrs Vig who owns numerous care homes throughout the South of England, predominantly older people services. The home is situated in a quiet residential area of Hove within walking distance of local amenities. There is nearby access to public transport. There is no parking available at the home, but two hour restricted paid parking is available in adjacent streets. Accommodation is provided over three floors in a large property that has been converted from two houses. A passenger lift enables residents to access all parts of the home. However, there is a short flight of stairs to mezzanine levels that place some limitations on residents with restricted mobility. The home would not be suitable for wheelchair users. The dining room can be accessed by a stair lift. Seventeen rooms are for single occupancy, of which eleven have en suite facilities and one double room that does not have en suite facilities. There is a lounge/dining room on the lower ground level and a quiet lounge on the first floor. This quiet lounge is used as an office and for use by residents. There are suitable numbers of communal toilets and bathing facilities located The Roan Rest Home DS0000014253.V375748.R01.S.doc Version 5.2 Page 5 throughout the home. There are grab rails placed throughout the home in areas where residents may require some assistance with mobilisation. Weekly fees range between £381 and £460. There are additional fees for; Hairdressing, Chiropody, newspapers and personal toiletries (at cost). This information was provided to the CSCI on the 5th June 2009. The Roan Rest Home DS0000014253.V375748.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. It should be noted that following consultation, it was identified that service users prefer to be called people who use services. For the purpose of this report, people who use the service will be referred to as residents. This site visit was facilitated by the Registered Manger and deputy manager. For the purpose of this report they will be referred to collectively as management. This unannounced site visit took place over seven hours on the 05 June 2009. Evidence obtained at this site visit, previous information regarding this service and information that we have received since the last inspection forms this key inspection report. An annual quality assurance assessment (AQAA) was sent to us by the service, completed by the home on the 19 March 2009. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. The AQAA was completed by the Registered Manager and returned when we asked for it. Ten resident surveys were sent to the home prior to the site visit of which all were returned. Six of these were completed by the resident themselves and four completed with assistance from staff or a relative. Six residents were met in the dining room and advised to let us know if they wished to speak individually with us. Individual conversations were had with three residents. One care plan was viewed and specific areas of care looked at in a further five care plans. Ten staff surveys were sent to the home prior to the site visit, of which nine were returned. Three visiting professionals were briefly spoken with. Four staff files were inspected, along with some training records. Medication procedures were viewed and the procedures and records for handling residents finances were inspected. Some individual rooms were viewed, along with communal areas. The quality assurance system, complaint records and quality monitoring checks in place were viewed/discussed. There were fifteen residents residing at the home on the day of the site visit. What the service does well: The Roan Rest Home DS0000014253.V375748.R01.S.doc Version 5.2 Page 7 Care plans provide clear guidance for staff on how to meet the needs of individuals. Care staff demonstrated an understanding of the individual needs of residents and was attentive to them on the day of the site visit. Residents are provided with opportunities to involve themselves in activities if they wish. Residents routines are to their own choice and preference. Residents choice and preferences are catered for with meals. Visitors are welcomed at the home. The home employs a stable and committed team of staff who know, understand and respect the needs of the people who live there. Low turnover of staff helps assist in promoting continuity of care. There are systems in place to ensure residents feel free to air their views and know that action will be taken where needed. Residents live in a homely environment and are provided with comfortable communal facilities. Some comments received from residents were: I am looked after perfectly by a superb team who make it the perfect home for me, I was so happy here, I came back, Its the best home in the world and General care and conditions very good. Two resident surveys identified in what the home does well commented everything. What has improved since the last inspection? What they could do better: Whilst residents currently residing at the home have their needs met, the home must ensure a comprehensive pre admission assessment is undertaken to identify all health, social and welfare needs to ensure all needs can be met The Roan Rest Home DS0000014253.V375748.R01.S.doc Version 5.2 Page 8 with the services and facilities provided at the home, this includes taking into account the layout of the services. Further evidence needs to be provided on how individual choices have been made and where restrictions may have been imposed, risk assessments need identify why this is so. i.e. self-medicating. Any minor shortfalls noted at this site visit, of which no requirement or recommendation has been made have been highlighted throughout the report of which management confirmed they will address or has already been identified in the AQAA as their plans for improvement in the next 12 months. The AQAA received from the home evidences that the home is working to improve the quality of the service provided at Roan Rest Home. It provides us with information on areas that have been improved in the last twelve months and what their plans for improvement are within the next twelve months. Feedback from residents and staff when asked what the home could do better, identified the majority thought nothing else. Some identified that more outings could be provided, weather permitting. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. The Roan Rest Home DS0000014253.V375748.R01.S.doc Version 5.2 Page 9 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 The Roan Rest Home DS0000014253.V375748.R01.S.doc Version 5.2 Page 10 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst current residents living at the home have their needs met, the pre admission assessment process poses a risk that some residents may be admitted into the home without all of their needs being identified prior to admission. EVIDENCE: The home has a Statement of Purpose and Service Users Guide that is available at the home and provides prospective residents/representatives with information about the services and facilities provided at the home. These documents advise that they are available in other formats on request. The Roan Rest Home DS0000014253.V375748.R01.S.doc Version 5.2 Page 11 All resident surveys identified that they received enough information to help them to decide if the home was the right place for them before they moved in and have received a contract. There was evidence of a pre admission assessment having been undertaken prior to admission. Management was advised that these assessments need to be expanded to include all areas of health, social and welfare needs and to ensure any specialist equality and diversity needs are reflected. Information is provided from other professionals wherever possible. Shortfalls in information could result in a resident being inappropriately placed. i.e. sight impairments For intermediate care residents, the home receives an assessment from the intermediate care team on which they base their decision on. Additional information is requested if needed. Management confirmed that they have previously refused to admit someone due to lack of information provided to them. Should an intermediate care resident choose to become permanent at the home, the home then undertakes their own assessment. Prospective residents/representatives are encouraged to visit the home prior to admission. Of the residents that were asked, all confirmed that they or a representative visited the home prior to moving in. Management confirmed that there is no resident at the home from any minor ethnic community, social/cultural or religious groups with any specific needs or preferences. There are four rooms allocated to provide intermediate care. Any specialist equipment is identified and provided by the various external agencies involved in providing the intermediate care support. This includes district nurses, occupational therapist and physiotherapists etc. A resident receiving intermediate care confirmed that they were provided with a choice to come to the home or not. The Roan Rest Home DS0000014253.V375748.R01.S.doc Version 5.2 Page 12 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are being met with the information provided in the care plans on the assessed needs of individuals. Residents are safeguarded by the medication procedures in place. EVIDENCE: The care plan viewed and specific areas of care looked at identified that there was guidance in place for staff on how to meet the needs of residents. There was evidence of care plans being reviewed on a monthly basis. All resident surveys answered identified that they always receive the care and support they need. A resident spoken with confirmed that they are familiar with their care plan and are involved in reviewing this. There is a key worker system in place and a resident confirmed that they were aware who their key worker is. The Roan Rest Home DS0000014253.V375748.R01.S.doc Version 5.2 Page 13 There was evidence that advice is sought from health professionals. This was confirmed by a residents written comment, If needed GP, dentist, chiropodist, hospital, rung straight away. Nine resident surveys identified that the home always makes sure they get the medical care they need. One identified they usually get this support. Three visiting professionals confirmed that they had no concerns regarding the services provided at the home and staff demonstrate an understanding of residents needs. The home continues to receive good support from the intermediate care team that consists of, nurses, physiotherapists, occupational therapists, GP etc. Management need to ensure that risk assessments are dated and signed when undertaken and reviewed to identify current information and who undertook the assessment. It was confirmed that risk assessments are reviewed every six months or earlier if the needs of an individual changes. Discussions were had on further ways to evidence how choices have been made. An example is that an assessment identified no for self medication. There was no information to identify if this had been the residents choice or the home deciding it was not safe for the individual to self-medicate. There was no risk assessment to identify if this was the case. It was confirmed that there a policies and procedures in place for all aspects of dealing with medicines. The content of these were not read at this visit. Medication Administration Record (MAR) charts and blister packs viewed identified that medication was being signed for at the time of administration. The home has had a new controlled drugs cabinet installed. There were no controlled drugs being used at the home at the time of this visit. There was evidence that clear records are being maintained of all medicines entering and leaving the home. Staff were observed to have a good professional rapport with residents and were heard to be calling them by their preferred term. Residents were observed to be treated with respect by the staff. Staff were observed to knock on residents doors prior to entering. Some written comments from staff surveys in what they felt the home does well were: Respects residents privacy and dignity and The home preserves and maintains their dignity, individuality and privacy. Makes every service users stay as homely and comfortable as possible. The Roan Rest Home DS0000014253.V375748.R01.S.doc Version 5.2 Page 14 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents lifestyle within the home is generally their own choice and residents are provided with sufficient stimulation to fulfil their interests and needs. Residents choice and preferences are catered for with meals. EVIDENCE: There is an activities person employed at the home for four hours, two days a week. Staff initiate activities when this person is not working. All resident surveys identified that there are always/usually activities the home arranges that they can take part in if they want. A resident survey and a staff survey felt in what the home could do better is to provide more outings. This shortfall had been identified in the AQAA as an area in which they could do better and is an area the home plans to improve in the next 12 months. Residents spoken with confirmed that their lifestyle within the home is their own choice. Residents were observed to move freely within the home environment. Written comments from residents and staff included: Try to The Roan Rest Home DS0000014253.V375748.R01.S.doc Version 5.2 Page 15 involve us in the games days but are not made to join in, they take me to the bank when I have to go and there is a lot of activities. Visitors are welcomed at the home and this was reflected in written comments from staff surveys. makes people (everyone) who lives or visit feel comfortable and You feel at home whether you are staff, visitor or service user. There are no visiting restrictions. A resident spoken with confirmed that they receive visitors and also go out of the home environment to meet their friends/family. Residents were complimentary about the food provided at the home, both written and verbally. Resident surveys identified that seven people always like the meals and three usually like the meals provided at the home. Comments received ranged from good to excellent with some written comments being: Meals are of a good standard, Always something to eat and drink out of meal time hours if you want it, good food, well presented and cooked nicely and provide good meals. Positive comments about the food were also reflected in staff surveys. The Roan Rest Home DS0000014253.V375748.R01.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents know how to make a complaint, reassuring those involved that they are being listened to and that action will be taken, if necessary. EVIDENCE: There is a complaints procedure available at the home. All resident surveys identified that there is someone they can speak to informally if they are not happy and know how to make a formal complaint. The AQAA identified that there have been no complaints made to them in the last 12 months. Feedback from staff surveys identified that they know what to do if someone raises concerns about the home. The home had previously advised that they were going to implement a survey to send to a complainant following completion of the complaint investigation to ensure they are happy with the way their concerns were dealt with and to assist in identifying areas from improvement. This had not been done to date, however will be considered again by management as part of their quality monitoring. We have been informed of three Safeguarding Adults investigations in the last 12 months. One was inconclusive, one unsubstantiated and one substantiated. Action has been taken by the home to ensure similar instances do not arise The Roan Rest Home DS0000014253.V375748.R01.S.doc Version 5.2 Page 17 again. Following relevant advice, the home took appropriate action to ensure incidents are not repeated and to further safeguard residents. The home is cooperative with the investigating authority. One incident was related to an individual being denied access to an ambulance. The leading authority advised the home to ensure that procedures are in place to ensure all staff are aware that if an individual requests an ambulance, one is called for them. This has been discussed with staff in meetings. It is recommended that written guidance be provided to staff regarding this procedure. Staff receive training in Safeguarding Adults procedures that includes information regarding whistle blowing. The Roan Rest Home DS0000014253.V375748.R01.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a homely environment and are provided with comfortable indoor communal facilities and their private accommodation personalised to suit their taste. EVIDENCE: The last inspection report identified that the outcome for residents with the environment was good. Management confirmed that there have not been any major changes made to the environment since the last inspection. Whilst walking around the home, it was noted that the home continues to be generally well maintained. The Roan Rest Home DS0000014253.V375748.R01.S.doc Version 5.2 Page 19 The AQAA identifies that an improvement they have made in the last 12 months is to identify in the maintenance book the priority of getting things fixed and are involving residents by asking their opinion about the environment and areas for improvement. Some residents were happy for us to visit their individual room and these were seen to be personalised to reflect the individuals choice and character. One resident informed us that they had new carpet and their room had been redecorated. They were not involved in the choice regarding this, however confirmed that they would not really want to have been involved. Radiators were observed to be guarded, however these guards would need to be removed should the temperature control require to be changed within an individual room. The registered providers should consider allowing easy access for individuals so residents may control the temperature independently. Some bases of divan beds appeared old and worn. This is for the home to assess and replace where needed. Following a previous recommendation, the home has sought telephone advice from the Health Protection Agency in regards to good infection control practices when no sluice facilities are available. Management confirmed that they have suitable procedures in place to ensure staff and residents are safeguarded. The home appeared clean on the day of the site visit. All resident surveys identified that the home is always fresh and clean. A written comment from a resident was the home does well in cleanliness in all parts of the home and also the bathroom and toilets. The AQAA identifies that staff receive training in prevention and control of infection and they have an action plan to deliver best practice in prevention and control of infection. There was evidence of in-house training in infection control being provided. The AQAA identifies that the home has achieved a five star rating from environmental health in an area that they have improved in the last 12 months. The Roan Rest Home DS0000014253.V375748.R01.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are being met with the number and skill mix of staff on duty and are safeguarded by the recruitment procedures in place. EVIDENCE: Feedback (verbal and written) from residents were complimentary about the staff with comments being: pleasant, They are kind and caring. Have a joke and speak with you, Staff are friendly and helpful, The staff are very helpful and are very good in all they do and Staff here are just great. Nine resident surveys identify that staff are always available when needed. Eight staff surveys identified that there are always enough staff on duty to meet the needs of residents. One felt there was usually enough staff. The home had a relaxed atmosphere on the day of the site visit. The AQAA identifies that there are 14 permanent care workers at the home, of which seven have National Vocation Qualification (NVQ) level 2 or above. The four staff files were viewed showed that good recruitment practices are in place. References are obtained, Criminal Record Bureau (CRB) and Protection The Roan Rest Home DS0000014253.V375748.R01.S.doc Version 5.2 Page 21 of Vulnerable Adults (POVA) checks are undertaken and application forms are completed. Where staff have commenced employment on just a POVA First check, the Registered Manager confirmed that they work supervised until an enhanced CRB is returned. A risk assessment was observed to be have undertaken to show that where information had been returned from the CRB, this posed no risk to residents. The AQAA identifies that three care staff have left employment in the last 12 months. This low turnover of staff assists is promoting continuity of care for residents. Management confirmed that staff are kept up to date with mandatory training. There was evidence of training records in a staff file viewed. Some training is provided in house, whilst others are provided by external trainers. Staff surveys identified that they are provided with training that is relevant to their role, helps them to understand and meet the individual needs of residents, keeps them up to date with new ways of working and gives them enough knowledge about health care and medication. All surveys identified that staff felt they always/usually have enough support, experience and knowledge to meet the different needs of people who live at the home. The Registered Manager confirmed that all new staff now complete the Common Induction Standards as set by Skills for Care. If a new staff member has NVQ qualifications, an in house induction is undertaken. The Roan Rest Home DS0000014253.V375748.R01.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from the home being run by an experienced and dedicated Registered Manager who ensures that the home is run safely and generally in the best interest of residents. EVIDENCE: The Registered Manager is currently undertaking a distance learning management course as required from the last inspection. There are plans in place to put forward the deputy manager for the role of Registered Manager. Management keep themselves up to date by reading relevant care magazines and other literature, accessing training and looking on the internet to keep up The Roan Rest Home DS0000014253.V375748.R01.S.doc Version 5.2 Page 23 to date with good practice guidance. The deputy manager has also completed the Registered Manager Award and is soon to complete NVQ level 4 in care. Staff survey results showed that the manager meets regularly with staff to give support and discuss any issues. Written comments from staff were: I feel the home is run very well, The home is run properly and we are given much support and the manager and deputy manager treat everyone well and the same. The AQAA identifies that they use a Mental Capacity Act assessment tool is implemented in the home and management are on the waiting list to attend formal training on the Mental Capacity Act and Deprivation of Liberty Safeguards (DOLS). There is information available to staff at the home regarding these subjects. There is currently no application for authorisation being processed. The home has a quality assurance and quality monitoring system in place to ensure that the home is run in the best interest of residents and meets its aims and objectives. Regular monitoring within the service also ensures residents continue to live in a safe environment. Surveys for residents, relatives/visitors and other stakeholders had just recently been undertaken. Procedures are in place to ensure that intermediate care residents are also provided with an opportunity to feedback regarding their stay at the service. Staff surveys have just been commenced. An analysis is undertaken of any quality monitoring surveys and points of action are identified. Results are displayed within the home. Staff and residents also have an opportunity to raise any issues/suggestions and meetings held every two months. Written quotes observed in the homes own quality monitoring were: staff has always got smile on their face, which makes a person feel comfortable and Food more than enough. There is a suggestion box at the home that provides people with an opportunity to anonymously make suggestions/complaints. Monthly visits are also undertaken by a representative of the registered providers and a report of these visits are provided to the Registered Manager, as required by legislation. The home may hold personal allowance for some individuals for safekeeping if the individual wishes. There was evidence that suitable procedures are in place to ensure residents monies are safeguarded. No staff member within the service is an appointee for any resident. Residents manage their own finances or make alternative arrangements themselves. Limited staff have access to residents money as a further safeguarding measure. It was confirmed that regular health and safety checks are undertaken within the environment. The AQAA identifies that equipment has been serviced or The Roan Rest Home DS0000014253.V375748.R01.S.doc Version 5.2 Page 24 tested as recommended by the manufacturer or other regulatory body. Dorguards were observed to be in place where an individual wishes to have their room door open. There was evidence within staff files that training is provided in health and safety matters i.e. Fire training, First Aid and manual handling etc. It was observed in some areas that the pipes supplying hot water were not covered. The home needs to assess this risk and take action wherever needed. The Roan Rest Home DS0000014253.V375748.R01.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 X X 2 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 The Roan Rest Home DS0000014253.V375748.R01.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 OP3 Regulation 14 Requirement That a comprehensive pre admission assessment is undertaken on prospective service users to identify all health, social and welfare needs. Timescale for action 30/07/09 2. OP7 12 This is to ensure all needs can be met with the services and facilities provided at the home. 30/07/09 That evidence be provided on how individual choices have been made and where restrictions may have been imposed, risk assessments need identify why this is so. This is to assist in promoting independence and evidence why restrictions may have been imposed to safeguard individuals. The Roan Rest Home DS0000014253.V375748.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Roan Rest Home DS0000014253.V375748.R01.S.doc Version 5.2 Page 28 Care Quality Commission South East The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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) Care Quality Commission (CQC). 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. 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