Care Home: Three Roses

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What the care home does well There was a welcoming and friendly atmosphere within the home. The home was clean and comfortable with well maintained grounds. The service is person centred in its approach. People living at Three Roses have their medical care needs met. Plans regarding their care are in place and are reviewed on a regular basis involving individual residents and their key worker. People are able to partake in a range of activities within the home and within the wider community. What the care home could do better: The registered manager agreed that some improvement is needed regarding medication systems to ensure that full audits can be easily undertaken. The use of communal soap needs to be discouraged as it can be a potential risk of cross infection. Random inspection report Care homes for adults (18-65 years) Name: Address: Three Roses Bromsgrove Road Holy Cross, Clent Stourbridge DY9 9QP three star excellent service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Andrew Spearing-Brown Date: 0 6 0 5 2 0 1 0 Information about the care home Name of care home: Address: Three Roses Bromsgrove Road Holy Cross, Clent Stourbridge DY9 9QP 01562730730 01562730310 threeroseshome@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Isobel Bowen-Shaw Type of registration: Number of places registered: Conditions of registration: Category(ies) : Three Roses Homes Limited care home 14 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 14 The maximum number of service users who can be accommodated is: 14 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) 14 Date of last inspection Brief description of the care home Three Roses is registered to provide residential care for up to fourteen younger adults who have learning difficulties. The home is under the control of Three Roses Homes Ltd., a registered charity, which is run on the basis of a non-profit making company. The Board of Trustees have appointed three Directors, one of these being Mr Michael Care Homes for Adults (18-65 years) Page 2 of 9 Brief description of the care home Noott, who acts as Company Secretary and also maintains regular oversight of the home. Mrs Isobel Bowen-Shaw, the registered care manager, has responsibility for the day-to-day running of the home. The fundamental philosophy underpinning the operation of the home was said to be an adaptation of the Rudolph Steiner approach to care and many of the existing resident group previously attended schools that had been run on Steiner principles. The premises have been developed and upgraded over the years to provide suitable and very pleasant accommodation. The building is single storey, and set in extensive grounds which border open countryside. The stated aim of Three Roses is to provide an environment which enhances the dignity, self respect and individuality of residents, where they are assisted to develop independence in selfcare, domestic competence and daily living skills by Learning through Doing. For up to date information upon fees the reader should contact the service directly. Care Homes for Adults (18-65 years) Page 3 of 9 What we found: This inspection was unannounced. Therefore nobody within the home knew that we were going to visit. The inspection was carried out by one regulatory inspector over one day. The last key inspection was carried out during June 2007. The outcome of that inspection was that we rated the service as Excellent. We carried out this inspection to ensure that the service is still maintaining this level of service. Since our last inspection we have written an Annual Service Review (ASR) about the service. An ASR is a document we produce taking into account information we have received about the service without carrying out a visit to the home. During our visit we looked at some records such as care records, medication records and staff records. We had discussions with the registered manager, one of the directors and the staff on duty. We met some of the people living in the home and took part in some activities that were taking place. We had a look around the home and some people showed us their bedroom. Prior to our visit we requested an Annual Quality Assurance Assessment (AQAA) from the service. This document was completed by the registered manager and returned to us. The returned AQAA was very detailed and told us a lot about the service provided. No new residents have moved into Three Roses since July 2008. The home currently has one vacancy. Within the AQAA the manager told us that prior to somebody becoming a resident an opportunity is given to visit the home and stay overnight. The manager is aware of the importance to carry out a detailed assessment of care needs regarding potential residents. We were told of plans to produce a DVD which will incorporate information within the Service Users Guide to ensure that people have sufficient information about the home before they move in. As part of this inspection we viewed a small number of care plans. A care plan is a document designed to give staff guidance in order that they are able to carry out the required care in a consistent way meeting identified care needs. We found them to be person centred concentrating on each individual. We read details such as I like the staff to wake me, open my window and support me to make my bed. Then remind me to have a wash and put the plug in the sink. Each month people meet with their key worker to discuss their individual plan and agree any changes that are necessary. We also saw Health Action Plans within which visits to health care professionals are recorded. During our visit we saw that people are supported to see a doctor, dentist or other health care professionals as needed. As part of this inspection we assessed the management of medication within the home. Medication is received directly from a dispensing GP practice. We viewed the current months Medication Administration Record (MAR) sheets. These are not pre printed Care Homes for Adults (18-65 years) Page 4 of 9 therefore the service has to hand write them or photocopy a previous months. Medication is booked into the home on a separate record from the MAR sheet. We carried out some audits of medication and came across some shortfalls in the system used. The records had no carry forward amounts and boxed medication is not dated to show when they are opened. As a result we found it difficult to balance some medication and time was needed to work out whether discrepancies were in place. We found that records needed to be improved to show when people were away from the care home in order to balance the stock held. However we are confident that people receive their medication as prescribed. The manager took on board the difficulty we had during our audit and stated that improvements would be made in order that this can be done easier in the future. During our visit we saw or became aware of a range of activities taking place. We saw people involved in crafts such as rug making and a number of residents showed us, with great pride, the work they had undertaken. People willing demonstrated to us how to make the rugs and allowed us to have a go. The home has a range of activities for people including a kiln for pottery work. Some residents challenged us to a game of table tennis. The home has some computers for residents to use. One resident sat with the manager doing e-mails and up dating their Facebook page. During the morning some residents went out to Tai Chi. People told us that they enjoyed this. People also told us about a music club within the home as well as another one which takes place within the community. During the afternoon people worked alongside members of staff writing their diaries. Some resident showed us their life history books. These were full of pictures of the individual with family and friends as well as showing more recent photographs and leaflets regarding events connect with the home. People told us about days out they have had to places including major West End Musical when they have toured the Midlands. We had a look around the home. We saw a large kitchen with a storage area leading off it. Within another area we saw some deep freezers containing home grown vegetables and fruit. Records are maintained to ensure that temperatures remain within the safe limit. The local district council rated food safety at Three Roses to be Excellent during October 2008. All bedrooms are single occupancy with en-suite facilities. Some residents showed us their bedroom. People had personalised their room to suit individual taste. We viewed communal bathrooms. These areas contained toiletries which are provided by the home. We saw some bars of soap which are used communally, this is not in line with good infection control procedures. Radiators seen were covered to prevent accidental scalding. Some pipework feeding radiators have no protective covering and were very hot to the touch. We brought this potential risk to the attention of the manager. We were told of plans to build a porch to the front door of the home. The grounds are well maintained. Some seating is provided on a tarmaced areas. Since our inspection the registered manager has informed us that the planned relaying of a patio has taken place. Care Homes for Adults (18-65 years) Page 5 of 9 The home has a recruitment process which makes sure that the required checks are undertaken prior to a new member of staff starting working. We saw that the service ensures it has a CRB (Criminal Records Bureau) disclosure and written references in place. Having these checks helps to reduce the risk of someone who is unsuitable gaining employment within the home. Staff we spoke to showed a dedication to providing a quality service. Staff were aware of their responsibility regarding the safeguarding of residents against abuse. Accident records are maintained as necessary. We viewed the records held regarding fire safety and saw that they were in good order. Three Roses holds small amounts of money in safe keeping for people. People hold their own key to an individual cash tin which is locked away. We checked the money held within three tins and found them to balance. What the care home does well: 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 2. Care Homes for Adults (18-65 years) Page 6 of 9 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 7 of 9 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, 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 1 2 20 30 A review of systems should take place to ensure that audits of medication can be carried out. The use of communal toiletries should be removed in order to ensure that people are not at risk of cross infection. Care Homes for Adults (18-65 years) Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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