Inspection on 25/02/10 for Roebuck Nursing Home

This is the latest available inspection report for this service, carried out on 25th February 2010.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Extracts from inspection reports are licensed from CQC, this page was updated on 16/05/2010.

Key inspection report Care homes for older people Name: Address: Roebuck Nursing Home Roebuck Nursing Home London Road Stevenage Hertfordshire SG2 8DS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Alison Butler     Date: 2 5 0 2 2 0 1 0 This is a review of 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. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 23 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. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Roebuck Nursing Home Roebuck Nursing Home London Road Stevenage Hertfordshire SG2 8DS 01438740234 01438894996 hr@roebuckcarehome.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Fine Care Homes LTD Trading as Roebuck Nursing Home Name of registered manager (if applicable) Ms Moira Edmondson Type of registration: Number of places registered: care home 63 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 63 The registered person may provide the following categories of service: Care Home with nursing. To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Older People - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Roebuck is a residential and nursing home and provides accommodation for up to 63 residents. Roebuck is trading as Fine Care Homes (Stevenage) Ltd. There is a car park to the front of the building for staff and visitors to the home. The home is split over three floors. All areas of the home are wheelchair accessible and two passenger lifts Care Homes for Older People Page 4 of 23 63 0 Over 65 0 63 Brief description of the care home are available to provide easy access to all floors. Each floor has a dining, kitchen areas for can be used for both residents and their relatives to make drinks. Lounges, assisted bathing facilities and a number of WCs are als available on each floor. The ground floor comprises of the main reception with an administrators and managers office. On the first floor there is a hairdressers salon, sensory room, computer room and a small gym for the residents use. On the top floor is the main kitchen and laundry. There is a large garden which is wheelchair accessible. For information on the up to date fees contact should be made with the manager. Information about the home and the service it offers is contained in the Statement of Purpose and the Service User Guide a copy of these are available in the home. Care Homes for Older People Page 5 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This first key inspection was conducted by one inspector representing the Care Quality Commission. However for the purpose of this report this will be shown as we. The manager submitted an annual quality assurance assessment (AQAA). This is a self assessment document which sets out in detail how well outcomes are being achieved for the people living in the home together with some statistical information. The AQAA provides the opportunity for assessing progress and how improvements are going to made over the coming year. Whilst at the home we spoke with residents, staff and visitors. We observed staff interaction with residents, examined care plans and key documents for example medication administration records, staff personnel files and training records etc. We also received surveys and the information has been included throughout this report Care Homes for Older People Page 6 of 23 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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. Care Homes for Older People Page 7 of 23 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Roebuck can be assured that they have their needs fully assessed prior to admission and are given the information to make an informed choice. Evidence: The home provides prospective residents with a copy of the statement of purpose and service user guide to provide them with the information to make an informed choice. The AQAA states these documents have been updated to incorporate the views of the newly admitted residents. There is a website but this is still work in progress and should allow prospective families and residents to access information about what the service can provide. Prospective residents and their families are encouraged to visit the home prior to making a decision to ensure they feel it is the right place for them. The manager and provider carries out a comprehensive pre-admission assessment prior to offering the person a place. This is done to assure the residents that the home is able to meet the persons needs and provide the required staffing levels. The assessment form the base line for the care plan which is put in place on arrival at the Care Homes for Older People Page 9 of 23 Evidence: home. There is a three month settling period where both parties are able to reassess the placement and make sure that the residents needs can continue to be met at the home. Care Homes for Older People Page 10 of 23 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Roebuck can be assured that their health and personal care needs will be met and they can expect to be treated with dignity and respect. Evidence: The care plans showed that whilst information was detailed on what support the residents require from the staff to meet their needs, to make them more person centred information should be included about what the residents is able to do for themselves first and then what additional support is required from staff to meet their health and personal needs. We found from talking to residents and staff that they were able to do some of their personal care tasks themselves for example wash their face, clean their teeth, this had not been recorded in their care plans. Risk assessments had been included within some of the plans examined. One person plan showed that the falls risk assessment was still to be completed and we were assured this would be done as a matter of urgency. There were detailed daily notes in place. All staff are responsible for ensuring information is recorded within these appropriately as these are used to review the persons care every month. Residents and visitors to the home were very complimentary about the care provided Care Homes for Older People Page 11 of 23 Evidence: and comments include, they are wonderful, they can not do enough for us. Observation of the staff showed us that they were kind, caring and encouraged residents to be as independent as possible. A check was carried out on the medication administration, storage and records which we found were generally well managed.However , we saw one nurse who administered medication without the use of gloves or a spoon which could potentially put them at risk of the medication being absorbed through the skin. We discussed this with the manager who will be taking this up with the member of staff. Care Homes for Older People Page 12 of 23 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Roebuck can be assured that they are offered various activities and recreational interests of their choice, and are encouraged to maintain links with families and the local community. Residents are provided with a balanced and wholesome diet. Evidence: As yet Roebuck is not fully occupied with only the ground floor open. Currently an activities co-ordinator spends one to one time with residents in the morning with small group activities are arranged in the afternoons. in the afternoon we saw that residents were being given a choice of musical to watch. The residents spoken to during the inspection said that they have played bingo and were lucky enough to win and are happy with the activities on offer and they can choose to join in or not. A local brownie group comes to the home every couple of months to entertain the residents. The local pastor comes and conducts weekly church services for those residents wishing to take part. Lunchtime was observed and we noted that it was a relaxed and unhurried experience, staff were seen to provide support to residents who required help with eating and this was done in a caring and unhurried way. We joined the residents for lunch and found that the lunch was very tasty and hot, Care Homes for Older People Page 13 of 23 Evidence: residents were generally complimentary about the food provided however, one person told us that, it is not like my cooking. Visitors are able to visit their relatives at any time that is convenient in consultation with the resident. Relatives confirmed this and said we are always made to feel welcome and we are able to make ourselves a drink in the kitchen. The activities coordinator is setting up a small not for profit shop so residents can purchase toiletries, chocolates etc. and they can order items to be purchased on their behalf. Relatives we spoke to were very happy with the care and comments include the home is second to none all homes for the elderly should be like Roebuck Care Homes for Older People Page 14 of 23 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Roebuck can be assured that their views and any concerns they may have will be listened to and acted upon. Robust polices and procedures are in place to protect them from abuse. Evidence: There is a clear procedure in place for reporting complaints. A folder is in place containing compliments and complaints. This was examined and showed us that complaints have been dealt with appropriately and the action and outcome recorded. Staff have been provided with training and support in dealing with complaints to ensure they are recorded and reported appropriately. The manager completes a weekly report which is provided to the directors of the home. Information from the AQAA and discussion with the manager and the proprietor showed that they will evaluate complaints and that these will enable them to improve the service for the benefit of the residents. Where residents are identified as not having capacity the manager would arrange for a Mental Capacity assessment and details would be recorded within their care plan. They have not yet had a resident admitted that has required this or tone that has not had family support. All staff , with the exception of the laundry person have received training in safeguarding adults as part of their induction. It is recommended that this training is arranged as soon as possible for the laundry person. Care Homes for Older People Page 15 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Roebuck can be assured they live in a welcoming, warm, clean and well maintained environment. Evidence: A tour of the building was conducted. As previously stated the home is not yet full and at the time of this inspection only the ground floor was occupied which has two units. All bedrooms have en-suite facilities (including showers). Residents are provided with keys for their rooms if they so wish and a risk assessment is conducted for their safety. There is a nurse station on each unit which provides an area to store care plans and a place for staff to complete daily notes. There are a variety of communal areas around the home to allow residents a choice of where to sit. There is an outside patio area for the residents to enjoy in the warmer weather. All areas throughout the home are wheelchair accessible. Whilst each of the bedrooms are furnished residents are encouraged to personalise them with furniture, ornaments and pictures from their previous home. A cold air system helps to eliminate odours throughout the home. There are appropriate policies and procedures in place for dealing with infection control. We received a concern which relates to there being no laundry service available over the weekend. We were told that this is due to the low numbers of people currently in residence. When we spoke with the laundry person they told us that they were able to clear the weekend laundry during their first shift on Monday. Care Homes for Older People Page 16 of 23 Evidence: The proprietors told us they will continue to review the staffing levels and they will increase them as appropriate to ensure that the laundry and cleaning of the home is maintained appropriately. Care Homes for Older People Page 17 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Roebuck can be assured that a robust recruitment procedure is in place to keep them safe and there are sufficient staff in place to meet their needs. Evidence: Examination of four staff files showed that all the required information and checks had been carried out prior to employment. One the day of the inspection there were sufficient staff on duty to meet the residents care and personal needs. Comments we received included, staff are marvellous, they are kind and caring, I could not ask for more. The manager has stated that all mandatory training is planned and they are to ensure all staff have a minimum qualification of NVQ 2. There is an induction programme in place for all new staff. Regular supervision of staff is carried out and feedback from staff told us that they felt they were well supported in their roles to ensure the residents receive the best care possible. Care Homes for Older People Page 18 of 23 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Roebuck can be assured that the home is run in their best interests and that their health, safety and welfare is protected through a series of checks and regular maintenance. Evidence: The registered manager has many years experience in care. Staff confirmed there is an open door policy and they are able to speak to both the manager and proprietor at any time if they have any concerns or ideas for making the lives for the people living at the home better. There is a quality assurance system in place which we were told encourages feedback from all people who live, visit and work at the home to improve the service that is provided. This is done through meetings, talking with visitors when they visit, through the reviews of the residents and through questionnaires. Visitors we spoke to felt that they are listened to and action is taken if appropriate to improve the lives of those who live at Roebuck. There are comprehensive policies and procedures in place to ensure staff are working and supporting residents safely. Care Homes for Older People Page 19 of 23 Evidence: Equality and diversity issues are understood by the staff and addressed through the care plans which describe how residents needs and preferences are to be met. The home does not manage residents finances as this is done through families. Fire safety records were checked and those seen were well kept and told us that the appropriate checks had been carried out to protect all residents, staff and visitors to the home. The manager completed the AQAA within the given timescales and it gave us the required information. Care Homes for Older People Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 18 Ensure all ancillary staff that work at the home receive training in safeguarding vulnerable adults so that they are clear on how to deal with an incident of abuse if it occurs. Care Homes for Older People Page 22 of 23 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. Copyright © (2009) Care Quality Commission (CQC). 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