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Inspection on 09/01/09 for Kathleen Rutland Home

Also see our care home review for Kathleen Rutland Home for more information

This inspection was carried out on 9th January 2009.

CSCI found this care home to be providing an Excellent service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Kathleen Rutland Home continues to be well managed and provides care that is tailored to individual people. People are supported to live a fulfilling life, where their needs are assessed and care plans drawn up, with the emphasis on supporting the persons abilities, in a safe and nurturing environment. the paperwork completed prior to people moving in includes that of Social Service, but relies more heavily on VISTA`s own assessment details, which provide a far greater depth of knowledge for this Service User group. People are offered a range of social and leisure activities that are arranged both within the home and in the community. The home is clean, safe and well maintained. There is a homely and relaxed atmosphere, which is backed up with specialised equipment such as talking notice and menu boards, highlighted doors to toilet and other important areas, and a personal computer, which transfers written letters and documents into a way which is "spoken" to people. This is significant as it not only reconises and promotes peoples independence, but recognises and increases peoples confidentiality. Staff are recruited safely with a number of security checks being in place before starting work at the home. Care staff demonstrated a very good awareness of the people they care for, being able to give a good account of peoples individual needs. They continue to be well trained with a number of routine courses and professional qualifications such as the National Vocational Qualifications (NVQ`s) being encouraged by the senior management. Medication is administered and stored securely, visits for the Doctor and specialist health staff being arranged on a regular basis. The special project which is ongoing with a Geriatrician from a local hospital, sees many benefits for Service Users, their relatives and staff, with less need to have lengthy trips to out patient clinics, and a more personalised health service. The staff continue to provide an excellent service to the people in the home, and continue to develop the ongoing care and environment for the benefit of Service Users.

What has improved since the last inspection?

The staff have welcomed the eden initiative, where thy have tastefully added a number of animals into the lives of people in the home. The manager and staff have introduced a computer, which has internet facilities, a web cam facility and has the ability to "read" documents and transfer the written words into a spoken commentary.

What the care home could do better:

The Statement of Purpose and Service User Guide, must be updated to include the latest information on complaints. The latest Quality Assurance information could be added to the Statement of Purpose or Service User Guide. This would allow prospective people considering living in thehome, what opinions current Service Users` have regarding the home. The policy and procedure for people wishing to self medicate, could be more detailed and explanitory.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Kathleen Rutland Home 117 Hinckley Road Leicester Forest East Leicester Leicestershire LE3 3PF     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Keith Williamson     Date: 0 9 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Kathleen Rutland Home 117 Hinckley Road Leicester Forest East Leicester Leicestershire LE3 3PF 01162394234 01162394234 paul.sykes@vistablind.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : VISTA care home 47 Number of places (if applicable): Under 65 Over 65 20 47 dementia sensory impairment Additional conditions: 0 47 The maximum number of service users who can be accommodated is: 47 The registered person may provide the following category of service only: Care Home Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia - Code DE Sensory Impairment - Code SI Old Age, not fallling within any other category - Code OP. Date of last inspection Brief description of the care home Kathleen Rutland Home For the Blind offers care for up to 47 older people who have a sensory impairment and up to 20 people with dementia. The care home is set in its own grounds with smaller residential bungalows for people with sensory impairment of sight and hearing live independently. The care home offers accommodation on ground and first floor, which can be accessed via the lift , stair lift or the stairs located throughout the home. All the bedrooms are single with en-suite facility and close to bathrooms. There are choices of communal sitting areas for people to use and a large dining room adjacent to the kitchen. The home is a smoke free area with the exception Care Homes for Older People Page 4 of 25 Brief description of the care home of a small lounge where people are able to smoke. The homes brochure provides information about the service to prospective and current Service Users and includes the terms and conditions of the stay. This was updated and is now available in other formats such as tape. The fees range from a £367 to £519 and is based in accordance with the assessment of care needs. People that live at the home are responsible for any additional charges such as hairdressing personal toiletries, private chiropody and holidays. The latest Commission for Social Care Inspection inspection report is available from the Registered Manager. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home 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: The focus of inspections is on outcomes for Service Users and their views of the services provided. The main method of inspection used was case tracking which involves selecting a sample number of clients and tracking their care they received through talking with them, where possible and looking at their records and accommodation, in this case four Service Users were chosen. This visit took place over one day, commencing at 9.30pm and took seven hours to complete. An opportunity was taken to talk with the Manager and staff, look around the home, view records, policies and care plans. Information was also obtained from the Annual Care Homes for Older People Page 6 of 25 Quality Assurance Assessment, which gives information on the Service Users, home and the staff group. Four staff were spoken with, and all Service Users were seen, and their interactions with the staff group observed. The quality rating for this service is three star. This means the people who use this service experience excellent quality outcomes. What the care home does well: What has improved since the last inspection? What they could do better: The Statement of Purpose and Service User Guide, must be updated to include the latest information on complaints. The latest Quality Assurance information could be added to the Statement of Purpose or Service User Guide. This would allow prospective people considering living in the Care Homes for Older People Page 8 of 25 home, what opinions current Service Users have regarding the home. The policy and procedure for people wishing to self medicate, could be more detailed and explanitory. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 25 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 10 of 25 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. Comprehensive assessment procedures ensure that Service Users needs and aspirations can be met. Evidence: Two Service Users assessments were examined. These were exceptionally detailed and contained information relating to all aspects of their needs. The assessment process covers information gathered by a Social Worker, and specific information by VISTA staff regarding more specialised needs and so give more detail to the plan. This is important as the Service Users plans will form part of any care plan. Details of regular re-assessments were also in place together in one of the files. This is important as it demonstrates the staff have up to date information on which to base any revised care plan. Files contained copies of the contract or terms and conditions of the persons stay, and Care Homes for Older People Page 11 of 25 Evidence: a copy of the Service User Guide. This document contains information on the home, the staffing and the complaints process. This document is needing to be updated with the current information on complaints, and on Quality Assurance, which demonstrates how well the home develops from comments and suggestions gathered from Service Users and other interested parties, by the home. The home does not offer intermediate care, which is usually care provided by a specialist provider, and following a significant period in hospital. Care Homes for Older People Page 12 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People continue to be well cared for having their care needs whilst promoting and maintaining their independence. Evidence: Three Service Users care plans were examined. These like the assessment information, were well detailed and covered all aspects of daily life. Staff intervention was clearly identified and there was evidence that the information was regularly reviewed. This covered personal care, communication, if the person wished a key to their bedroom door, individual choices on catering, pets and if friends or relatives could attend hospital appointments. These areas are important as they create the basis for the persons continuing stay in the home and independence for the future. The care files viewed contained evidence of the involvement of General Practitioners, District Nurses, chiropodist, and opticians. The home is also part of a specialist study where a consultant geriatricien visits people in the home, so providing an improved service, and ongoing care. Care Homes for Older People Page 13 of 25 Evidence: Risk assessments are routinely completed before any activities are undertaken. Staff displayed a good understanding as to why this was necessary. Staff complete daily notes covering all activities and the Service Users responses to them. Staff support the Service Users to make decisions about their daily life particularly in relation to their activities. Medication is well managed and stored appropriately. All staff administering medication have received training and are clear when they are responsible for this aspect of care. Clear protocols are in place relating to the administration of as required medicines. This ensures the safety of people in the home. There are some areas that require to be clarified, for people wishing to self medicate, with the policy and procedure needing to be reviewed. Staff were seen to offer personal care in a dignified manor, and peoples privacy was also seen to be taken into consideration at times throughout the visit. This is important as it ensures peoples values are upheld. Care Homes for Older People Page 14 of 25 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. The residents continue to make choices about daily living and offered a variety of meals, a range religious and spiritual, social and leisure interests that suits their preferred lifestyle. Evidence: Peoples social care and activities continue to be well organised. Pastimes are offered to the Service Users on a regular basis, these being both in and out of the home. One person spoken with enjoyed going to a local school to hear children read. There continues to be regular Service User and relatives meeting held at the home. This is important as it keeps people aware of changes in the home. There has been an addition of a personal computer, which is adapted to read documents and translate the content into spoken words. This benefits people by encourging their independance, and increasing their confidentiality. Service Users religious preferences are arranged around the multi denominational chapel being used by a number of Service Users in the home. This offers people with religious interests a chance to participate without needing to leave the home. Care Homes for Older People Page 15 of 25 Evidence: Menus were viewed and demonstrated that meals provided are nutritionally balanced appealing and ethnically appropriate. The cook produces a variety of diets to compliment the Service Users needs. The menu is displayed on the notice board inside the dining area and on a talking notice board, which has been specifically designed to inform people in a spoken way of what meals are available. There is a similar notice board to inform Service Users what activities are being offered during the week. A number of Service Users were observed discreetly being assisted with their meals. The interaction between the Service Users and staff was very positive. The home has recently started to offer the Eden initiative, where people are encouraged to interact with various animals, both in and out of the home. Recent additions to the aviary of birds, are three rabbits and six rescued chickens. Care Homes for Older People Page 16 of 25 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. Residents are protected by robust and accessible complaints procedure and by staff trained in the adult protection procedures. Evidence: People who were spoken with stated that they feel comfortable discussing any concerns with the homes manager or staff. One person stated I would call my daughter if there was any funny business another stated, I would call J (a senior staff member) or Social Services. The complaints procedures are openly available in the home, and are included in the Statement of Purpose and Service User Guide, though certain details have yet to be updated. Service Users spoken with felt they were safe and protected. The Adult Protection procedure has been introduced and staff spoken with confirmed their recent training and were aware of their duties to alert a senior member of staff of any concerns. Care Homes for Older People Page 17 of 25 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. The residentsbenefit from having a clean, well maintained, safe accommodation, which individually and collectively meets the residents needs. Evidence: Service Users live in a homely, comfortable and clean environment. The home is decorated and furnished to a standard that creates a comfortable atmosphere, and yet takes into consideration the needs of the majority of sight-impaired people in the home. There are several lounges on the ground and first floor of the home. There is a large dining room and conservatory close to the kitchen. Entry to the home and to the garden is wheelchair friendly. Both internal and external areas of the home are designed to be suitable for people who have a visual impairment. The extensive garden area is flat with climbing plants, raised flowerbeds and seating areas. Included is a sensory area with aromatic plants and flowers and a level access greenhouse. The staff are aware of cross infection and cross contamination issues, and this increases peoples safety in the home. Care Homes for Older People Page 18 of 25 Care Homes for Older People Page 19 of 25 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. The residents safety is maintained by a robust recruitment process and sufficient numbers of trained staff on duty. Evidence: Staff are all issued with job descriptions as part of the recruitment process. Those spoken with were clear about their individual roles within the home. The recruitment practices within the home were also discussed, and the home follows a set pattern where people are interviewed and security checks are put in place, prior to staff commencing work. This increases the safety for people in the home. The staff files in the homecontain some of the checks necessary by law, however the main files are held at the head office, and these shall be inspected at some stage in the future to ensure the validity of the process. Staff have individual training plans, which are compiled following an appraisal or supervision session. These determine what areas of experience the person needs to keep their training up to date. Care Homes for Older People Page 20 of 25 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. Health, safety and welfare are promoted and protected through the homes policies, procedures and management. Evidence: Quality assurance is well developed in the home with a number of questionnaires being distributed to Service Users, their relatives, staff and other interested parties visiting the home. Though findings from these have yet to be entered into the Service User Guide. This would inform prospective Service Users of the quality initiatives used, and how these affected the development of the home. Service User and staff meetings, staff supervision and appraisal are well established, these also add to the quality systems in the home. As do the visits from the Assistant Director, who visits on a regular basis, to oversee the development of the home and staff group. These issues are good practice and go some way to ensure the home is run in the best interests of the Service User Care Homes for Older People Page 21 of 25 Evidence: group. Further visits are made by the board of trustees who oversee the running of all homes within the group, and add a further tier to the quality management structure within the home. Two Service Users personal allowance records were sampled, and found to be correct. A number of records were sampled and checks are in place to ensure safe practices for Control of Substances Hazardous to Health (COSHH). All chemicals and cleaning agents are locked away but no data sheets were available at the time. These contain essential information on what to do in an emergency for each chemical stored. There is full recording of accidents, with these matching the daily records of Service Users. Care Homes for Older People Page 22 of 25 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 23 of 25 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 1 1 5 The Service User Guide, requires to be updated with the up to date contact details in the complaints section. This to enable any person using the document access to the correct information contained in it. 26/03/2009 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 1 The latest Quality Assurance findings should be added to the Service User Guide, to enable people to ascertain the efficiency of the home. The policy and procedure for people wishing to self medicate, could be more detailed and explanitory. This would assist the staff in following the process involved. 2 9 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!