Inspection on 05/09/06 for Rathgar Residential Care Home

This inspection was carried out on 5th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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.

Other inspections for this house

Rathgar Residential Care Home 19/03/08

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Rathgar Residential Care Home 349 Kettering Road Spinney Hill Northampton Northants NN3 6QT Lead Inspector Judith Roan Unannounced Inspection 5th September 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rathgar Residential Care Home Address 349 Kettering Road Spinney Hill Northampton Northants NN3 6QT 01604 499003 01604 499003 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) Golden Care (UK) Limited Vacant Care Home 23 Category(ies) of Dementia - over 65 years of age (23), Old age, registration, with number not falling within any other category (23) of places Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No one falling within the categories of OP and DE(E) may be admitted to Rathgar Residential Care Home where there are 23 persons within the categories of OP and/or DE(E) already accommodated. The maximum number of persons to be accommodated within Rathgar Residential Care Home is 23. Date of last inspection Brief Description of the Service: Rathgar is situated in a residential area on the main road to Kettering near to the town’s boundary. The home provides 13 single rooms and 5-shared rooms all with washbasin facilities. Some rooms have en-suite bathing facilities. On the ground floor residents have access to a small seating area in the hallway from the hall there is access to a large lounge and separate dining room. A further communal are is available in the conservatory. Residents have access to a range of bathroom facilities that are equipped with bath lifts. There is a small rear garden and courtyard that some of the ground floor bedrooms over look. Fee levels at the home are between £ 350 and £400 per week. Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for residents and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting four residents and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. Prior to the visit the inspector spent time collating evidence within the ‘record of inspection’ information from notifications, and information sent by the provider. The previous owner/manager assisted for a period of three months after the transfer of the home. A new manager has now been appointed and will shortly apply for registration. The inspection took place during the morning and afternoon, over a period of 9.5 hours and was carried out on an unannounced basis. What the service does well: The atmosphere in the home was friendly and relaxed, and carers were welcoming. Good care planning ensures that resident’s needs are met. Care practices within the home ensure that resident’s needs are met. There is good communication with healthcare professionals that regularly visit the home. The home is well maintained and hygienic. Resident’s choices are well documented and met. The recruitment process and care practices ensure that residents are protected. Carers are well supported and trained by an active management team. Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 7 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 Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The admission procedures implemented at the home ensure that new residents needs are met. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A copy of the service users guide are available to every resident and/or their family. A statement of purpose clearly states how the service intends to meet the needs of residents. Its also contains important information about policies and procedures and the skills of carers employed. The pre-admission assessment tool enables full information to be gained prior to admission so an initial care plan to be developed with a new resident. In discussion with relatives they had found the admission process very positive and for this reason and the warm welcome they had received they chose the home. Care files contained good information about residents and also had historical information that is used to develop carers understanding about an individual’s Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 9 specific needs. Life histories are also used to plan activities that residents would like and enjoy. Files contained information from Social Services and confirmed that these had been sent prior to the admission. Each files also contained a signed copy of the terms and conditions set out by the home. Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome area is good. A competent staff team meets Resident’s health and personal support needs. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A sample of residents was selected for case tracking purposes. Care plans are in place that contain detailed information on how the carers are to meet resident’s needs. Health care needs are referred promptly to medical services when required. It was evident that there is good communication between visiting healthcare professional with the result of residents gaining the appropriate level of support. Case tracking identified that individual plans of care are developed according to the residents assessed needs and that these are reviewed on a regular basis. The new manager and responsible individual are working on the development of the care plans so that they contain more information and are easily accessible for carers. In discussion with carers it was evident they were very knowledgeable about the needs of residents. In preparing new care plans every resident was being reviewed. Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 11 Resident’s individual plans of care evidenced that appropriate risk assessments are conducted in relation to the prevention of falls, movement and handling. Appropriate instruction is provided to carers to enable the risks to be reduced or managed. Risk assessments in relation to bed safety rails, nutritional vulnerability and skin care were not evident. In observation on how these were used it was evident that all safety practices are adhered to. Individual plans of care evidence the equality and diversity needs of residents. Resident’s religious needs were identified and each Sunday residents have the choice to access the service on TV. Local religious representative are contacted when a residents requests individual contact with their chosen church. Medication systems within the home ensure that residents are kept safe. Good recording systems ensure that medication is not over stocked. All medication is checked in with amounts recorded. In checking the medication held for residents case tracked the inspector found no errors. The medication trolley is presently stored in the dining room. It is recommended that a secure are is found for the trolley along with the trolley being secured to a fixed point. It is recommended that the homes manager review the storage as recommended by the Royal Pharmaceutical Society. Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. Activities were seen to reflect the individual needs of residents. Residents are supported well to maintain contact with families and the local community. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Individual plans of care reviewed provided evidence that residents are supported to achieve their expectations, preferences and choices. Improvements to the individual plans will record specific information in relation to chosen activities. One of the senior carers has been promoted of to ensure that there is a daily programme of activities based on the choice of residents. On admission residents and/or their families are asked to provide detailed information about their earlier life to develop life histories. These histories assist staff in communicating with people who are developing a dementia and in planning activities within the home. Care plans ensure that resident’s daily routines and preferences are recorded and followed. The newly appointed senior carer with responsibility for activities is beginning to plan both group and individual activities. Two member of the team have completed a distance learning training course on supporting people with Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 13 a dementia. Several more carers are waiting to begin the course. On the day of the inspection a volunteer was actively engaged in social activities with a resident at the home. These visits are on a regular basis and much valued by residents. Families are made very welcome and according to one relative they were highly satisfied with the support their family member was receiving. There was always a member of staff on duty that could give them information and they were kept informed about the care at the home. One issue raised about meeting the loss of a personal item that was important to assist the resident in their daily activities were being addressed. This however had not been communicated to the family and is an area that the homes maanger needs to review and consider how families are kept in touch about issues concerning their family member. Meals being served at the home can be taken by residents in the dining room, in their room or on a tray in the lounge. There is always a choice of two dishes at lunch and teatime. The inspector noted that residents were supported to eat their meals if required with staff being attentive to individual needs. Meals are served in two sittings so that service users that need additional assistance receive good support. Carers spoken to were fully aware of the needs of individual residents. One resident had been identified as not eating when in the presence of others and they now have their meals served aware form others. Full support is provided to ensure that they have a balanced and adequate diet. Residents requiring a special diet are catered for. Food seen on the day was served attractively and in a pleasantly maintained dining area. All staff wore different aprons over their care uniforms to maintain hygiene standards. Soft diets are noted in care plans and food is pureed if required. It is recommended that staff receive advice/training on the presentation of food and nutritional needs of older people especially those with a Dementia.. Individual food items need to be served separately and mixed only when carer is supporting a resident to eat. Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 14 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Quality in this outcome area is good. Residents can be assured that they will be listened to and protected by work practices within the home. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Residents and a relatives spoken with during the inspection were aware of the complaints procedure and felt confident that their views were considered important and acted upon. The complaints policy is in place and specifies specific timescales for acknowledgement of and the investigation of complaints. A short guide to making a complaint can be found in the resident’s users guide. Residents felt comfortable in making their complaints known and confirmed that action taken in the past had been positive. Within the homes policies there is a clear whistle blowing policy (Sharing their concern of abuse with a manager) and procedures to act in the event of a Protection Of Vulnerable Adults (POVA) issue. A POVA notification in June relating to a resident going missing was fully Investigated. New security arrangement at the home have been implemented to ensure residents safety. Carers spoken with were aware of the abuse awareness and whistle blowing Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 15 policies held at the home, with several having received training recently. To improve protection outcomes for residents all staff should receive basic adult abuse awareness training Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,29,21,22,23,24,25,26 Quality in this outcome area is good. The environment is maintained to a good standard of cleanliness and fit for purpose. Not all areas of the home were seen to be safe. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The home was found to be clean and hygienically maintained by a dedicated house keeping team who also undertake the laundry. Residents said that their laundry was well done and always came back ironed. Household cleaning products and toiletries that could harm residents were not securely kept. On touring the building toilet cleaner was found in all of the bathroom/toilet areas and denture cleaning tablet were found on dressing tables in bedrooms. The manager needs to review the COSHH assessments with the staff team and ensure that they are fully aware of the hazards. All toilet cleaner was removed immediately during the inspection. Regular health and safety training takes place at the home. Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 17 The home has a range of lifting equipment to assist with transfers from wheelchairs and for bathing. This equipment on loan from medical loans was seen to be fully maintained. Electrical equipment within the home has an annual test. The bath lifts that are battery operated did not have any records of maintenance. In discussion with the responsible individual it was agreed that advice would be sort as to the frequency of maintenance required from the manufacturer. Hygiene contracts are in place to deal with waste material at the home and to service equipment. Heating and water systems all had the required regular checks. The internal decoration was good and residents were happy about there environment. Bedrooms were seen to be personalised and homely. The new entrance hall that relocated the front door was welcoming and safe for residents to sit and watch the outside world go by the front door is kept locked for security with a key located in a glass sealed unit for emergencies. Carers on shift also hold a key on their personal to facilitate access for all residents and visitors to the home. Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 Quality in this outcome area is good. Residents are protected by the robust recruitment, training and supervision of carers. Work practices within the home demonstrate that carers are competent in meeting resident’s needs. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Staffing levels within the home were seen to meet the needs of residents throughout the day. Needs were promptly supported by care staff that undertook their duties in a friendly and caring manner. Resident’s confirmed that staff were always respectful and met their needs competently. Carers were knowledgeable about the needs of residents and demonstrated that they understood their role. Staff files demonstrated that a robust recruitment process is in place, with all appropriate checks being undertaken. These include references, criminal record bureau disclosures and health checks. New carers undertake a full induction programme that is followed by further in house training. Several staff are presently undertaking National Vocational Qualifications in care at Level two and other are waiting to progress onto level three. The organisation has an ongoing training programme that staff can apply for. Recently several key staff have undertaken and completed specialist training in Dementia Care. Several staff have completed basic abuse Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 19 awareness training and the inspector was informed that more training is planned to meet National Minimum Standards of required training. In discussion with the responsible individual the inspector was informed that over the next few months more carers would complete the specialist training so that there was continuity in their approach to supporting residents who have a dementia. Supervision occur on a frequently basis but there is no formal record kept. It is recommended as good practice to have records for both parties. Regular meetings take place between the members of the management team. Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37,38 Quality in this outcome area is good. Management practices within the home ensure that the home is run in the best interests of residents where their views are listened to and acted upon. Residents are protected by good record keeping and safety checks. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The quality assurance system ensures that resident’s views are noted. In discussion during the feedback meeting the responsible individual was encouraged to include the views of the staff team, families, health care professionals and other visitors to the home. The staff team have been reorganised and several team member have been given more responsibility and invited to share their views on the development of the service. Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 21 The inspector found that the home has detailed records on the maintenance system in place. All personal records are kept confidential. Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 22 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 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard OP7 OP15 OP25 OP24 OP30 OP18 Good Practice Recommendations The manager needs to ensure that risk assessments are completed to ensure that healthcare needs are fully met. Adequate training/advice needs to be available for key staff. The homes manager needs to review the COSHH procedures in relation to cleaning items within the home and ensure that hazardous items are stored safely All staff need to complete adult abuse awareness training within their induction period. Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rathgar Residential Care Home DS0000066316.V310505.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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