Inspection on 29/11/05 for Rathmore House

This inspection was carried out on 29th November 2005.

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

Rathmore House 07/09/07

Rathmore House 09/08/06

Rathmore House 16/12/04

Rathmore House 09/08/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Rathmore House 31 Eton Avenue London NW3 3EL Lead Inspector Ms Pippa Treadwell-Smith Unannounced Inspection 28th November 2005 10:00 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 Rathmore House DS0000010331.V250343.R01.S.doc Version 5.0 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. Rathmore House DS0000010331.V250343.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Rathmore House Address 31 Eton Avenue London NW3 3EL 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) 020 7794 3039 Central & Cecil Housing Trust Mr Michael McKeon Care Home 20 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0) of places Rathmore House DS0000010331.V250343.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st August 2005 Brief Description of the Service: Rathmore House is a listed building that has been adapted to become accommodation for older people. It is situated in a residential area of Swiss Cottage bordering Belsize Park. The home is owned by Central and Cecil Housing Trust. The aim of the service is to provide care to elderly people of both sexes, aged 65 years and over, who require a high level of support because of having dementia. Permanent care will be provided for service users assessed as having dementia and who may need some nursing care. Accommodation for service users is over three floors. There is a shaft lift, which gives access to all floors. There are a total of 20 bedrooms. Thirteen of which have ensuite facilities comprising a toilet and a hand basin. All floors have assisted bathrooms/showers and additional communal toilets. Since the last inspection there has a re-organising of the communal accommodation. There are now two lounge-cum-dining rooms on the ground floor. All rooms are linked via a call bell system. Service users have access to landscape grounds and a secure garden. Rathmore House DS0000010331.V250343.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day and lasted about four and a half hours. The manager was interviewed and assisted with the inspection. Service users and staff were spoken to. A variety of records including care plans, financial records and staff records were looked at. What the service does well: What has improved since the last inspection? What they could do better: Areas where the home could be doing better were discussed and agreed with the manager. There has been an audit on the care planning process carried out by the company. The recommendation from this audit should be Rathmore House DS0000010331.V250343.R01.S.doc Version 5.0 Page 6 implemented as service users would benefit from having a more consistent approach. 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. Rathmore House DS0000010331.V250343.R01.S.doc Version 5.0 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 Rathmore House DS0000010331.V250343.R01.S.doc Version 5.0 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): Standard 3 only as Standard 6 is not applicable to this service When service users move into the home, there is a system in place to ascertain the person’s needs and wishes. EVIDENCE: Six of the service users were spoken to. They said that they enjoyed living in the home. One service user said “At my age I am lucky to be living in a place like this”. Three care files were checked and each one contained an assessment from a Care Manager. There was clear evidence from one of the records that a key worker had been talking to the service users to determine her needs and wishes. The care records reflected the service users’ preference for vegetarian food and fish. This information had been gained from talking to the person. Rathmore House DS0000010331.V250343.R01.S.doc Version 5.0 Page 9 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): Standards 7, 9 & 10 An audit of the care plans shows that further work is required to ensure that they are person centred. There have been improvements to the medication administration records to ensure that medicines are safely handed out to service users. The philosophy in the home is that personal care is given in such a way as to preserve the privacy and dignity of the service users. EVIDENCE: As part of the required monthly visit, an audit has been carried out of the care plans. This clearly shows the strengths and weaknesses of the care planning approach in the home. The outcome of the audit is to achieve a consistent approach and level of detail in the care plans. An action plan has been completed as a result of the audit. It is important that this action plan is implemented. At the previous inspection, a deficiency was recorded to include photographs of service users on the medication administration records. There are improvements noted and the majority of the MARS sheets now have individual photographs of the service users. The work needs to be finished for safety reasons. Rathmore House DS0000010331.V250343.R01.S.doc Version 5.0 Page 10 The home has a philosophy of care that assists service users to retain their independence, privacy and dignity. These principles of social care also form part of the induction process for new staff. The care plans examined on the day of the inspection reflected the personal abilities of the service users and the areas where assistance was required. Staff were observed knocking on doors before entering and speaking to service users in a polite and respectful way. There was one incident between a staff member and a service users and this has been fed back to the manager at the plenary session. There is only one shared room in the home and screening is available. A single room is available but both e sets of relatives have requested no change to the situation. Service users said that the staff respected their privacy and dignity. One service user said “The staff are very charming”. Rathmore House DS0000010331.V250343.R01.S.doc Version 5.0 Page 11 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): Standard 14 Service uses are able to choose from a range of options to ensure that they are able to follow their preferred lifestyle. EVIDENCE: The home has a charter of rights and a philosophy of care. Both ensure that service users have a say in all decisions. Generally care plans recorded the likes and dislikes of the service users and the name they preferred to be called by. A choice of food is offered and the menu reflects the choices available. Discussions with and observation of staff showed that they are aware of the individuality of the service users and respond accordingly. The home has a policy and procedure in place for service users to have access to their personal records. Rathmore House DS0000010331.V250343.R01.S.doc Version 5.0 Page 12 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): Standard 18 The service users are protected by the home’s policies and procedures. EVIDENCE: The home has a protection of vulnerable adults policy and procedure, which is linked to the local authority guidance. There is also a whistle blowing policy. These are known to staff and training has been given. The care practice in the home is supported by policies and procedures with regard to safe keeping of service user’s finances, restraint and racial and other harassments. There is a robust and thorough recruitment and selection process in place. Rathmore House DS0000010331.V250343.R01.S.doc Version 5.0 Page 13 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): Standard 19 The standard of environment is good providing service users with an attractive and homely place to live. EVIDENCE: Since the last inspection the manager has made changes to the sitting and dining areas. A smoke room has been created out of the office at the entrance to the home. Only one service user smokes and infrequently so the room can double as a visitor’s room if necessary. The entrance hall had been a seating area and this has been turned into a reception area with a nurses station. The office has been moved to the quiet lounge and there are now two lounge-cum-dining rooms. Rathmore House DS0000010331.V250343.R01.S.doc Version 5.0 Page 14 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): Standard 27 & 29 Progress has been made for addressing the recruitment of staff to vacant post and as a result service users will receive a continuity of care. EVIDENCE: The manager confirmed that he is recruiting to the vacant posts. Two of the recruits are known to the home because they had worked as agency staff and the third is as a result of a good interview performance. At the time of the inspection there are five service users who require nursing and fifteen who need personal care only. A nurse is deployed for each shift over a twenty four period; there are three to four care staff on the morning shift, three deployed in the afternoon and evening and two deployed for the night shift. A good deal of positive feedback about the staff at the home was received from the service users. Typical comments being that “The staff are very kind”. As a result the service users’ experience of the home is of a caring environment where they feel they are looked after and allowed to make choices. The staff have built up a knowledge and understanding of the needs of each service user. Staffing levels for nursing will be increased as the number of service users who require nursing go up in order to ensure that their needs continue to be met. Records show that staff have done training in essential areas such as health and safety, first aid, manual handling, dementia awareness and fire Rathmore House DS0000010331.V250343.R01.S.doc Version 5.0 Page 15 awareness. Some staff are undertaking NVQ Level 2 training to improve their training skills further. One member of staff has completed the training, six will complete by the end of December 2005 and three will by February 2006 with a further member of staff enrolling by that date. The Deputy Manager has completed the Registered Manager’s Award and the Manager is currently enrolled on the course. The manager talked through the recruitment and selection process. The process includes all the relevant checks, including references, POVA and CRB. Fact-to-face interviews are conducted. The process is underpinned by equal opportunities. Rathmore House DS0000010331.V250343.R01.S.doc Version 5.0 Page 16 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): Standard 33, 35 & 38 Service users are able to benefit from living in a home that is run in their best interests. The financial interests of the service users are protected by the home’s policies and procedures. The home is a safe place to live for service users and to work for staff. EVIDENCE: There is a regular review of the home’s performance through a programme of audits and consultations, which include seeking the views of the service users, staff and relatives. There are monthly audit visits and each one focuses on a separate aspect of care eg care plans, menu planning, environment or finances. A relatives meeting is scheduled and service users are able to contribute to inspections. Feedback has not been actively sought from service users about the service provided through using anonymous user satisfaction questionnaires. Rathmore House DS0000010331.V250343.R01.S.doc Version 5.0 Page 17 The home has a policy on handling service user’s personal finances. There is a secure facility for safekeeping monies and valuables and the manager is looking into purchasing individual safes for service users. All transactions are recorded. The policy is for two staff to witness each transaction. The records show debits, credits and balances, which offer an audit trail. Receipts are retained. The previous inspection report looked at the arrangements for tea and coffee making facilities. These have not been implemented as yet because a review is being held as to the safety of the service users from scalding. Rathmore House DS0000010331.V250343.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X X X STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Rathmore House DS0000010331.V250343.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2. Standard OP7 OP9 Regulation 15(1) & (2) 13(2) Requirement The home is required to implement the outcome of the audit on care plans. Photographs of the service users are to be attached to their medication profiles. This is a work in progress Timescale for action 30/03/06 30/03/06 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. Refer to Standard OP7 Good Practice Recommendations It is recommended that signatures of service users, where appropriate and their relatives are obtained on assessments and care plans. This is to show that they have been fully involved in the process. Rathmore House DS0000010331.V250343.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Camden Local Office Centro 4 20-23 Mandela Street London NW1 0DU 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 Rathmore House DS0000010331.V250343.R01.S.doc Version 5.0 Page 21 - 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. 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