Inspection on 13/12/05 for Rawalpindi House

This inspection was carried out on 13th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Rawalpindi House 14/04/08

Rawalpindi House 04/10/06

Rawalpindi House 28/07/05

Rawalpindi House 09/08/04

Rawalpindi House 22/04/04

Rawalpindi House 10/03/04

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

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

CARE HOMES FOR OLDER PEOPLE Rawalpindi House Rawalpindi House 81 Hermit Road Canning Town London E16 4HR Lead Inspector Sarah Greaves Unannounced Inspection 13th December 2005 15:00 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 Rawalpindi House DS0000032077.V274601.R01.S.doc Version 5.1 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. Rawalpindi House DS0000032077.V274601.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Rawalpindi House Address Rawalpindi House 81 Hermit Road Canning Town London E16 4HR 020 7474 4500 020 7476 2225 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) London Borough of Newham Sybil McKenley Care Home 32 Category(ies) of Dementia - over 65 years of age (32), Old age, registration, with number not falling within any other category (32), of places Physical disability over 65 years of age (32) Rawalpindi House DS0000032077.V274601.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Can admit persons over 60 years of age up to maximum number. Date of last inspection 28th July 2005 Brief Description of the Service: Rawalpindi House is a 32-bedded residential home for older people. The home is owned and managed by Newham Social Services. The premises are on the ground floor and located in Canning Town, within walking distance of the underground station and very close to frequent bus services. The home is divided into four separate units; two of these units are registered for people with dementia. The home offers permanent and respite care. Rawalpindi House DS0000032077.V274601.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An announced inspection was conducted over two days in July 2005. The majority of the applicable National Minimum Standards were assessed in July 2005; therefore this inspection was primarily focused upon checking the home’s attainment of the requirements and recommendations issued in the July 2005 inspection report. The inspector spoke to service users and staff, and joined service users during their evening meal. Service users stated that they had participated in and enjoyed a music activity (a Christmas carols sing-along facilitated by visiting musicians), which had finished soon before the arrival of the inspector. What the service does well: What has improved since the last inspection? An announced inspection was conducted on 28th July 2005; six requirements and seven recommendations were issued in the previous report. The inspector found that four of the requirements were not met at the time of this inspection. Three of the recommendations were met, three have been repeated due to insufficient evidence to verify the home’s progress and one recommendation for the communal toilets to be made more homely had evidently not been actioned. Rawalpindi House DS0000032077.V274601.R01.S.doc Version 5.1 Page 6 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. Rawalpindi House DS0000032077.V274601.R01.S.doc Version 5.1 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 Rawalpindi House DS0000032077.V274601.R01.S.doc Version 5.1 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): 1,3 and 4 The service implemented appropriate actions to enable the needs of service users to be identified and assessed prior to admission to the home. EVIDENCE: A recommendation was issued in the previous inspection report for the home to make amendments to the Statement of Purpose (SOP); this recommendation has been repeated in this report, as the duty officer could not locate the SOP during this inspection. All of the service users were referred to the home by Newham Social Services and possessed an assessment undertaken by their allocated social worker at the time of the referral. Additional assessment information gathered by the home was contained in service users individual care plans. The Service User Guide was read during the previous inspection; this document possessed clear information relating to the general and individual needs that the home could meet (for example, dementia care and intermediate care). A recommendation was issued in the previous inspection report for the home to record whether prospective service users visited the service prior to moving in; this recommendation had been met and the information provided to Rawalpindi House DS0000032077.V274601.R01.S.doc Version 5.1 Page 9 the inspector indicated that people availed of opportunities to undertake a preliminary visit. Rawalpindi House DS0000032077.V274601.R01.S.doc Version 5.1 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 and 9 The management of medications needs further attention, including staff training. EVIDENCE: A random sample of care plans was viewed on one of the units; these were found to be satisfactorily maintained. Two requirements were issued in the previous inspection report relating to the management of medication and medication training for senior staff. The inspector found that a service user had a jar of sudocrem in their room (a medicated lotion that can be prescribed, or purchased from a chemist); however, this was not written up on the service user’s medication chart. The duty officer stated that a relative of the service user brought in the lotion; however, there was no evidence to document that this treatment had been discussed with the service user’s General Practitioner to ensure its safety and suitability. Another topical lotion not recorded on a medication administration record (a bottle of polytar medicated shampoo) was found in a service user’s room. The requirement for senior staff to receive ‘refresher’ medication training had not been actioned; however, the inspector was informed that this training was due to take place in January 2005. Rawalpindi House DS0000032077.V274601.R01.S.doc Version 5.1 Page 11 The inspector noted that an area on the medication administration charts containing guidance to staff was obscured due to the pharmacy applying its printed stamp to the documents. A recommendation has been issued in this report for the home to liaise with the pharmacist to ensure that that preprinted information on these charts is fully visible. The duty officer produced a medication guidebook (British National Formulary-BNF) that was published in 2001. A recommendation has been issued in this report for the home to ensure that an up-to-date edition of the BNF is made available. Rawalpindi House DS0000032077.V274601.R01.S.doc Version 5.1 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): All of these standards were assessed and met at the previous inspection. EVIDENCE: Rawalpindi House DS0000032077.V274601.R01.S.doc Version 5.1 Page 13 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): 17 Service user’s entitlement to the safeguarding of written confidential information is maintained. EVIDENCE: A requirement was issued in the previous inspection report for the home to ensure that service users care plans were stored in lockable facilities when not in use; this requirement was found to be satisfactorily met. Rawalpindi House DS0000032077.V274601.R01.S.doc Version 5.1 Page 14 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, 22 and 26. The premises are comfortable and clean, and specialist equipment is provided in accordance with the identified needs of individuals. Actions need to be taken to offer a more homely environment (specifically in communal toilets/some bathrooms). EVIDENCE: A requirement was issued in the previous inspection report for the home to ensure that the garden area is improved upon and equipped with sufficient garden furniture. The inspector toured the garden with the duty officer; due to this inspection being conducted in the winter it was difficult to ascertain the level of improvement so far achieved. The duty officer stated that gardening improvements were planned for Spring 2006. This requirement has been deleted and progress with the development of the garden will be monitored at the next inspection. A recommendation was issued in the previous inspection for the home to make the communal toilets more ‘homely’ (for example, with wall motifs, small Rawalpindi House DS0000032077.V274601.R01.S.doc Version 5.1 Page 15 pictures and/or colourful tiles). This recommendation was not met and has been repeated in this report. The inspector looked at some of the ‘specialist’ equipment in the home. Pressure relieving mattresses had been issued by the district nurses for service users with a pressure sore (or at risk of developing pressure sores). It was observed that a service user chose not to use the footrests on their wheelchair; this was appropriately documented and assessed on a risk assessment within their care plan. The home was otherwise found to be clean and free from any offensive odours. Rawalpindi House DS0000032077.V274601.R01.S.doc Version 5.1 Page 16 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): 29 Service users are protected via safe recruitment practices. EVIDENCE: The inspector looked at a randomly selected sample of staff recruitment files for Rawalpindi House, during a visit to Newham Council’s Human Resources Department in November 2005. The files viewed were found to be satisfactorily maintained in accordance to the Care Homes Regulations. Rawalpindi House DS0000032077.V274601.R01.S.doc Version 5.1 Page 17 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): 33 and 38. Although the home demonstrated practical measures taken to involve service users in the running of their home, new initiatives must be undertaken to provide people with formal opportunities to express and discuss their views about living at Rawalpindi House. The two repeated health and safety requirements must now be thoroughly addressed. EVIDENCE: The inspector looked at the schedule for Christmas entertainments for service users. In addition to parties, a Christmas lights trip and a karaoke, service users were encouraged to participate in ‘domestic’ activities such as the putting up of decorations and decorating of the tree. The inspector joined service users for their evening meal; service users were offered two choices of savoury dishes followed by a selection of cakes or fresh fruit. The inspector was informed at the last inspection that the home were attempting to establish a regular meeting for service users, which would be convened by an Rawalpindi House DS0000032077.V274601.R01.S.doc Version 5.1 Page 18 independent advocate. The manager was due to meet with Age Concern in August 2005 in order to discuss this arrangement. The inspector found that there had not been any progress in establishing meetings with an independent advocate. Although it is acknowledged that this is an issue beyond the control of the service, a recommendation has been issued in this report for the home to set up service users meetings, even if these meetings are chaired by the manager or a senior member of staff. The home may wish to consider other possible options in the absence of Age Concern offering an advocate (such as inviting a local councillor to observe/participate). A requirement was issued in the previous inspection report for the home to ensure that hazardous substances are kept securely at all times. This requirement has been repeated as a bottle of cleaning fluid was left in a communal bathroom. A requirement was issued in the previous inspection report for the home to ensure that the equipment in the first aid boxes is safely maintained. The inspector and the duty officer checked the equipment in the first aid box in the kitchen and found two items that had expired. Standards 34 and 35 (budgets and service users personal finances records) were not assessed, as the administrator was not present. Rawalpindi House DS0000032077.V274601.R01.S.doc Version 5.1 Page 19 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 2 X 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 1 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 X 2 X X 3 X X X 3 STAFFING Standard No Score 27 X 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X X X 1 Rawalpindi House DS0000032077.V274601.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? YES 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. Standard OP9 Regulation 13(2) Requirement The Registered Person must ensure that the issues raised relating to medication within the main body of this report are addressed. The Registered Person must ensure that staff with a responsibility for dealing with medication receive refresher medication training. The Registered Person must ensure that the equipment in the first aid boxes is safely maintained. The Registered Person must ensure that hazardous substances are kept securely at all times. Timescale for action 31/01/06 2. OP9 13(2) and 18 (1) 31/01/06 3. OP38 13(4) c 31/01/06 4. OP38 13(4) a 31/01/06 Rawalpindi House DS0000032077.V274601.R01.S.doc Version 5.1 Page 21 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 OP1 Good Practice Recommendations References to the former registration and inspection authority should be removed from documents within the Statement of Purpose and the information relating to the CSCIs role for complaints should be consistent with the information provided in the Service User Guide. Staff who have received training in reminiscence therapy should commence reminiscence activities, with initial support from the external facilitator and/or the manager in order to develop their confidence in this practice, if necessary. The communal toilets should be made more homely . The home should investigate methods to increase staff attendance at team meetings. The home should establish meetings for service users by 31/03/06. 2. OP12 3. 4. 5. OP22 OP32 OP33 Rawalpindi House DS0000032077.V274601.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ 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 Rawalpindi House DS0000032077.V274601.R01.S.doc Version 5.1 Page 23 - 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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