CARE HOMES FOR OLDER PEOPLE
Rearsby Home 34-36 Station Road Rearsby Leicetershire LE7 4YY Lead Inspector
Keith Williamson Unannounced 24 August 2005 at 9.30am 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 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. Rearsby Home C51 C01 S1820 Rearsby V245076 240805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Rearsby Home Address 34-36 Station Road Rearsby Leicestershire LE7 4YY 01664 424519 01664 424519 None Rearsby Home Limited Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Sairendri Jawahar Care Home 27 Category(ies) of DE Dementia - 27 registration, with number DE(E) Dementia over 65 - 27 of places MD - Mental Disability - 27 MD(E) Mential Disability over 65 - 27 Rearsby Home C51 C01 S1820 Rearsby V245076 240805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: No person under 55 years of age may be admitted to the home. Date of last inspection 20/04/05 Brief Description of the Service: Rearsby Residential home is a purpose built property in a quiet residential area of Rearsby village. This moderately sized home has space for 27 frail elderly residents, and specialises in residents suffering with Mental Health issues and Dementia. The home has a range of accommodation over 2 floors, both being serviced by a passenger lift. The home has a secluded garden that offers a level access from the home. The home is not situated near shops, though is well placed to access a local bus route to both Melton Mowbray and Leicester. Rearsby Home C51 C01 S1820 Rearsby V245076 240805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over 1 day and started at 9.30am. An opportunity was taken to look round the home, view records and policies and talk to the staff. The resident group were spoken with, though could not accurately comment on conditions in the home or staff, one indicating he did not wish to converse with the inspector. Of the residents’ relatives visiting, none wanted to be interviewed or pass comment to the inspector. The manager assisted the inspector throughout the day. What the service does well: What has improved since the last inspection? What they could do better:
A communication book is used; all personal details from this should be recorded into the daily records of each resident. The menu board could be completed accurately giving residents who are aware accurate information on the day’s main meal. Fresh milk could be offered to residents. Staff supervision for evening and night staff is not performed regularly enough. Staff could spend more time giving residents social input. Rearsby Home C51 C01 S1820 Rearsby V245076 240805 Stage 4.doc Version 1.40 Page 6 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. Rearsby Home C51 C01 S1820 Rearsby V245076 240805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Rearsby Home C51 C01 S1820 Rearsby V245076 240805 Stage 4.doc Version 1.40 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 standard(s) None. No standards were visited on this occasion as they were covered on the first inspection earlier in the year. EVIDENCE: Rearsby Home C51 C01 S1820 Rearsby V245076 240805 Stage 4.doc Version 1.40 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 standard(s) 7 &10. Residents are well looked after in respect of their personal care and staff respect residents’ privacy. EVIDENCE: The Inspector viewed two residents care plans; both were personalised, though again neither of the residents involved had signed their plan, this should not be the expected norm and each resident or their relative be involved in the care planning process; details in the “communication book” are not always reflected in the residents’ personal daily records, this must be amended and the main record have all the information. Social care needs are recognised in some of the plans, though staff still do not see spending time with residents as a priority. The inspector witnessed staff hoisting a resident, this task was performed appropriately. Rearsby Home C51 C01 S1820 Rearsby V245076 240805 Stage 4.doc Version 1.40 Page 10 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 standard(s) 12, 13, 14 & 15. Residents are assisted to exercise choice and control over their lives. EVIDENCE: The staff were seen interacting with residents in the home, though this was after the inspector enquired what social care or recreation was planned for that day. The reaction from one resident was unfavourable, indicating the activity was poorly planned and unsuccessfully executed, resulting in frustration and irritation for the resident. Another activity was more successful and enjoyed a good response from the small group of residents involved. The television in the lounge is not well placed and can be seen by a small percentage of residents, for the sake of clarity of communication it would be well advised to move this to a more open area. Relatives are openly welcomed, one witnessed seen assisting with a residents’ personal care on several occasions; another family assisting their relative to a hospital appointment, this is seen as good continuing care for the resident and involvement for the family. Menus are made up in advance and residents offered appropriate choices of meals and dietary supplements, though the menu board in the dining room is not actively changed to reflect the appropriate days menu. There is currently no cook in post; the Manager is actively involved in appointing a replacement. There was evidence of a balanced diet being on offer, though the inclusion of fresh milk would be an advantage for residents.
Rearsby Home C51 C01 S1820 Rearsby V245076 240805 Stage 4.doc Version 1.40 Page 11 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 standard(s) 18. Procedures are in place, which protect residents from abuse. EVIDENCE: The manager has not yet received her updated copy of “no secrets” the adult abuse protection policy, but demonstrates along with the staff, an appropriate knowledge of the issues surrounding adult protection and whistle blowing. Rearsby Home C51 C01 S1820 Rearsby V245076 240805 Stage 4.doc Version 1.40 Page 12 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 standard(s) 19 & 21. The home is comfortable and safe. The home now meets the required standards regarding environment. EVIDENCE: The last report highlighted four areas deficient in the environment of the home these have now been addressed. The plan of routine maintenance is in place, it is recommended that this be continually revised. Lounge chairs are being re-stained and the external paintwork of the home is currently being worked on. The extractor fan has now been repaired. Rearsby Home C51 C01 S1820 Rearsby V245076 240805 Stage 4.doc Version 1.40 Page 13 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 30. Residents are protected by well-trained staff. EVIDENCE: Staff training is well planned and executed in the home. The manager has an overview of the training required, and plans this in conjunction with the staff on an individual basis. Rearsby Home C51 C01 S1820 Rearsby V245076 240805 Stage 4.doc Version 1.40 Page 14 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 & 36. Residents are protected by a robust system of quality assurance, financial and staff checks. EVIDENCE: Evidence of quality assurance questionnaires are in place, these are distributed appropriately. Three residents’ finances were checked on this visit, all were found to be individually kept, correct and balanced with the ongoing paper records. Staff supervision and appraisals are in place and are partly planned around the ongoing training in the home. Rearsby Home C51 C01 S1820 Rearsby V245076 240805 Stage 4.doc Version 1.40 Page 15 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 x 3 x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x 3 x 3 3 x x Rearsby Home C51 C01 S1820 Rearsby V245076 240805 Stage 4.doc Version 1.40 Page 16 No 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. 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. Refer to Standard 7 12 33 Good Practice Recommendations It is recommended that all information from the communication book be copied into individual residents daily records. It is recommended that the television in the main lounge be repositioned to allow more residents to view it. it is recommmended that the findings of any quality assurance questionaires be added to the Statement of Purpose and Service User Guide. Rearsby Home C51 C01 S1820 Rearsby V245076 240805 Stage 4.doc Version 1.40 Page 17 Commission for Social Care Inspection The Pavilions, 5 Smith Way Grove Park Enderby Leicestershire National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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