Inspection on 25/06/07 for Rhodelands Care Home

This inspection was carried out on 25th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rhodelands Care Home 26/11/07

Rhodelands Care Home 27/07/06

Rhodelands Care Home 19/10/05

Rhodelands Care Home 24/06/05

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

CARE HOME ADULTS 18-65 Rhodelands Care Home Babbs Lane Doveridge Derbyshire DE6 5JT Lead Inspector Vanessa Davies Key Unannounced Inspection 25th June 2007 09:00 Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 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 Rhodelands Care Home DS0000062996.V340613.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 Adults 18-65. 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. Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rhodelands Care Home Address Babbs Lane Doveridge Derbyshire DE6 5JT 01889562815 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) Milbury Post Vacant Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th July 2006 Brief Description of the Service: Rhodelands is a large detached home in a quiet secluded lane. It is surrounded by large well-maintained gardens. All areas of the home and garden are accessible to the service users. There are a number of communal areas including a large, well-furnished conservatory. All bedrooms have en-suite bath or shower room. At the time of inspection there was a large log cabin being built within the grounds, it has a sensory room, an activity room and a small canteen with a vending machine to be fitted to meet the needs and expectations of service users. The home provides long term care for adults with a learning disability. Transport to access the community is also provided. Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was unannounced and the new manager for the home was present throughout. The information for this report was gathered by reading information provided by the manager prior to the visit and information gathered during a visit to the home by reading records, observing staff and speaking with a service user, although it was difficult to converse with the service user present, hence the lack of quotes in the report. The fees for the home start from £1606 dependant upon the support required. The home is registered to house 8 service users with a learning disability and at the time of the visit there were 7 service users living there. What the service does well: The new manager is in the process of reviewing and updating the service users files. The service users files included a detailed assessment of need. Care plans are individual and give a true and detailed picture of the service user enabling the staff to meet the needs highlighted. The Manager has worked hard to implement positive changes within the home, which has included recruiting a number of new members of staff. Service users have access to a range of activities and the manager is working towards developing other activities. Service users have access to a range of other professionals and positive links have been made with the Primary Care Trust. Medication is stored, recorded and administered safely. Clear policies and procedures are available for complaints, whistle-blowing and Safe Guarding Adults. Service users are made aware of the procedures and have used them. The home is a personalised as the service users will allow. The manager intends to implement a new system of recognition for a service user who is blind, enabling her to know where about in the home she is by the touch of a button. The home is regularly visited by the Operations Manager providing an external audit and support for the manager. Rhodelands Care Home DS0000062996.V340613.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. The summary of this inspection report can be made available in other formats on request. Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. Detailed assessments of need ensure that staff are enabled to meet the needs of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The new manager is in the process of reviewing and updating the service users files. The service users files included a detailed assessment of need. The manager stated that she intends to have an initial assessment of need for a service user before any offer of placement. She has developed an excellent care planning system to address the needs of the service users and was in the process of implementing this for all service users. Care plans are individual and give a true and detailed picture of the service user enabling the staff to meet the needs highlighted. Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed care plans and suitable recording charts ensures that staff are aware and able to meet the changing needs of the service users throughout their stay at the home. EVIDENCE: Since being appointed the Manager has clearly worked very hard to implement positive changes in the care planning process. The files examined had a detailed assessment of need, which held valuable information relating to the service users. The care plans are written with input from the service user where possible. The care plans include how to communicate with the service users, how to manage behaviours exhibited and how to react to any problems as they may arise. The care plans encourage service users to be independent and make choices as much as possible. Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 Page 10 The manager is in the process of implementing a new system throughout the home to enable one service user who is blind; to get around the home and be aware of where she is and which room she is entering. Service user records are kept in the office, which is locked when not occupied. The manager is arranging for a service user contract to be made available in Braille, again promoting independence. The daily records completed by staff include activities and appointments the service users have attended as well as their dietary intake for the day. Each of the service users files examined had a monthly weight chart and this was completed. Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is Good. Offering a wide range of activities, planning to offer other activities and involving the service users in this process helps to promote independence and improve quality of life. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Manager and staff provide an individual activity plan for each service user, each of the service users have access to a range of activities and this was evident when speaking with a service user on the day of the visit and reading the files. Service users access the local community on a regular basis. The service user spoken with was not able to name a particular friend, however the manager stated that service users are encouraged to make friends within the home and outside the home within the circles they attend. Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 Page 12 Service users are offered a healthy diet and are encouraged to participate in developing the menu and to be involved with the shopping. The manager intends to develop pictorial boards and to broaden the range of activities on offer. Although the home has had Service User meetings in the past they have not been very productive and very irregular, the new manager intends to implement these on a regular basis and ensure that any issues highlighted are addressed if possible in the staff meetings. Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. Detailed care plans and positive links with primary care trusts ensures that the health needs of service users are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each of the files examined detailed healthcare information, both past and present. The service user spoken with stated that staff supported him as he requested and this was evident during the visit. The new care plans include how to meet each service users health care needs, other professionals involved and monitoring and reviewing appointments. The manager stated that the service provision had improved over the last 12 months as she had ensured that all service users now have access to primary care facilities on a regular basis and areas of personal care had improved. Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 Page 14 Medication is stored, documented and administered appropriately. Medication is now only administered by the Senior on duty and each of the seniors have received training in the administration of medication from the manager who is a registered nurse. The training package includes a practical and written assessment. Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Positive approaches to whistle-blowing ensures that service users and staff feel listened to and that the issues are acted upon positively, ensuring the safety of the service users. EVIDENCE: As stated previously within this report the manager is arranging regular service user meetings and any issues highlighted will be discussed at the staff meetings. The service user spoken with stated that the staff did listen to him. The home has a clear complaints policy, Safeguarding Adults policy and procedures. whistle-blowing policy and It was evident that the manager listens very clearly to any concerns the service users have. There has been one Safeguarding issue at the home, which the home has dealt with and provided support for the service user involved. Since the appointment of the new manager there has been a change in staff team and this appears to have had a positive effect on the service users. The Operations manager undertakes monthly audits of the service users finances. The manager ensures that all new staff undertake an induction, which includes understanding policies and procedures and guidelines on physical restraint. Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 Page 16 The manager plans to ensure that all staff under-go training in physical restraint. Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is poor. Lack of a response to a broken fire alarm by the organisation potentially put service users and staffs lives at serious risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is in need of some refurbishment and the manager stated that she had assessed areas of the home and some updating has been completed and other areas will be completed in the near future. On the day of the visit the fire alarm system was not working, the manager had reported it 4 days prior to the visit, when, it was damaged by a service user, the manager had done everything she could to try to ensure the safety of the service users, however, the organisation had failed to act on the report of the broken alarm system as a matter of priority and the service users and staff were left at serious risk of harm. Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 Page 18 An immediate requirement was left and the manager contacted the inspector later the same day to confirm that the system had been repaired and was in working order. Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good. Positive staff attitudes and providing up to date training ensures that service users are cared for by suitably qualified staff and are therefore safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The new manager has worked very hard with staff training and building staff morale in order to improve the care provided. The improvements include a number of new staff members. The manager stated that she had arranged training in September 2007 for Infection Control, Epilepsy Awareness, Fire Safety, Manual Handling, Health & Safety, First Aid and all staff will complete LDAF (learning disability award framework). All staff have completed training in administration of Rectal Diazepam to ensure that service users with epilepsy needing this type of medication can receive it. The manager is a registered nurse and has developed a training programme for the administration of medication and staff who administer medication have completed the course. Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 Page 20 All staff records examined had a detailed application form, 2 written references, 2 proofs of identity and a completed Criminal Records Bureau check. Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39,42 Quality in this outcome area is poor. A new and experienced manager has improved morale and care provided for service users, however the lack of urgent response to a broken fire alarm system, by the Organisation left service users and staff at serious risk of harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has recently had a new manager and a number of staff changes, however it did appear to be relaxed on the day of the visit and the manager stated that she felt that things had now settled. The manager has moved from another home and has worked for the company for a long time; she has a great deal of experience working with the client Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 Page 22 group living at the home. She has clearly worked very hard to implement positive changes within the home. The manager evidenced a number of monitoring methods. The Operations Manager visits the home on a monthly basis to undertake Regulation 26 visits and provides a report. It was evident on the visit that the person responsible for Fire Safety checks had not been completing them as necessary and the manager was already aware of this and planned to address it later that day. This was concerning as the home had been without a fire alarm system for 4 days prior to the visit. The manager stated that she had reported it to the Company and they were arranging quotes, however this did leave service users and the staff at serious risk of harm. An immediate requirement was left and the manager contacted the inspector later the same day to confirm that the fire alarm system had been repaired and was now in full working order. Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 3 X X 1 X Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 Page 24 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. 1. Standard YA42 Regulation 23.4 Requirement The fire alarm system must be repaired. Timescale for action 25/06/07 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. Refer to Standard YA32 YA30 Good Practice Recommendations The Registered Person should ensure that staff receive training in courses arranged for September. The manager should ensure that she arranges for the curtains to re-hung throughout. Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Rhodelands Care Home DS0000062996.V340613.R01.S.doc Version 5.2 Page 26 - 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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