Inspection on 26/11/07 for Rhodelands Care Home

This inspection was carried out on 26th November 2007.

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

Rhodelands Care Home 25/06/07

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 Unannounced Inspection 26th November 2007 08:45 Rhodelands Care Home DS0000062996.V354852.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.V354852.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.V354852.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rhodelands Care Home Address Babbs Lane Doveridge Derbyshire DE6 5JT 01889 562815 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) www.milburycare.com Milbury Care Services Ltd Sarah Louise Jones Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Rhodelands Care Home DS0000062996.V354852.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The provider may provide the following category of service only: Care Home (PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: 2. Learning Disability - Code LD The maximum number of service users who can be accommodated is: 7 25th June 2007 Date of last inspection 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.V354852.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 Manager 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. All service users at the home are funded for 1:1 care with some funded 2:1 during activities. The home is registered to house 7 service users with a learning disability and at the time of the visit there were 6 service users living there. This report appears similar to that completed in June 2007, the reason for this visit was to establish whether the immediate requirement left in June had been completed. What the service does well: The Manager has continued 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 and working closely with them to ensure that the care they provide is appropriate. Service users have access to a range of activities and the Manager is working towards developing other activities, including more inclusion within the local community. 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. Rhodelands Care Home DS0000062996.V354852.R01.S.doc Version 5.2 Page 6 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. 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.V354852.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.V354852.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 assessed needs of the service users and therefore reach their full potential. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Manager continues the process of reviewing and updating the service users files. The filing system is much improved and information is readily available. The service users files included a detailed assessment of need. The Manager stated that she completes 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 continues 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.V354852.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. 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. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since being appointed the Manager has continued to work very hard to implement positive changes in the care planning process. The files seen had a detailed assessment of need, which held valuable information relating to the service users. The support plans are written with input from the service users where possible. The support plan is individualised, it holds easy to read and understand information. The care plans include a detailed pen picture of the service user, things of importance, things they would like to change, what makes them happy and Rhodelands Care Home DS0000062996.V354852.R01.S.doc Version 5.2 Page 10 unhappy and goals and aims. The care plans encourage service users to be independent and make choices as much as possible. Service user records are all stored within the office which is kept locked when unattended. All of the records are written in an easy to understand format, using simple English and pictures. Rhodelands Care Home DS0000062996.V354852.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, this is included in the support plan. Each of the service users have access to a range of activities and this was evident on the day of the visit and whilst reading through files. Service users access the local community on a regular basis, collecting a newspaper from the local shop, visiting the cinema and supermarkets. Rhodelands Care Home DS0000062996.V354852.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, this was evident on the day of the visit. Service users are supported to maintain regular contact with families and friends. The Manager intends to implement new ideas to improve the communication skills of the service users, including a speaking system to assist a service user who is registered blind. Rhodelands Care Home DS0000062996.V354852.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 other professionals 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.V354852.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.V354852.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 good. 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. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a clear complaints policy, whistle-blowing policy and Safe Guarding Adults policy and procedures. It was evident that the Manager listens very clearly to any concerns the service users and their representatives may have and since working at the home she has worked hard to develop relationships with service users, staff and relatives to ensure they are able to raise concerns with her. The Manager ensures that all new staff undertake an induction, which includes understanding policies and procedures and she plans to ensure that all staff complete a Certificate for Working with people with a Learning Disability (CWPLD). Rhodelands Care Home DS0000062996.V354852.R01.S.doc Version 5.2 Page 16 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 good. A clean safe environment helps to ensure that service users live in a safe home and promotes various independence skills. 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. The fire alarm is checked regularly and staff spoken with had received training and were clear about what to do in the event of a fire. All other monitoring was up to date. The Manager delegates a variety of monitoring to ensure that it is all completed as necessary, when she is not available. Rhodelands Care Home DS0000062996.V354852.R01.S.doc Version 5.2 Page 17 Rhodelands Care Home DS0000062996.V354852.R01.S.doc Version 5.2 Page 18 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. Regular up to date training and rigorous recruitment procedures ensure the safety of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The 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 who have now settled well into the home and its routine and have clearly built up positive relationships with the service users. The manager stated that training had taken place 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 Rhodelands Care Home DS0000062996.V354852.R01.S.doc Version 5.2 Page 19 programme for the administration of medication and staff who administer medication have completed the course. All staff records examined had a detailed application form, 2 written references, 2 proofs of identity and a completed Criminal Records Bureau check obtained prior to appointment. Rhodelands Care Home DS0000062996.V354852.R01.S.doc Version 5.2 Page 20 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 good. An experienced manager and dedicated staff team help to ensure that service users are assisted to reach their full potential and improve social skills. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Manager continues to work very hard to implement positive changes with the care planning process, the environment and in addition form positive relationships with the service users, their relatives and the staff. The manager moved from another home and has worked for the company for a long time, she has a great deal of experience working with the service user group living at the home. Rhodelands Care Home DS0000062996.V354852.R01.S.doc Version 5.2 Page 21 The manager evidenced a number of monitoring methods. The home has regular monitoring visits from a manager outside the home. The fire alarm records were up to date, the landlords gas safety record was up to date. All other safety checks were up to date. Rhodelands Care Home DS0000062996.V354852.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 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 3 23 3 ENVIRONMENT Standard No Score 24 3 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 3 X 3 X X 3 X Rhodelands Care Home DS0000062996.V354852.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. Refer to Standard YA30 Good Practice Recommendations The manager should ensure that she arranges for the curtains to re-hung throughout. Rhodelands Care Home DS0000062996.V354852.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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.V354852.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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