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Inspection on 20/05/05 for Robertson Nursing Home

Also see our care home review for Robertson Nursing Home for more information

This inspection was carried out on 20th May 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The residents spoken to during the inspection spoke very highly of the staff and the manager. They felt their views and feelings were taken into account and that staff responded well to any requests made. The manager was open and clear in discussions with the inspector and was keen to receive feedback and to learn from the inspection if this was needed. During the inspection observations by the inspector noted that service users were comfortable, felt able to talk openly about the home and the staff team. The relationship between the staff, manager and residents was warm and friendly.

What has improved since the last inspection?

No requirements were made at the last inspection and the home retains a sense of pride in the standard of service they provide.

What the care home could do better:

The home undertakes an assessment before anyone is offered the option of moving in. Following one admission it was found that the manager had not been given all of the information on which to make a decision. It was recommended that the home further consider where to gain information regarding a prospective resident.

CARE HOMES FOR OLDER PEOPLE Robertson Nursing Home Priorsfield Road Godalming Surrey GU7 2RF Lead Inspector Mrs Sue McBriarty Announced 20 May 2005 th 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. Robertson Nursing Home H58_s17637_Robertson_v218876_200505_stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Robertson Nursing Home Address Priorsfield Road Godalming Surrey GU7 2RF 01483 421033 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) Dr J R Colville Mrs Colette Patricia Knight Care Home 41 Category(ies) of OP - Old Age 41 registration, with number of places Robertson Nursing Home H58_s17637_Robertson_v218876_200505_stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Old age not falling into any other category (41). Date of last inspection 6th December 2004 Brief Description of the Service: Robertsons Care Home has provided nursing care for approximately 50 years. The current propriator has been the owner for the past 28 years. The owner of the home is referred to as the Clinical Director. The property is over hundred years old, it has retained a lot of its original character. In the past few decades extensions have been added, which have provided additional bedrooms and communal space. The property is set in its own grounds and is surrounded by a large mature garden. A range of communal facilities is located through the home, which includes a sitting room, dining room, library and conservatory. The library provides a quiet room with a range of books. The bedroom accommodation is arranged over two floors with the provision mainly being single rooms and with up to six rooms, which can be used as shared facilities. The registered manager oversees the clinical and care practice and takes responsibility for the administration and practical running of the home. The Clinical Director, training coordinator and human resources are based at the main office, which is located in Ascot, Berkshire. The Clinical Director visits the home several times per week. A team of nurses and care staff assist the registered manager. The home is able to provide nursing care for up to 41 older people. Robertson Nursing Home H58_s17637_Robertson_v218876_200505_stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, the first inspection for 2005 – 2006. During this inspection four (4) service users, the homes training co-ordinator and physiotherapist were spoken to. The inspector sat in on the lunchtime staff handover. Nine (9) comment cards were received, the cards received were from residents and family members. Four family members were also met during the inspection and their views of the home gained. The manager provided a pre-inspection report to the CSCI. A tour of the building took place and the inspector saw all communal areas and a number of bedrooms. Menus were seen and lunch sampled on the day. A number of documents were sampled including training records and personnel files; resident files were observed being completed by staff. The home was welcoming and all those within the home at the time of the inspection were open about their views of the service provided. This home prefers to call those living there residents and that term is used in this report. What the service does well: What has improved since the last inspection? What they could do better: The home undertakes an assessment before anyone is offered the option of moving in. Following one admission it was found that the manager had not been given all of the information on which to make a decision. It was recommended that the home further consider where to gain information regarding a prospective resident. Robertson Nursing Home H58_s17637_Robertson_v218876_200505_stage4.doc Version 1.30 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. Robertson Nursing Home H58_s17637_Robertson_v218876_200505_stage4.doc Version 1.30 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 Robertson Nursing Home H58_s17637_Robertson_v218876_200505_stage4.doc Version 1.30 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) 1, 3, 4, 5 Prospective residents were assessed prior to being offered a place at the home. They were able to visit the home and are offered a short stay to ensure that they have made the right personal choice. EVIDENCE: The manager ensured that all prospective residents were assessed before being offered a place at the home. One recent issue led to the recommendation from the inspector that they extend the people they contact for information to the person’s General Practitioner (with permission). The home has been required to make application for a variation of conditions of registration. The resident’s needs were changing and a number now have dementia. The trainer had been working with the staff team on the support needs of people with dementia and mental health in older age. Robertson Nursing Home H58_s17637_Robertson_v218876_200505_stage4.doc Version 1.30 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) 7,10,11 The home treats the residents with respect and dignity. Policies and procedures were in place for supporting people at the time of their death. EVIDENCE: Comment cards received were very complimentary of the home. One noted how the ‘care plan was regularly updated’ another that the service was ‘exemplary’. The residents spoken to during this inspection also spoke highly of the staff team and how they were cared for. All spoke of how their needs were met in a way that suited them. The home has a policy in place for supporting people at the time of their death. The home employs a physiotherapist who provides four hours a week support. The physiotherapist informed the inspector that the home enabled her to work effectively as she was employed to assist all those who needed support and not just those who could afford it. The service provided varied according to the need of the person and was based on assessment. Robertson Nursing Home H58_s17637_Robertson_v218876_200505_stage4.doc Version 1.30 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) 13, 14, 15 Family and friends were able to visit the home during the day. The residents were able to exercise choice and control. Menus were seen and were varied and nutritious. EVIDENCE: Throughout the day family and friends were visiting the home. Those spoken to say they are able to visit in private. The only restriction noted was in a comment card that said visiting was from 7am to 9pm each day. The home does not deal with resident’s finances; this was not a service they offer. The menus seen, comment cards received, resident views on the day and the sampled lunch evidenced that the food was varied and nutritious. Family members who have eaten there also commented on the good food. The pre-inspection report provided by the manager noted activities that take place either within or near the home for example; theatre trips, pets as therapy, manicures, mobile library and attendance at the golf club. Robertson Nursing Home H58_s17637_Robertson_v218876_200505_stage4.doc Version 1.30 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) 16, 18 The policies and procedures in the home and staff training assist in safeguarding the residents from abuse. EVIDENCE: No complaints had been received by the home within the twelve months prior to this inspection nor have any adult protection referrals been made. The complaints procedure was last reviewed in July 2003 and the home’s Adult Protection policy in April 2004. Robertson Nursing Home H58_s17637_Robertson_v218876_200505_stage4.doc Version 1.30 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, 20, 21, 22, 23, 24, 25, 26 The home provided adequate communal and individual space for the service users. Sufficient bathing and toilet facilities were provided. EVIDENCE: The home had been working on providing magnetic locks to the bedrooms this work has yet to be completed. The work was being undertaken on the advice of the fire safety officer. In the interim the bedroom doors were kept closed. The home was warm, comfortable and clean at the time of this inspection. The resident’s rooms seen had been personalised and were light and airy. Specialist equipment was observed being used by the residents. The external part of the home requires some work, as does the garden. The windows at the rear of the building (later build) required work as the paint had peeled away and the windows were unsightly. At the end of the garden was an area used to place large unwanted items until such times as they can be collected, occasional fires were lit to dispose of some rubbish and parts of the garden were overgrown with nettle growth. Garden rubbish had been left in Robertson Nursing Home H58_s17637_Robertson_v218876_200505_stage4.doc Version 1.30 Page 13 several areas of the same piece of garden. Further along a pond was in place, in some areas the paving surrounding the pond had either sunk away or been removed. Parts of the patio need work to reduce weed growth and a possible slip hazard. A requirement has been made to risk assess the garden area and to consider access issues. The home is required to apply for a variation to work with people who have dementia. Access was seen to be problematic as there is an area at the side of the house. A requirement has also been made to assess the rear windows to ensure any work required is undertaken. Robertson Nursing Home H58_s17637_Robertson_v218876_200505_stage4.doc Version 1.30 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 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) 27, 28, 29, 30 The staffing on the day of the inspection was adequate. The home has a recruitment policy in place. EVIDENCE: The files seen during this inspection were adequate. The inspector evidenced the Criminal Records Bureau (CRB) checks of the staff team. The home has a trainer who ensured that appropriate training was completed. All staff members were required to take part in a three day induction period before beginning work with residents. Other training provided included wound care, prevention of abuse, food hygiene awareness, nutrition and skin care. Staff members were also undertaking the NVQ Level 2 in care. Of the seventeen (17) care staff working at the home 7 had completed their NVQ Level 2 or above, two (2) were awaiting verification of their pass and one (1) had just stared the course. Robertson Nursing Home H58_s17637_Robertson_v218876_200505_stage4.doc Version 1.30 Page 15 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) 31, 35, 38 Records were held appropriately in the home. Some work was required to ensure the health and safety of residents. EVIDENCE: The manager is nurse qualified and in the process of completing the Registered Managers Award. The family members and residents spoken to were complimentary of her open management style and approachability. All those spoken to stated that they would approach the manager if they had any concerns or queries. The manager informed the inspector that the home does not deal with the resident’s money. Some chemicals were found in one bathroom and one corridor of the home. Both articles were air fresheners. It is required that these articles are in a lockable cupboard. These were removed during the inspection. Robertson Nursing Home H58_s17637_Robertson_v218876_200505_stage4.doc Version 1.30 Page 16 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 1 x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 2 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x 3 x x 2 Robertson Nursing Home H58_s17637_Robertson_v218876_200505_stage4.doc Version 1.30 Page 17 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 1 Regulation 4(3)(a)(b) Requirement The registered person must make application for a variation in category to meet the changing needs of service users. The registered person must ensure that the windows at the rear of the building are repainted and or repaired as required. The registered person must ensure that the garden and access areas to and from the garden are risk assessed and any action required taken to ensure the safety of service users. The registered person must ensure that all chemicals are kept in a lockable space. Timescale for action 30th June 2005 31st August 2005 31st August 2005 2. 19 23(2)(b) 3. 20 13(4)(c ), 23(2)(b) 4. 38 13(4)(a) immediate (20th May 2005) 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 3 Good Practice Recommendations It is recommended that the manager update the admission procedure to include other professionals to ensure that all information is provided prior to an admission. Version 1.30 H58_s17637_Robertson_v218876_200505_stage4.doc Page 18 Robertson Nursing Home Robertson Nursing Home H58_s17637_Robertson_v218876_200505_stage4.doc Version 1.30 Page 19 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Robertson Nursing Home H58_s17637_Robertson_v218876_200505_stage4.doc Version 1.30 Page 20 - 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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