Inspection on 11/11/09 for Roberttown Nursing Home

This inspection was carried out on 11th November 2009.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Roberttown Nursing Home 19/12/08

Roberttown Nursing Home 07/11/06

Roberttown Nursing Home 30/11/05

Roberttown Nursing Home 25/07/05

Roberttown Nursing Home 02/02/05

Roberttown Nursing Home 03/09/04

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Hawkhills

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Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report Care homes for older people Name: Address: Roberttown Nursing Home Church Road Roberttown Liversedge West Yorkshire WF15 8BE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Paula McCloy     Date: 1 1 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Roberttown Nursing Home Church Road Roberttown Liversedge West Yorkshire WF15 8BE 01924411600 01924408395 Manager.robertown@aermid.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: CSS Investments Limited care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: One specific service user under the age of 65, named on variation dated 20th November 2006, may reside at the home Date of last inspection Brief description of the care home Roberttown Nursing Home is purpose built and registered to provide nursing and personal care for up to twenty nine older people. The accommodation is arranged over three floors and all of the bedrooms are single occupancy. The home is located in its own grounds and there are adequate car parking facilities to the front of the home. The home is situated close to the facilities and shops in the village of Roberttown. The home is staffed twenty-four hours a day and there are wakeful night staff on duty. 1 9 1 2 2 0 0 8 0 Over 65 29 Care Homes for Older People Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The current weekly charges at Robettown Nursing Home range from £400.18 - £437.04 additional charges are made for hairdressing, chiropody and newspapers. This inspection was carried out to assess the quality of care provided to people living at the home. The inspection process included looking at the information we have received about the home since the last key inspection as well as a visit to the home, which lasted approximately 6 hours. During the visit we spoke to 4 people living in the home, 6 members of staff, the manager and 2 relatives. We also observed staff delivering care, looked at various records and looked around the home. Care Homes for Older People Page 5 of 26 Surveys were sent to 10 people living in the home, 10 staff and 5 health care professionals; these cards provide an opportunity for people to share their views of the service with us. Information received in this way is shared with the home without identifying who has provided it. Six people using the service, one member of staff and one social care professional wrote to us with their comments. Their comments have been used in this report. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 7 of 26 following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can go and look around the home to see for themselves if they think it is suitable. Staff assess people before they move in so they are sure they can meet peoples needs. Evidence: There is a Statement of Purpose and Service User Guide, however, these documents were not up to date and did not have all of the required information in them. For example there was no details of the complaints procedure or a sample contract or terms and conditions document. There was also no details about what the service offers or who the service is for. The manager told us that staff are working on a new Service User Guide that will give people more information. It is important that these documents are brought up to date and are available for people to take away, so that they have written information about the home and the services it provides. A member of staff from Roberttown will go and assess anyone thinking of moving into Care Homes for Older People Page 10 of 26 Evidence: the home. There is an assessment document that staff complete, which means that peoples needs are identified and that staff are sure they can meet those needs before people move in. We looked at the files for three people and found all of the assessment information we would expect, together with a care plan for each. Anyone thinking of moving into Roberttown can go and have a look round to see for themselves if they think it willl be suitable. We spoke to some relatives who told us that they had been to look around the home to see if they thought it would be suitable for their relative. They said that staff had been helpful and had given a good impression and they had been able to select a room that they felt their relative would like. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are being met. Evidence: We looked at three care plans because we wanted to see what individual needs had been identified and what action staff have to take to meet these needs. We found that generally the care plans were detailed and contained good information. All of the necessary risk assessments have been completed and staff are writing down the action they need to take to reduce or eliminate that risk. For example one person had been identified as being at high risk of developing pressure sores. There was a clear plan regarding the specialist equipment that was in place and instructions for staff about repositioning them. This persons has not developed a pressure sore which shows that the care plan is effective. Peoples health care needs are being identified and met. Staff are vigilant and GPs and other health care professionals are being involved as necessary. Details of any visits by health care professionals are documented in the individual care plan and show the Care Homes for Older People Page 12 of 26 Evidence: advice that has been given. We talked to staff about peoples care and support and they described the care that was written down in the care plans. This means that staff understand what they need to do to make sure peoples needs were met. The daily records, however, do not always reflect the care and support that staff are giving. For example one person is dependent upon staff to meet all of their needs. It wasnt possible from the written records to find out exactly what care was being delivered. It is important that staff write down the care and support they give so they can demonstrate peoples care is being delivered as detailed in the care plan. This will make sure that peoples needs are met in a consistent way. People generally looked well cared for and we saw that men had been shaved, peoples hair brushed or combed, spectacles were clean and peoples personal hygiene was well maintained. The people we spoke to told us that generally they like the staff and that they respond to their requests. The medication system is well managed. We watched part of a medication round. The nurse spent time with each individual, offering encouragement when needed. People are receiving their medication at the prescribed times and records are well maintained. We did note that none of the lotions or creams that have been prescribed are being signed for. We spoke to the acting manager about this and she agreed to make sure this happens in future. Specific medication records will be left in peoples bedrooms so that staff can sign that they have applied any necessary creams etc. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can follow their own routines. There are activities on offer to keep people stimulated and meals are the home are good. Evidence: The care plans we looked at all contained a life history and details of peoples personal preferences and likes and dislikes. This is important because it makes sure staff know about peoples past lives and experiences. It also makes sure they know what times people like to get up, go to bed, if they like to stay in their bedroom and what they like and dont like to eat and drink. There is an activities organiser who works for 16 - 20 hours per week. She usually works in the afternoons, but is flexible so that she can respond to peoples requests. Group and individual activities are arranged. On the day of our visit people played bingo and the activities person went to read to someone who was in bed. She will take people out to the local village if they want to go shopping and is currently arranging a trip to the White Rose shopping centre. We looked at peoples individual journals and saw people are being provided with a variety of activities to keep them stimulated. Staff told us that relatives are welcome at any time and can have a meal at the home Care Homes for Older People Page 14 of 26 Evidence: if they wish. People can choose where they see their visitors they can use the communal areas or their own bedrooms if they want privacy. In the surveys people told us that the meals are good. There is a choice of meal at breakfast and tea time. Currently there is only one choice of meal at lunchtime, however, the acting manager showed us some new menus that are going to be put in place that will give people the choice of two options. She is also planning on improving the tea time meal by the introduction of a sweet trolley so that people can choose from a range of puddings. People are asked about the meals at residents meetings so that they can influence what is provided. We observed the lunchtime meal. People received their nicely presented meals in a timely fashion and staff were available to assist people as necessary. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints and adult protection issues are being dealt with properly. This means that staff are listening to people and keeping them safe. Evidence: The home has a complaints procedure that is on display in the entrance hall, but is not in the Service User Guide. The complaints procedure needs to be added to the Service User Guide to make sure people can refer to it if they need to. In the surveys people told us that they did know who to talk to if they were unhappy or if they wanted to complain. We looked at the complaints log and could see that details of complaints that have been made have been recorded together with the action taken. This showed that complaints have been investigated properly. The staff we spoke to were able to tell us what they would do if they felt there were any practices in the home that werent in the best interest of the people living there. They also said that they had completed adult protection training. We could see from the training records that all of the staff have done this training. This means that staff are fully aware of all of the different types of abuse and about the reporting procedures. Care Homes for Older People Page 16 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is comfortable, clean and tidy. Evidence: Roberttown Nursing Home is in Liversidge and the shops in the local village are about a 10 minute walk away. The home is on a bus route. There is a large car park to the front of the building and pleasant gardens for people to use in nice weather. The accommodation at the home is arranged over three floors. There is a dining room on the ground floor and lounges on the second and third floor. All of the bedrooms are single and vary in shape and size. All of the bedrooms we looked at had been personalised with various pieces of furniture, pictures and ornaments. This made them look very homely. When we looked around the home we found that the hot water was extremely hot and one of the people living in the home told us that the shower wasnt in use. We asked the acting manager about this and we were told that the contractors were due to visit to replace the thermostatic mixing valves and make sure the shower water temperature is properly regulated. The home was very clean and tidy and people told us that this is always the case and there are never any unpleasant odours. Care Homes for Older People Page 17 of 26 Evidence: At the last inspection by environmental health the kitchen was awarded 5* for hygiene. This means that the standards of cleanliness are excellent. The laundry is well equipped and the laundry staff take good care of peoples clothing. The laundry cupboard was well stocked and bedlinen and towels smelt very fresh. Staff have completed training so that they are aware of infection control issues and what they have to do to stop the spread of infection. Care Homes for Older People Page 18 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff on duty to meet peoples needs. Staff are well trained and competent to do their job. Evidence: At the time of our visit there were 23 people living at the home. In the mornings there is one nurse on duty with three or four care staff. In the evenings there is one nurse and two - three care staff. At night there is one nurse and two care assistants. The caring staff are well supported by cooks, kitchen assistants, laundry assistants and domestics. This means that they can concentrate on delivering care and support to people and are not taken away to do other duties. The acting manager is aware that she needs to keep the staffing levels under review and increase them as more people are admitted or if people need more care. The staff we spoke to told us that there are enough staff on duty to meet peoples needs. We looked at some of the records relating to recently recruited staff to see if staff are appropriately checked before they start work at the home. Recruitment procedures are generally good, references are always taken up and checks are always made with the Criminal Records Bureau and against the Protection of Vulnerable Adults register to ensure that new staff are suitable to work with older people. Care Homes for Older People Page 19 of 26 Evidence: There are twenty care staff working in the home, fourteen have completed their NVQ (National Vocational Training) level 2 or 3 in care. This means that staff are trained and have been assessed as competent to do their job. There is a training matrix in place for each member of staff, which shows what training staff have received and what training they need to do. The acting manager needs to make sure staff complete Mental Capacity Act and Deprivation of Liberty training so that they fully understand this legislation. The acting manager told us that staff receive induction training when they first start working in the home and that they work with an experienced member of staff until they feel confident to work alone. There is an induction programme in place for staff to follow. This means that staff are given the training and information they need before they start working alone. Care Homes for Older People Page 20 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is being run in the best interests of the people living there. Evidence: The acting manager is a nurse who has worked at the home since June 2009. She is in the process of completing her registered managers award, this is the qualification we ask managers to complete and shows that they have been assessed as competent in that role. She also needs to apply for registration with us, she told us that she was in the process of doing this. The manager needs to register so that there is someone legally responsible for the management of the home. Staff told us that she has made a number of changes for the better and is very approachable. The acting manager has held meetings with people living in the home, staff and relatives to get their views about the service. She has also sent out surveys as another way to get peoples views and what they think about the home. When these are returned she needs to produce a report that can be given to people telling them about the results and what action is going to be take to address any issues that have Care Homes for Older People Page 21 of 26 Evidence: been raised. We wanted to look at the monthly reports that the provider has to write about the conduct and management of the home. There were no recent reports available. It is important that someone from the organisation visits the home every month and writes a report about the home. This makes sure the home is being manged properly and is being run in the best interests of the people living there. The manager should receive copies of these reports so that she knows if there is any action she needs to take as a result of these visits. The manager does hold money on behalf of people living there. We looked at the records and found that they were accurate. This means that people are protected from any financial abuse. There is a written Health and Safety policy. Staff receive moving and handling, health and safety, food hygiene, fire safety, first aid and infection control training. Staff told us that there is only one hoist available in the home at the current time as one is broken and has been sent for repair. This means that staff have to move the hoist between floors, which is time consuming and means that sometimes people have to wait longer than they may like to have their needs attended to. We spoke to the manager about this and she agreed to hire another hoist until the other one is repaired. Care Homes for Older People Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 13 A system must be put in 11/12/2009 place to make sure that staff sign the medication administration records to show that topical creams and lotions have been applied. This will make sure people receive treatments as prescribed. 2 16 5 The complaints procedure must be added to the Service User Guide. This will make sure that people have their own copy to refer to if they want to make a complaint. 31/12/2009 3 33 26 The area manager must 31/12/2009 write a monthly report about her visits to the home. This will make sure that the manager gets written details about any action that she Care Homes for Older People Page 24 of 26 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action needs to take to improve the service. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 1 The Statement of Purpose and Service User Guide need to be updated and additional information added so that people can take away written information about the home to see if they think it will be suitable for them. The daily records kept for people should reflect the content of the individuals care plan and whether or not outcomes of the care plan have been met for the individual. The hot water temperatures need to be properly regulated to make sure that people are not at risk of being scalded. All staff should complete Mental Capacity Act and Deprivation of Liberty training. This will make sure that they fully understand the implications in their day to day work. The manager needs to submit her application to us for registration. This will make sure there is someone legally responsible for the management of the home. A report should be produced that informs people about the results of the recent survey. This will show people what the outcome was and about any action that is being taken to address any shortfalls in the service that were identified. An additional hoist should be made available so that people do not have to wait to have their moving and handling needs met. 2 7 3 4 25 30 5 31 6 33 7 38 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!