Inspection on 19/12/08 for Roberttown Nursing Home

This inspection was carried out on 19th December 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Roberttown Nursing Home 11/11/09

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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Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives 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, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Tony Brindle     Date: 1 9 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 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 home is also registered to provide nursing and personal care for four adults under the compassionate care scheme. 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. The provider informed the Commission for Social Care Inspection on 04/10/06 that the fees range from #342.99 to #502.47. There are additional charges for hairdressing, newspapers and private chiropody. Information about the home and the services provided are available from the home in the statement of purpose and the service user guide. Care Homes for Older People Page 4 of 27 Over 65 29 0 Care Homes for Older People Page 5 of 27 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: This unannounced inspection was positive and enjoyable. We spent some time having a look at the paperwork at the home, and we talked to people who live at the home, had a look round the home, sampled the meals, checked the medication and money, and talked to the staff. The paperwork we looked at included peoples care plans and assessments, the medication, health and safety records, the menus and kitchen records, and the daily records made by the staff about the activities people had been involved in during the day. On the day of the visit, an operations manager from the company who run the home was visiting the service. We would like to take the opportunity to thank the people living at the home and the staff for their hospitality and patient co-operation throughout the inspection. Since we last inspected this service in 2006, we have not received any complaints about the service. There has been a Care Homes for Older People Page 6 of 27 change to the ownership of the home. There is currently no manager in place. The nursing staff and operations amangers continue to keep us informed of incidents and developments within the service. 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 following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 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 27 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. The information given to us by the nurse on duty, both verbally and in record form, demonstrates that there are satisfactory systems and procedures in place to ensure that peoples needs are properly assessed prior to moving into the home, and that they are given to the opportunity to visit it before moving in. The home does not provide intermediate care. Evidence: A discussion took place with the nurse on duty about what would happen if people wanted to move into the home. She explained that if someone wanted to move into the home, then she or one of the other nurses at the home with experience of assessments, would visit the person, and their family or representative, and undertake an assessment of their needs. The nurse on duty showed us the pre-admission records of 1 person who had recently moved into the home. These records were found to contain assessments about persons needs and desires, their health and personal care Care Homes for Older People Page 10 of 27 Evidence: needs, and information about their life history. There were written details of how these needs should be met, and the nurse on duty explained that this information had been gathered through meeting the person, talking to them, their family and the health and social care professionals involved in their life. Information contained within the care records confirmed that people with experience of undertaking assessments go to visit people to gather information about their on going health and personal care needs. The nurse on duty made it clear that if people wanted to visit the home, and meet the people and staff, then they would be able to do this. The records show that once an assessment is made, then a decision based on that information is made as to whether the service can meet that persons needs. The nurse on duty gave details of how a letter is sent to the person explaining the decision, and if the service can meet their needs, then arrangements are made for the person to move in. Information contained within the care records confirmed this. One person living at the home explained that they had been given good information about the home before moving in. Care Homes for Older People Page 11 of 27 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. Good information about how peoples needs should be met and how to minimize risks to people is available. Good support is given to help individuals make choices and decisions. Medicine management is good. People receive personal support in the way they prefer and require and the systems operated by the service realting to meeting peoples healthcare needs are proactive. The practice of leaving charts containing private and confidential such as turning charts out on the cooridors has a potential impact on peoples privacy and dignity as the information on the charts was available for anyone to look at. Evidence: At the last inspection it was noted that improvements to the way care needs are reviewed and recorded showed be improved. This has been been actioned. The nurse on duty showed us the care plan files of 3 people living at the home. She was able to explain the care planning process in detail, which she said includes making sure that the staff learn what is important to the person in everyday life so that they can be supported to live a fulfilling life. She added that the staff involved in the care planning Care Homes for Older People Page 12 of 27 Evidence: process, find out what the health and safety risks are to each person by talking to them and their families, and by undertaking a risk assessment, which was seen to be documented. Information contained within the care plan files confirmed what the nurse on duty had spoken about. She added that wherever possible, the person themselves, and or their family members (if appropriate) are involved in the care planning process. Again this was supported by way of information contained within the care plans with peoples signatures being seen on various documents or their representative if appropriate. People living at the home did not speak about the care planning process, but did say that the staff ask them about what they like to do, about what their interests are and about how they like to be supported to undertake certain activities such as washing, dressing, shopping and socializing. Staff at the home confirmed that they are involved in care planning, and were able to speak about the process in a manner that indicated that they understood the proecess, and understood how important care planning was. We looked at the daily records which were found to contain information about what people had been doing during the day and night. The information was seen to be factual and non-judge-mental, and when decisions had been made to participate in different activities, the reasons for this had been recorded. The nursen on duty explained that for some people, decision making can be difficult due to their level of cognitive ability, adding that when decision are made on a persons behalf, to engage in a social activity for example, then the staff always ensure that good records are kept so that the reasons why and when decisions are made by others can be clearly demonstrated. Information contained within the daily records confirmed this. The nursen on duty explained that personal supported is always provided to people in private, and that routines such as the times for going to bed, having baths, meals and other activities are flexible. She added that people are encouraged to choose their own clothes and hairstyle, and where possible peoples appearance reflects their personality. Discussions with people living at the home confirmed this. Observations made on the day of the visit confirmed that staff work with people in a sensitive manner, providing flexible personal support in ways that promote peoples privacy and dignity and where possible their independence. Information contained within peoples care files indicated that peoples health is monitored and any potential complications and problems are identified and dealt with at an early stage, including referral to the appropriate health-care professional. Feedback from relatives indicated that they were satisfied with the way in which staff at the home support people with their health-care needs. At the last inspection a requirement was made that improvements should be made to the medication systems operated within the home. This has been actrioned. A sample of the medications held at the home were looked at and everything was found to be in good order. The nurse on duty was able to explain in detail the medication policies and procedures, and these were found to be satisfactory. She explained that records are kept of all medications that are received, administered and disposed of within the home, and these systems Care Homes for Older People Page 13 of 27 Evidence: were found to be satisfactory and ensure there is no mishandling of peoples personal medication. The records confirmed this. The staff training records show that staff have had training in the use and medication. On looking around the home, it was noted that a number of chart containing private and confidential such as turning charts, had been left out on the cooridor. The nurse on duty agreed that this practice should cease as it had a impact on peoples privacy and dignity as the information on the charts was available for anyone to look at. Care Homes for Older People Page 14 of 27 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 living at Roberttown Nursing Home lead a reasonably active lifestyle, are well supported in this area. People are supported to keep in touch with family and friends, have their rights respected and have a healthy and varied diet. Evidence: The nurse on duty explained that the people who live at the home have differing interests and preferences as to how they spend their day. One member of staff said that there are activities put on in the home, and that people do get the opportunity to go out and take part in some recreational activities such trips on and visits to see family. One person living at the home said that they really enjoyed singing and dancing with the staff. Information contained peoples care plans indicated that people do get the opportunity to engage in a a small number of activities both inside and outside of the home, and the feedback we received from both people living at the home, concerning the types of activities people are engaged in and lifestyle they lead was positive. The menus were looked at, and were found to offer people a varied and nutritious diet. One person said that there was always plenty of food to choose from, and that if they didnt like what was on the menu, then the staff would make them something different. People confirmed that they are supported to keep in touch with Care Homes for Older People Page 15 of 27 Evidence: their families and friends, and the daily records show when family and friends visit. Care Homes for Older People Page 16 of 27 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. There are good systems in place for dealing with complaints appropriately. The systems and procedures in place to protect people from abuse and neglect are robust, and in line with those produced by the Local Authority. Evidence: The nurse on duty and operations manager explained that the home has a complaints procedure, which is available for all to see as it is posted in the entrance hall of the home. The procedure was seen to be satisfactory. The records show that the service has has some minor complaints within the last year which have been dealt with appropriately and to the satisfaction of the complainants. The records held by CSCI show that we have not received any complaints about this service. People who responded to our survey indicated that they knew who to speak to if they had a concern or complaint, and that they felt confident that their concern of complaint would be dealt with quickly and appropriately. One person living at the home who was spoken with said that they would speak to a staff member if they were worried about anything, and that they felt sure the staff would support them and deal with their worries properly. The nurse on duty explained that staff have had adult safeguarding training, and added that the service has a adult safeguarding policy and procedure, which is displayed within the home, given to staff, and used as a basis for staff training. She added that the organization also has a whistle blowing procedure. These policies and procedures were looked at the found to be in good order and in line with Care Homes for Older People Page 17 of 27 Evidence: the local authority safeguarding procedures. One member of staff who was spoken with was able to talk about what they would do if they suspected or witness abuse, and their explanation was found to be in line with the policies and procedures operated by the service. The personnel records held at the home show that the Protection of Vulnerable Adults register is checked before staff are appointed to work in the home. On looking around the home, it was noted that a number of chart containing private and confidential such as turning charts, had been left out on the cooridor. The nurse on duty agreed that this practice should cease as it had a impact on peoples privacy and dignity as the information on the charts was available for anyone to look at. Care Homes for Older People Page 18 of 27 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. People live in a comfortable home with plenty of space. All parts of the home are kept clean and tidy. Evidence: The operations manager explained that the comments he regularly gets back from people living at the home, their relatives and visitors state that people see the home as being comfortable, roomy, bright, cheerful and clean. On the day of the visit, the home was found to clean and tidy, with the furnishings and fittings being seen to be of a good quality and in good working order. People living at the home said that think it is kept clean and tidy. This was confirmed on having a look around the building. Hand washing facilities were found to be located appropriately throughout the building, and the registered manager explained that laundry facilities are sited so that soiled articles and clothing are not carried through areas where food is stored and prepared. This was confirmed on having a look around the building. On looking around the home, it was noted that a number of chart containing private and confidential such as turning charts, had been left out on the cooridor. The nurse on duty agreed that this practice should cease as it had a impact on peoples privacy and dignity as the information on the charts was available for anyone to look at. This been addressed under standard 10 of this report. Care Homes for Older People Page 19 of 27 Care Homes for Older People Page 20 of 27 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. A well trained staff team supports the people living at the home and the recruitment practices are good, with good procedures in place that offer people protection. However, access by bodies such as CSCI to personnel records needs to on a 24 hour basis. (This has been dealt with under standard 37 of this report) Evidence: The operations explained that the comments he regularly gets back from people living at the home, their relatives and visitors state that people believe the staff team to be approachable, reliable, honest and motivated to make sure people are cared for properly. Observations made on the day supported this, with staff being seen to work sensitively with people, communicating with people effectively and showing an interest in individuals. Feedback from people who completed our survey showed that they too believed the staff to be good at what they do, friendly and enthusiastic about the work they undertake. The administrator for the home was off duty at the time of the site visit, and as this person held the keys for the personnel records file, we were unable to inspect them. However, the operations manager supplied us with information following the visit about the recruitment and selection of staff, and this was found to be in order. It was explaiend to the operations manager that there needed to be system in place to ensure that the personnel and employment records could be inspected at anytime. Information supplied by the operations manager confirmed that the service obtains a Care Homes for Older People Page 21 of 27 Evidence: satisfactory Criminal records Bureau check before people start work, and that a check against the Protection of Vulnerable Adults register is made. The staff training records show that staff received good levels of training in all aspects of work within a care setting. Feedback from people who completed our survey indicated that they believed the staff to be well trained. Staff working at the home spoke about the training they had received, giving details of scenarios that come up from time to time, and details of what they would do, how they would deal with issues, and how they could do things differently if needs be. Care Homes for Older People Page 22 of 27 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. Good quality assurance systems are in place, and there are systems in place to protect the promote the health and safety of people living and working at the home. The company needs to ensure that the existing management cover continues to support the work of the staff so that the home runs effectively and efficiently, while the managers post is vacant. However, access by bodies such as CSCI to personnel records needs to on a 24 hour basis. Evidence: The records held by CSCI show that there is no registered manager working at the home at the present time, and the operations manager confirmed that the managers position is currently vacant. On the day of the visit, the nurse on duty explained that interviews were taking place to try and recruit a new manager. The records show that company managers regularly visit the home, and the operations maanger explaiend that he is kept up to date about how the service is running and issues in the home. The operations manager explained that the service obtains feedback from people using Care Homes for Older People Page 23 of 27 Evidence: the service, their relatives, and other relevant parties about the services provided by way of user satisfaction questionnaires. The records of these were seen, and the feedback supplied by people was seen to be positive. He added that there are audit and monitoring systems in place for various practices within the home such as medication, money, accidents and incidents. Again, the records of these were seen, and there were found to be satisfactory. The records relating to the health and welfare of people living and working in the home were seen, and were found to be satisfactory. These included records relating to weekly alarm system tests, food hygiene control measures, infection control systems, the regulation of water temperatures and the maintenance of equipment. As previously mentioned we could not access the staff recruitment and selection files as the only person with the keys to the filing cvabinet was off duty. It was explaiend to the operations manager that there needs to be a system in palce to ensure files such as these are accessible on a 24 hour basis so that effective inspections can take place. The operations amnager agreed that there should be a better system in place, and explaiend that he would look into this as soon as possible. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 9 13.2 The registered person shall 07/11/2006 make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. The medication records must be kept up to date. All medication carried forward from the previous month must be transferred onto the current MAR sheet. Care Homes for Older People Page 25 of 27 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 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 10 The practice of leaving charts containing private and confidential such as turning charts out on the cooridors should cease, as it has a potential impact on peoples privacy and dignity as the information on the charts was available for anyone to look at. The company needs to ensure that the existing management cover continues to support the work of the staff so that the home runs effectively and efficiently, while the managers post is vacant. Access by bodies such as CSCI to personnel records needs to on a 24 hour basis. 2 31 3 37 Care Homes for Older People Page 26 of 27 Helpline: 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 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. 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