Inspection on 19/01/06 for Robinson House

This inspection was carried out on 19th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Robinson House 10/07/08

Robinson House 14/07/06

Robinson House 21/06/05

Robinson House 18/10/04

Robinson House 20/04/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Robinson House 304 Sturminster Road Stockwood Bristol BS14 8ET Lead Inspector Vanessa Carter Unannounced Inspection 09:00 19 January 2006 th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Robinson House DS0000020334.V274965.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Robinson House DS0000020334.V274965.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Robinson House Address 304 Sturminster Road Stockwood Bristol BS14 8ET Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01275 544452 01275 544452 Brunelcare Mrs Janet Mary Ann Little Care Home 64 Category(ies) of Dementia (20), Dementia - over 65 years of age registration, with number (5), Old age, not falling within any other of places category (44) Robinson House DS0000020334.V274965.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. May accommodate up to 44 Persons aged 65 years and over requiring nursing care in Wilberforce or Davey Unit Up to 5 of these 44 places may be used for persons aged between 50 65 years with nursing care needs May accommodate up to 20 persons with dementia on the Canynge Unit Up to 5 of these 20 places may be used for persons aged between 50 65 years with dementia care needs Staffing notice dated 12/1/01 applies The Registered Manager must be a RN on Parts 1 or 12 of the NMC Register 21st June 2005 Date of last inspection Brief Description of the Service: Robinson House is a 64 bedded nursing home owned by Brunelcare, a nonprofit making charity organisation. The home is situated in the residential area of Stockwood, on the south side of Bristol. Brunelcare have other nursing homes in the Bristol area, namely Saffron Homes in Whitehall and Deerhurst in Kingswood. The home is purpose built and provides both single and double bedrooms, all with ensuite facilities of shower, toilet and wash hand basin. The home is divided into three separate units. Wilberforce and Davey are the nursing units and the third Canynge, is the EMI unit. The home is well supported by a team of volunteers who have a daily presence in the home. Placement is offered to both males and females, over the age of 65 years; however the Home can take up to 10 people between the ages of 50-65 (five on Canynge and five between the two nursing units). Robinson House DS0000020334.V274965.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out in order to monitor the home and ensure it is meeting the resident’s needs, in the way in which they want to be cared. A full inspection was not carried out and only a number of key standards were assessed. The inspector was in the home for a 4½-hour period and spoke to some staff and some residents. Those readers who require a fuller picture of the home should read the report dated 21 June 2005. What the service does well: What has improved since the last inspection? At the last inspection there were no requirements or recommendations issued. The home continues to provide good care to the residents. Robinson House DS0000020334.V274965.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Robinson House DS0000020334.V274965.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Robinson House DS0000020334.V274965.R01.S.doc Version 5.1 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 the following standard(s): 3 The home’s policy on admission of new residents to the home and the preadmission assessment procedure ensures that placement is only offered to people whose needs can be met. EVIDENCE: Any prospective resident will only be offered placement after a member of staff from the home has undertaken an assessment. Records examined verified that these assessments are carried out before the admission date. The home uses a comprehensive assessment tool to collate the information, ensuring that all personal, health, social, emotional and mental health needs are covered. The quality of the assessments is good and provides an in-depth knowledge of the person. The assessment then forms the basis of a plan of care, meaning that their identified needs will be met. Robinson House DS0000020334.V274965.R01.S.doc Version 5.1 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 the following standard(s): 7, 8 and 10 Residents are looked after well in respects of the personal and health care needs, and are treated in a respectful and courteous manner. However, the homes records must be maintained properly to ensure that all identified needs are appropriately met. EVIDENCE: Three care plans were examined, one from each unit. The plans were person centred and detailed specific needs of the person. Two plans recorded the identified needs and set out clear instructions in how these needs should be met. Appropriate language must be used at all times when making entries onto the care planning documentation. One person’s plan however, had not been finalised despite them being in residence for approximately four weeks, and there were no instructions for the care staff on what actions needed to be taken. This omission has the potential to place that person at risk of not having their care needs met, or not met appropriately. Robinson House DS0000020334.V274965.R01.S.doc Version 5.1 Page 10 The home ensures that residents healthcare needs are met, and there was evidence that a range of other healthcare professionals are consulted as necessary. One resident said the GP calls on them regularly, and that they were waiting to see the chiropodist. Where required, detailed recordings are made of wound care management regimes, and progress is monitored, in written recordings, and named and dated photographs. Specialist pressure relieving equipment is used when a resident is at risk of developing pressure sores, with all residents “level of risk” being reviewed on a monthly basis. Those residents spoken with reported that they are treated with respect and that the care staff and nurses and kind and friendly. Observations were that there was good interaction between the residents, care staff and ancillary workers. Personal care is provided in privacy and if needed, bedroom doors can be secured to provide added privacy. All residents were well dressed and looked well cared for. Robinson House DS0000020334.V274965.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 12, 13 and 15 Residents are able to choose how they spend their time and are given the opportunity to participate in a range of stimulating activities. Residents are provided with good meals. EVIDENCE: Residents are always asked what their preferred times of getting up and going to bed are, and also by what name they wish to be called. In general residents were heard being called by their first name. A range of activities are arranged for the residents and examples include music sessions, minibus trips, a recent Christmas party and birthday celebrations. Residents are able to choose whether to participate or not and can remain in their own rooms if they so wish. After each session, resident’s comments and feedback are recorded – both positive and negative. The home has an open visiting policy but no relatives were present during the morning of the inspection. Volunteers who regularly visit the home were going around with a trolley shop and chatting with the residents. Robinson House DS0000020334.V274965.R01.S.doc Version 5.1 Page 12 Residents are offered a cooked breakfast each morning and a choice of two midday meals. If neither meal is liked, alternatives are arranged with the kitchen staff. Comments from the residents about the food were “The food is marvellous”, “There is always too much” and “I get plenty to eat and drink”. Residents on the dementia care wing are encouraged to make their own choice of meal at the actual meal time, and will be offered additional snacks if they have not previously eaten well. The staff practice of setting up the small tables in the lounge area with place mats and cutlery must be reviewed. At 10.30am, four residents were sat in the lounge with these tables in front of them, and there was at least 1½ hours before the meal would be served. Robinson House DS0000020334.V274965.R01.S.doc Version 5.1 Page 13 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 the following standard(s): The standards in the section were not looked at during the inspection, however at the previous inspection in June 2005, the standards were met. EVIDENCE: Robinson House DS0000020334.V274965.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 19 and 26 The residents generally live in a well maintained, tidy and odour free environment, but some minor repairs are required. EVIDENCE: The home is well decorated throughout and generally well maintained. One resident praised the maintenance team in how they had recently decorated and arranged her bedroom. There were two areas where attention is needed. The closing mechanism on the door into the sluice area on Wilberforce needs to be slackened, as the door slams shut. This could potentially injure a staff member but also will disturb residents with the loud noise. A window in the corridor on Davy unit is without the locking handle device and can also be opened to its full extent. The manager reported that Brunelcare are already trying to source replacement parts for the window however CSCI request that it be temporarily made safe until essential works are carried out. Robinson House DS0000020334.V274965.R01.S.doc Version 5.1 Page 15 The home was clean, tidy and odour free throughout. Residents reported that their bedrooms are cleaned every day. The cleaner’s cupboard on Wilberforce was unlocked despite signage saying it should always be kept locked. However, this cupboard is only used for the storage of a trolley, when the cleaners are not using it – the home will remove this signage to prevent confusion. Robinson House DS0000020334.V274965.R01.S.doc Version 5.1 Page 16 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 Residents are cared for by staff that are skilled and able to meet their needs. EVIDENCE: On each of the units, there was one registered nurse and four care assistants and this meets the staffing notice. At the start of each shift, an in depth handover is provided to those commencing their duties, of all the residents condition and any changes that have occurred. The staff demonstrated an excellent understanding of the individual needs of the residents. This evidences that the residents are cared for by staff that are skilled, and able to meet their needs. One resident said, “all the staff are marvellous”. At the last inspection, standards 28, 29 and 30 were all met. Robinson House DS0000020334.V274965.R01.S.doc Version 5.1 Page 17 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 Improvements must be made to ensure that residents, staff and visitors to the home are safeguarded, and any unnecessary risks are eliminated. EVIDENCE: Two matters of concern were noted during a tour of the home: • On Davy unit, a corridor window had no lockable handle/catch and could be fully opened. • On Wilberforce unit, the sluice room door slams sharply shut, and could potentially be a hazard to staff. These facts evidence that the home must make improvements, with their health and safety auditing, to ensure that the home is a safe place to live and work. All of the other standards were met at the inspection in June 2005. Robinson House DS0000020334.V274965.R01.S.doc Version 5.1 Page 18 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 2 Robinson House DS0000020334.V274965.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Each resident must have a plan of care that details what actions the staff are to take, to meet identified needs. All areas of the home in which the residents have access, must be free from hazards. Repairs must be made to the identified window and door. Timescale for action 19/02/06 2. OP38 13(4)a 19/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP7 OP15 Good Practice Recommendations Appropriate terminology must be used in all homes recordings. Review the practice of setting up small tables in the lounge for meal times, too early in the morning. Robinson House DS0000020334.V274965.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Robinson House DS0000020334.V274965.R01.S.doc Version 5.1 Page 21 - 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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