Inspection on 21/06/05 for Robinson House

This inspection was carried out on 21st June 2005.

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

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

Other inspections for this house

Robinson House 10/07/08

Robinson House 14/07/06

Robinson House 19/01/06

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 Announced 21st & 22nd June 2005 09:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Robinson House D56_20334_RobinsonHouse_223783_Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Robinson House Address 304 Sturminster Road Stockwood Bristol BS14 8ET 01275 544452 01275 544452 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Brunelcare Mrs Janet Little Care home with nursing 64 Category(ies) of DE Dementia (20) registration, with number DE(E) Dementia - over 65 (5) of places OP Old Age (44) Robinson House D56_20334_RobinsonHouse_223783_Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 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 person aged between 50 - 65 years with nursing care needs. May accommodate up to 20 persons with dementia on Canynge ward. Up to 5 of these 20 places may be used for persons aged between 50 - 65 years with dementia care needs. Staffing notice dated 12/01/01 applies. The Registered Manager must be an RN on Parts 1 or 12 of the NMC register. Date of last inspection 18 October 2004 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. Brunelcare also have residential care homes in the Bristol area. The home is purpose built and provides single and double bedrooms. The home is divided into three separate units. Wilberforce and Davey are the nursing units and the third Canynge, is the EMI unit. Robinson House D56_20334_RobinsonHouse_223783_Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 8 hours. Evidence was obtained from a number of sources, namely: Pre-Inspection Information supplied by the Home Manager Talking to the manager and staff Talking to residents and visitors Talking to one GP Looking at staff and care records Looking at other documentation and policies of the home Comments cards received from relatives No requirements or recommendations have been made as a result of this inspection and the manager and staff must be congratulated for their hard work and dedication, to the residents and their families. What the service does well: What has improved since the last inspection? The home have complied with the four requirements made at the last inspection, showing compliance with the National Minimum Standards. All four requirements were in connection with health and safety issues, therefore the home has improved by ensuring that the health and safety of residents and staff is promoted and protected. Since the last inspection the home have converted unused space within the home to provide an additional single bedroom with ensuite facilities, thereby increasing the capacity of the home to 64. Robinson House D56_20334_RobinsonHouse_223783_Stage4.doc Version 1.30 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 D56_20334_RobinsonHouse_223783_Stage4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Robinson House D56_20334_RobinsonHouse_223783_Stage4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 3 The admission process is well managed and residents and their families are given clear information regarding the home, helping them make a choice about admission. EVIDENCE: The Statement of Purpose and Service Users Guide has been updated to reflect changes in the staff team, and changes to the Visitors Charter. This charter explains the home zero tolerance to aggressive behaviour and violence from visitors to the home. Prospective relatives were seen being shown around the home and had been given a copy, to enable them to make an informed choice about moving their relative to the home. In addition, the home have a “Welcome to Robinson House” brochure and this is given to all residents. A monthly newsletter is produced, and the residents are given the opportunity to include items of interest if they wish. June’s Newsletter included details about recent trips from the home, a garden party arranged for July, and of this CSCI inspection visit. Robinson House D56_20334_RobinsonHouse_223783_Stage4.doc Version 1.30 Page 9 Pre-admission assessments are completed prior to any new resident moving into the home. Care plans and health needs assessments are provided where local authority are involved in arranging the placement and some of the funding. There was evidence that residents have been assessed for the free nursing care contribution and where appropriate, entitlement to continence aids. The assessment tool is comprehensive and covers all aspects of a persons needs. Those assessments completed for people on the dementia care unit were particularly person-centred, and provided a detailed insight into that persons specific needs. Robinson House D56_20334_RobinsonHouse_223783_Stage4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 and 11 Residents are well looked after in respects of their health, personal and social care needs. The care plans are person centred and provide a clear and detailed picture of each residents needs. EVIDENCE: Six care plans were looked at, two from each unit. The plans were personcentred, and identified needs were clearly set out with instructions to the staff in how these needs should be met. One person’s plan stated “does not like to be troublesome, therefore…”. Another example was a very good plan for dealing with that persons resistance to being cared for. Evidence was recorded that those needs identified had been met, and this was done in a meaningful way. The quality of assessment and care planning exceeds the standards expected and the staff team should be commended for their excellent work. Where appropriate detailed records were kept in respect of wound management, and specialist pressure relieving equipment was being used. Records are maintained of all contacts with other healthcare professionals and this includes psychiatric services, tissue viability nurses, hospice nurses and social workers. Robinson House D56_20334_RobinsonHouse_223783_Stage4.doc Version 1.30 Page 11 A GP visiting the home, stated that doctors from the medical centre will visit the home frequently upon request, and that the nurses ensure a residents health care needs are fully met. The home follows safe practices for the receipt, storage, administration and disposal of medications. There is appropriate, official signage where oxygen is being stored and being used. Each unit is responsible for their own drugs but controlled drugs are securely kept in one unit. The home has had a large number of deaths in the last 12 months and the manager explained that residents who now come to live at the home are frailer, older and often with multiple health needs. An ongoing audit completed by the home is not showing any trends. Training records evidenced that a large number of staff have had death and bereavement training. The home has good links with the local hospice, and nurses are skilled to provide palliative and end of life care. Robinson House D56_20334_RobinsonHouse_223783_Stage4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15 The residents have the option to participate in a stimulating and varied life. Meals provided are of a good quality. EVIDENCE: As part of the care planning process, the times a resident prefers to get up and go to bed is identified. One resident stated that they could do what they wanted and go where they wanted. Residents on the dementia care unit were moving around independently, going out into the garden, sitting in the sun, or spending time in their own bedroom. One person who had previously declined to be assisted along to the lounge area, was helped at a later time, when she chose to do so. A team of volunteers, who will undertake activities with the residents, or spend time with them on a one to one basis, supports the home. A volunteer was comforting one resident who had become agitated. A group of residents were in the activities room doing some flower arranging whilst having tea and biscuits. One resident said they had just had a very pleasant lunch and another stated that the food was always “excellent”. Robinson House D56_20334_RobinsonHouse_223783_Stage4.doc Version 1.30 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 standard(s) 16 and 18 The complaints procedure is made available to the residents and visitors, and any complaints are listened to and acted upon. The arrangements for protecting residents from abuse are good, because of staff awareness and understanding of adult protection issues. EVIDENCE: The complaints procedure is contained within the statement of purpose, Welcome to Robinson House brochure and is displayed in the main reception. Residents and visitors spoken to during the inspection, stated their awareness of how to raise concerns and felt able to approach the management team. Two complaints have recently been received and these are in the process of being addressed. The manager explained the processes that will be undertaken to bring about a resolution for the complainant. Brunelcare have a clear policy document named Abuse of Older People, supported by a clear flow chart that details out the actions the staff must take if an allegation of abuse is made or abuse is suspected. Staff spoken to were able to demonstrate good awareness of adult abuse matters and their responsibilities in protecting the residents from any form of abuse. Brunelcare have a number of qualified trainers in adult abuse awareness, and will be commencing a programme of training sessions later in the year. Robinson House D56_20334_RobinsonHouse_223783_Stage4.doc Version 1.30 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 standard(s) 19, 23 and 26 Residents live in a well maintained, tidy and odour free environment. The dementia care unit being split over two floors, causes concern for visitors, and could potentially have an impact upon the level of care and supervision for the residents. The home was clean, tidy and free from odour throughout. EVIDENCE: The home is well decorated throughout – the lounge area on Wilberforce unit is to be re-decorated shortly as part of a planned programme of works in the home. Robinson House D56_20334_RobinsonHouse_223783_Stage4.doc Version 1.30 Page 15 One relative responded on a comment card about the difficulties in having the dementia care unit on two floors and the impact on staffing levels. The manager confirmed that it is still planned that the home be changed to incorporate the dementia care unit on the ground floor and the nursing unit on the upper floor. It is expected that the necessary works will take place in 2006. Since the last inspection, the home has converted an unused room into a further bedroom with ensuite facilities, thereby increasing the home capacity to 64. The home has a dedicated team of housekeeping staff who were seen working diligently in both the communal areas and residents bedrooms. Cleaning equipment was stored correctly and was not left out in the corridors when the member of staff was busy in a room. In between each of the units, alcohol gel handrub was sited. This is commendable and evidences that the home are being pro-active in preventing the spread of infection. Robinson House D56_20334_RobinsonHouse_223783_Stage4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30 Residents are cared for by skilled, qualified and well trained staff, who are enthusiastic about their work. The staff work well together to ensure that consistency of care is provided for the residents. The training opportunities available for staff ensure that they are competent to do their jobs. EVIDENCE: A relative responded on a comment card regarding staffing levels on the split dementia care unit, saying that they were inadequate. Staff spoken to on the unit felt that the levels were appropriate but this depended upon the needs of the residents at any given time. Another relative commented that the “nursing, care, administrative, laundry, and cleaning staff all make a valuable contribution to the well-being of the residents”, and that “the staff genuinely care about the residents”. There has been on minimal staff turnover since the last inspection and those staff spoken to had each worked at the home for many years. Use of agency staff is minimal with only 3 shifts covered by an agency worker in the last 8 weeks. Robinson House D56_20334_RobinsonHouse_223783_Stage4.doc Version 1.30 Page 17 Just under 50 of care assistants have already achieved an NVQ Level 2 in Care, however other staff are also in the process of completing their studies. The home follows robust recruitment procedures with staff expected to undergo psychometric testing, after completing an application form and supplying two references. The home had evidence that all staff have undergone CRB clearance and POVA first checks prior to taking up employment. The staff files of three recent recruits confirmed this to be the case. Brunelcare have an annual training plan and examples of training sessions arranged include first aid, infection control, food hygiene, fire, manual handling and specific health related topics. Each staff member has a training file that evidences the training they have undertaken and a sample were checked. Robinson House D56_20334_RobinsonHouse_223783_Stage4.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 36 and 38 The home is run in the best interests of the residents with their views being sought through a variety of means. Staff are appropriately supervised. Residents interests are promoted and safeguarded. EVIDENCE: The manager completes a number of audits on a monthly basis to look at trends. Accidents, falls and deaths are audited to determine why such events are happening and to determine if any preventatives actions can be taken. This is good practice. Residents and relatives will be having the opportunity to complete a Satisfaction Survey in the near future. The results from this will be formally published. ` A staff satisfaction survey was undertaken at the beginning of the year. Robinson House D56_20334_RobinsonHouse_223783_Stage4.doc Version 1.30 Page 19 Staff spoken to spoke enthusiastically about working for Brunelcare, and stated that they were listened to, and encouraged to put forward ideas. Regular unannounced inspections are completed by Brunelcare senior managers, and a report written and submitted to CSCI. The home has a planned programme of staff supervision for all staff members. The manager supervises the trained staff and cascades responsibility for the supervision of junior staff members to these staff. The records of staff supervision evidenced that the staff are supervised on at least a six times per year basis. In addition staff have an annual appraisal, their training needs are identified, and are fed into the training plan. The home has maintenance contracts in place for all utility services and electrical equipment. The fire officer last visited in April 2005. Environmental Health visited in March 2005. Health and safety audits are undertaken on a regular basis and staff training is available on health and safety issues. Robinson House D56_20334_RobinsonHouse_223783_Stage4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x x 3 x 3 Robinson House D56_20334_RobinsonHouse_223783_Stage4.doc Version 1.30 Page 21 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation NIL Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard NIL Good Practice Recommendations Robinson House D56_20334_RobinsonHouse_223783_Stage4.doc Version 1.30 Page 22 Commission for Social Care Inspection 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 D56_20334_RobinsonHouse_223783_Stage4.doc Version 1.30 Page 23 - 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!