Inspection on 22/11/06 for Rock Lea

This inspection was carried out on 22nd November 2006.

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

Rock Lea 20/02/08

Rock Lea 16/01/06

Rock Lea 05/07/05

Rock Lea 24/01/05

Rock Lea 26/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Rock Lea Abbey Road Barrow in Furness Cumbria LA13 9SJ Lead Inspector Ray Mowat Unannounced Inspection 22nd November 2006 07:30 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 Rock Lea DS0000036579.V314564.R01.S.doc Version 5.2 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. Rock Lea DS0000036579.V314564.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rock Lea Address Abbey Road Barrow in Furness Cumbria LA13 9SJ 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) 01229 894546 01229 894543 www.cumbriacare.org.uk Cumbria Care Mrs Hazel Phizacklea Care Home 26 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (26) of places Rock Lea DS0000036579.V314564.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 26 service users to include: up to 26 service users in the category of OP (Older people) up to 6 service users in the category of DE(E) (Dementia over 65years of age) 16th January 2006 Date of last inspection Brief Description of the Service: Rock Lea is a care home providing personal care and accommodation for 26 older adults, of whom six may have dementia. The registered provider is Cumbria Care, an independent business unit of Cumbria County Council. The Home is located in a residential area on the outskirts of Barrow-in-Furness, close to bus routes into the town. The home was formerly a Victorian residence and has retained many original features. It has been extended and altered to provide accommodation on two floors, accessible by a passenger lift. The home has two good size lounge/dining rooms and a conservatory lounge/diner. The home has an EMI unit for six people with its own lounge/dining area with accessible toilet and bathroom facilities. All the twenty-six rooms are single occupancy, with eight having en-suite facilities. The home has extensive grounds to the front and rear, including well-kept gardens and parking facilities. Information about the home is made available to existing and prospective residents in the Service User guide and Statement of Purpose, which are displayed in the foyer along with the previous inspection report. The range of fees currently charged range from £363 to £422 per week. Rock Lea DS0000036579.V314564.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit took place over two days the 21st & 22nd November 06. On the first day I arrived early to enable me to see the morning routines of the home. Over the two days I spent time talking to residents and staff and spent time in each unit of the home. I also got feedback from family members or representatives and other professionals either meeting them in the home or through the surveys sent out as part of this inspection. I spent time with the manager and supervisors and examined many of the records relating to the running of the home. What the service does well: What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Rock Lea DS0000036579.V314564.R01.S.doc Version 5.2 Page 6 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 Rock Lea DS0000036579.V314564.R01.S.doc Version 5.2 Page 7 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4, 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides prospective residents with suitable information to enable them to make an informed decision about moving into the home. The admissions process is thorough and ensures people’s individual needs can be met by the resources available in the home. EVIDENCE: The home has an informative statement of purpose and service user guide, which have been recently reviewed and updated. They are made available to all prospective new residents and their families or representatives. They are also displayed in the foyer of the home alongside the most recent inspection report. Most of the residents I spoke to said either they or their relative/representative had visited the home at least once before choosing to move in. The home also offers respite care, which gives people a chance to “test drive”, the home prior to deciding to move in on a more permanent basis. The manager or supervisors support prospective residents and their families during visits to the home, giving them chance to ask questions and discuss individual needs and requirements or arrange an additional visit. Rock Lea DS0000036579.V314564.R01.S.doc Version 5.2 Page 8 In addition to Social Work assessments and specialist assessments, the home complete their own needs assessment from these a care plan is developed that supports and guides staff in providing a consistent and responsive service. Rock Lea DS0000036579.V314564.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although all residents have a care plan in place based on the home’s needs assessment and other specialist assessments, the information contained needs to be kept up to date and reviewed on a regular basis, to ensure individual needs are being responded to appropriately at all times. EVIDENCE: All the residents have a care plan completed on admission to the home, which is based on the home’s needs assessment and any other specialist assessments or social work assessments in place. This includes a detailed manual handling risk assessment from which a manual handling care plan is agreed. There was evidence these are reviewed on a monthly basis, through the completion of a functional assessment, which assesses cognitive skills, health needs, motor skills and daily living skills. However after case tracking some resident’s files, examining other records and meeting the residents, it was evident that some needs had changed. These were recorded on the supervisors file, but the functional assessment had not been updated to record these changes. This brings into question the effectiveness of the functional assessment/review process and could lead to inappropriate responses from Rock Lea DS0000036579.V314564.R01.S.doc Version 5.2 Page 10 staff. The home is required to ensure all care plans are regularly reviewed and updated to reflect the changing needs of residents. Care staff act as a link worker for a number of residents working closely with a key worker, who is one of the supervisory staff, to ensure resident’s health care needs are recorded and responded to in a timely manner. The home works closely with a number of community health agencies with the District nurse visiting the home at least twice a day. All health interventions are recorded, however there was evidence that not all relevant information was being transferred onto the care plan. Currently daily diary notes completed by care staff and supervisor notes are held separately from the care plan, which could contribute to some information not being transferred onto the care plan. The manager is reviewing this system. However it is recommended all relevant information is recorded on the care plan to ensure a continuity of care. Although resident’s files contained weight monitoring charts, not all residents were having their weight monitored and recorded on a regular basis. In addition when fluctuations in weight were noted actions to be taken were also not recorded. It is recommended weight charts are updated and actions agreed when changes occur. The home is in the process of reviewing the content of care plans and introducing a pen picture/social history, as care plans are currently focussed on healthcare problems and some daily living skills. This is in line with current good practice and will ensure the plans reflect the whole person, what they value, their life experiences/interests and relationships. When talking to residents, these things are very important to them and something that all relevant staff should be aware of. This enables staff to provide a person centred approach. I examined three resident’s care plan files in detail these included assessments and a care plan as described. One of the residents was using the home for respite care but all relevant information was in place, which is good practice. The home has good systems in place to safely manage the medication in the home. I examined the record of all medication coming into and leaving the home and the medical record sheets (MAR) charts for a selection of residents. These were up to date and accurate. The home had completed PRN procedures to guide staff in the administration of all ‘as required’ medication including a record of creams. The supervisors take a lead role in the administration and management of all medication and they have all received suitable training. The home has a second member of staff they call a “quality checker” who supports the supervisor and checks that procedures are followed. Controlled drugs were also appropriately managed and a lockable fridge is in place for medication requiring refrigeration. Rock Lea DS0000036579.V314564.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were seen to be enjoying a good quality of life and exercising choice and control over how they lived their lives. On the whole the home provides a good range of activities, however the record of activities provided and who is involved should be more detailed. EVIDENCE: Based on my discussions with residents and records held in the home there are frequent visitors to the home. This includes family and friends who are “always made welcome”. Some residents I spoke to said how much they “look forward to the visits and going out for trips with their relatives”. The home has appointed an activities coordinator who takes a lead role in organising planned events and social activities. Residents look forward to the social events through the year, which include concerts/sing-along with a buffet tea, with a local group providing the entertainment and other seasonal events such as the Easter fair. A Christmas shopping trip is planned as well as other Christmas events. The home is endeavouring to provide a range of activities to residents, which include regular games of bingo, nail care, discussion groups, exercise sessions, and other tabletop sedentary activities. The mobile library also visits the home on a regular basis. When the weather allows they also make use of the gardens and grounds for exercise or just to relax. Rock Lea DS0000036579.V314564.R01.S.doc Version 5.2 Page 12 The recording of who takes part and what activities are provided is ad hoc and makes it difficult to assess if everyone’s needs are being met. Based on discussions with the manager and staff it is recommended that individual interests and preferences are recorded and a more detailed record of who takes part in activities is maintained to ensure all the resident’s needs are met. I joined a group of residents for lunch, this was served from hot trolleys in the dining area of the unit. People were offered a choice of two hot meals and a pudding, which was well presented. There was a relaxed atmosphere with staff providing unobtrusive support to residents, making the meal a relaxed social occasion. When I arrived in the morning the tables were set for breakfast with a choice of cereals and drinks on individual tables. This is good practice and enables people to maintain their independence. Rock Lea DS0000036579.V314564.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has robust policies and procedures in place, which safeguard residents and staff. Staff were knowledgeable and there was evidence of the home dealing appropriately with referrals. EVIDENCE: The home has a clear complaints policy and procedure that is made available to residents and their representatives and is displayed in the foyer. There have been no recorded complaints since the last inspection. Based on feedback from surveys and discussions with residents they were aware of how to complain and who to complain to. As one resident said, “Any problems and I just tell the staff, they sort it out”. The home has their own policy and procedure relating to the Mistreatment of vulnerable adults, which is in line with the Local Authority procedures. The home had a copy of the latest procedure displayed on the notice board. The home provides relevant training using a training video, discussion groups and also through supervision and staff meetings. Staff I spoke to were aware of their responsibilities and the reporting procedures of the home. The home has made two referrals under Adult Protection since the last inspection, which have been handled appropriately. Rock Lea DS0000036579.V314564.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Rock Lea provides a homely and well maintained living environment for residents. It is furnished and decorated to a good standard. Residents feel safe and relaxed in their home. EVIDENCE: The home and grounds are in good condition well maintained and provide a safe and homely living environment for the residents. Access throughout the home is good with ramped access on all the ground floor and a passenger lift to the first floor. The bedrooms I inspected were personalised with resident’s own furniture and belongings such as ornaments, photographs and in one room drawings done by their grandchildren. This gives the rooms a homely feel and is something residents value. All the rooms are fitted with a call bell system that is accessible to residents. All areas of the home were clean and hygienic and there were no malodours. The home has been following a planned programme of repairs and maintenance, which is based on an annual condition survey. Two of the Rock Lea DS0000036579.V314564.R01.S.doc Version 5.2 Page 15 lounges and two bedrooms had been recently decorated and new carpets fitted, with residents involved in the choosing of wallpaper and colour schemes. I discussed with the manager and staff how the environment could be improved for people with dementia. Ideas discussed included the use of signs and pictures to help residents identify rooms and the contents of cupboards, to make things more accessible and promote their independence when moving around the home. It is recommended the home look at making the environment more accessible to people with dementia. Rock Lea DS0000036579.V314564.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although the home has an experienced and well-trained team the manager should review the deployment of staff to ensure resident’s needs can be met throughout the day. EVIDENCE: Since the last inspection there has been a low turnover of staff with two new appointments. I sampled the staff files including the two new members of staff. All the relevant documentation was in place and suitable checks and references were completed. The organisation has robust recruitment policies and procedures in line with current good practice. Rock Lea has an experienced and well trained team of staff and on the whole ensures resident’s needs are met. However this does get compromised at key times in the dementia unit and when a staff absence is not covered by a relief staff. On the first morning of my visit there was one member of staff on duty for the six residents on the dementia unit. However due to their differing needs, through no fault of their own, the staff member was struggling to respond to individual demands. On the second day a member of staff rang in sick and was not covered, which again impacted on the care being delivered, especially when a member of the care staff was taken ‘off the floor’ to act as the ‘quality checker’ on the medication round. It is recommended the manager review the deployment of staff within the home at key times to ensure the home is able to meet the needs of residents in a safe manner. Rock Lea DS0000036579.V314564.R01.S.doc Version 5.2 Page 17 The provision of NVQ training for staff has been good with staff “feeling valued and getting good support” to complete the award. There was evidence of other training taking place both in core skills and specialist areas, however the training record was not available on this occasion as it was being transferred onto a new system, this will be examined at the next inspection. The home provides placements for students from the local College of Further Education or Training provider. There were two present during this visit. It was evident they were being well supported and benefiting from the practical experience. Rock Lea DS0000036579.V314564.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37, 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager and staff team work closely to ensure the home is run in the best interests of residents. The safety and well being of residents and staff is safeguarded by the home’s policies, procedures and practice. EVIDENCE: The manager is responsible for the formal supervision of the supervisory team. In the managers absence this formal supervision was adhoc, although regular supervisory meetings were held, which other managers attended to provide support. More regular formal supervision to support and guide their practice would have been beneficial to the supervisors in the manager’s absence. The majority of care staff were receiving regular supervision with a record maintained and held on personal files, although there had been some disruption in the manager absence. Annual appraisals are also completed for all staff with personal development targets agreed. Rock Lea DS0000036579.V314564.R01.S.doc Version 5.2 Page 19 The home was in the process of compiling the results of their recent annual survey with residents and significant others. In addition to the formal survey, through the linkworker/keyworker system, identified staff work closely with a few individuals to monitor and record their health and well being. I spot checked resident’s personal monies held by the home. These were securely stored and detailed records maintained of all transactions. The monies I checked all balanced and records were up to date and accurate. I examined the servicing and maintenance records required by regulation, these were all in order. The manager was made aware of the changes to the fire regulations. Rock Lea DS0000036579.V314564.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 2 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 2 3 3 Rock Lea DS0000036579.V314564.R01.S.doc Version 5.2 Page 21 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(2) b Requirement The home is required to ensure all care plans are regularly reviewed and updated to reflect the changing needs of residents. Timescale for action 01/01/07 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 3. Refer to Standard OP7 OP8 OP12 Good Practice Recommendations It is recommended all relevant information is recorded on the care plan to ensure a continuity of care. It is recommended weight charts are updated and actions agreed when changes occur. It is recommended that individual interests and preferences are recorded and a more detailed record of who takes part in activities is maintained, to ensure all the residents’ needs are met. It is recommended the home look at making the environment more accessible to people with dementia. It is recommended the manger review the deployment of staff within the home at key times, to ensure the home is able to meet the needs of residents in a safe manner. 4 5. OP22 OP27 Rock Lea DS0000036579.V314564.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: 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 © 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 Rock Lea DS0000036579.V314564.R01.S.doc Version 5.2 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!