Inspection on 05/07/05 for Rock Lea

This inspection was carried out on 5th July 2005.

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

Rock Lea 20/02/08

Rock Lea 22/11/06

Rock Lea 16/01/06

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 05 July 2005 07:20 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. Rock Lea F58 F10 s36579 rock lea v232536 050705 ui stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Rock Lea Address Abbey Road Barrow in Furness Cumbria LA13 9SJ 01229 894546 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) Cumbria Care Paulina Holland Care Home 26 Category(ies) of OP - Old Age registration, with number DE(E) - Dementia, over 65 of places Rock Lea F58 F10 s36579 rock lea v232536 050705 ui stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service must at all times employ a suitably qualified and experienced manager who is registered with the National Care Standards Commission. 2. A maximum of twenty six older people (OP26) may be accommodated, six of whom may also have dementia (DE(E)6). 3. The staffing levels for the home must meet the Residential forum Care Staffing Formula for Older Adults by 1st April 2004. Date of last inspection 24 January 2005 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 and toilet and bathroom facilities. All the twenty six rooms are single occupancy, with eight having ensuite facilities. The home has extensive grounds to the front and rear, including well kept gardens and parking facilities. Rock Lea F58 F10 s36579 rock lea v232536 050705 ui stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place at 7.20 am enabling the inspector to meet night staff before going off duty and also to observe the morning routines of the home. During the course of the inspection the inspector met with the majority of residents, families visiting the home and a visiting district nurse. Five staff were formally interviewed with the inspector spending time with the manager and supervisors throughout the day. Time was spent in all areas of the home talking to residents and observing the routines of the home, including having lunch with a group of residents. What the service does well: What has improved since the last inspection? What they could do better: Over the last twelve months the acting manager has addressed the major concerns regarding the running of the home. However further action is required in the following areas to ensure residents are safeguarded and individual needs are appropriately met. Access and egress from the fire exit identified must be improved. PRN procedures must be signed and dated to ensure safety of residents and appropriate reviews take place. Risk assessments to support selfadministration of medication must be developed. Within care plan files, specific healthcare needs and medical conditions must be clearly recorded with guidance in place for staff. A review of administration Rock Lea F58 F10 s36579 rock lea v232536 050705 ui stage 4.doc Version 1.40 Page 6 hours for the home is recommended, to ensure the effective and efficient running of the home. 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. Rock Lea F58 F10 s36579 rock lea v232536 050705 ui stage 4.doc Version 1.40 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 Rock Lea F58 F10 s36579 rock lea v232536 050705 ui stage 4.doc Version 1.40 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, 3, 4, 5 The home has good admission procedures in place that ensure residents are provided with relevant information. This enables them to make an informed choice about moving into the home and that it will be able to meet their needs. EVIDENCE: All prospective residents are offered a service user guide a copy of which is also held in the office. This contains all relevant information to enable people to make an informed choice about moving into the home. The home follows a formal admission procedure that ensures that on the day of admission, all relevant information and procedures are completed with the residents. There was evidence of both the homes own assessments and social services assessments held on file. Based on these and through ongoing consultation, the home completes a record of personal preferences and daily routines, to guide staff in delivering a personalised care package. This includes information such as morning routines, preferred form of address and other daily needs and choices, which are important to the person. Rock Lea F58 F10 s36579 rock lea v232536 050705 ui stage 4.doc Version 1.40 Page 9 Care plans were being reviewed on a monthly basis by the key worker or supervisor, including the completion of a functional assessment that closely monitors needs and abilities, ensuring changes are noted and responded to. Rock Lea F58 F10 s36579 rock lea v232536 050705 ui stage 4.doc Version 1.40 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, 10. Although care plans were informative and staff had a good understanding of individual needs, the recording of specific healthcare needs and some medication records were inconsistent. EVIDENCE: Care plans have been developed based on initial and ongoing assessments. These were found to be personalised and informative. However some of the recording of specific health conditions and needs was inconsistent, resulting in a lack of information and guidance being available to staff. One of the three files case tracked by the inspector, did not contain a manual handling risk assessment. In the same file there was only minimal information relating to diabetes care. The manager explained that training was planned in relation to diabetes care, which should improve this situation. The inspector met with a visiting district nurse. She explained that their team visit the home at least twice a day to support a resident with their diabetic care, in addition to dealing with other issues as they arise. She described the home having good communication with the community health team, with the home asking for advice and following guidance when appropriate. Rock Lea F58 F10 s36579 rock lea v232536 050705 ui stage 4.doc Version 1.40 Page 11 Since the last inspection there was evidence of the home liaising with the Occupational Therapy department regarding the use of bed rails and for other aids and adaptations to promote and maintain independence. Through the monthly review and functional assessment personal and healthcare needs were monitored. The medication records were examined and on the whole found to be up to date and accurate, however PRN medication protocols were not signed or dated. This could cause confusion and makes it difficult to assess if they are current. One resident carries and administers their own angina spray, promoting independence in this way is good, however a risk assessment must be developed. Warfarin records were up to date and accurate, information relating to the potential problems associated with Warfarin, were being added to medical records, which is good practice. Rock Lea F58 F10 s36579 rock lea v232536 050705 ui stage 4.doc Version 1.40 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, 13, 14, 15. The range and number of activities provided by the home had increased, which had a positive affect. Independence and choice were encouraged and promoted, which is good practice. EVIDENCE: With the increase in staff hours, the manager has been able to appoint a member of staff who takes a lead responsibility for facilitating activities in the home. A record of activities provided was maintained in the office, enabling the effectiveness of activities to be assessed. The activities recorded were dependent on staff taking a lead role. It is recommended the home review the types of activities and resources they provide and encourage people to access resources and equipment independently of staff, in addition to the planned group activities. Resident spoken to talked about how much they enjoy the garden, either sitting out in the nice weather or going for a walk. On the day of the inspection a member of staff provided a sweet trolley, which residents obviously looked forward to and enjoyed. One resident said it gives them “ a bit of pleasure buying the sweets and sharing them with friends or staff”. Daily routines in the home were on the whole based around individual needs and preferences. Some people spoken to had risen early and had a drink in their rooms’ prior to breakfast. Others preferred to get up later and had Rock Lea F58 F10 s36579 rock lea v232536 050705 ui stage 4.doc Version 1.40 Page 13 breakfast either in their rooms or in the dining area. This level of choice and flexibility was appreciated by residents and is good practice. The home had introduced for residents to get their breakfast independently rather than waiting for staff. Cereals were laid out on the table with jugs of milk, tea and coffee pots and orange juice, which promoted independence and the maintenance of skills. The inspector joined residents for lunch, during which they spoke about the quality and choice of food available. Everyone spoken to said, “the food was good” and “you get a lot of choice”. Rock Lea F58 F10 s36579 rock lea v232536 050705 ui stage 4.doc Version 1.40 Page 14 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, 18. The home’s policies, procedures and practice ensure residents are safeguarded at all times. EVIDENCE: The home was now keeping a record of all complaints in the office, which was available for inspection. There had been no complaints recorded since the last inspection. The home has sound policies and procedures in place, which are issued to all residents and displayed in the home. Through both NVQ and induction and foundation training staff receive training regarding recognising and responding to mistreatment and abuse. The home uses a video for refresher training and also sends key staff on social services training to ensure best practice is maintained. Based on discussions with staff, they had a good knowledge of their role and responsibilities in relation to mistreatment and abuse and safeguarding residents. Rock Lea F58 F10 s36579 rock lea v232536 050705 ui stage 4.doc Version 1.40 Page 15 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, 20, 21, 22, 23, 24, 25, 26. The home is decorated and furnished to a good standard, with an ongoing programme to maintain a homely and safe environment. Paths and patios were in need of attention to make them safe. EVIDENCE: All the communal areas of the home were inspected on this occasion. On the whole the décor and furnishings are of a good standard, with the home tastefully decorated to incorporate the period features. The home has an ongoing programme of repairs and renewal with priorities identified and dates agreed for work to be completed. One area of concern is the condition of the paths and patios to the side and rear of the home. The path outside a fire exit was covered with rotting leaves, which were slippery and a hedge overhung the path, which were a hazard and would be problematical if used in an emergency. Remedial action must be taken to ensure access and egress from this exit is improved. The manager had arranged for the rear patios to be cleaned and cleared of moss, which had built up and was a slipping hazard. Rock Lea F58 F10 s36579 rock lea v232536 050705 ui stage 4.doc Version 1.40 Page 16 Residents had their own personal toiletries, which they took with them to the bathrooms. Communal bathrooms and toilets also had anti-bacterial soap dispensers to encourage and support good hygiene. Individuals had personalised their rooms with pictures and possessions giving them a homely feel. Rock Lea F58 F10 s36579 rock lea v232536 050705 ui stage 4.doc Version 1.40 Page 17 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, 30. The recruitment of staff to the vacant posts has ensured residents receive a consistently good quality of care. Staff are well motivated and committed to maintaining these standards. EVIDENCE: Based on discussions with resident, staff and management staff morale has improved since the home has had a full compliment of staff. On examination of the rotas staffing levels have been consistent and all absences appropriately covered. The home has regular relief staff who cover absences, meaning regular staff only picking up occasional extra shifts. This has resulted in staff, in their own words “feeling less stressed” as there was no pressure to cover vacancies and absences all the time. The other benefits the home was enjoying were lower sickness levels and staff being “motivated and enjoying their jobs”. Another factor that has contributed to this, was the use of peripatetic NVQ assessors, who have progressed people through their NVQs giving them a real sense of achievement and value. Residents and staff confirmed since the uplift in staff hours, that they have been able to provide a “quality service” with staff having time to talk and respond to residents, rather than rush past them moving onto the next task. An NHSU student is filling one of the two remaining vacant posts, whilst the other is being covered between the regular relief staff. The manager has a system to monitor and record training activity and through regular supervision and appraisals training needs were identified and prioritised. The home was in the process of introducing Continuous Rock Lea F58 F10 s36579 rock lea v232536 050705 ui stage 4.doc Version 1.40 Page 18 Professional Development files for all staff, which will be completed and updated through supervision, therefore ensuring a suitably skilled workforce. Two staff recently employed by the home were previously working in the home as students. However they underwent the normal recruitment procedures and interview process prior to being appointed. Developing and nurturing young people into the caring role, is a positive investment from which the home has reaped the rewards. Rock Lea F58 F10 s36579 rock lea v232536 050705 ui stage 4.doc Version 1.40 Page 19 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) 31, 32, 33, 37, 38. The manager and supervisors provide clear leadership and support to the residents and staff, ensuring the home is run in a safe manner and in the best interests of residents. EVIDENCE: Due to the extended absence of the registered manager, the acting manager, Ms Hazel Phizacalea must now complete the Registered Manager fit person process with the commission. Since her appointment Ms Phizacalea has a good understanding of her role and has gained the respect of both residents and staff, who spoke positively about the support and leadership she provides. She has a good knowledge of the needs of residents and the management responsibilities under the Care Home regulations, working positively with the Commission. Rock Lea F58 F10 s36579 rock lea v232536 050705 ui stage 4.doc Version 1.40 Page 20 The home only has four hours administrative support each week, with supervisors and the manager taking on the remainder of administrative tasks. The problems this can create were discussed with the manager. It is recommended the manager review the home’s budget allocation to assess if further administrative hours can be found, to support the efficient and effective running of the home, whilst allowing supervisors to support the care workers and respond to the needs of residents. Rock Lea F58 F10 s36579 rock lea v232536 050705 ui stage 4.doc Version 1.40 Page 21 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 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 2 3 3 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 Standard No 16 17 18 Score 3 x 3 3 3 3 x x 3 3 2 Rock Lea F58 F10 s36579 rock lea v232536 050705 ui stage 4.doc Version 1.40 Page 22 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 7 Regulation 12 Requirement Information in care plan files, relating to healthcare needs and medical conditions, must be more detailed All PRN protocols must be signed and dated. The path outside the fire exit identified must be cleared and made safe and accessible. Timescale for action 1st September 05 1st September 05 18th July 2005 2. 3. 9 19 13 13 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 9 27 Good Practice Recommendations It is recommended risk assessments are developed to support residents to self administer medication when approrpiate. A review of administration hours for the home is recommended, to ensure the effective and efficient running of the home. Rock Lea F58 F10 s36579 rock lea v232536 050705 ui stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith, Cumbria CA11 9BP 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 Rock Lea F58 F10 s36579 rock lea v232536 050705 ui stage 4.doc Version 1.40 Page 24 - 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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