CARE HOMES FOR OLDER PEOPLE
Rockingham House 22 The Mount Malton North Yorkshire YO17 7ND Lead Inspector
Karen Ritson Unannounced 14 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. Rockingham House J53 JO4 S7670 Rockingham House V230129 140605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Rockingham House Address 22 The Mount Malton North Yorkshire YO17 7ND 01653 697872 01653 699612 susan@bingham.freeserve.co.uk Mr Richard Charles Dales 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) Mrs Susan Jane Bingham Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Rockingham House J53 JO4 S7670 Rockingham House V230129 140605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 07/12/04 Brief Description of the Service: Rockingham house is registered to provide personal care for up to twenty six older people. The home also offers short-term care, including day care. Rockingham House does not provide nursing or specialist care and consequently any nursing needs will be the responsibility of the local health care services. The propetry is Victorian, set in large grounds in a quiet residential area of Malton. It is conveniently located for all main community facilities including the public transport network. It is built on four floors with the ground to second floor being serviced by a passenger lift. The lower ground floor is accessed internally via stairs or a stair lift or externally through the garden area. The home has been sympathetically converted into a care home from a private house and an extention has been added. The gardens are landscaped, with a pond and seating for service users and their guests. There is parking space for several vehicles. Rockingham House J53 JO4 S7670 Rockingham House V230129 140605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Tuesday June 14th 2005 and was the first of two during this inspection year. The inspection took nine hours to complete, which includes time to prepare and to write the report. The manager was available throughout the inspection. Four service users, a visitor, a GP and all staff on duty were spoken to. This inspection has focused upon medication, complaints, the environment, staffing issues and health and safety. Other key standards will be considered at the next inspection. Staff and service user comments will be mentioned in more detail in the body of the report, however, all comments were positive regarding level of care offered by the home. What the service does well: What has improved since the last inspection? What they could do better:
The home has complied with all recommendations and requirements of previous inspections and is in the process of complying with requirements of the most recent environmental health department visit. All requirements of the fire service have been complied with. The manager has completed her Registered Managers Award studies and is awaiting her certificate. She continues to work towards improvements within the home through quality assurance questionnaires, staff supervision, a programme of routine
Rockingham House J53 JO4 S7670 Rockingham House V230129 140605 Stage 4.doc Version 1.30 Page 6 maintenance and a regular review of all policies. All spoken to said the manager was approachable and that any concerns were quickly addressed. 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. Rockingham House J53 JO4 S7670 Rockingham House V230129 140605 Stage 4.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 Rockingham House J53 JO4 S7670 Rockingham House V230129 140605 Stage 4.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) None of the standard were inspected. EVIDENCE: Rockingham House J53 JO4 S7670 Rockingham House V230129 140605 Stage 4.doc Version 1.30 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 standard(s) 9 Service users are protected by the homes’ medication policy and procedure. EVIDENCE: The home operates a NOMAD system for medication. Several service users medication cassettes were checked against the recording sheet and were accurate and up to date. All medication is kept in a trolley which is kept locked in the upper office and attached to the wall when not in use. All controlled medication is recorded in a controlled drugs register although at present only temazepam is being treated as a controlled drug and being recorded in this way. The home operates a suitable returns procedure. All staff who administer medication have competed a comprehensive correspondence medication training course. All service users said the home took care of their medication and that they were satisfied with the way in which it was handled. Staff said they felt confident that they knew the medication procedure. A visiting GP said that he was confident that the staff would call the surgery appropriately and that he had a good working relationship with the home. Rockingham House J53 JO4 S7670 Rockingham House V230129 140605 Stage 4.doc Version 1.30 Page 10 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) None of these standards were inspected. EVIDENCE: Rockingham House J53 JO4 S7670 Rockingham House V230129 140605 Stage 4.doc Version 1.30 Page 11 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 Service users are protected by the homes’ complaints policy and procedure. EVIDENCE: A complaints policy and procedure have been produced by the home. This is suitable and lists the contact details of CSCI. Service users said they could mention any difficulty or concern and that all staff took their concerns seriously and tried their best to sort out any problems. All were aware they could contact CSCI if not satisfied with the homes investigation of a complaint. Rockingham House J53 JO4 S7670 Rockingham House V230129 140605 Stage 4.doc Version 1.30 Page 12 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, 24 26. Service users live in a well-maintained environment. EVIDENCE: The home is well laid out, with access to upstairs rooms via passenger and stair lifts. The home is also well decorated, with adequate natural light. The home complies with the local fire service and a new fridge is on order to comply with the environmental health department requirement that the fridge door seals needed attention. Service users said they enjoyed the gardens and the interior décor of the house. Service users have comfortable rooms, all of which are decorated to a high standard. The room, which required attention at the last inspection, has been redecorated. All service users have the facility for secure storage of valuables. The home is clean and free from odour. Members of staff on rota carry out the laundry. The laundry assistant left her employment recently. This post is due to be filled. The washing machines are modern and meet all requirements fro disinfection standards. Service users and visitors said that there were no problems with the laundry.
Rockingham House J53 JO4 S7670 Rockingham House V230129 140605 Stage 4.doc Version 1.30 Page 13 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 Service users welfare is protected by the staffing levels in the home. EVIDENCE: Three members of staff are on duty during each day time shift, one of which is a senior carer. The home additionally has a cook, kitchen assistant and three cleaners on duty for part of the day. According to the manager there are always additional staff available during the day at peak times. The staff rota confirmed this. The night staffing consisted of two staff on waking duty and the manager on-call via the telephone. A staff rota was available which identified the on-duty times of the staff and their roles. Rockingham House J53 JO4 S7670 Rockingham House V230129 140605 Stage 4.doc Version 1.30 Page 14 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) 31,33 and 38. Service users’ safety is protected. EVIDENCE: The manager has recently completed all required units for the Registered Managers Award. These have been submitted for assessment. As she already holds an equivalent qualification to NVQ Level 4 in care, the manager will be suitably qualified by the end of 2005. Service users and visitors all said that the manager was a competent and caring person and all felt she was experienced and effective in her role. At the last inspection, an outcome of a survey of visitors to the home including the relatives of the service users was inspected. In general it indicated that that all were satisfied with the service provided. It was, however, recommended that where there were negative comments then these should be
Rockingham House J53 JO4 S7670 Rockingham House V230129 140605 Stage 4.doc Version 1.30 Page 15 responded to by writing to the individual if possible. The manager provided evidence that these comments had been responded to in writing. All actions taken in response to the survey were also recorded. An inspection of the premises and the records showed that the manager has continued to ensure that the environment is safe for the staff and service users. The staff confirmed that they had been provided with health and safety training. Rockingham House J53 JO4 S7670 Rockingham House V230129 140605 Stage 4.doc Version 1.30 Page 16 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 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x
COMPLAINTS AND PROTECTION 3 x x x x 3 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 Standard No 16 17 18 Score 3 x x 3 x 3 x x x x 3 Rockingham House J53 JO4 S7670 Rockingham House V230129 140605 Stage 4.doc Version 1.30 Page 17 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 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 Good Practice Recommendations Rockingham House J53 JO4 S7670 Rockingham House V230129 140605 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection York Area Office Unit 4, Triune Court Monks Cross York, YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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