CARE HOMES FOR OLDER PEOPLE
Rockley Dene Residential Park Road Worsbrough Barnsley S70 5AD Lead Inspector
Steven Vessey Unannounced 7 September 2005 09:30
th 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. Rockley Dene Residential J51 S18277 Rockley Dene V241615 070905 UI Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Rockley Dene Residential Address Park Road Worsbrough Barnsley S70 5AD 01226 245536 01226 280187 None Angel Care Plc 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 Beryl Skidmore PC Care Home Only 40 Category(ies) of OP Old age (40) registration, with number of places Rockley Dene Residential J51 S18277 Rockley Dene V241615 070905 UI Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 11th January 2005 Brief Description of the Service: Rockley Dene is a purpose built home specialising in providing residential care for up to 40 residents over the age of 65 years. It is situated in a residential area of Barnsley close to amentities and on the local bus route. The home comprises of 22 single rooms, 3 of which are en-suite, and 9 double rooms, 2 of which are en-suite. A range of communal rooms is provided, including 3 lounge areas and a large dining room. The home has sufficient bathing facilities, aids and adaptations such as ramps, a lift and handrails are available. A central kitchen and laundry room serves the home. The grounds are provided with a range of seating. A car park is available. Rockley Dene Residential J51 S18277 Rockley Dene V241615 070905 UI Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over approximately six hours from 09:25 to 15:30 The inspection process included a partial inspection of the premises, inspection of a sample of records and policies, discussions with staff, residents and relatives and observation of staff carrying out their duties. The majority of residents and staff were seen during the inspection and the inspector had the opportunity to speak to six staff, five residents and relatives in some detail. What the service does well: What has improved since the last inspection?
Care records clearly informed staff how to meet the needs of the residents; these were reviewed regularly with the involvement of residents and relatives. Staff had received compulsory training and received some supervision on a regular basis. The replacement of some carpets and floor covering and the purchasing of some equipment had improved the living environment for residents. Equipment was stored in appropriate areas maintaining the health safety and welfare of residents. The complaints log contained all the required information. Rockley Dene Residential J51 S18277 Rockley Dene V241615 070905 UI Stage 4.doc Version 1.40 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. Rockley Dene Residential J51 S18277 Rockley Dene V241615 070905 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 Rockley Dene Residential J51 S18277 Rockley Dene V241615 070905 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) 3, standard 6 is not applicable at the home. Resident’s needs had been assessed prior to admission to the home. EVIDENCE: Three care plans included a full assessment of the needs of the residents. Rockley Dene Residential J51 S18277 Rockley Dene V241615 070905 UI Stage 4.doc Version 1.40 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) 7, 8 and 9 Residents and their representatives had been involved in formulating and reviewing of care plans, which reflected the assessed needs of residents. In the main resident’s health care needs were met, however this could be improved by including a nutritional assessment in all residents care plans. In the main medication was managed well, however a medication pot containing liquid medication left on a table in the dining room compromised the safety of residents. EVIDENCE: Three care plans included detailed information as to the actions required by staff to meet the needs of individual residents and were reviewed. Risk assessments were in place for the administration of medication, the development of pressure areas and moving and handling. One care plan included a nutritional risk assessment. The deputy manager stated that nutritional risk assessments were included in care plans where an issue with nutrition had been identified. Residents or their relatives had signed some risk assessments and care plans. Relatives stated that they were aware of the information in care plans and were kept well informed of any changes. Residents seen were well cared for, they were clean, their hair and nails had been attended to and male residents were shaved.
Rockley Dene Residential J51 S18277 Rockley Dene V241615 070905 UI Stage 4.doc Version 1.40 Page 10 Records were kept of medication being received into and leaving the home. There were medication administration records for residents, which were completed appropriately, maintaining resident’s health safety and welfare. Senior care staff had been appropriately trained to administer medication. Medication, including controlled drugs was in the main stored safely and securely, however during an inspection of the dining room following breakfast a medication pot containing some liquid medication had been left unattended. Rockley Dene Residential J51 S18277 Rockley Dene V241615 070905 UI Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15. Residents are given choice in many aspects of their lives and a variety of activities are provided, however some residents would like the opportunity to go on more outings. Relatives are encouraged to visit and be involved in resident care. Residents receive a choice of food, which is of good quality and can choose where they eat. Not all residents were assisted to eat in a discreet and sensitive way. EVIDENCE: Residents and staff stated that residents could choose when they get up and go to bed and could spend time in their room when they want to, maintaining their choice and independence. Residents stated that they were happy with the activities on offer, but some residents and staff stated that they thought the service would be improved if residents had the opportunity to go out more. Relatives stated that activities are provided and staff encourage residents to participate, entertainment is provided and some residents get the opportunity to go out. Residents and relatives stated that visits can take place at any reasonable time and that they are always welcomed into the home by staff.
Rockley Dene Residential J51 S18277 Rockley Dene V241615 070905 UI Stage 4.doc Version 1.40 Page 12 Residents were positive about the food served, comments included, “the food is good”, “we can choose what we want to eat” and “we can’t go wrong with the food”. The food served corresponded with the menu displayed on the tables. The dining area was pleasant. The tables were set with cloths, cruet, cutlery and teapots. Residents were offered choices throughout lunch. A member of staff was assisting a resident to eat whilst standing at the side of their chair. Rockley Dene Residential J51 S18277 Rockley Dene V241615 070905 UI Stage 4.doc Version 1.40 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 Residents and relatives were aware how to complain and thought that their complaints would be listened to and dealt with. EVIDENCE: A copy of the complaints procedure was displayed in the foyer. A complaints log was available; no complaints had been logged recently. Relatives stated that they had been given information about complaints prior to the resident’s admission to the home. Some residents stated that they would tell staff if they were not happy, but also stated that they had nothing to complain about. Relatives and relatives thought that any complaints would be listened to and attempts would be made to resolve them. Rockley Dene Residential J51 S18277 Rockley Dene V241615 070905 UI Stage 4.doc Version 1.40 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, 22 and 24 The home was in the main well maintained. Bathrooms were clean, well decorated and not used to store inappropriate items. Residents were happy and comfortable in their rooms. EVIDENCE: In the main the home was well decorated and well maintained. Residents stated that they were happy and comfortable in their rooms. The deputy manager stated that some new bathroom flooring, new flooring in the wheelchair room and some new carpets had been fitted. Some new equipment including a vacuum cleaner, a microwave and some new beds had been purchased. Bathrooms were clean, well decorated and were not used for the storage of inappropriate items. Resident’s bedrooms were clean and personalised; residents stated that they were happy and comfortable in their rooms. Rockley Dene Residential J51 S18277 Rockley Dene V241615 070905 UI Stage 4.doc Version 1.40 Page 15 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, 29 and 30 Sufficient staff with an appropriate mix of skills was on duty to meet the needs of residents. Residents were not fully protected by the recruitment policies and procedures. Staff receive induction training and have opportunities for further training. EVIDENCE: The deputy manager was on duty on the morning of the inspection, there were also, one senior care assistant, three care staff, a domestic, a laundry assistant and the administrator on duty. Residents and relatives stated that there was sufficient staff on duty to meet the needs of the residents. Two out of three staff files contained appropriate recruitment information including two references and CRB disclosures. Residents are not fully protected as one file contained one written reference and two staff members had commenced employment before the date on their CRB disclosure. Staff files contained confirmation of staff training, staff stated that they had received induction training and had opportunities for further training. Rockley Dene Residential J51 S18277 Rockley Dene V241615 070905 UI Stage 4.doc Version 1.40 Page 16 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, 36 and 38 Staff receive regular supervision, however this did not include discussions relating to their role, work performance and training and development needs. In the main the health safety and welfare of residents and staff were maintained. EVIDENCE: Three staff files contained evidence that supervision was taking place regularly. The emphasis of the supervision was on providing training for staff. Some staff spoken to did not recognise that they were receiving supervision. They stated that they did not have a regular one to one meeting with a senior member of staff to discuss issues relating to their role, work performance and training and development needs. Rockley Dene Residential J51 S18277 Rockley Dene V241615 070905 UI Stage 4.doc Version 1.40 Page 17 Records were in place stating fire equipment had been checked, regular fire drills had taken place and that staff had received fire training. Staff confirmed that they had received fire and moving and handling training, promoting resident safety. Gas appliances had been serviced and the electrical testing had been carried out. Records were in place to show that water temperatures were checked; these identified some outlets, which were faulty and discharging hot water at a low temperature. Evidence was in place to show that this had been rectified. Accident records were fully completed regularly audited by the manager. Information relating to accidents was recorded in residents care plans. The deputy manager stated that new window restrictors had been fitted on the recommendation of the health and safety executive following a recent visit. Rockley Dene Residential J51 S18277 Rockley Dene V241615 070905 UI Stage 4.doc Version 1.40 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 2
COMPLAINTS AND PROTECTION 3 x x 3 x 3 x x STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 2 x x x x 2 x 3 Rockley Dene Residential J51 S18277 Rockley Dene V241615 070905 UI Stage 4.doc Version 1.40 Page 19 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. 4. 5. Standard 8 9 12 15 29 Regulation 15 13 16 16 19, Schedule 2 Requirement All residents care plans must include risk assessments relating to nutrition. Medication must not be left unattended around the home. Residents must be consulted about outings they wish to undertake. Residents must be assisted to eat in a discreet and sensitive way. Staff must not commence employment without the receipt of a satisfactory CRB, POVA check and the receipt of two written references. Timescale for action 07.12.05 07.10.05 07.12.05 07.08.05 07.08.05 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 31 36 Good Practice Recommendations The registered manager should have a level 4 NVQ qualification in management or equivalent by 2005 Staff supervision should include discussions relating to their role, work performance and training and development needs.
J51 S18277 Rockley Dene V241615 070905 UI Stage 4.doc Version 1.40 Page 20 Rockley Dene Residential Rockley Dene Residential J51 S18277 Rockley Dene V241615 070905 UI Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Ground Floor, Unit 3 Waterside Court Bold Street Sheffield, S9 2LR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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