Inspection on 05/12/05 for Rockliffe House

This inspection was carried out on 5th December 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Rockliffe House 08/12/08

Rockliffe House 13/12/07

Rockliffe House 23/01/07

Rockliffe House 07/06/05

Rockliffe House 12/10/04

Rockliffe House 06/05/04

Rockliffe House 19/03/04

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

CARE HOMES FOR OLDER PEOPLE Rockliffe House 466 Beverley Road Kingston upon Hull East Yorkshire HU5 1NF Lead Inspector Angela Sizer Unannounced Inspection 5th December 2005 09:00 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 Rockliffe House DS0000046755.V263707.R01.S.doc Version 5.0 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. Rockliffe House DS0000046755.V263707.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Rockliffe House Address 466 Beverley Road Kingston upon Hull East Yorkshire HU5 1NF 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) 01482 342906 Joanne Marie Bush Jean Susan Goodwin Joanne Marie Bush Care Home 21 Category(ies) of Sensory impairment (21), Sensory Impairment registration, with number over 65 years of age (21) of places Rockliffe House DS0000046755.V263707.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th June 2005 Brief Description of the Service: Rockliffe House is owned by Rockliffe House Limited, it is a small family business that only owns the one care home. Rockliffe House is registered for up to 21 people of either gender providing personal care and accommodation for both younger adults and older persons with a visual impairment. The majority of the residents are older persons, some of whom have been residing in the home for a number of years. Rockliffe House is on Beverley Road approximately 1½ miles from Hull city centre. It benefits from being sited by HERIB’s headquarters, which provides support and a day centre that Rockliffe’s residents attend. Nearby are local shops, pubs and churches. The home is on major bus routes into Hull. Accommodation is on three floors with 6 double and 9 single rooms. Communal space consists of a 3 different lounges and a separate dining room. There is an enclosed patio/garden area to the side of the home. The home has a passenger lift and there is a small parking area to the front. Rockliffe House DS0000046755.V263707.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and lasted for 6 hours, prior to the visit 2 hours work was carried out in preparation. A tour of the building was undertaken, records were looked at including staff and residents files. Some of the residents and one staff member were spoken to throughout the course of the day to find out what it was like for people who live here. The registered manager and deputy manager who are also the registered providers were present throughout the inspection and was told how the inspection had gone at the end of the day. The inspector would like to thank the residents, management and staff for welcoming her into their home and contributing to the content of this report. What the service does well: What has improved since the last inspection? Some of the paperwork has improved a great deal and this ensures that the resident’s needs are recorded and that they receive what help they need. Rockliffe House DS0000046755.V263707.R01.S.doc Version 5.0 Page 6 The environment continues to be improved and the home is a nicer place for the residents to live in. 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. Rockliffe House DS0000046755.V263707.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Rockliffe House DS0000046755.V263707.R01.S.doc Version 5.0 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 the following standard(s): 2&5 Information is given to the residents to ensure that they can make an informed choice about where to live. Each resident is given a contract or terms and conditions this does not fully inform the person of the care offered or what is included in the fee. EVIDENCE: It was clear from speaking to the residents that they are given information about the home either prior to or shortly after admission. One person who was staying at the home on a respite basis stated that he wished to move in permanently, “I came for two weeks, but have really settled and I want to move in now on a permanent basis”. He explained that he was able to visit the home prior to his admission and that he had decided upon Rockliffe because it had “a very nice atmosphere”. Each resident is given a contract that details the terms and conditions of their stay, this requires further attention in order to fully meet standard 2 and should include the overall care and services (including food) covered by the fee Rockliffe House DS0000046755.V263707.R01.S.doc Version 5.0 Page 9 and any additional services to be paid for over and above those included in the fee. Rockliffe House DS0000046755.V263707.R01.S.doc Version 5.0 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 the following standard(s): 9 & 11 The home has a medication procedure, but this is not always followed and therefore could pose a risk to the residents’ health. The home deals with the death and dying of residents in an appropriate way ensuring that dignity and respect is maintained. EVIDENCE: The home has a medication policy and procedure in place and operates a monitored dosage system, therefore most of the medication is clearly marked with the person’s details and the day and date to be given. Unfortunately from checking the medication administration charts not all of them correlated to the medication stock available and this could pose a risk to the residents health. All staff have received thorough training from Selby College with regard to the safe administration of medication, this course was accredited. All new employees must also undertake accredited medication training. The pharmacist visits on a regular basis and undertakes an audit of the medication system. There is a homely remedies policy that had been agreed with a local GP and includes the provision of paracetamol, lactulose, eardrops and vicks rub. Rockliffe House DS0000046755.V263707.R01.S.doc Version 5.0 Page 11 The home had suffered a recent death of a resident and from speaking to a staff member she confirmed that the management had supported staff members following this death. She said, “all staff offer support in a caring and respectful way and treat people as they would want to be treated”. She also demonstrated a good awareness of the needs of someone who is terminally ill or dying. Many of the staff have also undertaken loss and bereavement training. Rockliffe House DS0000046755.V263707.R01.S.doc Version 5.0 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 the following standard(s): 15 Residents are offered a healthy, nutritious and varied diet. The food is of a good quality and plentiful. EVIDENCE: From speaking to the residents it was clear that a wholesome and varied diet was offered. Several of the residents commented about the high standard of food, “the food is very good”, “I always have seconds and a pudding”, “there is always a choice”. Lunch on the day of the inspection was pork casserole or steak and vegetables followed by bananas and custard or jam sponge and custard. Staff were observed to support and assist where necessary, whilst maintaining independence for the residents. A recent Environmental Health Department visit did not raise any issues, the report has not yet been received. Rockliffe House DS0000046755.V263707.R01.S.doc Version 5.0 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 the following standard(s): 16,17,18 Minor attention is needed with regard to the procedure for dealing with complaints and training in relation to the protection of vulnerable adults would enhance the protection already offered to residents. EVIDENCE: The home has a complaints policy and procedure in place. Each resident has a complaints form in their individual file and these are completed if there are any complaints or issues. The procedure does not state a timescale of 28 days, but staff and residents are aware of what to do if there is a complaint made. One resident stated, “I would tell one of the staff or Jean or Joanne, I know they would help me sort any problems out”. There have been no complaints since the last inspection. There is a multi-agency Protection of Vulnerable Adults procedure manual and the home has developed it’s own procedure that includes whistle blowing. The manager and deputy manager have attended the training course and two other staff members are booked on to undertake the training. The remaining staff members will need to undertake further training as currently the basic induction programme does not cover the protection of vulnerable adults. One staff member was spoken to and demonstrated an awareness of abuse and what the procedure would be in reporting any such abuse. All staff are checked via the Criminal Records Bureau and a record of this was held on individual files. Rockliffe House DS0000046755.V263707.R01.S.doc Version 5.0 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 the following standard(s): 19,21,22,23,24,25,26 The registered providers have made further progress with regard to the upgrading of the decoration and fabrication of the building. To ensure that residents live in a homely and comfortable environment the work needs completing for all the facilities within the home. EVIDENCE: Over the past year the registered providers have made great improvements to the overall presentation of the building. Unfortunately, due to the size of this large Victorian house there are some areas still requiring attention. The registered providers stated that they have undertaken a full audit of the building and allocated a budget for repairs, redecoration and renewal and over a period of time and are determined to upgrade all areas. The majority of the furniture in communal areas has been replaced, there are new curtains to the downstairs communal lounges, hallway, landing and some bedrooms. Some of the residents have received new beds, bedding, headboards, wardrobes, drawers and coffee tables. The registered providers should be commended in this report for the improvements made to the environment. Rockliffe House DS0000046755.V263707.R01.S.doc Version 5.0 Page 15 A tour of the building was undertaken, the home was well presented in all areas and hygienic with no malodours detected. The male toilets downstairs still require a lock fitting and tiles to be replaced, following a discussion with the registered providers it was clear that they have plans to change the usage of these toilets into an office and would re-locate the toilets upstairs, further discussion with CSCI will need to take place prior to any planning permission being sought. The registered providers also discussed some plans to change the current staff room into a single bedroom and an upstairs unused staff bedroom into a single bedroom, again this will require further discussion with CSCI. The three communal lounges all require new carpets as these are very worn in places and could pose a risk of falling/tripping to all of the residents who have little or no sight. The downstairs front lounge also requires redecoration. The home has been assessed by an occupational therapist and has a variety of aids and adaptations in place for staff to use. There are two hoists, one for downstairs and one for the first floor. Individual rooms are personalised, safe and comfortable and residents are able to bring into the home their own possessions. Rockliffe House DS0000046755.V263707.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 & 29 The residents are not supported and protected by a robust recruitment practice exposing them to some risk of poor care. EVIDENCE: Staffing levels have been maintained to the basic figure agreed by the CSCI. The home employs 13 care staff, only 1 person has achieved NVQ level 2, the remainder of the staff group have commenced the NVQ training and hopefully will complete this by February 2006. The staffing files examined were deficient in that they did not all contain 2 references, contact not having been made with previous employers in the care business and no health declaration having been made. Staff spoken to confirmed that they did have a CRB check in place prior to commencing employment. Rockliffe House DS0000046755.V263707.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,36 & 38 The management of the home is carried out with leadership and appropriate guidance; ensuring residents receive a quality of care, which is consistent. A resident centred ethos is promoted within the home. Supervision is offered to staff, but not on a regular basis. The health and safety of the residents is not always ensured. EVIDENCE: Since the last inspection some of the work place risk assessment documentation has been improved, but further amendment is required to clearly detail all specific hazards and how the risk can be reduced or managed. The home does have a fire risk assessment in place, there is a fire policy and procedure and staff have identified roles in monitoring the equipment on a regular basis, fire tests are carried out weekly and a full fire drill occurs twice a year. Portable appliance testing has now been carried out and the appropriate Rockliffe House DS0000046755.V263707.R01.S.doc Version 5.0 Page 18 documentation was in place confirming this. Fire training is offered to all staff on an annual basis. From inspection of staff files there was no evidence to confirm that training had taken place and where staff have undertaken training with a different care provider then certification or written evidence of any training must be provided. The home offers a basic induction programme and usually within 6 months of employment all of the mandatory training courses would be undertaken including fire safety, health and safety, first aid, infection control, moving and handling and basic food hygiene. The majority of the staff group have not undertaken any training with regard to the Protection of Vulnerable Adults. The Environmental Health Department carried out a visit recently, the manager stated that no concerns were raised and the home has not received the report as yet. Both the manager and the deputy manager have achieved NVQ level 4 in both Care and Management. It was clear from speaking to staff that both informal and formal supervision is offered to them, unfortunately from inspection of records this was found not to be on a regular basis. The written documentation covered a variety of areas including key worker role and responsibility, training and personal development. Rockliffe House DS0000046755.V263707.R01.S.doc Version 5.0 Page 19 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 X 2 X 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 3 18 3 2 X 2 3 3 3 3 3 STAFFING Standard No Score 27 X 28 2 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X 2 X 2 Rockliffe House DS0000046755.V263707.R01.S.doc Version 5.0 Page 20 Yes 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 OP2 Regulation 5b Requirement The Registered Person must ensure that the statement of terms and conditions includes the overall care and services (including food) covered by the fee and any additional services not covered by the fee. (Previous timescale 12/02/05 not met) The registered person must ensure that the medication procedure is followed and recording improved. The registered person must ensure that the complaints procedure includes a 28 timescale for dealing with complaints. (Previous timescale not met – 1/9/05) The registered person must ensure that all staff undertake training with regard to the Protection of Vulnerable Adults. The registered person must ensure that the recruitment procedure is robust and obtain the following information in respect of persons working in the DS0000046755.V263707.R01.S.doc Timescale for action 05/02/06 2 OP9 13,17 05/02/06 3 OP16 12,13,17, 22 05/02/06 4 OP18 12,13,18 05/02/06 5 OP29 17,19 Sched 23,4,8 05/02/06 Rockliffe House Version 5.0 Page 21 6 OP30 17,18 7 OP36 13,17 home; two written references, where a person has previously worked in a care position written verification or the reason why she ceased to work in that position and a statement by the person as to their mental and physical health. (Previous timescale not met – 01/07/05) The registered person must ensure that evidence is provided in relation to any training courses attended by staff. The registered person must ensure that regular supervision is offered to staff and evidence of this is recorded. 05/02/06 05/02/06 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 OP19 OP28 OP38 Good Practice Recommendations The registered person should upgrade the male toilet and put locks on the toilet doors and make good the tiling to the walls 50 of all care staff should obtain the NVQ level 2 in care as soon as possible Work place risk assessments require further expansion to include more detail about the prevention and management of risk Rockliffe House DS0000046755.V263707.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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. 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