Inspection on 27/04/07 for Rockrose

This inspection was carried out on 27th April 2007.

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

Rockrose 25/09/09

Rockrose 07/07/09

Rockrose 10/02/09

Rockrose 12/02/08

Rockrose 02/06/06

Rockrose 21/10/05

Rockrose 03/06/05

Rockrose 01/02/05

Rockrose 02/04/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Rockrose 10 Kingsfield Road Herne Bay Kent CT6 7EA Lead Inspector Nicki Dawson Key Unannounced Inspection 27th April 2007 10:00 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 Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rockrose Address 10 Kingsfield Road Herne Bay Kent CT6 7EA 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) 01227 740549 Mr Sookdeo Sawock Miss Uyjayantimala Aubeeluck Miss Uyjayantimala Aubeeluck Care Home 7 Category(ies) of Old age, not falling within any other category registration, with number (7) of places Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Rockrose is a care home, registered to provide accommodation and personal care for 7 older people aged 65 years and over. Currently, 5 older people live in the home. It is owned and managed by Mr Sawock and Miss Aubeeluck, who live on the first floor of the premises. They have been the registered owners / managers of this home since 1998. This is a detached chalet-style property located in a quiet residential area of Broomfield. There is access to public transport close by, with local amenities being situated at a further distance. All the residents’ bedrooms are single occupancy, ground floor rooms, with en-suite facilities. The communal areas consist of a lounge and dining room/ sun lounge. There is an enclosed garden to the rear of the property. The current fees for the service at the time of the visit range from £299 per week. Additional charges are stated in the terms of accommodation. Information on the Home’s services and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User Guide. There is no e-mail address for this home. Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which means that the homeowners did not know that the inspector was going to visit. The inspection started at 10am and took seven hours. The inspection process involved discussion with the home owners (one of whom is the registered manager); a conversation with the agency staff on duty; and conversations with all five residents, in addition to joining them for lunch. Time was also spent examining records, including staff files, residents’ files, and policy and procedure, maintenance and medication records. What the service does well: What has improved since the last inspection? What they could do better: Written records are not kept of all medications that are given to residents. This potentially places residents at risk of receiving the wrong medication. The home is required to immediately address this concern. The home could be more proactive in making sure that all residents receive dental care. If costs are involved they need to seek resident’s wishes and clearly record these in their plan of care. The homeowners need to make sure that they keep up to date with current employment practices. If they do not apply the right checks before they employ staff, they potentially put residents at risk of abuse. Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 Page 6 There should be a clear written record of all training undertaken and all training that is planned in the future. This is to make sure that people who give direct care to the residents’ keep up to date with current care practices. The home’s quality assurance programme needs to be developed further to make sure that the home is run in the best interests of the people who live there. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 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 Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents have all the information they need to choose whether to live at the home. Each new resident’s needs are assessed before moving to the home and they are given a contract clearly setting out the terms and conditions of their stay. EVIDENCE: The home has a ‘statement of purpose’ that sets out the aims, objectives and philosophy of the home, together with the services and facilities provided for residents. The ‘service user’s guide’, clearly sets out for residents, the services and facilities that they can expect if they move to the home. It contains some pictures of the home and is printed in large, well spaced out lettering to aid people with visual difficulties. The homeowners explained that the home fees Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 Page 9 are subject to change and are therefore not currently included in the document. A contract covering the terms and conditions of residency is in place. It has been changed to include what is and what is not covered in the weekly residential fee. This is helpful to new residents. The resident and their representative sign a copy of the contract. For residents who are admitted to the home through social services, a joint care management assessment is obtained. The home also completes a brief assessment. The homeowners explained that if the resident were placed privately a more detailed assessment of the potential resident would be carried out. All residents are admitted with the first 4 weeks of the placement being on a trial basis. Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are treated with respect and their care needs are recorded. Not all residents’ health care needs are met and medication practices potentially put residents at risk of being given the wrong medication. EVIDENCE: Care plans contain resident’s health, personal and social care needs. They have been developed since the last key inspection to include a small amount of information on resident’s emotional needs and domestic needs. Not all resident’s care plans contain a photograph of the resident as is required by the regulations. The homeowners agreed to make sure that all files contain a photograph of the resident. A relative said that they understand their relatives care plan. They said that if there are any changes in their relatives care needs, they can talk to the Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 Page 11 homeowners and any necessary changes will be made. An agency member of staff said that she had not viewed resident’s care plans. However, she said that the homeowners were good at communicating the resident’s needs to her. Indeed, she did have a good understanding of the resident’s care needs. It is hoped that when the home employ permanent staff, the care staff will use care plans on a daily basis to guide them in how to care for the residents at the home. Care staff said that the homeowners respond quickly to any changes in residents’ health. A relative said that she takes her relative to all her health care appointments, but the home would do this for her relative if she were unable. There is a form in each resident’s file to record when a resident has an appointment with a health care professional. The homeowners explained that because they have not been able to access a NHS dentist for new residents, residents do not have regular dental check ups. The homeowners agreed to support all residents to receive regular dental checkups either through the NHS or privately. And that if residents do not wish to pay for dental care, this choice will be noted in their care plan. The safety of one resident is at risk due to the homeowners not keeping a record of the medication that is given to her. It is required that the home take immediate action to make sure that a record is kept of all medicines administered to all residents. The home’s medication cupboard is disorganised. It contains medication for two residents that have left the home over 6 months ago and surplus medication for one resident. This should have been returned to the pharmacist. The medication policy states that resident’s are supported to take their own medication. However, this contradicts the resident contract that states that the home administers all resident’s medication. The home owners agreed to review the resident contract to ensure that it does promotes resident’s rights and abilities. It was observed throughout the inspection and confirmed by a relative that residents are treated with dignity and respect in this home. When a resident wanted to speak to the homeowner, the homeowner replied yes, she would speak to the resident in her own room Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s are generally content with their lifestyles. Their choices are usually promoted, they enjoy their meals and they are able to keep in contact with family and friends. EVIDENCE: Residents said that they are able to follow their own routine and rise and go to bed when they choose. The majority of residents said that they were happy to spend their day in their room, or chatting and watching television in the lounge. One resident stated that she would not like to go out on any trips organised by the home, but another said that, “there is not much to do here”. The homeowners stated that the residents’ benefit greatly from chatting with staff and it was observed that small conversations took place each time a member of staff walked into the lounge. A relative described the home as, “small and friendly”. Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 Page 13 There is a notice on the front door that states that residents resting time is between 1.30 and 3.30pm, but a visitor did call and said that they could do so at any reasonable time. Residents have access to a telephone. Residents are supported to make choices. The exception is with regard to selfadministration of medication and the home owners agreed to review this to promote resident choice. (see health and personal care section) The inspector was invited to lunch with the residents. Lunchtimes are relaxed and music is played to add to the atmosphere. All the residents enjoyed their meals. Residents said that if they do not like what is for dinner that day and alternative is offered. Records are kept of all food provided to residents and a healthy and varied diet is offered. Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Resident’s and relatives are confident that their complaints will be listened to and acted upon. All staff need to receive training in adult protection to ensure that the residents are adequately protected from abuse. EVIDENCE: The home has updated their complaints policy, which is a clear and comprehensive document. A record of complaints is maintained together with the action taken to remedy the complaint. The home has received one complaint since the last key inspection, which was dealt with appropriately. There have been no complaints made to the CSCI. Relatives and staff said that the homeowners were easy to approach if they had any concerns or worries. One resident said, “I was told all about how to make a complaint when I came to the home”. The home has a policy on safeguarding adults, which contains types of abuse and possible indicators as well as monitoring and prevention measures. There is a checklist of action to take if abuse is suspected or evidence is found, which Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 Page 15 states that CSCI is the main agency to contact. The policy needs to reflect that social services are the lead agency in any suspicion of abuse. The homeowners agreed to add this to the policy. The home also has a copy of the latest Kent and Medway protocol to ensure a timely and co-ordinated approach. The home also has a policy on whistle blowing. Staff records show that only one of the homeowners has attended training in safeguarding adult protection. It is required that all staff have a through understanding of safeguarding adults. Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s live in a safe and comfortable home. EVIDENCE: All areas of the home are homely, comfortable and clean. The furniture is domestic in style and there are homely touches throughout. All bedrooms, bathroom, WC and communal areas have accessible call bells. The rear garden area provides a pleasant and private area to walk or sit in and residents said that they gained pleasure from it. The home has a “No Smoking” policy, which is clearly stated in the contract. There is a lounge and conservatory, with a ramp and handrail to the rear garden. Each area has a TV and either a radio or video so that residents have a choice, and there is a range of seating, to meet residents’ individual needs Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 Page 17 and preferences. There is also a dining area, with tables arranged to enable residents to sit as a group or alone. The bathroom is sited on the ground floor and has an integral shower attachment so that residents have a choice, plus a hoist and grab rails. It was observed that the bathroom lock did not work. The homeowner agreed to ask the maintenance man to fix this to ensure resident’s privacy. Residents and relatives stated that they were pleased with their rooms and particularly liked the en-suite facilities available with all rooms. Each bedroom has an en-suite WC and hand-basin. This clearly ensures these facilities are readily accessible to them and that privacy is assured. All bedroom doors have magnetic door closers linked to the fire alarm system, so that they can be left open to suit individual preferences but will slam shut when the fire alarm is activated. Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 29 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. An effective staff team, meet the residents’ needs. Residents are not protected by the home’s recruitment practices. EVIDENCE: Both homeowners live at the home and are involved in the direct care of the residents. There is also an agency member of staff who works flexible shifts. She has worked at the home on and off for the past eight years. There is also a handyman who works from 9.30am till 12.30 every weekday. Residents’ comments were very positive about the support that they receive from staff. One resident said that, “the staff are kind and helpful. It is a friendly home. Another said, “you only have to ask and they will do it for you”. It is pleasing that the homeowners are in the process of recruiting two permanent members of staff. However, the homeowners are not up to date with all the checks that must be made on care staff before they can be employed at the home. They were advised and sent the relevant information to ensure that residents’ are protected by the home’s recruitment practices. Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32, 33 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from an approachable home manager. The home needs to develop its quality assurance system to ensure that the home is run in the best interests of the residents who live there. Staff need to be trained in all areas to ensure that the health, safety and welfare of residents is promoted and protected at all times. Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 Page 20 EVIDENCE: Rita Aubeeluck is the registered manager. She is a RGN and has successfully completed her Registered Managers Award. She keeps up to date with current practices by undertaking a range of training. Both homeowners live on site and are actively involved in the day-to-day care of the residents. This means that there is a shared and visible line of accountability; and staff, residents and relatives always know who to talk to. Residents, relatives and staff said that both homeowners were very approachable. The home is required to seek the views of residents, their relatives and other stakeholders in the community to make sure that the home is run in the best interests of the residents. This is called a quality assurance system. The registered manager has attended training on quality assurance. She has sought the views of residents in the form of an annual questionnaire and has a book for recording the comments of relatives and other professionals. This information needs to be expanded and used with the any complaints received to form an annual summary about the quality of care at the home. The homeowners agreed to do this. The arrangements for managing residents’ finances were not inspected on this occasion, as families and other parties outside the home’s control have responsibility for this. Since both the home owners are involved in the direct care of residents they need to keep up to date with training in a number of essential areas. This has not occurred, although some training has been undertaken since the last inspection. The homeowners said that they were planning training but gave no definite dates. This is also what was said at the last key inspection. It is recommended that the homeowners write a training plan for themselves with timescales to ensure that training in all statutory areas is undertaken. The home keeps up to date with the maintenance of all essential services and equipment. Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 3 X 3 X X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X X X X 2 Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 (2) Requirement When medication is administered to residents it must be clearly recorded. This will ensure that people receive the correct levels of medication. This is an immediate requirement. All staff must have an understanding of safeguarding adults, through training or other measures, to prevent residents being placed at risk of harm or abuse Before a new member of staff is employed an appropriate crb/pova check must be obtained to ensure the safety of residents. Lifting training must be provided for all staff that work with people that have been assessed as having difficulty in moving themselves Fire training must be provided to all people that work in the home to ensure that they know what to do in the event of a fire Timescale for action 27/04/07 2 OP18 13 (6) 27/10/07 3 OP29 19 schedule 2 (7) 14 (8) 27/05/07 4 OP38 27/10/07 5 OP38 23 (4) d 27/10/07 Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 Page 23 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 OP1 OP38 Good Practice Recommendations The service user guide should contain the range of possible fee prices A training plan should be developed to record past and planned training to make sure that staff are trained in all essential areas Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rockrose DS0000023526.V339008.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!