Random inspection report
Care homes for older people
Name: Address: Rockrose 10 Kingsfield Road Herne Bay Kent CT6 7EA two star good service 10/02/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Eamonn Kelly Date: 0 7 0 7 2 0 0 9 Information about the care home
Name of care home: Address: Rockrose 10 Kingsfield Road Herne Bay Kent CT6 7EA 01227740549 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Sookdeo Sawock,Miss Uyjayantimala Aubeeluck care home 7 Number of places (if applicable): Under 65 Over 65 7 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 7 The registered person may provide the following category/ies of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Rockrose provides support for up to 7 people. Currently, the registered providers live on the first floor of the premises. There is good access to public transport and car parking is available at the front. Residents bedrooms are single occupancy and are all ground floor rooms with en-suite facilities. Residents have access to two lounge areas and to a garden that is suitable for use by frail people. Information about weekly fees
Care Homes for Older People Page 2 of 10 1 0 0 2 2 0 0 9 Brief description of the care home and other charges is available from the registered providers and information about services and facilities is contained in the guide to the service. Care Homes for Older People Page 3 of 10 What we found:
The Commission received reports from Kent Social Services about concerns for residents at the home. A representative of the Commission attended a case conference chaired by the Safeguarding Adults Co-ordinator. The Commission received reports following an inspection by contracting officers and a copy of a letter to the providers from KCCs Contracts Manager advising that there was a suspension of referrals now in place. This means that, due to concerns by the local authority about the levels of support in place for residents, the service is unable to admit new clients funded by a local authority. A visit to the service was made by a CQC inspector on 7th July 2009. This comprised meetings with the owners, a carer, a volunteer and three residents. The fourth resident was attending hospital as a day patient at the time. The main purpose of the visit was to discuss the providers financial and business plan with them. Some of the issues arising from Kent County Council reports were discussed. Mr Sawock re-iterated that both he and Miss Aubeeluck are experiencing great personal pressures because of the health requirements of residents and the difficulties in addressing these. In particular, the constant attention needed by one resident who is doubly incontinent is taking its toll on the providers. Both providers referred to the continuing and mounting pressures and the long hours they work. As a result of the nursing requirements of residents, Mr Sawock felt that both providers remain unable to focus on administrative matters associated with the support of residents. This included the upkeep of residents support records and recorded risk assessments. These, he said, must remain less important than the direct care and nursing of residents. They said they know that current care regulations and national minimum standards place a duty on registered providers to be able to demonstrate financial viability and to be able to ensure there is effective and efficient management of the home. They referred to their decision to focus on direct care rather than on bureaucratic matters because of the range of pressures on them. Mr Sawock and Miss Aubeeluck provided an outline of the the financial position of the service. Kent County Council advised the Commission that residents are receiving healthcare support and are not at immediate risk. Healthcare agencies are keeping the KCC Safeguarding Vulnerable Adults Co-ordinator and Contracting Officers aware of developments. Relatives and another placement agency are being kept informed by Kent Social Services. The Commission has been advised of steps being taken by KCC regarding the longer term support of clients. These actions are being taken to achieve a higher degree of certainty that residents health and well being is protected. Since the previous CQC inspection, one resident has significantly deteriorated and the reasons for this were discussed during this inspection visit. There is a continuing failure by the providers to maintain the residents personal records to support their care, treatment and support. This is acknowledged by the providers but they do not intend to correct the failure.
Care Homes for Older People Page 4 of 10 Another resident is presenting, according to Mr Sawock, a severe challenge to the providers because of the consequences of double incontinence and accelerating behavioual difficulties. A resident is experiencing a continuing sequence of falls and the onset of dementia is thought to be accelerating. The fourth resident receives regular district nuring support and remains mobile and lucid. All residents are in their mid to late eighties. A carer was on duty at the time of the visit. She said she works Tuesdays and Thursdays only between 9.15am and 1.15pm. Her duties are personal care and cleaning of the premises. The owners rely heavily on the services of agency staff. The evidence for this comes from statements from the owners at a recent case conference and via CQC and KCC Contracting inspections. The owners are currently in conflict with an agency carer who is claiming that she was injured whilst on duty at the premises. Mr Sawock provided an outline of the difficulties this issue is causing. A volunteer buys shopping and, according to a resident, carries out errands for residents and talks to them. There is no CRB (criminal records bureau) in place for the volunteer. Mr Sawock undertook to address this without delay. Mr Sawock and Miss Aubeeluck said they are aware of the need to have a staff group in place in the event of achieving near or full occupancy. However, as the intention is to sell the business, they do not intend to recruit or train new staff. Miss Aubeeluck said that she attended a KCC seminar on the Mental Capacity Act recently. The providers said they are aware they are not meeting a number of care home regulations and national minimum standards. The KCC contracts manager advised the service in writing on 7th July 2009 of breaches to KCCs contractual specification. These are deemed to be of a sufficiently serious nature that a Poor Practice Level 3 Contracts Warning Flag has been applied to the contract. This means that:Contractual specification concerns are being investigated and there is evidence that the service provider is in breach of the contract specification. The evidence is that the providers do not intend to address the causes of the breaches to local authority contractual specifications. Mr Sawock stated unequivocally during the inspection that records required by law cannot be maintained because of the need to concentrate all available hours and effort on direct care. This could have poor consequences for residents. For example, where the direct care of a resident involved analysis of important information about food and fluid intake essential records did not show this information. Contracting officers have, over a long period of time, mentored the providers on how to carry out this work. The providers continue to fail to carry out this essential part of the work for supporting vulnerable people in their care. What the care home does well:
The premises are well maintained. Care Homes for Older People Page 5 of 10 The owners are both qualified nurses. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 10 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 34 25 The registered provider must 04/09/2009 ensure that the care home is financially viable for the purpose of achieving the aims and objectives set out in its Statement of Purpose. The registered provider is asked to supply to the Commission a copy of its accounts and a copy of its current businees plan. People using the service are unlikely to be confident that the service provider is able to meet the obligations and liabilities of the service. This is because providers who are compliant with the law will have the financial resources needed to provide the services as described in the Statement of Purpose. The regulation requires providers to maintain a financial position that allows them to to deliver the regulated activity in a way that meets registration requirements. Care Homes for Older People Page 8 of 10 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 2 37 17 The registered providers 04/09/2009 must keep accurate personalised care, treatment and support records for each person who uses the service. People using the service are unlikely to be confident that their personal records are maintained to support their care, treatment and support. This is because providers who are compliant with the law will keep accurate personalised care, treatment and support records for each person who uses the service. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 10 of 10 - 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!
