Inspection on 26/05/09 for Rodney House

This inspection was carried out on 26th May 2009.

CQC found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rodney House 15/07/09

Rodney House 23/02/09

Rodney House 26/02/08

Rodney House 05/06/06

Rodney House 25/10/05

Rodney House 06/01/05

Rodney House 19/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 10/07/2009.

Random inspection report Care homes for older people Name: Address: Rodney House 4-6 Canning Street Liverpool Merseyside L8 7NP one star adequate service 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: Simon Hill Date: 2 6 0 5 2 0 0 9 Information about the care home Name of care home: Address: Rodney House 4-6 Canning Street Liverpool Merseyside L8 7NP 01517093883 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) : EBS Services Ltd care home 56 Number of places (if applicable): Under 65 Over 65 0 53 0 mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Conditions of registration: 28 0 2 2 named males and 1 named female service user under 52 years of age within the overall number of 56 No more than 56 persons shall be accommodated at any one time. One named service user in the category Mental Disorder, excluding learning disability or dementia under 52 years old may be accommodated Date of last inspection Brief description of the care home Rodney House is a large former hotel, situated in a conservation area close to Liverpool city centre. Both of Liverpools cathedrals, shops, libraries and museums are Care Homes for Older People Page 2 of 17 Brief description of the care home within walking distance of the home. Accommodation is provided in single rooms (56), on three floors with lift and stair access. There are two lounges and a designated smoking room on the ground floor with dining rooms situated on the ground floor and the basement area. On street parking is limited. Rodney House is registered to provide care and support to older people. Many of the service users are self-caring, though they need support and reminding to maintain personal standards of health and hygiene. A copy of the most recent inspection report by the Care Quality Commission is available from the manager. The current scale of weekly charges is 270.00 to 390.00 Care Homes for Older People Page 3 of 17 What we found: We carried out this visit to make sure medicines were being handled safely. The inspection was carried out by a pharmacist inspector and it lasted eight hours. We checked a sample of medicines records, medicines stock and peoples care plans. Overall we found some shortfalls in the way medicines were being handled that were placing the health and wellbeing of people at unnecessary risk. When we checked the medicines records against medicines stock we found a clear system of stock control that made checking medicines simple and easy to do, stock was usually recorded correctly on receipt into the home, as were medicines disposed of. However, we found numerous medicines were not given to people. Of the records we checked we found at least ninety-two doses of medicines were missed in the last month for fourteen people because their medicines were not available to give. The manager and owner both explained that they had just started using a new pharmacy and there had been some problems obtaining a continuous supply. We found one person went without their medicine used to control epilepsy for two days, two people went without some strong medicines to help with their mental health problems for 8 days and other people missed medicines such as inhalers for asthma, medicines to control excessive stomach acid, vitamin supplements and painkillers. Going without prescribed medicines can seriously affect a persons health and wellbeing. We checked a sample of the medicines records and found numerous medicines were not given to people because they had been refused or staff had not given them because that person had been drinking alcohol. When we checked the records of these people we found their care plans had little information about how these issues were to be safely managed, which means some medicines might be unnecessarily omitted. We also found that when medicines were refused staff did not always attempt to give them at a later time. Going without medicines can seriously affect a persons health and wellbeing. We looked at a further sample of care plans and records to check if medicines were properly reflected in them. Several people that were prescribed when required medicines did not have any information about how and under what circumstances they should be given. One person that was being given a medicine used to help anxiety had no written guidance about how it should be used. We gave some advice to the manager and the owner about these issues because having clear written plans helps make sure people get their medicines when they need them. We looked at how people were supported to look after their medicines and found the paperwork was incomplete. No risk assessments had been carried out and care plans did not have any information about how people were to be supported. One person that we spoke with was looking after one of their own medicines but when we checked their medicines records and care plan we found no information about this. Having up to date care plans helps make sure people receive the right amount of support to manage their medicines safely. We checked how controlled drugs (medicines that can be misused) were handled. A cupboard was used for storage but this was not suitable and was not properly attached to the wall so it did not meet the requirements of the law. A special register was used for Care Homes for Older People Page 4 of 17 record keeping and the entries we checked were usually witnessed, accurate and complete. Witnessed records and secure storage of controlled drugs help prevent mishandling and misuse. We looked at how staff were trained and how medicines were checked. We saw no formal recorded audits (checks of the medicines) although we did see some paperwork that the manager was planning to use. The manager said staff had received regular medicines training and their competency in handling medicines had been formally assessed. We gave some advice about how medicines should be handled and how to improve the audits to help make sure medicines are given to people correctly and to help make sure staff have the necessary skills. What the care home does well: 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 5 of 17 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 1 6 The statement of purpose 30/05/2008 must accurately reflect the services and facilities being provided at Rodney House. With particular regard to the service user categories. 2 1 4 The statement of purpose 14/05/2009 must accurately reflect the range of needs that Rodney House is intended to meet and the services and facilities to be provided. This is to ensure prospective service users, their relatives or supporters can have sufficient information on which to make an informed choice/decision. 3 3 14 A full assessment of needs must be undertaken prior to an offer of placement being made to a prospective service user. This is to ensure Rodney House is confident it can meet the identified needs and lifestyle choices of a prospective service users and that they do not have a negative impact on the 30/04/2009 Care Homes for Older People Page 6 of 17 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 people already living at the home. 4 3 14 Prior to admission to Rodney 30/04/2008 House a full assessment of needs must be carried out. This is to ensure the staff team posses the skills and experience to support them with the individual needs. 5 4 14 Where specialist care needs 30/04/2009 are idenfied in the assessment process the home must be able to evidence they have the skills and expertise to meet these needs. This is to ensure service users and their representatives have confidence that the home they enter will meet their needs. 6 7 15 Care plans and risk 30/06/2008 assessments must be produced in consultation with residents, other professionals and where appropriate their representatives that accurately reflect their holistic needs. This is to ensure a person centred approach to an individuals care needs is adopted rather than a generalised approach to their care. Care Homes for Older People Page 7 of 17 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 7 7 15 Care plans must accurately 01/06/2009 reflect the care needs of service users and provide detailed information to enable the staff team to support them effectively and safely. This is to ensure service users needs are met in a safe and supportive manner. 8 8 12 Service users health care needs must be effectively supported and monitored. With health care professionals advice and input sought when changes in health or mental well being are observed. This is to ensure service users health and well being is promoted and maintained by the care practices of the home. 30/04/2009 9 9 13 Medication procedures must effectively safeguard residents ensuring they receive their prescribed medication at the stated times and intervals. Service users medication must be administered in accordance with the the prescribers instructions. If medication is refused or omitted detailed records must be kept and medical advice sourght. 30/04/2008 10 9 13 30/04/2009 Care Homes for Older People Page 8 of 17 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 This is to ensure service users healthcare conditions are being effectively treated. 11 10 12 Service users must where 15/06/2009 practicable be involved in the drawing up of their care plans. This is to ensure service users wishes and needs with regard to how they are supported with their personal care is met. 12 12 16 A programme of activities to 30/06/2008 promote residents mental, emotional, intellectual and physical wellbeing must be provided. This is to ensure residents are offered a range of options to engage in positive social activities. 13 12 16 A varied programme of activities must be provided. This is to ensure service users are able to engage in meaningful activities and build positive relationships within the home community to support them to maintain their emotional and mental well being. 29/05/2009 14 12 12(4)(b) Staff members employed at 30/05/2008 Rodney House must be provided with a basic understanding of the cultural needs and historical events that have impacted on Page 9 of 17 Care Homes for Older People 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 residents? lives. This is to ensure the staff team have the skills and knowledge to engage with residents in all aspects of their lives. 15 14 12 The challenging behaviours of some service users must not continue to have a negative impact on the quality of life of the remaining service users. This is to ensure each service users rights to exercise choice and control over their lives is respected and valued. 25/05/2009 16 15 16 Nutritional supplements must 27/04/2009 be given as directed by healthcare professionals This is to ensure service users nutritional needs are supported and monitored effectively to maintain their health and general wellbeing. 17 18 13 If physical restraint is to be used on service users a detailed support plan must be produced and the staff team must receive appropriate training. This is to ensure service users safety and legal rights are protected at all times. 30/04/2009 18 18 13 The staff team must be provided with suitable conflict resolution training 29/06/2009 Care Homes for Older People Page 10 of 17 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 and protection of vulnerable adults training. This is to ensure they have the necessary skills and knowledge to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. 19 19 23 A detailed risk assessment 29/05/2009 must be carried out to ensure a safe environment is maintained. Particularly with regard to damaged windows, tripping hazards and damaged plasterwork around the home. This is to ensure service users live in a comfortable and safe environment that meets their assessed needs. 20 20 23 Seating in the lounge areas should be in sufficient numbers to meet the needs of the service user group. This is to ensure there are opportunities for service users to spend time together if they so choose. 21 22 23 service users must be supported to be able to independently access the entance of the home or an alternative access must be made available. This is to ensure service users can independently Care Homes for Older People Page 11 of 17 30/06/2009 20/07/2009 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 access the community when they choose. 22 25 23 The temperature in all areas of the home must be maintained at a comfortable temperature. This is to ensure service users health and welfare is maintained by living in an environment that is warm and comfortable. 23 27 18 Staff members employed by the home must have the skills and expertise to support service users appropriately and safely. Particularly with regard to the use of physical intervention and conflict resolution training. This is to ensure service users are supported in a safe and supportive manner and results in positive outcomes in their daily lives. 24 27 18 The training programme for 30/07/2008 the staff team must be reviewed. To ensure they have the knowledge and skills to support residents with more specialised needs such as alcohol dependency, cognitive impairment and learning disabilities. 22/06/2009 20/04/2009 25 28 18 A detailed training plan must 18/05/2009 be produced, which ensures Page 12 of 17 Care Homes for Older People 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 the identified health and social care needs of service users can be met. This is to ensure service users assessed individual needs can be met by a competent and skilled staff team. 26 30 18 The induction programme must be reviewed. This is to ensure service users are supported by a staff team who are confident they know how to support service users and are aware of their responsibilites as a care worker. 27 30 18 The induction programme currently used must be reviewed to ensure more detailed information is provided about residents? needs and key policies and procedures such as safeguarding and equality and diversity issues. A review of the quality assurance systems in operation must take place. This is to ensure service users, their families and other stakeholders views of the service provided at the home are actively sought. So that changes and improvements made reflect their needs and aspirations. Care Homes for Older People Page 13 of 17 29/05/2009 30/07/2008 28 33 24 29/06/2009 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 interests 29 38 12 Safe working practices must 20/04/2009 be adopted at all times. Particularly with regard to maintaining records of safety checks such as fire safety records. This is to ensure service users health and safety is maintained at all times. Care Homes for Older People Page 14 of 17 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 9 13 An effective system of medicines auditing must be developed. This will help make sure medicines are handled safely. 30/06/2009 2 9 13 For people that look after their own medicines a regularly reviewed written risk assessment and care plan must be developed. This will help make sure they receive the right amount of support from staff to do it safely. 30/06/2009 3 9 15 Peoples care plans must contain sufficient detail, information and instructions to staff about how to meet each persons health and welfare needs. This will help make sure their health and wellbeing is protected. 30/06/2009 4 9 13 Controlled drugs (medicines 27/08/2009 Page 15 of 17 Care Homes for Older People 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 that can be misused) must be stored in a legally compliant controlled drug cupboard. This will help prevent mishandling and misuse 5 9 13 Medicines must be given to people as prescribed and must not be allowed to run out of stock. This is important because missing medicines can seriously affect a persons health and wellbeing. 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 30/06/2009 Care Homes for Older People Page 16 of 17 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). 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