Inspection on 03/07/07 for Rodwell Farm Nursing Home

This inspection was carried out on 3rd July 2007.

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 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

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Rodwell Farm Nursing Home Row Town Addlestone Surrey KT15 1HH Lead Inspector Mary Williamson Unannounced Inspection 3rd July 2007 10:30 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 Rodwell Farm Nursing Home DS0000069750.V339590.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. Rodwell Farm Nursing Home DS0000069750.V339590.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rodwell Farm Nursing Home Address Row Town Addlestone Surrey KT15 1HH 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) 01932 853371 01932 8273741 grahamcare@msn.com Rodwell Farm Nursing Home Ltd Mrs Karen Susan Raggett Care Home 46 Category(ies) of Dementia - over 65 years of age (0), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (0), Old age, not falling within any other category (0), Physical disability (0) Rodwell Farm Nursing Home DS0000069750.V339590.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing – (N) 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) Physical disability (PD) Mental disorder, excluding learning disability or dementia, over 65 years of age (MD (E)) Dementia, over 65 years of age (DE (E)) The age/age range of the persons accommodated in the (OP), (MD (E)) and (DE (E)) categories may be 60 years and over. The maximum number of service users to be accommodated is 46. 2. 3. Date of last inspection 20/08/2006 Brief Description of the Service: Rodwell Farm Nursing home is registered to provide nursing care for up to forty-six residents. Included in the total beds registered it may also provide nursing care for nine younger residents with a physical disability. The home is located in a semi rural part of Surrey, close to farmland and a residential area. The home has good road links and is within easy driving distance of a number of town centres. It is set in extensive grounds, some of which have been used to create a sensory garden. Rodwell farm provides accommodation in single and shared rooms many of whish have en-suite facilities. There is a wide range of specialist equipment in the home to meet the assessed needs of the residents. Fees range from £536.17 to £895 per week. This does not include newspapers, hairdressing, chiropody, holidays, transport, and arranged outings. Rodwell Farm Nursing Home DS0000069750.V339590.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first site visit of a key inspection and was unannounced. The inspection took place over five and a half hours. Mary Williamson who is a Regulation Inspector undertook the inspection. The Operational Director for the organisation Mrs Hazel Stace was present for most of the inspection and represented the establishment. A tour of the premises was undertaken and a number of records relating to the care of the residents and the management of the home were examined. Discussions were held with several residents both individually and in small groups. They were keen to share their experiences about the home and the feedback and comments were positive and complimentary. It was also possible to talk with the activities coordinator who explained the activities programme and what is available to address individual and collective needs. Staff recruitment and training arrangements were explored and discussion with staff confirmed their knowledge of resident’s needs and various procedures in place. The home has employed a quality consultant who was present during the inspection and demonstrated the systems in place for monitoring quality assurance. The manager completed and submitted an AQAA (Annual Quality Assurance Assessment) electronically prior to the inspection, which was very detailed and informative. Information from this was sampled during the inspection. The Commission for Social Care Inspection would like to thank the residents and staff team for their help and hospitality during this inspection. What the service does well: The home has a good admissions procedure in place ensuring that assessed needs can be met. Care plans are maintained electronically and all staff heve the skills to access these and update them daily. The care and support provided to residents is good and relatives visiting the home also confirmed this. Rodwell Farm Nursing Home DS0000069750.V339590.R01.S.doc Version 5.2 Page 6 Residents exercise choice and control over their daily lives, and cultural and social requirements are included in care pans. The catering arrangements in the home meet the nutritional needs of the residents. Residents commented that, “ the food is good here”. Special diets are catered for, and themed meals are planned. There was a cowboy meal organised for the following day to celebrate Independence Day. Staff are professional and polite, and interact with residents in a positive and caring way. The home is well managed and there is a good management support structure to ensure the efficient administration of the home. What has improved since the last inspection? What they could do better: The home has recognised the need for continuous upgrading of decoration to narrow corridors due to heavy wheelchair traffic. The home also recognises the need to support staff with communication skills where English is not their first language. It was recommended in the content of this report that resident’s photographs should be kept in the medication recording charts to promote safe practice in the administration of medication. Rodwell Farm Nursing Home DS0000069750.V339590.R01.S.doc Version 5.2 Page 7 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. Rodwell Farm Nursing Home DS0000069750.V339590.R01.S.doc Version 5.2 Page 8 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 Rodwell Farm Nursing Home DS0000069750.V339590.R01.S.doc Version 5.2 Page 9 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, 3, and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents have sufficient information available to them in order to make an informed choice about the home. Pre admission needs assessments are in place. The home does not provide intermediate care. EVIDENCE: There is a statement of purpose and service user guide in place, which is available to all prospective residents and their relatives in order that they can make an informed choice about the home. One prospective relative visiting the home said she had been to see several homes and was “made to feel welcome here”, and the information provided was good. Individual pre-admission needs assessments are undertaken on all residents to ensure that specific needs can be met. The manager or the nurse manager undertakes these assessments. Four of these needs assessment were randomly sampled, which were detailed and informative. Whenever possible prospective residents well are encouraged to visit the home, and if this is not possible then relatives will make the choice on their behalf. Rodwell Farm Nursing Home DS0000069750.V339590.R01.S.doc Version 5.2 Page 10 The home does not provide intermediate care. Rodwell Farm Nursing Home DS0000069750.V339590.R01.S.doc Version 5.2 Page 11 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 good. This judgement has been made using available evidence including a visit to this service. Resident’s health, personal, and social care needs are being met as outlined in individual care plans. Privacy and dignity is respected. The medication procedure in place safeguards the residents in the home. EVIDENCE: Computerised care plans are in place for all the residents in the home. These are well written with information gathered from the pre admission needs assessment. Input from the resident whenever possible, and information obtained from relatives. Four care plans were randomly sampled and these are well maintained, and reviewed regularly. All staff have a security password and access these plans daily to update and record information. Staff also have ongoing training in computer skills to help them with report writing and input of information. Risk assessments are also in place and form part of the care plan. These include assessments for manual handling, a falls analysis, nutritional assessments, skin care assessments (Waterlow Score), and an assessment for the use of bedrails. Rodwell Farm Nursing Home DS0000069750.V339590.R01.S.doc Version 5.2 Page 12 The arrangements in place to meet the health care needs of residents are satisfactory. All residents are registered with a local GP. Weekly visits to the home by a GP take place but more frequent visits are arranged when necessary. The chiropodist visits every six weeks and an optician attends the home regularly with yearly eye tests arranged. Residents can attend their dental practice or a dentist also visits the home on a regular basis. Physiotherapy, occupational therapy and rehabilitation therapy are all available on referral by the GP. There is a policy in place for the administration of medication. Boots the chemist supply the medication to the home mainly in blister pack format. They also undertake audits of medication. The medication recording charts were seen and are well maintained. It was recommended that a photographic identification of each resident be kept on the front of each chart. Controlled drugs are in use and they are stored and recorded correctly. All staff who administer medication receive regular training, and follow the homes policies and the Nursing and Midwifery Council’s Code of Professional conduct. Privacy and dignity are observed and staff were seen to treat residents respectfully and address them in a polite manner. Staff knock on bedroom doors prior to entering. Screens are provided in shared rooms. Rodwell Farm Nursing Home DS0000069750.V339590.R01.S.doc Version 5.2 Page 13 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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The activities programme in place meets the collective and individual needs of the residents. Family links are maintained and residents are offered a wholesome and nutritional diet. EVIDENCE: It was possible to discuss the activity arrangements with the activities coordinator. Individual assessments of need are in place according to ability and choice. One to one activities are more manageable on the dementia unit for example reading, talking, manicure and massage, where as group activities are more popular in the main lounge to include film shows, weekly musical entertainment, art group. There is also a lounge that the younger residents use. This has recently been equipped with a large screen television and Sky. The activities coordinator stated that the Age Concern bus is used for day trips and taxis are user for evening outings. There is also a hairdressing service in the home. Family links are maintained and visitors are welcome in the home at any reasonable time. Relatives are also encouraged to participate in care planning and to attend reviews of care. Spiritual needs are supported and care plans take into account individual cultural and social requirements. One resident attends Mass weekly, and a Rodwell Farm Nursing Home DS0000069750.V339590.R01.S.doc Version 5.2 Page 14 Church of England service takes place on Wednesday in the home. Visits from various clergy are arranged on request. It was possible to talk with the cook and to sample the menus in place. The cook plans these with input from the residents and comments from residents meetings. Lunch was observed and the food offered was wholesome and appetising. The residents surveyed stated that the food was always very good. Special diets are catered for and staff were seen to offer sensitive support to residents who required help with feeding. Rodwell Farm Nursing Home DS0000069750.V339590.R01.S.doc Version 5.2 Page 15 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 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure and the abuse awareness procedure in place protect residents from abuse. EVIDENCE: The home has a complaints procedure in place and a copy of this is available to all the residents and their relatives. There is also a copy of this included in the service user guide. There is also an abuse awareness policy in place and all staff have training in this policy, which is included in induction training. During discussion with staff it was apparent that they would know what to do is an episode of abuse occurred. The home has a copy of Surreys Multi Agencies Policies and Procedures on Safeguarding Vulnerable Adults and senior staff have attended training in these procedures facilitated by local authority and this has been cascaded throughout the staff team. Rodwell Farm Nursing Home DS0000069750.V339590.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, 23, and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The location and layout of the home and the garden are suitable for their stated purpose. The home is comfortable, well decorated and furnished to a good standard. The standard of cleanliness and hygiene is good. EVIDENCE: The home is spacious, comfortable and well maintained. Communal accommodation includes several lounge and dining areas, which are all well furnished and decorated. Resident’s bedrooms are mainly single occupancy with some shared rooms. Individual rooms have been personalised and residents are encouraged to bring personal items of furniture and possessions with them if they wish to do so. Malodour was present in one room, which had been identified and being monitored. The home has an infection control policy in place and all staff are aware of this policy. The laundry is well equipped to meet the requirements of the home. Rodwell Farm Nursing Home DS0000069750.V339590.R01.S.doc Version 5.2 Page 17 The laundry staff are aware of infection control procedures and were able to demonstrate how infected laundry is managed. Rodwell Farm Nursing Home DS0000069750.V339590.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, 28, 29, and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The number and skill mix of staff is sufficient to meet the current needs of residents. The recruitment procedures and the training arrangements protect the residents living in the home. EVIDENCE: The staff duty rota was seen and the number and skill mix of staff on duty was sufficient to meet the current residents needs. There are eleven care staff and two qualified nurses on duty for the morning shift, this is reduced to eight carers and one qualified nurse who work the afternoon shift and one qualified nurse and three carers work night duty. One resident stated, “The staff always come when I ring my bell.” The home also employs housekeepers, laundry assistants, kitchen assistants, a cook an administrator, and a maintenance person. The recruitment procedure in the home is robust and protects the residents living there. Three staff employment files were randomly sampled. These are well maintained and contained all the required documentation including a written application form, two written references, an employment history and a CRB (Criminal Records Bureau) disclosure reference number. The home manager oversees the training in the home. There is a training schedule on display in the office, which outlining various dates for courses and when update training is due. Rodwell Farm Nursing Home DS0000069750.V339590.R01.S.doc Version 5.2 Page 19 All staff undertake three months induction in line with Skills for Care training. Over 75 of staff have achieved NVQ level 2, which is rewarded by an increase of salary. External assessors are user for NVQ training. Mandatory training is also in place and includes manual handling, food hygiene, infection control, first aid, fire safety, COSHH and abuse awareness. Rodwell Farm Nursing Home DS0000069750.V339590.R01.S.doc Version 5.2 Page 20 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, 33, 35, and 36, and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed in the best interests of residents. The health, safety and welfare of residents and staff are promoted. EVIDENCE: The home is well managed by a registered manager who is a qualified nurse. She holds her Registered Managers Award, is an NVQ assessor and has worked in the home for twelve years in a senior position. She was not present during the inspection. There is a deputy manager in post who had commenced employment the previous day. The home also benefits from the support of the organisation’s operational director (the ex home manager) who visits the home one day each week. Formal supervision is in place. This is undertaken by the operational director at eight weekly intervals and recorded electronically. Any issues identified are Rodwell Farm Nursing Home DS0000069750.V339590.R01.S.doc Version 5.2 Page 21 monitored and review dates highlighted. An example of this was demonstrated to the inspector. Staff appraisal also takes place annually and recorded. There are robust systems in place to monitor quality assurance, and the home is constantly looking to improve the service it provided. He home employs an external company to carry out six monthly surveys with residents and relatives. The results of this survey are published into a report and discussed with the staff team. Resident’s views are sought constantly. One resident stated that he is always consulted about her opinion. Regular residents meetings take place, with separate meetings specifically for the younger residents. The home has also employed a quality consultant to assist in maintaining quality assurance. It was possible to speak with her during the inspection when she demonstrated the ISO quality audit system she undertakes on a regular basin. She is also in the process of reviewing all policies and procedures. The inspector was informed that the home does not handle resident’s personal financial affairs. This is either managed by relatives or a designated representative. There are lockable facilities available in individual bedrooms to keep valuables safe. Health and safety policies and procedures in place were sampled throughout the day. All staff undertake health and safety training which includes, manual handling, food hygiene, abuse awareness, fire safety, first aid, and COSHH. Risk assessments are in place for all identified risks and safe working practice. Fire safety arrangements include regular staff fire safety training, weekly alarm tests, regular fire rills, and a contract for maintaining fire fighting equipment and emergency lighting. Rodwell Farm Nursing Home DS0000069750.V339590.R01.S.doc Version 5.2 Page 22 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 3 X 3 Rodwell Farm Nursing Home DS0000069750.V339590.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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 Refer to Standard OP9 Good Practice Recommendations It is recommended that a photograph of each resident be kept on the front of each medication-recording chart for identification purpose and to promote safe practice. Rodwell Farm Nursing Home DS0000069750.V339590.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Rodwell Farm Nursing Home DS0000069750.V339590.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. 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