CARE HOMES FOR OLDER PEOPLE
Rookwood 26 Silverdale Road Burgess Hill West Sussex RH15 0EF Lead Inspector
Mrs D Peel Unannounced Inspection 18th January 2006 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 Rookwood DS0000014684.V278656.R01.S.doc Version 5.1 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. Rookwood DS0000014684.V278656.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Rookwood Address 26 Silverdale Road Burgess Hill West Sussex RH15 0EF 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) 01444 232215 South Coast Nursing Homes Limited Mrs Charmain Holmes Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Rookwood DS0000014684.V278656.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 24th August 2005 Brief Description of the Service: Rookwood is a care home able to provide personal care and support to 25 residents who are over 65 years of age. The property is detached and situated in a residential area close to the centre of Burgess Hill. Local shops and community facilities are close by. Private accommodation is arranged on two floors, the upper floor being accessed by passenger lift. Four bedrooms are on an upper mezzanine floor, which can only be accessed by a short flight of steps and six bedrooms are in the new extended part of the building. Communal space consists of a dining room, a lounge and a newly built sun lounge. Rookwood DS0000014684.V278656.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 3.75 hours on the 18th January 2006. This was the second visit to the home this year and it was carried out to complete the annual inspection programme for the year 2005 required by the Care Standards Act 2000. The inspector arrived at 10.00am and was met by the senior carer in charge, staff and four residents who were in the dining area waiting for their transport to a local Age Concern day centre. During the visit the inspector saw the majority of the 20 residents living at the home and spoke with 6 residents at length about there views of the home. The care records of 3 residents were viewed during the visit along with other records, which showed how care needs were being met. The records of 2 recently employed staff were also inspected and 3 staff were spoken with informally during the visit. Not all the National Minimum Standards for Older People were assessed at this inspection but throughout the year all key standards have been assessed. This report may be read in conjunction with the previous report dated 24th August 2005 to gain broader view of the homes provision of a care service. What the service does well: What has improved since the last inspection?
Rookwood DS0000014684.V278656.R01.S.doc Version 5.1 Page 6 Whilst the care plans were of a good standard at the last visit to the home a new format has been introduced which is easy to understand and update. The plans provide staff with the information, which they need to meet the assessed needs of residents. Since the last visit the home has had an extension built which consists of six new en suite bedrooms and a sun lounge, which opens out on to a patio for residents to enjoy in the summer. The kitchen has been refurbished and extended to double its original size. Walls and flooring have easy clean surfaces and there is now a serving hatch from the kitchen to the dining room. The lounge furniture has been replaced with new chairs and bedrooms continue to be redecorated and bedroom furniture replaced. The home has a new call alarm system which residents can transport from room to room so that they can call for assistance from anywhere in the building. As a result of inspection of medication records at the last visit to the home a waste medication book has been introduced to record any medication, which may be dropped or spilled. At this visit the inspector did not find any hot water outlets to be a concern as at the last visit to the home. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rookwood DS0000014684.V278656.R01.S.doc Version 5.1 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 Rookwood DS0000014684.V278656.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,4,5 Prospective residents, their relatives and friends have an opportunity to visit the home to look at the facilities available and assess its suitability before moving in. EVIDENCE: A sample contact was viewed during the inspection, which stated what the fee paid covered and included the room number to be occupied. Two residents spoken with who had recently moved into the home spoke about their experiences of moving to the home. One commented that they had been to visit and look around with a friend. The other resident thought that their family had been to look around for them before suggesting a visit to the home. Care records showed that relatives usually visit the home on behalf of prospective residents to see if the home will meet their relative’s needs. Rookwood DS0000014684.V278656.R01.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Systems for care planning give clear information to assist with all aspects of health, personal and social care needs. Records are in place to monitor the health care needs of residents to make sure that any signs of residents being unwell are recognised. EVIDENCE: A new system of care planning has been introduced since the last visit to the home. Four care plans were examined at this visit. They were clear and easy to understand. The plans were regularly updated to show the changing needs of the residents. Progress notes are updated to monitor the heath and well being of residents. District Nurses visit residents who are in need of short-term nursing care and they have the responsibility of assessing pressure area needs and providing wound care. On the day of the visit two district nurses visited a resident who had been discharged from hospital the previous day. The senior carer in charged confirmed that she had been able to ring up the surgery and arrange the visit. Records show that visits by health care professionals are recorded.
Rookwood DS0000014684.V278656.R01.S.doc Version 5.1 Page 10 Risk assessments are in place ensure the safe moving and handling of individual residents. Staff confirmed that a waste medication book had been introduced to record any medication, which is dropped or spilled. Rookwood DS0000014684.V278656.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15 Residents who are able are encouraged to take part in activities outside the home so that they can maintain contact with family, friends and the community. Meals are well managed and offer choice so that residents have a variable diet and have meals, which they can look forward to. EVIDENCE: When the inspector arrived at 10.00am four residents were sat in the dining area waiting for their transport to the local Age Concern day centre. This is an opportunity for residents to meet other people outside the home and develop other interests. They stay for lunch and return home later in the afternoon. One residents spoken with talked about the church service that they had attended on occasions outside the home. They had met with interesting people who had completely different lives. This resident felt that this had given them an opportunity to view old age in a different way. Three visitors visited the home during the inspection. Staff made them welcome, offering coffee and tea after checking with the residents where they wanted to see their visitors. The majority of residents spoken with thought that the food at the home was of a good standard and offered choice.
Rookwood DS0000014684.V278656.R01.S.doc Version 5.1 Page 12 The dining area at Rookwood is bright and a pleasant area to join others to eat a meal and socialise. The inspector joined residents for the main meal of the day, which was chicken cobbler, brussels sprouts and potatoes followed by an orange roulette. Alternative soft diet food was provided for at least one person in the dining room. Staff were available to assist those residents who needed help to eat their meal. This was carried out in a discreet manner offering support and encouragement when required. Drinks were offered and some residents accepted a small sherry with their meal. Rookwood DS0000014684.V278656.R01.S.doc Version 5.1 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 The home has policies and procedures for responding to adult protection matters training is provided to ensure that staff are able to recognise and report abuse. EVIDENCE: Rookwood has its own policies and procedures to safeguard residents from abuse in addition to the West Sussex Multi Agency policies and procedures. Adult protection training is on the company-training schedule and the inspector was told that staff are encouraged to attend the training. Rookwood DS0000014684.V278656.R01.S.doc Version 5.1 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,23,24,25,26 Incomplete work required by the Fire Officer puts residents at risk from a fire emergency. The home is clean and residents have a comfortable, homely environment to live in and enjoy Bedrooms are comfortable and meet the needs of the residents. Residents are encouraged to contribute to making their bedrooms their own by having their own personal possessions around them EVIDENCE: There have been many developments to the home since the last visit, which have improved the environment for residents to enjoy. The home has had an extension built which consists of six new en suite bedrooms and a sun lounge, which opens out on to a patio for residents to enjoy in the summer. Rookwood DS0000014684.V278656.R01.S.doc Version 5.1 Page 15 The kitchen has been refurbished and extended to double its original size. Walls and flooring have easy clean surfaces and there is now a serving hatch from the kitchen to the dining room. The lounge furniture has been replaced with new chairs and bedrooms continue to be redecorated and bedroom furniture replaced. The home has a new call alarm system which residents can transport from room to room so that they can call for assistance from anywhere in the home. A new shower/bathroom is almost ready for use near to the lounge with a new toilet facility already in use. The office is currently being relocated to provide a more spacious area for administrative duties within the home. After the last visit to the home the Fire Officer was asked to visit with regard to a number of bedroom doors, which did not have intumescent strips, fitted. The Fire Officer made five Requirements, which had time scales for completion attached to them. At this visit the inspector saw that one of the requirements had not been carried out by the timescale of three months. A requirement has been made that the providers take action to carry this work out and inform the Fire Officer of the delay. At the last visit to the home the inspector expressed concern over hot water temperatures in certain bedrooms at the home. On the day of this visit water leaving hot water outlets sampled was satisfactory. There remain a few radiators uncovered at the home but at the time of the visit they were not hot. There is an ongoing programme of covering radiators at the home, which should include the remaining radiators still uncovered. Rookwood DS0000014684.V278656.R01.S.doc Version 5.1 Page 16 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28,29,30 The staff-training programme provides staff with the majority of skills, which they need to do their job, and enables them to provide a reasonably safe environment for residents. EVIDENCE: There is a core staff team at the home, who offer consistency to the residents. Staffing levels are set to meet the changing needs of residents. Eight out of twenty four care staff hold the equivalent of an NVQ level 2, or above, qualification, which does not yet meet the target of 50 by 2005. However the inspector was told that another six staff are currently undertaking an NVQ and another two staff have just registered to do an NVQ. There is an ongoing training programme run by the company and new staff undertake an induction programme. Staff records viewed at this visit had improved but students being employed are currently not being required to obtain CRB and POVA clearance. The Care Standards Act 2000 and the Care Homes Regulations 2001 do not distinguish between full time staff and students and therefore are items listed in Schedule 2 and 4 of the Care Homes Regulations must be kept at the home. Rookwood DS0000014684.V278656.R01.S.doc Version 5.1 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38 The homes staff records do not fully safeguard the residents’ best interests. Some practices do not promote and safeguard the health and safety of residents living at the home. EVIDENCE: To protect residents living at the home records for students employed to work at the home must be expanded to meet the items listed in schedule 2 and 4.6 of the Care Homes Regulations 2001. The inspector was told that it has not been normal practice to acquire CRB and POVA clearance for students. The records of a recently employed student did not include evidence of that persons identification. The Fire Officer visited on the 12th September 2005 and made a number of requirements, some of which have been carried out within the timescales given
Rookwood DS0000014684.V278656.R01.S.doc Version 5.1 Page 18 by the Fire Officer. However, one requirement, which should have been carried out within 3 months of the fire officer’s visit, has yet to be carried out. A requirement has been made that the providers take action to carry this work out and inform the Fire Officer of the delay. Rookwood DS0000014684.V278656.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 X 3 3 X 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 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 1 3 3 X 3 3 2 3 STAFFING Standard No Score 27 x 28 2 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X 1 1 Rookwood DS0000014684.V278656.R01.S.doc Version 5.1 Page 20 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 OP38OP19 Regulation 13.4(a) 23.4 Requirement Requirements of the Fire Officer must be carried out. Provider must inform the CSCI by timescale for action as to what steps have been taken (after further consultation with the Fire Officer) to carry out Requirement 3 made by the Fire Officer. Records for Students employed to work at the home must comply with Schedule 2/4 of the Care Homes Regulations. Timescale for action 23/02/06 2 OP37OP29 19 01/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP38OP25 Good Practice Recommendations All radiators should be guarded to protect residents from burns. Rookwood DS0000014684.V278656.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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