CARE HOMES FOR OLDER PEOPLE
Rose Bank 48 Station Road Scholes Leeds LS15 4BT Lead Inspector
Kathleen Firth Unannounced 10.00 am11 05 05 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 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. Rose Bank J52 S1424 Rose Bank V224779 110505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Rose Bank Address 48 Station Road Scholes Leeds LS15 4BT Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0113 2650027 0113 2650027 MR F Brown Mrs L Brown Care home 13 Category(ies) of Old age (13) registration, with number of places Rose Bank J52 S1424 Rose Bank V224779 110505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 07.09.04 Brief Description of the Service: The home is situated north of Leeds and is a large house with three single and one double bedroom on the ground floor, and six single and one double room on the first floor. Access to the first floor is by means of a stairlift for people unable to manage the stairs. Prospective residents need to have a mobility risk assessment done prior to admission to ensure they would be safe on the stairs. There is a call system throughout the home. People are welcome to bring their own furniture and possessions with them if this is their choice. Nursing care is not provided by the staff at the home but they are supported by the local healthcare teams including GPs, community nurses and if required specialist services. There are plans to extend the home in the future to improve accommodation and offer more space. Rose Bank J52 S1424 Rose Bank V224779 110505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over six hours by one inspector on Wednesday 11th May 2005. The inspector toured the building, spoke with the manager, residents, staff, and visitors, examined residents’ records including care plans, menus, staff rosters and the Service user guide. The manager, staff, residents and visitors were all very helpful throughout the inspection process and were happy to take part in it. Six residents, three staff members, the manager and two relatives were spoken to during the inspection. What the service does well: What has improved since the last inspection?
All residents now receive a statement of terms and conditions of the home. The maintenance problems raised at the last inspection have now been resolved and the fitting of radiator guards has been completed. Care plans have been improved and now accurately reflect the needs of each service user.
Rose Bank J52 S1424 Rose Bank V224779 110505 Stage 4.doc Version 1.30 Page 6 Regular staff supervision sessions have been introduced and a training plan is now in use. Records concerned with the running of the home and the protection of the residents are accurate and up to date. Certificates were seen confirming that the gas appliances in the home had been checked in November 2004. 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. Rose Bank J52 S1424 Rose Bank V224779 110505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Rose Bank J52 S1424 Rose Bank V224779 110505 Stage 4.doc Version 1.30 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 standard(s) 1,3, 5 People are able to make an informed decision about the home from the written information they receive and from what they are able to see on their visit to the home. EVIDENCE: All prospective residents are given a brochure containing all relevant information about the home. This includes information concerning the services offered by the home plus the names and address of local advocacy and legal services. Useful information about the area where the home is located is also in the brochure. Armed with this information residents are able to make an informed decision about coming to live at the home. The Manager or her deputy assess prospective residents and make a decision about admission. The pre and admission assessments were in the residents’ files and were seen to be very comprehensive, containing sufficient information for staff to know what the needs of the people are. Residents spoken to confirmed that they or their families had visited the home and had seen the home’s information prior to their admission.
Rose Bank J52 S1424 Rose Bank V224779 110505 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9 &10 Staff are aware of the residents’ needs and there is good communication amongst the staff group. Residents are treated with dignity and have their privacy maintained at all times. EVIDENCE: Care plans seen contained healthcare, social and religious needs alongside actions required to ensure these needs are met. The plans were clear, concise easily understood and there was evidence that the plans are reviewed and updated on a regular basis. Risk assessments alongside the coping strategies were in place where appropriate. Separate sheets are in the residents’ files to record visiting healthcare professionals’ visits and any actions required. The manager confirmed that the home has a good working relationship with the local healthcare team and receive good back up from them. Evidence was seen that regular visits by dentists, chiropodists and opticians are in place. Residents said that they are well looked after and confirmed that their privacy and dignity are maintained. Some residents said that staff could not do enough for them and one man described them as “smashing”. One relative
Rose Bank J52 S1424 Rose Bank V224779 110505 Stage 4.doc Version 1.30 Page 10 said that he was kept informed about his father’s condition and the staff had acted promptly when medical help had been required. He said his father’s condition had improved since being admitted to the home and his father confirmed this. No resident looks after their own medication and the home has a good policy in place to handle this. Medication records seen at the inspection were all signed and up to date. The ordering, storage and administration of medicines were all seen to be appropriate. All staff have been trained in the handling and administration of medication. Rose Bank J52 S1424 Rose Bank V224779 110505 Stage 4.doc Version 1.30 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 standard(s) 12, 13, & 15 Residents are encouraged to be part of the decision making process within the home and to make choices about their own lifestyle. They are supported to maintain contact with family and friends. Visitors are welcomed at the home. A good, varied, nutritious diet taking into account individual choices is provided at the home. Activities are offered at the home to suit individual abilities and choices. EVIDENCE: People spoken to confirmed that they feel able to voice ideas or concerns that they may have and are listened to. There is an activity organiser at the home for part of the week. Activities that take into account resident’ likes and dislikes are held and are people free to join in or not. One resident showed some flowers that had been made the previous day during an activity. Residents said that different activities are organised including board games, jigsaws and cards. Visitors are welcome to visit the home at any time, the ones spoken to confirmed this. Some people are able to go out with family and friends and this is recorded on their care plans. Recently one resident celebrated her 100th birthday and a limousine was organised by the home to take her out for a meal and a ride. The local minister holds a religious service on a monthly basis and these are well attended.
Rose Bank J52 S1424 Rose Bank V224779 110505 Stage 4.doc Version 1.30 Page 12 People from the local community come into the home at special times including Christmas and residents at the home are made to feel part of the community. Residents spoken to said that they enjoy the meals at the home and that they are always good and one person described them as excellent. The meal seen was nicely presented and nutritious in content. Staff were seen to offer help as required to ensure that people could eat their meal without problems. Evidence was seen to confirm that residents are weighed on a regular basis and action taken if any problems arise. Rose Bank J52 S1424 Rose Bank V224779 110505 Stage 4.doc Version 1.30 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 standard(s) 16, 17, 18 Residents and their relatives have their views listened to, taken seriously and action taken to resolve issues. Residents have their rights protected and are protected from abuse. EVIDENCE: The appropriate policies and procedures were seen to be in place and staff confirmed that they had received Adult Protection training. Staff are aware of how to handle any complaint they may receive. A copy of the complaints policy is displayed near to the signing in book and on the wall in the dining room in addition to been in the Service User Guide. The names of advocacy services are also in the guide. Residents and visitors confirmed that they feel able to approach the manager or her staff if they have any concerns and these are dealt with quickly and appropriately. Residents are enabled to take part in the voting process, either by the postal system or going to the local polling station. Help is given to residents where required to ensure they are able to complete the voting papers correctly. Rose Bank J52 S1424 Rose Bank V224779 110505 Stage 4.doc Version 1.30 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 standard(s) 19, 20,21, 23, 24, 26 The home offers a safe, well-maintained environment for the residents. Their rooms are comfortable and they can have their own possessions around them. EVIDENCE: The home is decorated and furnished to a good standard throughout and their own rooms have been personalised by them bringing their own possessions at the time of their admission. There is a safe in each bedroom for residents to store their valuables and money. Staff were seen to knock on bedroom doors before entering. Residents have easy access to all areas of the home and gardens. Some said that they were looking forward to sitting in the gardens once the better weather came but in the meantime they enjoyed looking out at them. All areas of the home were clean and tidy and nothing was seen that could cause a hazard to residents walking around. There is a call system installed throughout the home. There are sufficient toilets and bathrooms to meet the needs of the present residents including assisted bathing facilities. The manager said that there are plans for an extension of the home that will
Rose Bank J52 S1424 Rose Bank V224779 110505 Stage 4.doc Version 1.30 Page 15 improve some of the facilities. All staff attend Control of infection training and the home has the relevant policy and procedures in place to deal with this. Rose Bank J52 S1424 Rose Bank V224779 110505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, 30 Residents are supported and protected by the robust recruitment procedures. Staffing numbers and skill mix ensure that residents’ needs can be met. EVIDENCE: The staff numbers were appropriate at the time of the inspection; residents and staff confirmed that this is the normal way of working. Staff rosters also confirmed the numbers on duty at any time. Evidence was available to confirm that written references are obtained and CRB checks made before staff are allowed to start working at the home. Recruitment is carried out under equal opportunities legislation. All staff undergo an induction process and there is a commitment to training With courses planned throughout the next year. Staff confirmed that they are able to access relevant training courses without any difficulty. The home is on target to ensure that 50 of staff attain NVQ level 2 within the designated timescale. Staff meetings are held where possible and staff appeared to have an understanding of each other’s roles as well as their own. Rose Bank J52 S1424 Rose Bank V224779 110505 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 35, 38 The home is well managed and the interests of the residents were seen as very important to the manager and staff. These interests are safeguarded at all times. EVIDENCE: The manager is a qualified nurse and has eighteen years experience in working with older people. She is still working on the Registered Manager’s award and has almost completed it. Speaking to residents, staff and relatives it was clear that she offers excellent support and is always prepared to listen to people. Good interactions were seen between the manager, staff, residents and the visitors present. Evidence was seen that regular formal supervision sessions are in place with written records kept of these. Records about financial matters were seen to be up to date and maintained correctly.
Rose Bank J52 S1424 Rose Bank V224779 110505 Stage 4.doc Version 1.30 Page 18 The manager showed a good understanding of Health and Safety and confirmed that all staff receive training in this area. Staff were seen to use correct movement and handling techniques when transferring a resident from one chair to another. Records of the fire alarm tests were seen to be up to date. Rose Bank J52 S1424 Rose Bank V224779 110505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 4 x 3 x 3 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 3 13 3 14 x 15 3
COMPLAINTS AND PROTECTION 3 3 3 x 3 3 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x 3 x x 3 Rose Bank J52 S1424 Rose Bank V224779 110505 Stage 4.doc Version 1.30 Page 20 yes 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. 1. Standard OP 31 Regulation 9 Requirement The manager must complete the Registered Managers award. (Previous timescale of 31.03.05 not met) Targets set with regard to numbers of staff gaining NVQ must be achieved. (Previous timescale of 31.03.05 not met) The registered persons must implement a quality assurance system that shows evidence of self-monitoring, self-audit, review and action planning. (Previous timescale of 31.03.05 not met) Timescale for action 31.08.05 2. OP 28 18 31.08.05 3. OP 33 24 30.06.05 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 Good Practice Recommendations Rose Bank J52 S1424 Rose Bank V224779 110505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Aire House Town Street Rodley LS13 1HP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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