Inspection on 16/01/06 for Rose Farm Care Home

This inspection was carried out on 16th January 2006.

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

Rose Farm Care Home 07/11/07

Rose Farm Care Home 22/01/07

Rose Farm Care Home 15/09/05

Rose Farm Care Home 30/03/05

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Rose Farm Care Home Main Street Styrrup Doncaster South Yorkshire DN11 8NB Lead Inspector Jayne Hilton Unannounced Inspection 16th January 2006 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 Rose Farm Care Home DS0000061468.V278541.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. Rose Farm Care Home DS0000061468.V278541.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Rose Farm Care Home Address Main Street Styrrup Doncaster South Yorkshire DN11 8NB 01302 744664 01302 746900 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) R S Care Homes Ltd Mrs Lorraine Ball Care Home 54 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (35), Old age, not falling within any other of places category (19) Rose Farm Care Home DS0000061468.V278541.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Within the total number of beds, a maximum of 35 may be used for the category DE(E) Within the total number of beds, a maximum of 19 may be used for the category OP Within the total number of beds, a maximum of 2 may be used for the category DE 15th September 2005 Date of last inspection Brief Description of the Service: The home is situated in the quiet village of Styrrup. There is good access to nearby towns of Retford, Doncaster, Rotherham and Worksop. The home comprises three units. The Cottage which caters for 8 service users with low dependency needs, The Barns for 17 service users with varying dependency needs and the Garden Wing offers a safe and a secure environment for other service users with dementia. The Cottage is an adapted building more suited to service users with low dependency needs due to its sizes and layout. The Barns and The Garden Wing are purpose built. The gardens are pleasant and safe. There is ample car parking space at the front of the building. The home appears to be sufficiently adapted to cater for the needs of people with a disability. There is a passenger lift. A call bell is fitted throughout the building. Rose Farm Care Home DS0000061468.V278541.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on 16th January 2006 and commenced at 10.30am and completed at 1.50pm. The focus of the inspection was mainly to assess compliance with the previous requirements and recommendations set and to assess the remaining key standards not assessed at the previous visit. The methodology used for this assessment, was the examination of two care plans and associated records. Inspection of health and safety record, a sample of staff personal files, service users financial records, a part tour of the building, including some service users rooms, accident records, complaints records and a selection of policies and procedures. Two service users were spoken with and various staff throughout the inspection. The Cottage was inspected at this visit and a part tour of The Barnes. What the service does well: Prospective service users have the information they need to make an informed choice about where to live and have their needs assessed. Service users and their representatives know the home they enter will meet their needs. Service users have comprehensive care plans in place, which includes, service users preferences. Their healthcare needs are generally well met. Service users feel they are treated with respect and their right to privacy is upheld. Service users can be assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. Service users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social and cultural religious and recreational needs and are helped to exercise choice and control over their lives. Service users enjoy their meals and mealtimes. Service users know how to make a complaint and are protected from abuse. Service users live in a clean, safe well maintained environment with access to safe and comfortable indoor and outdoor communal facilities. The washing and lavatory facilities are adequate and the home is equipped with specialist equipment to maximise service users needs. Service users bedrooms suit their needs with their own possessions around them. Service users financial interests are safeguarded Service users live in a home, which is run and managed by a person who is fit to be in charge. The new manager was registered in December 2005. The health and safety and welfare of service users and staff are promoted and protected. Rose Farm Care Home DS0000061468.V278541.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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 Farm Care Home DS0000061468.V278541.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 Rose Farm Care Home DS0000061468.V278541.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): 1,2,3,4 Prospective service users have the information they need to make an informed choice about where to live and have their needs assessed. Not all service users had a written contract in place. Service users and their representatives know the home they enter will meet their needs. EVIDENCE: A new statement of purpose was produced on 16th December 2004; a copy is available on the reception area and in all the three units of accommodation. A large service user guide has been prepared with photographs and is also available for viewing in the reception area. The homes brochure is in the process of being brought up to date, due to change in manager. The manager reported that the provider has decided to use the brochure a service user guide and is to ensure that it specifies all of the specified information. [Regulation 5 [2] states that a copy of the service user guide shall be supplied to each service user] Rose Farm Care Home DS0000061468.V278541.R01.S.doc Version 5.1 Page 9 Most service users are issued with a contract/terms and conditions, however to meet the standard fully all service users should be issued with terms and conditions. A comprehensive assessment document is used for all new admissions. Two service users assessment and care plans were examined, all assessments met the standard 3.3 requirements. The home has a new admissions procedure which clearly indicates that new service users are admitted only on the basis of a full assessment undertaken by people trained to do so and which service users and their relative/representative have been party to. The manager visits the service user wherever possible. There is a section on the new care plan system for the manager to sign that the home can meet the needs of the service user. This must be signed at all times to meet with the requirements of Regulation 14. A resident profile compliments the assessment. Social worker assessment were seen for those where provided. The home was granted a variation to the existing registration to 25 beds for service users with dementia and 25 beds for old age. External sources and training has been sought to reflect good practice where possible in dealing with service users with dementia. Staff, appear to be well supervised and supported. Service users were happy with the care offered and reported that staff were kind and respectful. The management of behaviour has been addressed and is included in the care plan system, again the process of evaluation and clearer identification of how the aggression presents, what has worked well in the past etc needs to be included. Rose Farm Care Home DS0000061468.V278541.R01.S.doc Version 5.1 Page 10 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): 7,8,10,11 Service users have comprehensive care plans in place and their healthcare needs are generally well met. Service users feel they are treated with respect and their right to privacy is upheld. Service users can be assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. EVIDENCE: A new care-planning format has been introduced, which on the whole appears to be a good system and there was noted improvement in their completion since the last inspection. Care plans were observed to be, reviewed at least monthly and the review included an evaluation of whether the service users needs have changed. There is a service users profile included. Care plans were signed by service users or by representatives. Assessments were in place for manual handling, mobility, risk of falls, continence and tissue viability. A process for reviewing these monthly has been implemented. Service users, are currently assessed by, the district nurse for pressure sores. The documentation regarding service users health needs was much improved and provided clear records of visits and treatments and follow ups. There was Rose Farm Care Home DS0000061468.V278541.R01.S.doc Version 5.1 Page 11 evidence of bowel monitoring and nutritional assessments were being introduced. Service users psychological health is monitored. Service users who were described as ‘aggressive’ had care plans in place for dealing with this, others did and were well documented, however staff need to be clear about what they mean when they state aggressive [see standard 4] Blood sugar monitoring was seen for diabetic service users. The manager reported that a system \is in now in place for reporting and monitoring unexplained bruising. Accident records were observed to be completed satisfactory, apart from the reference number. A procedure for storing urine samples etc has been devised so that everyone is clear. Staff were observed to knock before entering rooms and staff and service users confirmed that service users privacy was respected at all times. Two service users who were spoken with were aware that they could have a key to their bedroom or lockable facility but had chosen not to have them. The manager presented evidence that work is ongoing about how this will be addressed within care plans. The wishes of service users at the end of their life had been obtained. It would be beneficial for service users to make any special requests regarding their needs and wishes for any special arrangements to make them more comfortable in their final days and for any special instructions upon their death. Policies and procedures are in place for dealing with dying and death. There have been a number of deaths recently at the home of several long term service users. All have been notified to CSCI. Rose Farm Care Home DS0000061468.V278541.R01.S.doc Version 5.1 Page 12 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, 14,15 Service users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social and cultural religious and recreational needs and are helped to exercise choice and control over their lives. Service users maintain contact with family and friends and the local community as they wish. Service users enjoy their meals and mealtimes and would benefit from large print menus placed on the dining tables. EVIDENCE: A programme of activities is provided by an activities co-ordinator The staff, and service users spoken with stated that there has been a marked improvement in the quality and level of activities undertaken by the service users. Outings have been co-ordinated on a more regular basis and a full weekly activities program tailored for the varying needs of the service users has been placed. Some of the activities offered include nail care, arts and crafts, games, Bingo, movement to music, quizzes, reminiscence groups, knitting/sewing and film shows. An entertainer/singer is arranged periodically. Participation in activities is recorded. Information is provided in the statement of purpose regarding maintaining contact with service users friends, relatives/representatives and service users spoken with conformed they can receive visitors in private. Comments were Rose Farm Care Home DS0000061468.V278541.R01.S.doc Version 5.1 Page 13 made that the minibus is currently out of use. The manager confirmed that it is being assessed for major repair. Rooms examined were personalised and service users spoken with confirmed that they were able to exercise personal autonomy and choice. Service users records were kept secure and access facilitated where necessary. The menu was displayed in the Cottage, although service users stated they are offered a choice. It is recommended that a large print version of the menu be provided on each table so that service users can be informed each morning of the day’s menu. The vegetarian options provided should be included on the menu. The menu appeared varied and nutritious. Service users reported that the food was good and that it was served in portions according to their preferences. Service users were observed to be assisted appropriately and given time to complete their meal as they wished. Rose Farm Care Home DS0000061468.V278541.R01.S.doc Version 5.1 Page 14 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): 16,18 Service users know how to make a complaint and are protected from abuse. EVIDENCE: The home has a compliments and complaints procedure, which was clearly displayed in the reception area. There were no reported complaints. On speaking with service users, all stated they were aware of how to make a complaint and said they felt confident they would be taken seriously Three referrals had been referred under the adult protection procedures to Social Services, the outcomes were that no issues were raised in relation to care at the home. The majority of staff have undertaken training in abuse awareness. A new whistle blowing policy has been implemented but this was not examined at this inspection. Rose Farm Care Home DS0000061468.V278541.R01.S.doc Version 5.1 Page 15 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): 19-26 Service users live in a clean, safe well maintained environment with access to safe and comfortable indoor and outdoor communal facilities. The washing and lavatory facilities are adequate and the home is equipped with specialist equipment to maximise service users needs. Service users bedrooms suit their needs with their own possessions around them. There was some mal-odour noted on entering the home, which needs to be eradicated. EVIDENCE: The location and layout of the home appeared to be suitable for its stated purpose and appeared clean smelled fresh overall and was in decorative order. Each unit has it’s own, communal lounge and dining space. The home is a nonsmoking building. Lighting and ventilation is adequate throughout the home. Furnishings are domestic in character and appeared of good quality. Each unit has its own bathing and toileting facilities. Liquid soap and disposable towels are provided in all the communal bathrooms and toilets. On examination those seen appeared clean, safe and functional. Rose Farm Care Home DS0000061468.V278541.R01.S.doc Version 5.1 Page 16 The home appears to be sufficiently adapted to cater for the needs of people with a disability. Handrails are fitted throughout. There is a passenger lift. A call bell is fitted throughout the building. Visual cues are sited around the home to assist those service users with dementia. The pre inspection questionnaire reported there had been no change to the building, however an application has been made for the number of beds to be increased. Rooms examined appeared spacious and well furnished. Service users’ rooms appeared comfortably furnished and meet all the requirements under standard 24. Bedroom doors are fitted with approved safety locks but there was evidence that this information is being collated in care plans that service users had been offered a key enabling service users to maintain their privacy if they so wish. Bedrooms are personalised and reflect the taste of each individual. A lockable facility is provided in each room for safe storage of personal medicines, and any item of value. Call bells are reachable from the beds. Service users spoken with on the day said that they were satisfied with their accommodation. Rooms appeared well lit and naturally ventilated. Rooms are centrally heated and heating may be controlled in the service user’s own room. Central heating radiators are low surface temperature type. Lighting is domestic in character and includes a bedside light. Emergency lighting, which is an integral part of the fire alarm system, is provided throughout the building. There is a fire risk assessment in place. The home was overall clean and hygienic, however some mal odour was noted on entering the home, which should be eradicated. Rose Farm Care Home DS0000061468.V278541.R01.S.doc Version 5.1 Page 17 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): 29 Service users are not fully supported and protected by the homes recruitment policy and practices. EVIDENCE: The staff files highlighted to be in breach at the previous inspection were all noted to comply with the regulations, however the home has employed some staff from overseas via a recruitment agency and although paperwork in relation to qualifications, references, passports etc were evident, there was no evidence that these staff had undergone the appropriate CRB checks. Two did not contain work permit information. A requirement is therefore set in relation to this. The provider and manager is advised to consult the updated guidance dated November 2005 in relation to the employment of staff from overseas. Rose Farm Care Home DS0000061468.V278541.R01.S.doc Version 5.1 Page 18 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): 31,35, 38 Service users live in a home, which is run and managed by a person who is fit to be in charge. A new manager has recently undergone the process for registration. Service users financial interests are safeguarded. The health and safety and welfare of service users and staff are promoted and protected. EVIDENCE: The newly Registered Manager is currently undertaking the Registered Managers Award which will be completed soon. Staff reported that they were confident in the new manager and that she, would be, supported, by them. Standard 35 was assessed fully and found to be satisfactory, A procedure is in place for handling service users finances and the systems in place were on the whole satisfactory. Rose Farm Care Home DS0000061468.V278541.R01.S.doc Version 5.1 Page 19 There appeared to be good systems in place for health and safety management. There are systems in place for the prevention of legionella. Risk assessments for all safe working practice topics and fire risk assessments were available. A Health and Safety Poster was observed in the Cottage. Window restrictors were observed in the home. Training in health and safety was provided to a satisfactory level. There was evidence of the gas safety check being carried out and the 5 yearly circuit safety check was carried out in July 2004. Policies were in place for health and safety. Environmental Health officer visited the home in June 2005. There were no issue identified. Overall the health and safety of service users appeared to be safeguarded. Rose Farm Care Home DS0000061468.V278541.R01.S.doc Version 5.1 Page 20 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 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 X 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X 3 X X 3 Rose Farm Care Home DS0000061468.V278541.R01.S.doc Version 5.1 Page 21 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 OP29 Regulation 7,9,19 Requirement The Registered Person must ensure that all staff employed from overseas have the necessary documentation in place and are appropriately police checked as specified in the CSCI guidance dated November 2005. Timescale for action 16/03/06 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. 2 3 4. 5 Refer to Standard OP8 OP2 OP15 OP23 OP26 Good Practice Recommendations Ensure staff explain what they mean by aggression and detail in the notes, how is this presented by service users Issue all service users with terms and conditions Provide large print menus on the tables on a daily basis and include vegetable options. Inform the Inspector of the outcomes of all of the POVA investigations. Eradicate the mal odour present in the home observed on the day of the inspection. Rose Farm Care Home DS0000061468.V278541.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 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. 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