Inspection on 29/06/05 for Rossendale Hall

This inspection was carried out on 29th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Rossendale Hall 09/01/09

Rossendale Hall 28/05/08

Rossendale Hall 30/05/07

Rossendale Hall 09/01/07

Rossendale Hall 08/08/06

Rossendale Hall 16/03/06

Rossendale Hall 23/11/04

Rossendale Hall 12/08/04

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Ruskin Lodge

Clover House

Dystlegh Grange

The Good Companions

Cuerden Grange Rest Home

Springfield Cottage

Parkside

Park Lodge

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

CARE HOME ADULTS 18-65 ROSSENDALE HALL HOLLIN LANE SUTTON MACCLESFIELD CHESHIRE SK11 0HR Lead Inspector JULIE PORTER Unannounced 21 & 29 June 2005 09:30 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. ROSSENDALE HALL F51 F01 S6617 Rossendale Hall V234308 210605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Rossendale Hall Address Hollin Lane Sutton Macclesfield Cheshire SK11 0HR 01625 252216 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) Rossendale Trust Christian Blythe Care Home 30 Category(ies) of LD Learing Disability (28) registration, with number LD(E) Disabilities Over 65 (2) of places PD Physical Disability (10) ROSSENDALE HALL F51 F01 S6617 Rossendale Hall V234308 210605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 This home is registered for a maximum of 90 Service Users to include: No more than 39 Service Users in the category OP (Old age, not falling within any other category No more than 51 Service Users I the category DE(E) (Dementia aged 65 years and over). 2 The registered provider must, at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidance which may be issued through the Commission for Social Care Inspection. 3 Date of last inspection 23 November 2004 Brief Description of the Service: The Rossendale Trust was established in 1973 and provides both residential and day care for adults with learning disabilities. Rossendale Hall, registered to provide care for 30 people with learning disabilities, is a detached hall built in the 1930s situated in its own grounds in a rural location on the outskirts of Macclesfield. The home has been adapted and extended over the years and currently comprises of three self-contained units: the ‘Hall’, the ‘short stay’ and the ‘long stay’. Despite their names, both of the latter two units provide permanent care.On the day of the inspection, there were 27 service users living at Rossendale Hall. Accommodation is in single and shared bedrooms situated on the ground and first floors. The rooms are smaller than the sizes identified in the national minimum standards (Standard 25 of the National Minimum Standards for Care Homes for Younger Adults). However, as the home was registered and in use before 31 March 2002, the home does not have to meet this standard.Local amenities, in the village of Sutton and at other Rossendale Trust services, are a short drive away. ROSSENDALE HALL F51 F01 S6617 Rossendale Hall V234308 210605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over two days for approximately eight hours and included a tour of the premises and grounds, discussions with residents, eight of the staff on duty and meeting with the trustees. Records kept at the home were also checked. What the service does well: 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. ROSSENDALE HALL F51 F01 S6617 Rossendale Hall V234308 210605 Stage 4.doc Version 1.30 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection ROSSENDALE HALL F51 F01 S6617 Rossendale Hall V234308 210605 Stage 4.doc Version 1.30 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1-5 Residents have their care needs assessed before moving to the home so they can be sure that the home can meet their needs. Without a contract detailing the terms and conditions of their residency their rights are not protected. EVIDENCE: Information is available regarding the home, staff said that new residents would be invited to the home before moving in and that the feelings of the current residents would be taken into consideration as it is “their home.” Care needs would be assessed before the person moved to the home to ensure that their needs could be met. A written contract of the terms and conditions of their stay is being developed; at the moment staff are unaware of the terms and conditions of their residency; the fees charged and what they cover. See requirement 1 ROSSENDALE HALL F51 F01 S6617 Rossendale Hall V234308 210605 Stage 4.doc Version 1.30 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7 &10 Staff working in the home know the residents well, however there is a risk if the care plans are not kept up to date and in the absence of staff who know them well the residents may not receive the care they need. EVIDENCE: Improvements have been made to the information held in the home, residents plans included life histories; likes; dislikes and their needs. The plan was not specific in how to meet these needs, for example what the staff have to do to support with personal care. Each resident has a diary to record appointments and activities and therefore the care plans are not always current. See requirement 2 Talking with staff they were unclear about what information should be shared with others, they talked of families knowing each other for a number of years and residents who have known each other since they were children. See recommendation 1 ROSSENDALE HALL F51 F01 S6617 Rossendale Hall V234308 210605 Stage 4.doc Version 1.30 Page 9 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11 - 17 Staff have known the residents for a long time and are able to encourage residents to pursue their interests, not supporting the residents to maintain their dignity or with appropriate relationships may leave the residents vulnerable. EVIDENCE: Staff were seen helping residents with meals in a friendly and supportive way, meals were available at various times to suit the lifestyle of the people living in the home. Two residents have jobs locally and are given minimal support to do this, part of the day centre is in the heart of Sutton village and residents were seen there on the day of the inspection. Staff talked of a few residents who may become over familiar (touching and hugging) with staff or visitors to the home, my experience of this was that it was not threatening but was inappropriate, consistent management of this needs to be developed to help residents with their personal relationships. On two occasions staff were either seen or heard via a monitor providing intimate personal care, consideration must be given to the residents’ dignity during these times. See requirement 3 & 4 ROSSENDALE HALL F51 F01 S6617 Rossendale Hall V234308 210605 Stage 4.doc Version 1.30 Page 10 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 -20 The residents are supported by a staff team who know them well, the staff are able to understand the residents needs. Not following guidance about medication administration puts the residents at risk. EVIDENCE: One resident has their own medication which is reviewed as part of her care plan. The medication records were checked and showed a number of minor errors in recording as discussed with the manager. Instructions from the consultant on the 13 March to reduce medication had not been followed and an explanation could not be given. Covert administration of medication must only be given following the agreement of all interested parties. See requirement 5 ROSSENDALE HALL F51 F01 S6617 Rossendale Hall V234308 210605 Stage 4.doc Version 1.30 Page 11 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 -23 Without training for staff on protecting adults from abuse, staff and residents are vulnerable. The homes’ complaints procedure is not effective. EVIDENCE: None of the staff spoken to at the inspection had had attended training on how to protect people from abuse and how to use the adult protection procedures. The home has a complaints procedure, the residents spoken with said they would speak to the staff if something was wrong, these conversations and complaints are not always recorded and therefore the home cannot show how it is monitoring its performance. ROSSENDALE HALL F51 F01 S6617 Rossendale Hall V234308 210605 Stage 4.doc Version 1.30 Page 12 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 -30 Although the home is clean, tidy and homely, it would benefit from having a planned schedule of maintenance work and renewal program for furniture so that residents live in a safe, comfortable environment at all times. EVIDENCE: The home was clean, tidy and homely. Window restrictors are now being fitted to all upstairs windows to reduce the risk to residents from falls. A number of rooms and carpets have been identified as needing redecoration or replacing. Further redecoration will be needed after the re-wiring is finished. Talking with staff they said that a residents’ money was being used to buy a suitable bed. See requirements 8 & 9 ROSSENDALE HALL F51 F01 S6617 Rossendale Hall V234308 210605 Stage 4.doc Version 1.30 Page 13 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 Most of the staff spoken with have worked for Rossendale Trust for a number of years, and have developed an understanding of the residents needs. EVIDENCE: Staff were enthusiastic about NVQ training but not clear other training needed for them to carry out their jobs and would benefit from having individual training and development plans. Personnel, training and supervision records were not seen during the inspection. ROSSENDALE HALL F51 F01 S6617 Rossendale Hall V234308 210605 Stage 4.doc Version 1.30 Page 14 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 -43 Although the best interests of the residents are important to the staff, they do not have all the training and information they need in order to support residents’ rights. EVIDENCE: Three of the residents spoken with said they enjoyed living in the home, they knew all the staff and who was in charge of the home. The manager has recently been registered with the Commission for Social Care Inspection. Internal quality monitoring systems (Regulation 26 visits) need to be in place and ways of obtaining the views of residents, relatives and staff about the home to enable it to develop the service it provides. Policies and procedures have been developed for the home and staff confirmed they are being discussed during supervision. See requirements 10 &11 ROSSENDALE HALL F51 F01 S6617 Rossendale Hall V234308 210605 Stage 4.doc Version 1.30 Page 15 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 2 Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x x 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 2 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 2 3 3 Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 ROSSENDALE HALL Score 3 2 2 x Standard No 37 38 39 40 41 42 43 Score x 3 2 3 3 3 3 F51 F01 S6617 Rossendale Hall V234308 210605 Stage 4.doc Version 1.30 Page 16 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 5 Regulation 5 Requirement Residents must be given a written contract or statement of the terms and conditions of residence at the home. These should include information about the accomodation provided and the method of payment of their fees Care plans must be reviewed to reflect the residents current needs Residents must be encouraged not to be over familiar with staff and visitors to the home. Staff must ensure that residents are treated with dignity and respect at all times Staff must receive training and follow guidance in relation to medicine administration All staff must receive training on protecting people from abuse and on adult protection procedures. Plans must be drawn up for each member of staff to receive training relevant to the role they perform. The complaints procedure must be suitable to the residents needs and a record kept of the complaint and action taken F51 F01 S6617 Rossendale Hall V234308 210605 Stage 4.doc Timescale for action 30/09/05 2. 3. 4. 5. 6. 6 15 17 20 23 15 12 12 13 18 30/09/05 30/09/05 30/09/05 30/09/05 01/10/05 7. 22 22 30/09/05 ROSSENDALE HALL Version 1.30 Page 17 8. 24 23 9. 10. 25 39 16 26 11. 39 24 The home must have a planned schedule of maintenance to ensure the residents live in a safe comfortable home Residents must be provided with furniture including a bed, bedding, flooring and curtains Visits to the home must be undertaken by a nominated person for the trustees at least once a month and a report produced Quality monitoring systems must be adopted to ensure service users views are sought 30/09/05 30/09/05 31/07/05 and ongoing 30/09/05 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 10 Good Practice Recommendations The manager should review the staffs understanding of the homes policy about confidentiality. ROSSENDALE HALL F51 F01 S6617 Rossendale Hall V234308 210605 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich Cheshire CW9 7LT 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. Extracts may not be used or reproduced without the express permission of CSCI ROSSENDALE HALL F51 F01 S6617 Rossendale Hall V234308 210605 Stage 4.doc Version 1.30 Page 19 - 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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