Inspection on 30/05/07 for Rossendale Hall

This inspection was carried out on 30th May 2007.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rossendale Hall 09/01/09

Rossendale Hall 28/05/08

Rossendale Hall 09/01/07

Rossendale Hall 08/08/06

Rossendale Hall 16/03/06

Rossendale Hall 29/06/05

Rossendale Hall 23/11/04

Rossendale Hall 12/08/04

Similar services:

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 Ms Julie Porter Unannounced Inspection 30 May 2007 08:30 Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 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 Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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. Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rossendale Hall Address Hollin Lane Sutton Macclesfield Cheshire SK11 0HR 01260 252500 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) Rossendale Trust Christian Blythe Care Home 30 Category(ies) of Learning disability (28), Learning disability over registration, with number 65 years of age (2), Physical disability (10) of places Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide care for a maximum of 30 service users including: Up to 30 service users in the category of LD(learning disabilities) Up to 2 service users in the category of LD(E) learning disabilities, 65 years and over) Up to 10 service users in the category of PD (physical disabilities) 9th January 2007 Date of last inspection 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 consists of three self-contained units: the Hall, Riverside and Hillside. 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, it 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. Information provided by the manager on 16 April 2007 identified that fees ranged from £460.00 to £503.00 per week. Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on the 30 May 2007 and lasted 7.5 hours. The visit was carried out by one inspector. This visit was just one part of the inspection. Before the visit the home manager was asked to complete a questionnaire to provide up to date information about services in the home. CSCI questionnaires were also made available for residents, families, and health and social care professionals such as doctors, nurses and social workers to find out their views. Other information received by CSCI since the last key inspection was also reviewed. During the visit various records and the premises were looked at. A number of residents were also spoken with and they gave their views about the service. What the service does well: What has improved since the last inspection? There is information about the home available so that people who may be interested in moving in can see what is available there. People who live at the home now have contracts between themselves and the home so they know what is and what is not included in the cost of their care. Thorough recruitment procedures are now used when new staff are appointed that include all the necessary checks to make sure that staff are suitable to work with the people who live at the home. Staff training is improving so that the people who live at the home are supported by suitably qualified and trained staff. Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 7 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 Outcomes Statutory Requirements Identified During the Inspection Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People moving into the home have their needs assessed before they are offered a service and information about the home is available to them so that they know their needs can be met there. EVIDENCE: There is information about the home and what services it provides so that people can decide if they want to move in. The information available (the statement of purpose and service user guide) includes pictures and symbols so it easy to understand. Nobody has moved into the home since the last inspection. However, there are processes to follow when this does happen. These include carrying out an assessment of the person’s needs before they move in so that the person, their family and the staff all know that the person’s needs can be met there. The assessment would cover information about the person’s health needs and their likes and dislikes so staff would have an understanding of these when the person moved in. The manager confirmed that visits to the home would be arranged before any decision was made to move there. Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 9 Contracts are now in place stating the terms and conditions between the home and the residents. Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans for the people who live at the home do not accurately reflect their needs so they may not get the care/support they need. EVIDENCE: The files for three of the people who live at the home were checked. All contained useful information. However, the files contained information and old assessment documents dating back years that no longer apply to the way that people need support currently. So, although there is a large amount of information, it does not provide any useful guidance for staff on the person’s current needs and what they need to do to meet those needs. Most of the staff have worked at Rossendale Trust for a long time and have got to know the residents well. They are able to discuss at length what they need to do to meet the needs of the people living at the home but without accurate care plans this could not be checked. Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 11 The staff at the home have been working hard to develop comprehensive care files for each person who lives there. The new files will include information presented in an easy to read way, with pictures and will be introduced over the next six weeks. Examples of the new care files were seen although these were not in place for all the residents yet. However, care needs to be taken to make sure that these become working documents that identify people’s needs and goals and how/when/by whom these will be achieved. One person who lives at the home said that food and snacks were locked away. Keys to the larder are available on request from staff. The staff explained that this was to make sure that one person who has diabetes did not eat too much or the wrong type of food. However, this action being taken to monitor this person’s condition is having a direct impact of all the others living in the home. Risk assessments have been completed to reduce risks to people in respect of the home they live in. Further work is being done to include risks involved in people’s individual lifestyles and choices. Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to make choices within their capabilities but further work needs to be done to ensure that action is taken to help them to fulfil their wishes so they have control over their lives. EVIDENCE: During the visit three people who live at the home were spoken with at length as they had asked to meet the inspector when they completed their CSCI comment cards. All the people spoken with were on the whole happy living in the home. One person said that he wished more things were available to do in the evenings and weekends, but there aren’t enough staff. Another said that she would like to go out more and that outings to noisy pubs did not suit her, as she liked a quiet drink. Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 13 Little evidence was found of regular weekend activities. Staffing levels remain the same during the week as weekends even though most of the residents are out during weekdays at various centres. During this time, staff usually do household tasks. One person said that she liked to go to the day centre. People at the home attend the Rossendale day centre, the Oakwood project or Carter House day centre during weekdays. A number of them do voluntary work. Further opportunities for education will become available when the new learning zone resource opens in Macclesfield. On the day of the visit a group of people who live at the home were getting ready to go to Manchester United football ground. All three care plans included information about the people’s families and showed there was regular contact with them. Comments returned from relatives indicated that the home always/or usually helped their relative to keep in touch with them, and that they were always kept up to date with important issues. During a tour of the houses it was noted that only some of the bedrooms have been fitted with locks. The terms of the contract and information in the service user guide states that when people are away from the home for any reason, hospital stays, holidays or visits to family their personal belongings in their bedroom will be kept secure. There was no opportunity to observe the mealtime during this visit. However during previous visits, mealtimes appear to be sociable occasions. Menus were checked; they included traditional and more exotic food and fresh produce and are usually cooked by staff. Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by staff who have worked with them for a long time and staff training is available so they know what to do to meet the residents’ needs. EVIDENCE: Staff have worked in the home for a number of years and know the people who live there well. The people who live at the home have a variety of individual needs from needing minimal support to having to have support for all aspects of their personal care. Since the last inspection a specialist bath has been fitted in Riverside. Maintenance contracts are in place for all other specialist equipment. Staff said that the newer hoist is easier to use than the old one. Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 15 During the visit there was an opportunity to discuss one person’s care with a visiting nurse. He was very complimentary about the care the resident was receiving and said that the person’s mental and physical condition was much improved following his discharge from hospital. Four CSCI comment cards were returned from health and social care professionals. All were positive and one stated, “I have always had great confidence in the quality and competence of the staff”. All three care plans inspected showed that healthcare professionals were monitoring people’s health care needs. There is good liaison between the home and the community nursing team, epilepsy nurse and the community learning disability nurse. Policies and procedures are in place regarding medicine administration and following the last inspection staff have receive training so they can give medicines safely to the people who live at the home. Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies, procedures and staff training are in place in relation to adult protection to ensure that the people who live at the home are safeguarded from harm. EVIDENCE: There is a written complaints procedure for the home. The complaints record was inspected and showed that the concerns had been dealt with properly. The complaint log showed what the complaint was, how it was dealt with and the outcome. Advise was given to improve the way the information was recorded so that a clear audit was available and information was easier to monitor. A number of residents in the home would not be able to use the complaints procedure and consideration should be given on how staff can support these residents to raise concerns/complaints. Since the last inspection all staff have now attended formal training relating to adult protection procedures. No referrals have been made to the adult protection team since the last inspection. Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Significant improvements have been made to the maintenance of the three houses so that the people at the home live in hygienic, safe surroundings. EVIDENCE: A guided tour of the home was done that included all communal areas and some bedrooms. Nobody who lives at the Hall was there during the visit and the member of staff on duty was cleaning. Three people were at home in Riverside and two in Hillside. All areas of the home were clean and fresh. Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 18 There are a number of twin rooms in the home; the people living in those rooms have shared them for a number of years. This arrangement should be reviewed at the next opportunity to check whether those people continue to be happy to share a room or would prefer to have one of their own. A number of the bedrooms in the home do not meet the space requirements set out in the National Minimum Standards for Care Homes for Younger Adults. However the home was registered before these standards came into force and is therefore not required to meet that standard. Most residents do not have a key to their bedroom. Privacy screens have been purchased and where seen in various locations around the houses. Kitchen units, broken tiles, sealant have been replaced and the worn worktops have been replaced in The Hall; the bath has been re-enamelled. The fitting of the specialist bath in Riverside has unfortunately left a bare patch in the floor covering. This is now a hazard and means the floor is not sealed from water and possible infection. The floor covering will need to be replaced/repaired. The lounge has been painted since the last inspection and was fresh and bright. The manager said that a specialist bath has been ordered for the Hillside house as people are finding it more difficult to use a domestic type bath as they get older. This bathroom would also benefit from re-decoration. Kitchen cupboards and worktops in Hillside are showing signs of wear and tear and some action should be taken now to prevent further deterioration. Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 19 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Robust recruitment processes are in place and staff have received some training to ensure they deliver care safely. EVIDENCE: Staff training and development plans have been compiled and some training has taken place with further training available during June. All staff have received training in adult protection. All senior staff responsible for giving out medicines to the people who live at the home have now attended medicine administration up dates. Further training is planned for moving and handling and fire safety training. Staff they were very enthusiastic about the training available to them. One said that she thought it had had a positive impact how she felt about the work she does and she now enjoyed coming to work. Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 20 Currently only nine of the home’s twenty nine care staff have achieved a National Vocational Qualification (NVQ) in care at level 2 or above. However a further seven people have recently been enrolled for further qualifications. No new staff have been recruited since the last inspection. Following the last inspection the manager provided information to the Commission for Social Care Inspection confirming that all new staff will be subject to satisfactory Criminal Bureau Checks before they start work in the home. Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 21 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff have not achieved all mandatory training in health and safety and therefore cannot adequately demonstrate they have the skills and knowledge to safeguard the welfare of the residents. EVIDENCE: The manager is registered with the Commission for Social care Inspection. He has a National Vocational Qualification (NVQ) level 4. The manager confirmed that visits by a nominated person on behalf of the Rossendale Trust, in accordance with Regulation 26 of the Care Homes Regulations, have taken place. It was agreed that copies of the reports of these will be sent to the Commission for Social Care Inspection. Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 22 A development plan for the ongoing provision of care services in the area has been undertaken. A training plan is available for staff working in the home and while they have not yet achieved all mandatory training including fire safety, moving and handling the improvement has been significant. Service contracts are in place for gas, electrical equipment and other equipment at the home. Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 23 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 Standard No Score 1 3 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 2 26 2 27 2 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 15 3 16 2 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 2 X Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 YA6 Regulation 15(2) Timescale for action Care plans must be reviewed 13/07/07 regularly and updated to reflect the residents’ current needs. This requirement remains unmet from the previous inspection on 16/03/06,08/08/06, 28/02/07. The problems with the 31/07/07 environment identified in this report must be attended to as part of the planned schedule of maintenance with appropriate timescales. Staff must continue to receive 31/08/07 training relevant to the role they perform and must receive moving and handling, fire safety and other outstanding mandatory training so that care can be provided safely. The report produced by the 30/06/07 nominated person in accordance with Regulation 26 of the Care Homes Regulations must be supplied to the registered manager and the Commission for Social Care Inspection. Requirement 2. YA24 23(b)(d) 3. YA32 18 4. YA39 26 Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 25 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. Refer to Standard YA7 YA9 YA16 YA25 Good Practice Recommendations The manager should review the arrangements of keeping food locked away and the impact this has on the people living in the home. Risk assessments should continue to be developed so they include all aspects of the residents’ daily living. Locks suitable to the needs of the residents should be fitted to bedrooms, so that their possessions can be kept securely and residents are afforded privacy. The manager should review the arrangements for providing shared bedrooms at the next opportunity so people have the chance to choose whether or not they want to share a bedroom. 50 of staff should have achieved NVQ level 2 as a minimum sp people are receiving care from a skilled and qualified group of staff. 5. YA32 Rossendale Hall DS0000006617.V333237.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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