Inspection on 09/01/07 for Rossendale Hall

This inspection was carried out on 9th January 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 8 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 30/05/07

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

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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 9th January 2007 11:00 Rossendale Hall DS0000006617.V316072.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.V316072.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.V316072.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.V316072.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 sevice 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) The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The registered provider must provide staff to meet the dependency needs of service users at all times and shall comply with any guidelines that may be issued through the Commission for Social Care Inspection. 8th August 2006 2. 3. 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 comprises of three self-contained units: the Hall; the short stay, which has been named Riverside since the last inspection; and the long stay, now named Hillside. Both of the latter two units provide permanent care. 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. Information provided by the manager on 17 July 2006 identified that fees ranged from £375.00 to £519.75 per week. Rossendale Hall DS0000006617.V316072.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 09 January 2007 and lasted 5.5 hours. Finding of the visit were given to the registered manager and the newly appointed manager on 15 January and lasted 2 hours. The visit was carried out by one inspector. This visit was just one part of the inspection. Before the visit the home owner/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 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? New paperwork has been developed to be used with possible new residents. Information about people’s health, mobility, likes and dislikes is gathered to make sure that the person’s needs can be met at the home. Contracts of the terms and conditions of living in the home have been developed which include pictures so that the residents know what they can expect, and what is and is not included in the fee. Work has started on assessing and minimising risks relating to the environment so that residents’ welfare is safeguarded. Records are kept of all complaints, the nature of the complaint and the outcome, so that residents are assured their views are listened to. Rossendale Hall DS0000006617.V316072.R01.S.doc Version 5.2 Page 6 Twenty-three staff have attended training in relation to adult protection so that residents are protected from harm 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.V316072.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.V316072.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): 2,4,5. Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. As staff from the home are not yet making assessments of possible residents’ needs before they move in, the home cannot show the person’s needs can be met there so they may not get the care and support they require. EVIDENCE: One residents’ file that was inspected included information about his attendance at the Rossendale Trust’s day centre, Oakwood. This information related to what the resident was doing in 1997. An assessment of the resident’s needs was not available from his funding authority, although staff from the authority had attended a review meeting on 31 August 2006. Following the last inspection the home has developed its own assessment document, which includes information about health, mobility and communication. Rossendale Hall DS0000006617.V316072.R01.S.doc Version 5.2 Page 9 A record was available of the visits that the prospective resident had made to the home before moving in, including a visit for tea, an overnight stay and a visit for a long weekend. The information also included their thoughts about moving to the home. The home has developed a contract of the terms and conditions of living in the home. Rossendale Hall DS0000006617.V316072.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 poor This judgement has been made using available evidence including a visit to this service. Without identifying the residents current needs and assessing the risks associated with activities and daily living the residents may not be adequately safeguarded. EVIDENCE: Three care files were inspected and although they contained information regarding the individual’s past, information did not identify the persons’ current needs or how those needs would be met. A timetable was available in the home that identified annual reviews, which had been planned for all residents involving the residents, staff and other interested parties. The manager said that representatives from the resident’s funding authority did not always attend these meetings. Rossendale Hall DS0000006617.V316072.R01.S.doc Version 5.2 Page 11 Residents are encouraged to make decisions for themselves, within their abilities. Following the last inspection the home has developed a satisfaction survey to establish if residents are happy with aspects of their care and choice of health care professionals. The manager said that a local advocacy group is starting work with the residents to promote confidence and help them speaking up for themselves. Since the last inspection a consultant has started work with Rossendale Trust. His role is to identify and assess potential risks to residents’ wellbeing and to provide training to staff on the risk assessment process. Work is well underway in assessing environmental risks but assessments about the residents’ activities and daily living and staff training have only just started. Rossendale Hall DS0000006617.V316072.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): 16 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are supported to make choices so they maintain control over their lives within their individual abilities. EVIDENCE: Standards 12,13,15, and 17 were met at the last key inspection so were not looked at again during this visit. Three residents confirmed that they had keys to their bedrooms and liked living in the home. Evidence was seen on one resident’s file that he did not want a key to his room. Residents were seen coming and going throughout the day, returning from work or activities, having lunch at home and talking with staff about what they had done or were about to do. The atmosphere was relaxed and jovial. Rossendale Hall DS0000006617.V316072.R01.S.doc Version 5.2 Page 13 Two bathrooms did not have locks on their doors. The manager said that they had been fitted originally and the matter would be addressed. Rossendale Hall DS0000006617.V316072.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 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Equipment must be provided by the home to meet the needs of the residents, so that care can be provided for them safely. EVIDENCE: At the last key inspection, there was ample evidence to show that residents’ physical and emotional health needs are met. Two health care professionals responded to the CSCI questionnaires and raised no issues. Policies and procedures for medicine administration were in place so these standards were not checked again during this visit. Staff support residents with their personal care depending on the residents’ ability. Three residents continue to have difficulties with bathing. Electrical and plumbing work has been completed in preparation for fitting a specialist bath and the manager confirmed that the bath is due to be fitted early in February. The cost of maintenance and repairs/servicing of equipment needed by the resident is now met by the home. Rossendale Hall DS0000006617.V316072.R01.S.doc Version 5.2 Page 15 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. Most of the staff have received adult protection training so that they are aware of their responsibility in protecting residents from harm. EVIDENCE: A complaints procedure has been developed using pictures for residents who have limited literacy skills. Following the last inspection each house has now introduced a logbook to record all complaints made by residents or their families. Since the last inspection twenty-three staff have attended training relating to adult protection. Staff said that they had enjoyed the training and felt confident in reporting any concerns they may have. Rossendale Hall DS0000006617.V316072.R01.S.doc Version 5.2 Page 16 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. Although significant improvements have or are planned for the fabric of the building some issues are still unresolved, leaving residents and staff exposed to unnecessary risk. EVIDENCE: A tour of the premises the Hall, Riverside and Hillside was undertaken as part of the inspection. The home has a number of double bedrooms and although the current residents have shared for a number of years, the manager should review this arrangement at the next opportunity. The home’s Statement of Purpose states that single rooms will be offered when available. Rossendale Hall DS0000006617.V316072.R01.S.doc Version 5.2 Page 17 At the last visit a requirement was made that privacy screens must be provided in shared rooms. Residents have been ask if they want a screen which they have declined. However on the day of the visit one resident was poorly and in bed due to an upset stomach. The resident has a physical disability and needed significant support with personal care and occupied a shared room. Screens are not available in the home to maintain individuals’ privacy and dignity on such occasions. A window restraint has now been fitted to a residents’ upstairs window, restricting his access to a flat roof and minimising the risk of potential falls. Evidence was provided of work recently undertaken by the home’s maintenance person during October and November, and maintenance expenditure requirements for the 1st quarter of 2007. However this document did not include the timescale in which the work should be completed. The maintenance schedule does not identity the work needed to replace the bath with the enamel that is worn away to the extent that it poses a risk of cross infection. Nor does it identify the work needed in the kitchen of the Hall to replace worn kitchen worktops, kitchen sealant and areas that pose a risk to health and hygiene. The manager confirmed the electrics and new water systems necessary before the home can install a specialist bath in Riverside are now in place. The bath is due to be fitted early February. Rossendale Hall DS0000006617.V316072.R01.S.doc Version 5.2 Page 18 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): 32,33,34,35,36 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Poor recruitment processes and staff training not being available could lead to residents being at risk of harm or poor practice. EVIDENCE: A list has been compiled dated 11 January 2007 of the future staff training needs relating to Health and Safety. On the day of the visit it was identified that eleven people have received training in moving and handling; sixteen have current 1st Aid qualifications and twenty-three staff have recently attended training relating to adult protection. Administration of medication training has been planned for 24 January and 14 February 2007. Staff have not received fire safety training. There was no evidence available to suggest that staff are offered training relating to the specific needs of the current residents in the home. Rossendale Hall DS0000006617.V316072.R01.S.doc Version 5.2 Page 19 Information provided by the manager on 18 December 2006 stated that 30 of the staff have achieved a National Vocational Qualification at level 2 or above. Six files for staff who had been employed by the home since the last visit were inspected. Five of the files did not contain full and satisfactory information in accordance with Schedule 2 of the Care Homes Regulations. Records provided by the manager showed that all six staff began work before Criminal Record Bureau disclosures had been received and that two staff continue working in the home before any clearance had been received. CSCI sent a warning letter to the home regarding this matter on 10 January 2007 to ensure that the manager and trustees of the organisation were aware of this situation and seeking their urgent action to rectify it. At the last visit it was identified that no formal arrangements were in place to supervise staff on a one to one basis. The home is in the process of making changes to the management structure and this matter will be addressed. Rossendale Hall DS0000006617.V316072.R01.S.doc Version 5.2 Page 20 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 poor. This judgement has been made using available evidence including a visit to this service. Staff have not undertaken training relating to health and safety and therefore do not have the skills and knowledge to safeguard the welfare of the residents adaequately. EVIDENCE: The registered manager for the home has other responsibilities within the organisation and consequently trustees have appointed a new manager from within the home. Information has been provided to the home regarding the process of registering a new manager and the Commission for Social Care Inspection is awaiting the application. Rossendale Hall DS0000006617.V316072.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection received information on 28 November 2006 of a visit made to the home by a nominated person, representing the owners of the home, under Regulation 26 of the Care Homes Regulations. A number of requirements made during this visit are outstanding from previous inspections and have now exceeded the home’s own timescales agreed in their improvement plan. There has been some improvement in the training available and undertaken by staff. However all staff need to undertake mandatory training in relation to health and safety, moving and handling, food hygiene, first aid and fire safety. Information provided by the manager showed that service contracts are up to date in relation to gas supply, electrical installation. The home’s records were inspected and are maintained appropriately in respect of the fire equipment, emergency lighting, alarms and fire extinguishers. Rossendale Hall DS0000006617.V316072.R01.S.doc Version 5.2 Page 22 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 X 2 1 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 2 ENVIRONMENT Standard No Score 24 2 25 2 26 2 27 2 28 X 29 2 30 2 STAFFING Standard No Score 31 X 32 2 33 2 34 1 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 X X X 2 X 2 X X 2 X Rossendale Hall DS0000006617.V316072.R01.S.doc Version 5.2 Page 23 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 YA2 Regulation 14(1) Timescale for action Residents must not be admitted 28/02/07 into the home unless the home can demonstrate that their assessed needs can be met. This requirement remains unmet from the previous inspection on 08/08/06 Care plans must be reviewed 28/02/07 regularly and updated to reflect the residents’ current needs. This requirement remains unmet from the previous inspection on 16/03/06 & 08/08/06 Risks to health and safety of 28/02/07 residents must be identified and so far as possible eliminated This requirement remains unmet from the previous inspection on 08/08/06 Bathing facilities suitable for the 28/02/07 needs of the residents must be provided in Riverside. This requirement remains unmet from the previous inspection on 08/08/06 Requirement 2. YA6 15(2) 3. YA9 13(4) 4. YA18 23(2) Rossendale Hall DS0000006617.V316072.R01.S.doc Version 5.2 Page 24 5. YA32 18 6. YA24 23 7. YA25 16(2) 8. YA34 19(1)-(4) Staff must receive training relevant to the role they perform, including all mandatory training. This requirement remains unmet from the previous inspection on 16/03/06 &08/08/06 The problems identified in this report must be attended to as part of the planned schedule of maintenance with appropriate timescales. This requirement remains unmet from the previous inspection on 16/03/06 & 08/08/06 Privacy screens must be provided in double occupancy rooms to ensure privacy and dignity is maintained. This requirement remains unmet from the previous inspection on 08/08/06 Criminal Records Bureau disclosures must be obtained for all new staff working in the home before they start work. The registered person must ensure that full information regarding staff (as set out in Schedule 2 of the Care Home Regulation 2000) is available before they commence employment. Previous timescale of 08/08/06 not met. 31/03/07 31/03/07 28/02/07 10/01/07 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 Good Practice Recommendations Standard YA3 The home should not confirm residency in the home unless it can demonstrate that residents’ needs can be met. Rossendale Hall DS0000006617.V316072.R01.S.doc Version 5.2 Page 25 2. 3. 4. YA25 YA32 YA36 The manager should review the arrangements for providing shared bedrooms at the next opportunity 50 of staff should have achieved NVQ level 2 as a minimum by 2005 Regular recorded supervision meetings should take place as a minimum six times per year. 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