Inspection on 17/01/06 for Rossendale Nursing Home

This inspection was carried out on 17th 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 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 Nursing Home 18/09/07

Rossendale Nursing Home 07/08/06

Rossendale Nursing Home 17/05/05

Rossendale Nursing Home 09/11/04

Rossendale Nursing Home 13/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Rossendale Nursing Home 96 Woodlands Road Ansdell Lytham St Annes Lancashire FY8 1DA Lead Inspector Mrs Lynne Lynch Unannounced Inspection 17th January 2006 09:30 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 Rossendale Nursing Home DS0000006077.V252405.R01.S.doc Version 5.0 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. Rossendale Nursing Home DS0000006077.V252405.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Rossendale Nursing Home Address 96 Woodlands Road Ansdell Lytham St Annes Lancashire FY8 1DA 01253 737740 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) Mrs Caroline Taylforth Care Home 27 Category(ies) of Dementia (17), Old age, not falling within any registration, with number other category (10) of places Rossendale Nursing Home DS0000006077.V252405.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 27 service users to include: up to 10 service users in the category of OP and up to 17 service users in the category of DE 17th May 2005 Date of last inspection Brief Description of the Service: The Rossendale Nursing Home is registered with the Commission for Social Care Inspection to provide personal and nursing care for 27 service users of either sex aged 65 years and over. Care is offered to those with physical/medical needs and those with dementia (up to 17 service users). The Rossendale Nursing Home is a detached Victorian property, which retains many of its original features. Three en-suite bedrooms were added to the home in 2004.It is situated in a residential area of Ansdell Lytham St Annes, overlooking Grannies Bay. The home is within easy reach of shops and local amenities. It is situated on a bus route and within five minutes walking distance of Ansdell railway station. Service users are encouraged to retain their links in the community and every effort is given to ensuring that relationships, hobbies and interests are pursued. Relatives, friends and visitors are made welcome at the home at any time. Service users accommodation is provided in nineteen single rooms and four double rooms, nine of which have en-suite facilities. Communal areas are provided in two lounges, a dining room and a conservatory. The conservatory is designated a smoking area. There are attractive gardens to the front and side of the home which are accessible to service users, and there are car parking facilities at the rear of the home. Rossendale Nursing Home DS0000006077.V252405.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 9.30am and took place over 5 hours. The Inspector spoke to one resident, three staff and the manager. Comment cards were issued during the inspection, however none were received back at the time of the report. A tour of the premises was undertaken. The people living at the home all with the exception of one gentleman have various degrees of cognitive impairment. Time was spent observing people living at the home, Except for one gentleman conversations with residents were brief and limited. What the service does well: What has improved since the last inspection? Several bedrooms in the home have been refurbished with more work being planned in this area. The home now has all but one care staff NVQ qualified which exceeds the minimum level required. Rossendale Nursing Home DS0000006077.V252405.R01.S.doc Version 5.0 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. Rossendale Nursing Home DS0000006077.V252405.R01.S.doc Version 5.0 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 Rossendale Nursing Home DS0000006077.V252405.R01.S.doc Version 5.0 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): None of the above standards were inspected at this visit. EVIDENCE: Rossendale Nursing Home DS0000006077.V252405.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 and 10 There are good systems in place within the home in respect of medication, however these are not always applied, posing a risk to residents. Resident’s privacy and dignity is upheld. EVIDENCE: The current medication administration records (MAR) were examined and it was noted that the recording of administration was not always accurate. The use of the key coding system at the bottom of the MAR was not always used effectively. The manager is advised to develop this key code system further to ensure any non-administration is clearly explained. A couple of dose omissions without explanation were noted and medication had not been given from the monitored dosage system but had been signed as administered. The above errors indicate staff relying heavily on the monitored dosage system and not following the correct administration procedures, namely referring to the medication administration record whilst assembling the medication and signing the record immediately after witnessing the resident taking it. The manager is advised to take appropriate steps to ensure all staff understands their responsibilities in administering and recording medication as prescribed by the GP. The home has good storage and a register in place for controlled drugs. Rossendale Nursing Home DS0000006077.V252405.R01.S.doc Version 5.0 Page 10 Residents were treated with respect and dignity throughout the inspection. One gentleman spoken to confirmed that staff were always courteous and helpful not just to him but also to all residents in the home. Rossendale Nursing Home DS0000006077.V252405.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the above standards were inspected at this visit. EVIDENCE: Rossendale Nursing Home DS0000006077.V252405.R01.S.doc Version 5.0 Page 12 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 and 18 Arrangements for handling complaints are in place and concerns are responded to appropriately. The home has a procedure in place for dealing with allegations of abuse. EVIDENCE: The complaints procedure is clearly written and is contained in the Statement of Purpose. A record of all complaints made is kept in the home and this details the action taken and the outcome of the investigation. The home has received no complaints since the last inspection and non have been received by the Commission for Social Care Inspection. The home has a procedure in place for dealing with allegations of abuse. The manager and staff spoken to had a good understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. The home’s training addresses issues of physical and or verbal aggression and inappropriate behaviour displayed by Service Users. A whistle blowing policy is in place and staff are made aware of this via training. One gentleman said, “I have no complaints the home is nice and the staff are absolutely brilliant”. Rossendale Nursing Home DS0000006077.V252405.R01.S.doc Version 5.0 Page 13 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 and 26 Improvements to the décor have been made. Some areas of the home still require redecoration. The home requires a maintenance and renewal plan to provide residents with safe and comfortable surroundings. EVIDENCE: The Rossendale is satisfactorily decorated and generally well maintained, the inspector advised of some minor repairs that were required which included radiator cover requiring re affixing and a toilet cistern repaired. Day to day maintenance is noted in a book and the Registered provider’s husband then carries this out. All residents spoken to were comfortable in the home and happy with their surroundings. Some bedrooms have been refurbished to a good standard and this is part of an on going programme. The home needs to develop a maintenance and redecoration plan for the forthcoming year. The home has purchased a Health and Safety management system, which ensures training for staff and provides environmental risk assessments for the home. Booklets are provided for staff to outline their key responsibilities in respect of maintaining a safe environment. The manager was strongly advised Rossendale Nursing Home DS0000006077.V252405.R01.S.doc Version 5.0 Page 14 by the inspector to ensure all ingestible products such as shampoo and bubble bath are locked away due to the vulnerability of the homes residents. There are three sluice rooms within the home. The washing machine has a sluicing facility and meets the required temperatures for the control of infection. The home was generally clean with the exception of the conservatory area, which as on previous visits was in need of more thorough attention. Rossendale Nursing Home DS0000006077.V252405.R01.S.doc Version 5.0 Page 15 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): 27, 28, 29 and 30 There is a good match of well-qualified staff offering consistency of care within the home. The arrangements for staff training are very good with staff demonstrating a clear understanding of their roles. The policies and procedures for the recruitment of staff on this occasion did not provide safeguards for the protection of service users and potentially placed service users at risk. EVIDENCE: Rossendale Nursing Home DS0000006077.V252405.R01.S.doc Version 5.0 Page 16 The Rossendale is staffed well with a good mix of staff on duty at all times. On the day of this unannounced inspection the home had one qualified staff and five care staff on duty alongside the owner/manager who is also nurse qualified. The manager of the home holds a teacher-training certificate and is very supportive of staff training. The home provides adaptation training for nurses and this is something that the manager takes very seriously and has recently refused to recommend one member of staff for qualification. The homes staff access mandatory training via a local reputable training organisation. All newly appointed care staff undertake a basic one-week induction to the home and then work through the detailed Training Organisation of the Personal Social Services induction training programme that culminates in a performance review. Once induction training has been successfully completed, recently appointed members of staff are then routinely registered for NVQ Level 2 training. This process has enabled an exceptionally high number of care staff at the home to achieve an NVQ qualification in care. Staff spoken with were enthusiastic about the training opportunities available with one carer stating that she felt ‘service user needs were being addressed very well and staff pull together’. The inspector highlighted to the manager that there was a need for Dementia awareness training in the home and this was felt to be essential due to the category of residents supported. All the staff spoken with felt that the staffing was adequate to meet individual needs. One staff member advised that one of the residents requires continuing support and therefore receives 1:1 support; staff share this responsibility providing support in two hourly sessions. One gentleman said, “the staff are very respectful, they are very good with me, I have a heart problem, they come the instant I push my call bell”. One staff spoken to was part way through her adaptation training she said that she had regular supervision and appraisal and also was observed in practice. There was evidence of Criminal Record Bureau (CRB) checks being undertaken for the majority of staff. The manager was reminded that any outstanding clearances must be chased up and that staff must not commence employment without evidence of the Protection of Vulnerable Adults register being checked, followed by a suitable CRB clearance being received. In addition the home employs several oversees staff members and the only Criminal Record Check on file are the ones from their country of origin. The manager was informed that all staff including oversees staff must be referred to the Criminal Records Bureau for clearance prior to employment. Rossendale Nursing Home DS0000006077.V252405.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 33 and 35 The manager is qualified, experienced and supported by the senior staff in providing clear leadership throughout the home. Resident’s financial interests are safeguarded. EVIDENCE: The registered manager of the home has many years experience in the care field and advised that she has completed her Registered manager’s awards and is awaiting her certificate for this. Despite a recent accident the manager of the home has continued to run the home and has worked hard to ensure that standards are maintained. The staff and service user spoken to said that the management team were helpful and approachable. None of the residents in the home completely manage their finances, with only two residents able to access and utilise their money. All fees and expenses are paid either by relatives or via a solicitor. One gentleman said, “ I talk to the staff a lot, the boss is very good, I can speak to any of them”. Rossendale Nursing Home DS0000006077.V252405.R01.S.doc Version 5.0 Page 18 All residents’ personal money is kept within a locked facility and clear records of these were viewed and seen to have double signatures for all transactions. The home ensures that residents who are unable to go out shopping are able to purchase personal items and clothing via catalogues or from a small stock maintained at the home. One resident spoken to advised that he likes the home to keep his money safe, he said “I can get my money anytime, I go out most days on my scooter and can do my own shopping”. Rossendale Nursing Home DS0000006077.V252405.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X X Rossendale Nursing Home DS0000006077.V252405.R01.S.doc Version 5.0 Page 20 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 OP29 Regulation 19 Requirement A criminal records bureau check must be requested for new staff employed to work at the home before they start work. (Previous timescale of 17/05/05 not met) The registered manager is required to make arrangements for the recording, safe administration and disposal of medication. The following issues were identified: 1. The manager to develop the medication key code system further to ensure any non-administration is clearly explained. 2. Dose omissions without explanation were noted and medication had not been given from the monitored dosage system but had been signed as administered. A system of audit should be introduced. 3. Items such as eye drops should be dated upon opening. Rossendale Nursing Home DS0000006077.V252405.R01.S.doc Version 5.0 Page 21 Timescale for action 17/05/05 2. OP9 13(2) 31/01/06 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. Refer to Standard OP19 OP19 OP30 Good Practice Recommendations The home should have a maintenance and renewal programme, to ensure a homely, comfortable environment is maintained. All ingestible products should be kept in locked facilities. All care staff should receive training in Dementia care. Rossendale Nursing Home DS0000006077.V252405.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Nursing Home DS0000006077.V252405.R01.S.doc Version 5.0 Page 23 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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