Inspection on 10/11/08 for Rosslyn

This inspection was carried out on 10th November 2008.

CSCI found this care home to be providing an Poor service.

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

Rosslyn 27/11/07

Rosslyn 09/01/07

Rosslyn 28/06/06

Rosslyn 13/10/05

Rosslyn 16/05/05

Rosslyn 18/10/04

Rosslyn 10/05/04

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

CARE HOMES FOR OLDER PEOPLE Rosslyn 29 Bagdale Whitby North Yorkshire YO21 1QL Lead Inspector Karen Ritson Key Unannounced Inspection 10th November 2008 10:00 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 Rosslyn DS0000007728.V373254.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 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. Rosslyn DS0000007728.V373254.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosslyn Address 29 Bagdale Whitby North Yorkshire YO21 1QL 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) 01947 820931 Mr Jeremy William Southgate Manager post vacant Care Home 11 Category(ies) of Old age, not falling within any other category registration, with number (11) of places Rosslyn DS0000007728.V373254.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th November 2007 Brief Description of the Service: Rosslyn provides long-term accommodation and personal care for a maximum of eleven older people. The home is located on a main route into Whitby and is conveniently situated for the shops and other community facilities including transport links. Rosslyn is a traditional house with modern extension built on two floors with the communal areas and two bedrooms being located on the ground floor. One bedroom has an en suite toilet facility. A stair lift gives access to the first floor for residents with limited mobility and consequently the residents placed in bedrooms on the first floor have to be reasonably ambulant. The home has its own parking facilities and there is on-road parking within close proximity. The front of the house has ramp access as well as steps. The home has a statement of purpose and service user guide, which provide information about the scope and nature of the care and facilities on offer. These, with CSCI reports, are available on request at the home. The fee charged is usually £375 per week; however, this may vary with the degree of assessed needs. Hairdressing and newspapers are not included in this fee and these are charged at cost. Rosslyn DS0000007728.V373254.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. The inspection for this service took 12 hours. This includes time spent gathering information and examining documentation before and after two unannounced site visits and in writing the report. The site visit took place on 10/11/08 between 9:30am and 12.30 noon. Information for this inspection was gathered from the following: A tour of the premises Observations of care throughout the day of the site visit. Speaking with people. Speaking with staff. Case tracking people on the day of the site visit. Notifications sent to the commission from the home since the last inspection. • Examining policies, procedures and records kept at the home. • Examining information regarding the home on the file kept by CSCI. • Considering comments made by relatives, health care and social services staff. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. All key standards were looked at during this inspection. There is no manager for this service. Two care assistants assisted throughout the day. • • • • • • What the service does well: What has improved since the last inspection? Rosslyn DS0000007728.V373254.R01.S.doc Version 5.2 Page 6 Staff are now recruited only after a check that they are suitable to work with vulnerable people. 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. Rosslyn DS0000007728.V373254.R01.S.doc Version 5.2 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 Rosslyn DS0000007728.V373254.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 People who use the service experience good quality outcomes in this area. Prospective service users and their representatives have the information needed to choose a home, which will meet their needs. They have their needs assessed, and the home makes sure it can meet those needs before making an offer of a placement. This judgement has been made using a range of evidence including a visit to the service. EVIDENCE: People receive a comprehensive assessment of care needs prior to admission. All areas of care needs are considered, and are mostly thoroughly dealt with, however, a consideration of people’s interests could be more detailed so that the home can plan how to offer activities that are personalised for each person. Risk assessments for individuals are detailed and specific to the care Rosslyn DS0000007728.V373254.R01.S.doc Version 5.2 Page 9 they need. This means people are considered as individuals and their safety in this respect is protected. The home does not offer intermediate care. Rosslyn DS0000007728.V373254.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 People who use the service experience poor quality outcomes in this area. The personal care that people receive through their care plans is generally based on their individual needs. The principles of respect, dignity and privacy are put into practice. Medication is not administered in a way which protects the safety of people living at the home and so their health is not adequately protected. This judgement has been made using a range of evidence including a visit to this service. EVIDENCE: A plan of care is available for each person and notes are made three times each day about how each person is and what they have been doing. The previous manager has drawn up most care plans, but a care assistant has Rosslyn DS0000007728.V373254.R01.S.doc Version 5.2 Page 11 copied the format when the registered individual made an admission recently. Health care professionals are consulted when drawing up the plan and all visits by such professionals have been recorded until the last manager left. The care assistants who are running the home at present, understand that people need access to advice and attention from GP’s, District Nurses and other specialists; however, their knowledge of the detailed health care needs of individuals is incomplete. One person had occasional visits from a Community Psychiatric Nurse, but the carers said they were unsure what this was for. The care plans are kept under regular review, but there is no evidence that people or their representatives had been involved in the process. Although care plans cover all required areas of care, people’s interests could be better recorded. The home uses a Boots MDS system for medication, which means that most medication is received into the home in blister packs. Not all medication can be provided in this way however, and the carers said that there was no auditing system for packeted medication. It is therefore not possible to check how many tablets aught to be in stock. This could lead to errors in administration, which could put people’s safety at risk. The home has a separate locked cabinet for controlled medication, which is good practice, although no person is prescribed such medication at the moment. One care assistant has received external training in the safe handling of medication. She said that she had told other staff how to administer medication and that when they were on shift without her they were left to do this unsupervised. This potentially places people at risk of misadministration of medication and must be remedied urgently. Throughout the day of the site visit, staff were observed treating people with respect and regard to dignity. People said they were treated with kindness and enjoyed living at Rosslyn. Rosslyn DS0000007728.V373254.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 People who use the service experience adequate quality outcomes in this area. They are not all enabled to make informed choices about the way they live their lives. They have a good diet they enjoy. This judgement has been made using a range of evidence including a visit to this service. EVIDENCE: People said they had outings with family or friends and two enjoyed watching sky television in their rooms. The staff said that people sometimes enjoy doing domestic tasks such as washing up, dusting or folding sheets and occasionally they would play a game of dominoes or cards. During the warmer months people can sit outside the home, also, occasionally people go out for a ride in the car. Those people who wish to follow religious observance are assisted to do so and visits take place from more than one denomination. The home puts on a Christmas party where all friends and relatives are invited and the atmosphere on the day of inspection was relaxed and friendly. Staff spent time chatting with people and treating each person as an individual. Rosslyn DS0000007728.V373254.R01.S.doc Version 5.2 Page 13 However, the home offers little in the way of activities tailored to the assessed social needs of each person. Staff said that people often did not wish to join in with activities, finding them too much bother. There is not sufficient effort being made to discover what each person might be interested in. The home is caring for some people with specific needs due to their medical condition and their social and lifestyle needs were not adequately addressed in their care plans. Examination of daily notes showed that that little was being done in practice either. The home has a semi open visiting policy avoiding meal times or late visits. People said they enjoyed the meals and that they had choice. A midday meal was observed, and was of a high quality. Nutritional needs and meal choices are recorded, which helps with planning menus and ensuring people receive the right diet. Rosslyn DS0000007728.V373254.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience poor quality outcomes in this area. They are able to express their concerns, and have access to an effective complaints procedure. Their welfare is not sufficiently protected. This judgement has been made using a range of evidence including a visit to this service. EVIDENCE: Social services professionals commented that one person had complained that the TV reception in her room made watching TV impossible since the direction of the signal had altered in Whitby recently. Despite being asked to get the aerial direction changed, this has not been done. The home has a complaints procedure but this is clearly not effective. The carer who was assisting during the inspection said she had completed NVQ level 2 in care and had begun level 3 in which she had covered keeping people safe from abuse. She was very clear on what needed to be done if she witnessed or suspected abuse. Not all staff have had this training, though some have had training from an external source last year. Abuse awareness must be a priority for all staff working at the home to ensure people are protected at all times. There had never been any referral from the home through the protection of vulnerable adults procedure. Rosslyn DS0000007728.V373254.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience adequate quality outcomes in this area. People live in a reasonably decorated and comfortable home, however, work needs to be done to ensure all areas of the home are free from dampness to protect the welfare of those living at the home. The laundry is satisfactory for the needs of people at the home. This judgement has been made using a range of evidence including a visit to this service. EVIDENCE: The home is reasonably decorated. All hazardous cleaning materials are kept locked away in the laundry room, normally only accessed by staff. Health and safety information is displayed on the walls. The stair lift is in operation and is Rosslyn DS0000007728.V373254.R01.S.doc Version 5.2 Page 16 regularly serviced. The bathroom wallpaper is peeling away from the wall and the wall is very damp. In one of the bedrooms, the wallpaper has come away from the wall and the wall is also very damp. This must be remedied to provide a pleasant and healthy living environment for the people at the home. The laundry room is separate from the kitchen and the equipment is suitable for the needs of those living at the home. Rosslyn DS0000007728.V373254.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 People who use the service experience adequate quality outcomes in this area. Staff are in sufficient numbers but are not adequately trained to meet the needs of people in the home. Staff are now recruited according to policy to ensure people are cared for by people suitable to do so, but only after prompted to do so by CSCI. This judgement has been made using a range of evidence including a visit to this service. EVIDENCE: Staffing levels are sufficient for the needs of those who live at the home. During the day there are two members of staff on duty and at night there is one awake with one on call. Staff no longer receive induction to ‘skills for care’ guidelines. This is because new staff have been recruited when there has been no manager to provide an adequate induction for them. Care assistants already working at the home have assisted new staff by showing them around and acquainting them with fire equipment and introducing them to people living at the home. The induction is not adequate and does not prepare staff to develop the skills necessary to offer good well-informed care. Most staff have begun foundation training but this is not complete, although some have received Rosslyn DS0000007728.V373254.R01.S.doc Version 5.2 Page 18 manual handling and first aid training. Staff have not all received infection control training for example. When the previous manager left her employment several other staff left their employment at the same time. This meant that shifts needed to be covered urgently. The carers who were left in charge had the task of recruiting new staff which they did to the best of their ability, however they did not have the training to recruit staff according to the procedural guidelines. It was apparent that the correct procedure was not properly adhered to when the most recent staff were recruited. However, all now have been checked against a list of people who must not work with vulnerable people and have been cleared, they have also have had police checks. Rosslyn DS0000007728.V373254.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 and 38. People who use the service experience poor quality outcomes in this area. The home does not have a manager and this creates a serious risk that people living at the home do not receive safe or well- informed care. The quality assurance system is not yet effective. People are also at risk because the home has inadequate safety procedures. This judgement has been made using a range of evidence including a visit to this service. EVIDENCE: The home has no manager. The previous manager, who had not yet been registered with CSCI left her employment in September and has not been Rosslyn DS0000007728.V373254.R01.S.doc Version 5.2 Page 20 replaced. The home was caring for seven people when the inspection took place. The staff on duty were unfamiliar with the role of CSCI, the detail of the National Minimum Standards and Regulations. This means that at present, the users of the service do not have the benefit of staff who understand the regulatory framework for care. The quality assurance system is in the planning stages, with some surveys having been completed by users of the service, but wide surveying to include relatives and others who come into contact with the home has not yet begun. Results of the surveys have not yet been compiled, and there is no annual plan devised from the results of such surveys. It is therefore not possible to say that the home plans improvements based on the views of those who come into contact with the service. The home handles the personal allowances for several people living at the home. Money kept and records of spending were checked and all tallied. This ensures people’s financial welfare is protected. As there is no manager, staff receive no supervision, this means staff do not receive the guidance and support to assist them to provide good safe care for the people living at the home. Those who live at the home are at risk because the staff have an inadequate understanding of the procedure for evacuation in case of a fire, they do not know of any fire risk assessment for the home. The staff on duty could not locate all maintenance certificates so that it was not possible to find out if these were up to date or that electrical equipment or gas appliances were safe. Risk assessments for the environment could not be located and the staff did not know of any. This means that inadequate procedures are in place to ensure people living at the home are kept safe and they are therefore at risk. Rosslyn DS0000007728.V373254.R01.S.doc Version 5.2 Page 21 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 2 1 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 1 X 3 1 X 1 Rosslyn DS0000007728.V373254.R01.S.doc Version 5.2 Page 22 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 OP31 Timescale for action 8, 12(1) The home must have a manager, 31/01/09 to protect the welfare of people at the home and provide support to the staff so they can offer good care. 13(2) The registered person must 31/12/08 make proper provision for the safe handling of medication, through providing adequate training for staff and having a system that allows packeted medication to be audited correctly. 13(4)(a-c) The home must develop risk 31/12/08 assessments for safe working practices to show that it is free from hazards to the safety of service users. 23(4)(a) The registered person must after 30/11/08 consultation with the fire authority, take adequate precaution against the risk of fire, make arrangements for the evacuation in the event of fire of all people in the care home and by means of fire drills ensure that staff and service users are aware of the procedure to be followed in case of fire, including DS0000007728.V373254.R01.S.doc Version 5.2 Page 23 Regulation Requirement 2 OP9 3 OP38OP38 4 OP38 Rosslyn 5 OP31 26 6 OP19 23(2)(b) 7 OP12 12(2)(3) 8 OP18 13(6) 9 OP30 18(a)(c) the procedure for saving life. The registered provider must visit the care home at least once a month unannounced and must prepare a written report on the conduct of the care home and supply a copy of this report to the commission for social care inspection. The areas where wallpaper is peeling from the wall must be remedied to ensure service users enjoy a home of sound construction which is in a good state of repair. Service users must have their interests assessed and be given opportunities to choose interesting and stimulating activities and enabled to follow them. The home must ensure that all staff have abuse awareness training to protect service users from harm The registered provider must ensure that staff receive induction training to enable them to offer care based on best practice. 31/01/09 31/12/08 31/12/08 30/11/08 31/03/09 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 OP36 Good Practice Recommendations Staff should receive regular supervision in line with standard 36. Rosslyn DS0000007728.V373254.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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. Extracts may not be used or reproduced without the express permission of CSCI Rosslyn DS0000007728.V373254.R01.S.doc Version 5.2 Page 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!