Inspection on 20/06/05 for Rotherbank

This inspection was carried out on 20th June 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Rotherbank 26/10/06

Rotherbank 19/12/05

Rotherbank 06/12/04

Rotherbank 09/06/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Rotherbank Rotherbank Farm Lane Liss Hampshire GU33 7BJ Lead Inspector Peter J McNeillie Unannounced 20 June 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Rotherbank v231924 h54 s11720 rotherbank v231924 200605.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Rotherbank Address Rotherbank Farm Lane Liss Hampshire GU33 7BJ 01730 892081 01703 892081 rotherbank@btinternet.com www.rotherbank.com Christine Hillyer Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Christine Hillyer CRH 21 Category(ies) of DE Dementia - 4 registration, with number OP Old age - 21 of places DE(E) Dementia - over 65 - 21 Rotherbank v231924 h54 s11720 rotherbank v231924 200605.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Four service users only in the category DE to be admitted over the age of 55 years Date of last inspection 6th December 2004 Brief Description of the Service: Rotherbank is a privately owned and managed home offering care and support for up to to 21 older persons in the catories oldlder persons OP and DE and DE(e) Dementia.The home is situated in a residential area of in Liss Forest village, a short distance from local amenities.The home offers accomadation on on two floors with a chair lift accessing the first floor. The majority of service users are accommodated in single rooms some fitted with ensuite toilet and washing facilities. Two shared double rooms are available. This service has one bed designated for respite care. Rotherbank v231924 h54 s11720 rotherbank v231924 200605.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the first of two annual inspections for 2005/2006. During this inspection which took place between 9:15am and 1:00pm. The inspector who was assisted by the deputy manager spoke with 12 residents and all of the staff on duty. Evidence was also gathered from a tour of the building, reading records, care plans, previous reports comments by management /staff and observations. What the service does well: What has improved since the last inspection? Since the last inspection the recording of drugs decanted from containers provided by a pharmacist a separate record has been introduced in line with comments made in the last report. Rotherbank v231924 h54 s11720 rotherbank v231924 200605.doc Version 1.30 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. Rotherbank v231924 h54 s11720 rotherbank v231924 200605.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Rotherbank v231924 h54 s11720 rotherbank v231924 200605.doc Version 1.30 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 standard(s) 3 The home has a well developed system of assessing and identifying residents needs which ensures residents safety and assessed needs can be met. EVIDENCE: Records seen confirmed that service users were only admitted on the basis of a full and detailed pre admission assessment of needs and risk by the manager or other member of the senior staff. Where possible the assessment would take place where the potential service users was residing. Documentation seen confirmed a number of other external health care professionals including GPs, geriatricians, continence advisors, physiotherapists, occupational therapists and care managers were consulted and contributed to the assessment process but did not include evidence to confirm the resident or their representative were consulted. Records were also available to confirm that re assessments are carried out on all residents on a regular basis. As with pre admission assessments a range of external health care professionals were consulted but as before evidence to support the involvement / consultation with the resident or their representative was not seen. Rotherbank v231924 h54 s11720 rotherbank v231924 200605.doc Version 1.30 Page 9 Rotherbank v231924 h54 s11720 rotherbank v231924 200605.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,and10 The arrangements for planning care are clear ensuring that the health and personal care needs of resident are met were satisfactory and their privacy and rights respected.The home has adequate policies and procedures in place ensuring the medication needs of residents are met. Rotherbank v231924 h54 s11720 rotherbank v231924 200605.doc Version 1.30 Page 11 EVIDENCE: Communication with a number of residents was very difficult. Residents spoken to all said they were satisfied with the service the home offered and confirmed they were treated with respect and dignity and were able to exercise choice with day to day matters eg food, bedtimes etc . A sample of six care plans were viewed. Care plans which were reviewed monthly included information on how identified needs were to be met. The inspector did comment that whilst there were photographs of residents on file, best practice would indicate all care plans should include residents photograph. All of the care plans had been produced by the same person. The inspector suggested that key workers assume responsibility for the production of plans and members of the management team monitor. Residents confirmed any personal care was given in private, staff always knocked and waited before entering their bedroom, they were able to make/receive telephone calls and receive visitors in private. Files seen and comments made by staff and residents confirmed consultation with a range of external health care professionals eg doctors, district nurses, community phychiatric nurses, psycho geriatricians, physio/occupational therapists take place. Residents and staff confirmed all were free to choose their own GP and the source of other personal services eg chiropodists, dentists optician etc. Any restriction on choice with regard to a GP was outside the control of the resident or the home’s management. Records and observations confirmed a number of both personal and communal aids had been provided following consultations and a specialist assessment of need. Aids currently in use included walking frames, wheelchairs, hoists, raised toilets and grab rails. A detailed medication policy and procedure covering the storage, handling and disposal of drugs and medicines was available. Records seen confirmed that all drugs and medicines (which were securely stored) were recorded when administered to service users or disposed of. During the previous inspection it was highlighted that when drugs are administered/decanted from a container other than that provided by the pharmacist no separate record was being maintained. This issue has now been addressed and a record is now being kept. All staff involved in the administration of drugs and medication have received training. Where service users are not responsible for their own medication detailed risk assessments and evidence to support that the issue was consulted upon was available. Rotherbank v231924 h54 s11720 rotherbank v231924 200605.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 and 15. The social activities family contacts and the provision of varied and nutritious meals were well managed and reflected service users interests and choices. Rotherbank v231924 h54 s11720 rotherbank v231924 200605.doc Version 1.30 Page 13 EVIDENCE: All of the residents spoken with expressed satisfaction with the quality of their day to day lives. In accepting there had to be a routine the view was expressed that flexibility was very much in evidence. To quote one resident, “We are free to do our own thing at any time we want.” The inspector formed the view that routines were arranged to meet the needs of the service users and not the needs of the home/staff. A list of in-house and community activities was available these included scrabble, cards ,bingo, music and movement, art/crafts as well as visits out to local places of interest, shopping etc. Residents confirmed visitors were welcome at any time and that they were able to maintain links with the local community if they wished through a local lunch club,local churches and trips out. All of the service users spoken to expressed in glowing terms total satisfaction of the quality, quantity and choice of food available. An extensive and varied menu based on service users likes and dislikes was seen. The inspector noted at lunchtime that all meals were presented in an attractive and appetising manner, this was also commented on by service users. Special diets and assistance with feeding (if required)can be catered for. Whilst there are set meal times advertised these are flexible to meet residents needs and wishes .Residents are free to take their meals in their own room if they wish. During the last report it was noted that whilst the nutritional need of some residents were being assessed, assessments on all service users was not being routinely undertaken. Records seen indicated all residents now receive nutritional assessments. Rotherbank v231924 h54 s11720 rotherbank v231924 200605.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16and 18 The home has clear policies and procedures in place which ensures residents are protected from abuse. The complaints procedure was satisfactory with evidence that residents feel their views will be acted upon. EVIDENCE: The home’s adult protection policy and procedure which operates in tandem with the Hampshire County Council policy and procedure designed to protect vulnerable residents from abuse was available as were records to confirm all staff had received training in the procedures to follow should they suspect abuse has occurred. Staff spoken with confirmed they were fully aware of the procedure to follow should they witness or suspect the abuse of any resident. The complaints procedure which was also included in the service users guide gave information on how to contact The Commission for Social Care Inspection (C.S.C.I) was seen as was a record of complaints. No complaints had been received since the last inspection. that indicated one minor complaint had been received and dealt with complaints had been since the last inspection. Residents spoken to stated they felt comfortable in raising any concerns they had with the home’s management and were confident any matters raised would be dealt with fairly and promptly Rotherbank v231924 h54 s11720 rotherbank v231924 200605.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19and 26 A safe, well maintained, clean and suitably furnished home and accessible garden is provided for service users which meets their needs. EVIDENCE: A tour of the building, garden comments from residents and staff confirmed that the building was fit for its stated purpose, accessible, safe, well maintained and meeting residents individual and collective needs. The inspector did however highlight a raised paving stone to the rear of the property which presented as a trip hazard. A verbal undertaking was given by the deputy manager the matter would be attended as soon as possible. Furniture was comfortable and homely and in keeping with the décor. All of the rooms were fully furnished. Aids to assist service users currently include, handrails, ramps, bath hoists, raised toilets and a stair lift. The home was clean, hygienic and free from adverse odours. An infection control policy and procedure was in place. Since the last inspection two bedrooms have been redecorated and refurbished, new furniture provided for the conservatory and a new electronic security system linked to the fire alarm installed. Rotherbank v231924 h54 s11720 rotherbank v231924 200605.doc Version 1.30 Page 16 Rotherbank v231924 h54 s11720 rotherbank v231924 200605.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28 and 30 Residents needs are met by sufficient numbers of well trained and supported staff. EVIDENCE: At the time of the inspection four care staff including the deputy manager plus a cook were on duty. The staffing levels appeared adequate to meet the needs of the residents an opinion shared by the residents who were full of praise for their carers comments such as good girls, always willing to help, always there when we want them etc were a sample of the residents positive responses to the staff. In checking the care plans the inspector noted that care staff are allocated “prime time” which allows them to offer one to one support on a regular basis to the less able and high needs residents. Care staff confirmed the level of staffing and training allowed them to deal with residents in an unhurried manner. Following induction and foundation training and a probationary period all staff are expected to participate in an NVQ training programme. Currently 88.2 of staff have either been trained to NVQ level 2, 76.5 to NVQ level 3 and 11.76 to \NVQ level 4. The staff and management are to be congratulated for the high level of training and qualification achieved which is far in excess of the 50 by the year 2005 expected by the standards. The majority of staff have also all completed a ten week examination course in caring for people with dementia. Rotherbank v231924 h54 s11720 rotherbank v231924 200605.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 The management of the home seeks the views and opinions of residents and safeguards the health and safety of staff and residents through the implementation of safe working practices. Rotherbank v231924 h54 s11720 rotherbank v231924 200605.doc Version 1.30 Page 19 EVIDENCE: A health and safety policy, control of substances hazardous to health (COSHH) assessments, equipment servicing and accident records were available as were records to confirm all staff have receive training in the techniques of moving and handling first aid health and safety and the procedures to follow in the event of fire (including evacuation. All of the hot water supplies to baths were fitted with thermostatic controls set at 43 degrees centigrade and all radiators and hot pipes were covered. All wash hand basins were provided with soap and towels. Rotherbank v231924 h54 s11720 rotherbank v231924 200605.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x 3 Rotherbank v231924 h54 s11720 rotherbank v231924 200605.doc Version 1.30 Page 21 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action 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 Good Practice Recommendations Rotherbank v231924 h54 s11720 rotherbank v231924 200605.doc Version 1.30 Page 22 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton Hampshire, SO15 1GW 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. 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