Inspection on 26/10/06 for Rotherbank

This inspection was carried out on 26th October 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 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 19/12/05

Rotherbank 20/06/05

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 Forest Hampshire GU33 7BJ Lead Inspector Mrs Michelle Presdee Unannounced Inspection 26th October 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 Rotherbank DS0000011720.V315959.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. Rotherbank DS0000011720.V315959.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rotherbank Address Rotherbank Farm Lane Liss Forest Hampshire GU33 7BJ 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) 01730 892081 Mrs Christine Ann Hillyer Mrs Christine Ann Hillyer Care Home 21 Category(ies) of Dementia (4), Dementia - over 65 years of age registration, with number (21), Old age, not falling within any other of places category (21) Rotherbank DS0000011720.V315959.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Four service users only in the category DE to be admitted over the age of 55 years 19/12/05 Date of last inspection Brief Description of the Service: Rotherbank is a privately owned and managed care home offering accommodation and support for up to 21 older persons in the categories OP (older persons) DE (dementia between 55 and 65 years of age) and DE (e) (dementia over 65 years of age). The home is sited in a residential area in Liss Forest village, a short distance from local amenities. Residents are accommodated on two floors, with the majority of service users 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. The fees for the home range from £385.00 to £525.00 per week. Rotherbank DS0000011720.V315959.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During this unannounced inspection, which lasted over five hours a tour of the building was undertaken, staff, service users and visitors were spoken to. Relevant paperwork including assessments, care plans, policies, procedures and service records were examined. Information received from the preinspection questionnaire was always used to help make the judgements on the home. It was noted all comments received by service users, visitors and staff were of a positive nature. The inspector was assisted by the deputy manager and later by Mrs Hillyer the manager and owner of the home. On the day of the inspection 20 service user were being accommodated, the eldest resident looking forward to celebrating her 103rd birthday during the week following the inspection. One bed is used for respite care. What the service does well: What has improved since the last inspection? The home tries to continually improve the physical environment of the home. The home has recently purchased new fire doors, the conservatory has been replaced, and new carpets have been fitted in the communal areas. New basins have been fitted in some areas. There are plans next year to replaced two of the bathrooms in the home. The daily menus now include pictures to assist service users. Rotherbank DS0000011720.V315959.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Rotherbank DS0000011720.V315959.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 Rotherbank DS0000011720.V315959.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments give a clear picture of a service users needs, ensuring their needs are met. Family members and other professionals are encouraged to be part of the assessment. Service users are given the opportunity to come and spend time in the home before moving in. EVIDENCE: The files of the last three service users to be admitted to the home were examined. The inspector was advised all potential service users are invited to look and spend some time in the home before moving in. If this is not possible one of the management team will visit the service users at home or in hospital. All potential new service users are given a copy of the statement of purpose/service user guide. The home also keeps a file of information by the front door for all visitors to view, which includes the statement of purpose/ service user guide, complaints procedure and the last inspection report. The Rotherbank DS0000011720.V315959.R01.S.doc Version 5.2 Page 9 assessments seen gave a clear account of the service users needs and abilities. Family members had been asked to complete some information, which gave a bigger picture of the service user. Care management assessments were also available, where appropriate. Nutritional, mental abilities/disabilities and risk assessments were all part of the assessment. The home does not provide intermediate care. Rotherbank DS0000011720.V315959.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans provide adequate information, to ensure care staff have all information needed to meet a service users needs. Health care needs are well documented with a range of services available to meet service users needs. Medication is well managed in the home and offers appropriate protection for service users. The core values of privacy and choice are promoted in the home. EVIDENCE: The care plans of the three assessments viewed were examined. It was found all care plans gave a good account of how to meet a service users needs and gave good detail of how this should be done. Care plans were split into different sections, which listed the plan of care, the risks involved and how these could be managed. Family members are invited to reviews and their views will be recorded. Service users are also encouraged to be part of the review; it was noted on one review seen the service user had been asked to Rotherbank DS0000011720.V315959.R01.S.doc Version 5.2 Page 11 join in but had declined. Care plans are reviewed on a monthly basis and signed by two carers. Care plans include all details of a service users health needs. The inspector was advised the home has good relationships with all health professionals who visit the home. All visits by health professionals are recorded in the care plan. The home has an optician, dentist, chiropodist, and all relevant medical practitioners who will visit the home. Service users can see the relevant health professional in private. The home has a relevant drugs procedure, which is available to all staff members. Most staff have undertaken a three-month training course on medication; three members of staff are hoping to undertake this soon. The home uses a monitored dosage system, which is delivered on a monthly basis. All medication is checked when it enters the home. Medication is stored in the medication cupboard, which has two locks to gain access to any medication. Medication of four service users was checked on the day and matched the records held. It was noted temazepam is being stored in the cassette boxes and is not being recorded as a controlled drug. It was agreed it would be good practice to record temazepam in the controlled drugs register, which would be signed by two carers. All medication left at the end of the month is returned to the pharmacist, who signs a record. No service users are currently self-medicating. From observations on the day it was clear service users are treated in a respectful manner by staff and in a way, which promotes their privacy. All communal bathrooms and toilets had appropriate locks. All service users bedroom doors had appropriate locks. The inspector was advised no service users have a key to their door, but this is down to choice. Service users have lockable space in their bedrooms which some service users use. The inspector was advised some bedrooms are locked during the day, due to the medical problems of one service user. The service users who are affected are unable to go to their rooms unaided and all family members have been informed and have agreed. Staff were seen to knock on doors before entering a room. Care plans detail giving service users a choice of clothes when aiding them to get dressed. All staff have knowledge of the core standards, which is undertaken during their induction period. Rotherbank DS0000011720.V315959.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a variety of social activities, giving service users the choice to join in when they wish. Visitors are made welcome to the home and can see service users in private. A varied menu is available and good quality food is served to service users. EVIDENCE: A range of activities is offered in the home. Assessments and care plans detail service users past interests and hobbies. One service user enjoyed swimming and plans had been made for them to go swimming, however this was not successful, but it had been tried. On the day of the inspection two service users were enjoying painting. Movement to music takes place every morning, which service users are free to join in if they wish. A range of musical instruments has recently been bought, which staff reported service users really enjoy. Two members of staff have been on a course, which related to providing activities for service users with dementia. The library visits once a month and ministers visit the home on a regular basis. The majority of service users have Rotherbank DS0000011720.V315959.R01.S.doc Version 5.2 Page 13 visitors and enjoy social outings. The home has no restrictions on visiting and service users can see their visitors in private. Two visitors spoken to on the day who visit the home on a regular basis confirmed they can always see their relative in private and are always made welcome. It was clear service users are offered choices in their daily living tasks. Care plans reminded carers to ask service users regarding choices when getting washed, dressed and in other activities. Service users can choose to join in activities if they wish. Breakfast is organised to ensure those service users who like to get up early can have breakfast early, whilst a later breakfast is arranged for the service users who like to lie in bed in the mornings. The home has a pleasant dining room, where meals are served. The dining tables are laid at meal times. A bowl of fresh fruit was available. The dining room had a large clock, which also tells the date, month and year and a weather chart. The menu is displayed in the dining room on a daily basis and now has pictures of each meal. The home has a rotating four-week menu, which demonstrated a varied and balanced diet is provided. All service users spoken to felt the meals were of a good quality and a choice was available. Fresh vegetables are served daily and cakes are baked in the home. The cook had a list of service users likes and dislikes. Rotherbank DS0000011720.V315959.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A comprehensive complaints procedure is available, which service users and visitors felt able to use. Staff have knowledge and training on abuse, which offers protection for service users EVIDENCE: The home has a complaints procedure, which details all the necessary information, including names, addresses, telephone numbers and timescales. The home has received no complaints since the last inspection. Visitors stated they would know how and who to complain to. Service users spoken to on the day stated they would speak to the manager if they were unhappy and felt their complaint would be dealt with. The home has relevant paperwork to assist staff with knowledge on abuse and adult protection and the appropriate procedures. Formal training on abuse has taken place and is arranged on an annual basis. The next training is due to take place next week. Care staff had knowledge of the different types of abuse and what to do if abuse was suspected in the home. Rotherbank DS0000011720.V315959.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, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a clean, safe, pleasant and well-maintained environment for the enjoyment of service users. EVIDENCE: All areas of the home were clean, safe, warm and well maintained. Whilst walking around the home no unpleasant odours were detected. The home has a dining room, a large lounge, which is split into two and a new conservatory. The bedrooms seen which were chosen at random were clean and decorated to a good standard. Some service users had brought their own furniture into the home. All bedrooms had a number on and a flower to aid service users. The two double bedrooms had screens. The home has a laundry room, which has Rotherbank DS0000011720.V315959.R01.S.doc Version 5.2 Page 16 suitable equipment and each service user has their own laundry basket, all clothes are labelled. Rotherbank DS0000011720.V315959.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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The good staffing levels enable staff to meets service users needs. Staff have good knowledge and receive regular training to ensure they can meet service users needs. The lack of good recruitment procedures could put service users at risk. EVIDENCE: The home employs twenty-one members of staff and has a planned duty rota. The rota demonstrates who works what shifts. The home has adequate staffing levels to meet the needs of service users. In the mornings there are a minimum of three carers working in the home and two staff working in the office. All staff including the manager, deputy manager and senior staff work on the floor at some time. At night-time two members of staff work a waking duty. Service user and visitors spoken to all had praise for the care staff and felt there was always adequate staff on duty. All members of staff have to undertake National Vocational Qualifications (N.V.Q. Level) 2; all but one member of staff have this qualification. A large percentage of staff have N.V.Q. Level 3. Staff spoken to felt the qualifications had helped them in their work despite some having many years experience. Rotherbank DS0000011720.V315959.R01.S.doc Version 5.2 Page 18 The staff records of the last three members of staff were examined. It was found these were not consistent with each other and for some not all necessary checks had been undertaken. For one member of staff there was only one written reference and it was difficult to establish where this had come from, for another staff member there were three written references. It was noted for one member of staff who had started work in the home seven months ago no satisfactory Criminal Record Bureau (CRB) check or check against the Protection Of Vulnerable Adults (POVA) list had been undertaken. For another member of staff a check had been made against the POVA list but no CRB check had been received. This area was discussed and it was agreed this could potentially put service users at risk. All new staff undergoes an induction period and induction training. Records were seen, which demonstrated both the manager and staff member sign when the staff member is competent in a certain area. Training is taken very seriously in the home and all staff undertake routine training in abuse, dementia, health and safety, food hygiene, first aid, manual handling and health and safety. Mrs Hillyer and another member of staff have undertaken qualifications, which allows them to do some of the training inhouse. Rotherbank DS0000011720.V315959.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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed. Service user views are always considered when decisions are made in the home. Health and safety procedures in the home ensure service users are protected. EVIDENCE: The home is owned and managed by Mrs Hillyer, who has many years experience running residential homes. Mrs Hillyer has completed an N.V.Q. Level4. The deputy manager has also completed her N.V.Q. Level 4 and a Rotherbank DS0000011720.V315959.R01.S.doc Version 5.2 Page 20 Registered Managers Award. All staff on duty felt the home was well managed and they would be able to discuss any problems with Mrs Hillyer. It was clear from observations and discussions on the day the home is organised and run in the best interests of service users. Routines are flexible to meet service users needs. Views of the home are sought from visitors but this is on an informal basis. Staff meetings and residents meetings take place, which are well attended and actions take place following these meetings. The home manages the personal allowance for several service users. Records were checked and it was found this was being done in a manner, which ensured no mistakes could be made. All monies going in and out were recorded with receipts being maintained. The balance of two service users finances were checked and it was found these were accurate and matched the money held. No immediate obvious hazards to health and safety were observed in the home. Staff are provided with plastic gloves and aprons, which were worn appropriately on the day. Coshh (Control of Substances Harmful to Health) assessments have been carried out. Cleaning fluids were kept locked away. A range of policies and procedures were in the home, which were available to staff. The fire logbook was seen, which demonstrated the necessary tests were being carried out in the agreed timescales. Staff were receiving adequate sessions in fire issues in a twelve-month period. Servicing records were available demonstrating all the necessary equipment had been regularly serviced. Rotherbank DS0000011720.V315959.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 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Rotherbank DS0000011720.V315959.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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 17 (1) (2) Requirement All necessary checks must be completed before staff work in the home. Timescale for action 30/12/06 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 Refer to Standard OP9 Good Practice Recommendations All controlled medication should be stored and recorded as controlled medication. Rotherbank DS0000011720.V315959.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Rotherbank DS0000011720.V315959.R01.S.doc Version 5.2 Page 24 - 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!