Inspection on 14/10/08 for Rotherlea

This inspection was carried out on 14th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Rotherlea Dawtrey Road Petworth West Sussex GU28 0EA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Edward McLeod     Date: 1 4 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Rotherlea Dawtrey Road Petworth West Sussex GU28 0EA 01798345940 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Deborah Jane Cronin Type of registration: Number of places registered: Shaw Healthcare Ltd care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 34. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home 34 0 Over 65 0 34 Care Homes for Older People Page 4 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection was arranged to assess the compliance of this new service with the national minimum standards and care homes regulations. We prepared for this visit by obtaining from the provider the homes annual quality self-assessment audit and through our survey forms we obtained views of people living in the home and staff. We also took into account other information received on the service. Some of the views and information have been included in the writing of this report. During our visit we talked to four people living in the home, and to one relative, three members of staff, the manager Mrs Cronin and her line manager Ms Lawrence. We Care Homes for Older People Page 5 of 28 sampled three sets of care records, five sets of staff recruitment and training records, and a number of other records including complaints and health and safety records. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they or people close to them have been involved in. This tells the home all about them and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they or people close to them have been able to visit the home and have got accurate and up to date information about the home. If they decide to stay in the home people have an easy to understand contract or statement of terms and conditions between them but this at present does not include how much they will pay and what accommodation the home provides for the money. Evidence: We sampled the homes statement of purpose which is published in large print and is Care Homes for Older People Page 9 of 28 Evidence: available in the entrance hall of the home. This sets out the aims and service to be provided in the home. We sampled the service user guide which is also published in large print and available in the entrance hall of the home. This sets out information on the service for people living in the home or who may be interested in living there. The six people living in the home who had completed our CSCI survey form told us they had received enough information about the service prior to admission. We looked at three sets of care records and found that each person had been provided with a terms and conditions by the provider which sets out their rights and responsibilities. We found that the copies of the terms and conditions we sampled did not include all the information which the terms and conditions is expected to include and which are set out in the Care Homes for Older People national minimum standards. We also found that a paragraph in the terms and conditions which advises the person if they will be sharing a room or have a room to themselves has not been altered to indicate to the person if they will be accommodated in a sharing room or single room. A requirement has been made concerning the contract or terms and conditions. Care Homes for Older People Page 10 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health, personal and social care needs are met. The home has a plan of care that the person or someone close to them has been involved in making. If they take medicine they manage it themselves if they can. If they cannot manage their medicine the care home supports them with it in a safe way. Peoples right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life the care home will respect their choices and help them feel comfortable and secure. They and people close to them are reassured that their death will be handled with sensitivity dignity and respect and take account of their spiritual and cultural wishes. Evidence: We sampled three sets of care plans and found that these were setting out action Care Homes for Older People Page 11 of 28 Evidence: which needs to be taken to ensure the persons health, personal and social care needs are met. We found that the persons care needs were being reviewed on a monthly basis, although it was not clear if the person or their advocate had been involved in this review. We discussed with the home manager Mrs Cronin that care plans needed to better indicate the persons choices and preferences so that care more suited to their needs could be provided. Mrs Cronin advised us that this has been identified (for example in the recent monthly provider report for September 2008) and that staff training in care planning had been arranged to address this issue. The six people living in the home who responded to our survey told us that they receive the care that they need. A local authority care manager who responded to our survey told us that the home appeared well informed about the needs of the person she was visiting. The five staff who responded to our survey told us they always receive up to date information on the care needs of the people they are caring for. Care records we sampled indicated that people were accessing the health care services he or she was in need of. For example, plans were in place to address medical needs such as diabetes, and people had been accessing their doctor and where needed services such as chiropody, hearing and eyesight tests. Records sampled also indicated that the home was supporting people to access specialist medical services where a need for this was identified. We looked at one set of records for food and fluid intake, which indicated that the person was being supported to eat and drink well. People told us in their survey forms that they are receiving the medical support they are in need of. Mrs Cronin told us in the homes annual quality assessment audit (the AQAA) that staff are receiving training in administering medicines and undergo competency assessments in this. Mrs Cronin advised us that one person in the home takes responsibility for managing their own medicines and an assessment for this to consider any safety issues was undertaken and recorded. We were advised by Mrs Cronin that this assessment is Care Homes for Older People Page 12 of 28 Evidence: regularly reviewed. There are suitable arrangements in place for the storage of medicines and for the administration of controlled medication. Staff we spoke to during our visit told us that the medication system in the home was working well and that possible errors are minimised. One member of staff said there was a good routine in place for administering medicines and that staff will talk with the pharmacist if there is a need to arrange medication times which are better suited to the person receiving the medication. Mrs Cronin told us that regular audits of medication records are made to ensure medicines are being given correctly and staff we spoke to confirmed this. The AQAA tells us that staff are trained to respect peoples privacy and support them to retain their dignity and independence. Staff talked to us about how peoples dignity and choice are being supported, for example whether they might choose to take part in an activity or not. Mrs Cronin advised us that where the persons choices in relation to end of life care had not been recorded the home was making enquiries to ensure they obtained this information. Interactions between staff and people living in the home which we observed indicated that people are being supported in a way that as far as possible is unobtrusive and observes their dignity and privacy. For example with their toilet or hygiene needs. Care Homes for Older People Page 13 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks at a time and place to suit them. Evidence: There is an activities co-ordinator employed part time in the home. On the day of our visit the activities co-ordinator was not working. We observed that one member of staff had brought in some magazines for people to read, and one woman took particular interest in these. The same member of staff had Care Homes for Older People Page 14 of 28 Evidence: also brought in a film for people to watch in the afternoon. We found some evidence in care plans of peoples interests and of activities which they had joined in on, such as quizzes, exercises, and a residents meeting. One woman we noted enjoyed having soft toys around her, and staff assisted her in re-arranging these to her satisfaction. The AQAA tells us that the home has a mini-bus and people have the opportunity to go out to local events and places of interest, and there was a folder of photographs of outings and events in the home. Some of the events were referred to in a newsletter for people living in the home and their relatives or advocates which we looked at during this visit. For example one woman living in the home had been granted a wish for it to be Christmas, so staff arranged an extra Christmas day in July with Christmas dinner, trees and decorations, with all staff and visitors encouraged to take part. The people living in the home who responded to our survey told us that regular activities are being provided in the home. The report of the monthly visit carried out by the provider in September 2008 notes that staff were observed to be involving service users in activities and were both sensitive and good humoured in their approach. There are some arrangements in place for people to observe their religions by people visiting from local churches. Staff we spoke to gave us examples of how peoples choice is encouraged. For example, one person who doesnt like to eat fruit or sandwiches which has just come from the fridge now has these left out to lose their chill before they are brought to her. During our visit we observed a lunch taking place. Mrs Cronin told us that people fill out or are assisted to fill out their food preferences for the next day, which helps planning the meals. People are also asked for their comments after the meal. The main meal choice on the day of our visit was bacon roll or fish pie. People who responded to our survey said they liked their meals in the home. Care Homes for Older People Page 15 of 28 Evidence: During our visit people who didnt like the meal offered were able to request something different, and so two people opted to have soup instead. While the meal was planned to take place at 12.30, the serving of food was very slow and some people did not receive their main meal until 1.10 p.m. We discussed this with Mrs Cronin and it was felt that the time taken to serve up the meal could be improved. There was a calm and relaxed atmosphere during the meal and people who needed assistance with eating were receiving this in a calm and unobtrusive way. People who were asleep or not hungry were given the opportunity to have their meal later. During our visit people were being offered hot and cold drinks and snacks throughout the day. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. If people have concerns with their care they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. If people have concerns with their care they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. Evidence: The home has a complaints procedure in place, which is summarised in the service users guide for people receiving a service. People living in the home told us in their survey forms that they know how to make a complaint and who to speak to if they have concerns. We looked at the homes record of complaints and found that complaints were being investigated appropriately, and that complainants were being advised of the outcome of the complaint and any action taken. Care Homes for Older People Page 17 of 28 Evidence: A care manager told us in their survey form that the homes manager had responded to a concern raised by a family member in an appropriate manner. The home has a copy of local safeguarding procedures, and has been making appropriate referrals to the local authority to ensure people in the home are being protected. Mrs Cronin advised us that she has attended a briefing on local safeguarding procedures. During our visit we found recorded evidence that the home is taking appropriate action to safeguard people living in the home. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People stay in a safe and well maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. Their room feels like their own, it is comfortable and they feel safe when they use it. Evidence: The building is new and purpose built. We looked at six bedrooms and the communal areas which are presently in use. Accommodation is on ground and first floor levels, with stairs and passenger lift access between the floors. There is a garden area which Mrs Cronin said they were hoping to develop in the coming year, including an area for an allotment. The home has been decorated and furnished to a good standard, and arrangements Care Homes for Older People Page 19 of 28 Evidence: are in place for maintenance work to be carried out when needed. Accommodation is arranged with individual units of ten bedrooms which lead on into a sitting and dining area for each unit. At the time of the visit people living in the home are also able to make use of the activities rooms which it is planned will be part of a separate day centre facility in the future. Bedrooms seen have en-suite facilities, and have sufficient space to allow safe hoisting or use of a wheelchair if this is required. People have personalised their bedrooms, usually with the support of relatives. En suite showers have safety features such as grab rails and space for manoeuvre. Where the need for other specialist equipment, such as an air mattress to reduce an identified risk of pressure areas, these are being obtained for the person. Bedrooms seen provide comfort and privacy, have good natural light and are appropriately furnished. All areas of the home visited were found to be clean and hygienic, and the six people living in the home who responded to our CSCI survey told us that the home was always fresh and clean. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from managers. Evidence: The AQAA tells us that the home has 8 full time and 15 part time members of staff to meet the needs of 29 people accommodated. The AQAA tells us that 19 care staff have achieved the national vocational qualification (NVQ) in care at least to level 2, and that 2 care staff are presently undertaking NVQ training. We sampled recruitment records for three members of staff employed within the past five months, and found that suitable checks and references had been obtained before they commenced work in the home. We sampled the training record and checks provided by the agency for the two Care Homes for Older People Page 21 of 28 Evidence: members of agency staff working on the morning of our visit, which indicated that agency staff had undertaken relevant training and undergone the required criminal records bureau (CRB) checks. CSCI staff survey forms which we received indicated that a good induction training is provided for new staff, and staff feel they have the right support, experience and knowledge to do the job they are doing. Staff told us they were receiving the training they needed to do their job. One member of staff told us in their survey form that they receive regular training which they find helpful. We looked at the training records for two care staff and found that they were up to date with the range of training which care staff are expected to regularly undertake. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. Evidence: The manager Mrs Cronin is registered with the Commission as manager of the service and continues to update her training and initiate improvements in the service, for example in the quality of the individual care plans in the home. One member of staff we spoke to told us that Mrs Cronin was approachable and felt Care Homes for Older People Page 23 of 28 Evidence: that issues raised would be sorted out. Feedback on how the service is performing is being encouraged by monthly residents meetings and three monthly relatives meetings, and comments can be left in a comments box in the entrance hall. We sampled a monthly report carried out by the service provider on 27/8/08 on how the service is performing and discussed with Mrs Cronin and Ms Lawrence, who carried out the visit on behalf of the provider and completed the report, what action had been taken. Mrs Cronin and Ms Lawrence told us what action had been taken to make the improvements suggested in the report. The home has been in operation for six months. The service is aware that an annual quality assurance audit which gives feedback to the people whose views on the service have been obtained and which summarises improvements which will be made to the service must be carried out each year. We discussed with the manager the arrangements in place for holding small sums of money for people living in the home. A system is in place for the safe handling of this money. We sampled staff supervision records for three members of staff, which indicated that staff are receiving one to one supervision which is covering training needs and workplace issues. We talked to a team leader who told us she had recently undertaken training in providing one to one supervision for staff. The AQAA tells us that staff receive mandatory fire training and the home complies with all fire regulations. The AQAA also tells us that required safety checks and services on equipment and facilities in the home have been carried out in the past year. Discussion with staff and sampling of training records tells us that staff are receiving training in required health and safety topics such as manual handling, control of hazardous substances, infection control and safe food handling. Mrs Cronin advised us that the Safer food better business system is not in place in the Care Homes for Older People Page 24 of 28 Evidence: kitchen, and we have recommended that the service contact their local Environmental health team for advice concerning this. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 2 7 Each service user must be provided with a written contract or statement of terms and conditions with the home which meets Care homes for older people national minimum standard 2.2 People need to receive information on the fees to be paid and by whom and the room to be occupied. 29/12/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 38 It is recommended that the service seek the advice of the local environmental health department on the system used by the home to record and monitor safe food practice. Care Homes for Older People Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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!