Inspection on 22/05/07 for Rough Lee House

This inspection was carried out on 22nd May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rough Lee House 18/05/09

Rough Lee House 22/03/06

Rough Lee House 05/10/05

Rough Lee House 18/10/04

Rough Lee House 25/05/04

Rough Lee House 03/10/02

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Ruskin Lodge

Dystlegh Grange

The Good Companions

Springfield Cottage

Cuerden Grange Rest Home

Cornmill Nursing Home

Vitalise Sandpipers Centre

Sue Ryder Care Birchley Hall

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

CARE HOME ADULTS 18-65 Rough Lee House Rough Lee Road Accrington Lancashire BB5 2LR Lead Inspector Mrs Susan Hargreaves Unannounced Inspection 22nd May 2007 10:00 Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 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 Rough Lee House DS0000009441.V335811.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 Adults 18-65. 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. Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rough Lee House Address Rough Lee Road Accrington Lancashire BB5 2LR 01254 393152 01254 393152 mallen08@tiscali.co.uk 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) The Alex Group Mrs Sheila Baines Care Home 15 Category(ies) of Physical disability (15) registration, with number of places Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd March 2006 Brief Description of the Service: Rough Lee House offers 24-hour personal care for up to 15 younger adults with physical disabilities. The home is a detached purpose built property with large gardens and a car park. All accommodation and facilities are located on the ground floor. Communal rooms include a conservatory and spacious lounge with dining area. These are suitable for a variety of both individual and group activities. Accommodation is provided in 11 single and 2 twin-bedded rooms. There are no en-suite rooms but bathroom and toilet facilities are close to all rooms. Rough Lee is close to Accrington, local amenities and public transport. The current fees charged at Rough Lee are from £363.50 to £374.50 per week. Additional charges are payable for transport, toiletries, holidays, trips out and stationary. A statement of purpose and service user guide was available to prospective residents and their relatives on request. Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. • The inspector came to Rough Lee House on 22 May 2007 to do a key inspection. • The inspector spoke to the people staying at the home. • The inspector also spoke to the manager, the deputy manager and 2 members of staff. • The care records of 2 people staying at the home were inspected • Records about how the home is run were also looked at. • The inspector looked round the home. What the service does well: • Members of staff were friendly. One resident said, I get on well with all staff. • Two members of staff said they liked working at Rough Lee House. One of them said, “It’s the nicest job I’ve ever had.” One resident said, “There’s plenty of things to do.” These included, baking, using the computer, quizzes, music and movement and crafts. Residents went on trips out shopping, to Cleveleys, Blackpool and to concerts. DS0000009441.V335811.R01.S.doc Version 5.2 Page 6 • • Rough Lee House • Residents went in small groups for meals, bowling and for a drive in the mini-bus to have afternoon tea or to the pub. • One resident said, “The meals are lovely.” • Another resident said, “I like living here, the food’s good. They come round with the menu.” • Some visitors said the home was always clean and they always felt welcome. What has improved since the last inspection? • The manager and the deputy manager have done some training called ‘The registered manager’s award.’ What they could do better: • To make sure medication is looked after safely it must be kept inside a locked medicine cupboard. • Volunteers must have a police check and 2 written references before they can look after residents. This keeps residents safe from abuse. • To make sure the home is run properly the responsible person must visit every month and write a report about the home. • All staff must have training about fire safety. This makes sure all staff know how to prevent fires and know what to do if there is a fire at Rough Lee House. Please contact the provider for advice of actions taken in response to this inspection. Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 Page 7 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. Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A thorough admissions procedure ensures the needs of people using the service are identified and met. EVIDENCE: There have been no new admissions to Rough Lee for sometime. However, the manager explained that she had recently visited and assessed a prospective resident. An assessment completed by social services was also available. This lady had visited Rough Lee and met the residents. Information about the home was available on their website and in the statement of purpose and service user guide. Easy read versions of these documents are available. Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s involvement in care planning makes sure their decisions are respected and their care needs are addressed. EVIDENCE: The individual care plans of two residents were inspected. These plans identified the needs of each resident and explained how these were met. Appropriate risk assessments had been carried out. Information about how identified risks were managed was also included in the care plans. Information about the changing needs of each resident was frequently added to their individual care plans. Both care plans were formally reviewed in January. The residents had been involved in their review and had signed their agreement to the care plan. Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 Page 11 Residents were encouraged to make decisions about their lifestyle and activities. These were recorded in their individual care plans. Contact details for advocacy services were available should a resident wish to use them. Residents were encouraged and supported to manage their own finances. Records of transactions involving resident’s money were seen to up to date and accurate. Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents were supported to have an active and fulfilling lifestyle. Meals were planned to suit the tastes of all residents. EVIDENCE: All the residents asked said there were plenty of things to do at the home. These included, baking, quizzes, music and movement, bingo, crafts, computers and learning computer skills. During the inspection residents were observed enjoying a variety of activities. Two ladies were listening to records in the conservatory, a group of residents baked some buns, another resident was writing a letter and one resident was knitting. One resident said, “I go to Church on Sunday’s and I go to bingo on Thursday nights.” Residents also talked about how much they had enjoyed going to a Jason Donovan concert. Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 Page 13 A care worker said residents were also taken shopping, out for meals and to the pub. Trips to Blackpool and Cleveleys were also arranged. Four of the residents were on holiday in Italy at the time of the inspection. The daily routine was flexible to meet the needs and preferences of the residents. One resident said she decided when to get up and go to bed. Another resident said, “I get up at seven in the morning and go to bed at 10pm.” Visitors were welcomed into the home at anytime. The relatives of one resident said they always felt welcome. All the residents asked said the meals were good and they were given a choice of menu. One resident said, “I like living here the food’s good as well.” Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personal and healthcare needs of each resident were identified and met. Medication was stored in a way that could put some residents at risk. EVIDENCE: The two care plans inspected contained detailed information about the health and personal care needs of each resident. Residents were registered with a GP and had access to other healthcare professionals. Personal care was carried out in the privacy of the resident’s own room or the bathroom. Two residents said how much they enjoyed having a bath each morning. Records for the management of medication were available. However, handwritten instructions on the medication administration records were not signed or witnessed. Written guidance about when medication prescribed ‘when required’ should be given to individual residents was not in place. Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 Page 15 At the time of the inspection medication was stored in a domestic style fridge in the office. A bottle of medicine had been left on top of fridge. The manager said the office door was always locked when there wasnt a member of staff inside. The Manager explained that medication was stored in the fridge following advice from the pharmacist last summer when the weather was hot. The manager was advised that according to the Royal Pharmaceutical Society’s guidelines medication should be stored securely in a locked cupboard. The manager sent a fax to the commission on 24/05/07 explaining that further advice had been taken and alternative arrangements for storing medication were being made. Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents felt able to express their concerns. Staff had a good understanding of protection issues. EVIDENCE: A copy of the complaints procedure was displayed in the home. No complaints have been made to the home or the commission since the last inspection. Policies and procedures relating to safeguarding of vulnerable adults, harassment and ‘whistle blowing’ were in place. This issue was discussed with two members of staff. They said they would report any concerns immediately. Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The house and grounds were maintained to a high standard and provided a comfortable and ‘homely’ environment for the residents. EVIDENCE: The home was clean, tidy and well maintained. All decoration and furnishings were of a good quality. Communal rooms were spacious and suitable for a variety of social and cultural activities. All areas of the home were accessible to residents who used wheelchairs. Residents had personalised their rooms to meet their own needs and preferences. Residents were encouraged to keep their own rooms clean and tidy. They were also encouraged to recycle their own rubbish. At the time of the inspection one bathroom was having a whirlpool bath installed and therefore temporarily out of use. Although only one bathroom Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 Page 18 was in use the residents continued to have their daily bath. A new ‘wet room’ with shower, toliet and hand basin was also in the process of being installed. The grounds were ell maintained and accessible to all residents. Laundry facilities were suitable for the size of the home. Infection control policy in place. Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Members of staff had the skills and knowledge necessary in order to meet the needs of the residents. EVIDENCE: Examination of the duty rota confirmed that a sufficient number of staff were on duty for all shifts to meet the assessed needs of the residents. An additional member of staff was usually on duty on Mondays, Wednesdays and Saturdays to help with activities. At the time of the inspection four residents were on holiday in Italy. Two members of the committee, the husband of a committee member, a bank carer and her husband accompanied these residents. Although four of these people had been recruited as volunteers or bank staff none of them worked regular shifts at the home. Moreover, one of these people was not employed as a volunteer at Rough Lee and a CRB check and written references had not been obtained. Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 Page 20 The files of four members of staff appointed since the last inspection were examined. These files indicated that all the required pre-employment checks to ensure protection of the residents had been completed prior to appointment. Residents were involved with the selection process for new staff. All applicants were expected to spend time with the residents before their interview. Structured induction training was in place for all new members of staff. The deputy manager was further developing induction training to ensure it met the current ‘Skills for Care’ standards. All members of staff had an individual training plan. Fifty seven percent of the care staff had achieved NVQ qualifications at level 2 or above. One resident said, “The staff are very nice.” Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,41 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was effectively managed and provided person centred care for all residents. EVIDENCE: The registered manager has several years experience of caring for younger adults with disabilities. The manager and the deputy manager have almost completed the NVQ registered manager’s award. Residents were encouraged to express their opinions and concerns about the quality of care and facilities at anytime. Residents meetings were held every six months. Meetings with families and residents were held every three months. Minutes of these meetings were available. Anonymous satisfaction Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 Page 22 questionnaires were distributed to residents, their relatives and volunteers annually. Evaluation of these questionnaires confirmed the overall satisfaction of residents and their relatives of the care provided at the home. A family support group also meets several times a year to plan special events like the summer fayre, trips out and holidays. An annual business and development plan to help monitor the quality of the service and further improve outcomes for residents was in place. The manager has continued to monitor the home’s performance against the National Minimum standards. She has also developed an action plan to further improve standards. Despite requirements made at previous inspections the responsible individual has not been making unannounced visits to the home every month in accordance with regulation 26. Fire alarms and emergency lighting were checked regularly. A fire risk assessment was in place. Fire drills had been held in February 2006 and 2007. The manager was advised to have them more frequently. The two care workers on duty at the time of the inspection had not received fire awareness training. Records of routine servicing of equipment were seen. These included up to date gas safety and electrical installation certificates. The testing of small electrical appliances had taken place in February 2007. Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 4 X 2 2 X Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 Page 24 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 YA20 2 YA34 19. Schedule 2 17(2) Schedule 4 (5) Standard Regulation 13(2) Requirement Timescale for action 29/07/07 3 YA41 4 YA42 23(4)(d) To prevent medication error and ensure the safety of residents all medication must be stored securely in a locked cupboard. In order to safeguard residents 22/05/07 from abuse thorough recruitment procedures must be in place for all members of staff including volunteers. To ensure the manager receives 29/07/07 proper support and supervision the registered person must make an unannounced visit to the home every month and provide a report for the manager under regulation 26. A copy of this report should be supplied to the commission. (Timescale of 30/12/05 not met.) To promote the health and 31/08/07 safety of staff and residents all members of staff must have fire awareness training. Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 Page 25 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 YA20 Good Practice Recommendations All handwritten instructions on medication administration records should be signed and witnessed. Rough Lee House DS0000009441.V335811.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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. 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