CARE HOMES FOR OLDER PEOPLE
Roughcote Hall Farm Roughcote Lane Caverswall Stoke On Trent Staffordshire ST11 9ET Lead Inspector
Wendy Snell Unannounced Inspection 24 February 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Roughcote Hall Farm DS0000005101.V285025.R01.S.doc Version 5.1 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. Roughcote Hall Farm DS0000005101.V285025.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Roughcote Hall Farm Address Roughcote Lane Caverswall Stoke On Trent Staffordshire ST11 9ET 01782 397440 01782 777299 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) Mrs Yvonne Pointon Mrs Yvonne Pointon Care Home 3 Category(ies) of Learning disability (3), Learning disability over registration, with number 65 years of age (3), Old age, not falling within of places any other category (1) Roughcote Hall Farm DS0000005101.V285025.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. LD- Minimum age 43 yrs on admission 1 OP relates to current occupancy only Date of last inspection 19th September 2005 Brief Description of the Service: Roughcote Hall Farm is a large detached property set in seven acres, situated on the outskirts of Stoke-on-Trent. It is located in a rural area and there are no transport links. The home uses its own transport to reach community facilities and services. The home has a dog and cat and each of the residents take a great interest in them and assist in their day-to-day care. The home is registered for three residents and at the time of this unannounced inspection a fourth service user was having a short stay. This had been agreed by the Commission for Social Care Inspection (CSCI). The owner (Mrs Yvonne Pointon) has completed a variation proposal for consideration by CSCI to increase the number of residents to six. The Proprietor and her husband live on site. Roughcote Hall Farm is a large, comfortable family home that has been adapted to provide suitable facilities. On the ground floor, there is a large kitchen/diner, a lounge and conservatory, a separate toilet, laundry room and two single bedrooms, one of which has en-suite facilities. There are two staircases to the first floor, one of which has a stair-lift in place. On the first floor, there are two single bedrooms and a separate shower room. Roughcote Hall Farm DS0000005101.V285025.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on a Friday morning. Mrs Pointon, who is the owner and registered manager, one care staff and two service users were spoken with. Paperwork relating to the care and support of the service users and care staff training records were examined. Mrs Pointon has submitted an application to the Commission for Social Care Inspection to add two further bedrooms. The progress of the building work was discussed and the changes that had taken place were viewed. What the service does well: What has improved since the last inspection? What they could do better:
The manager needs to risk assess the ability of a service user to use the stairs to ensure that she is safe.
Roughcote Hall Farm DS0000005101.V285025.R01.S.doc Version 5.1 Page 6 The manager has made a good start in addressing outstanding training needs and now needs to make sure that all training events are attended to ensure that she, and her staff, continue to develop the skills needed to support the service users within the home. 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. Roughcote Hall Farm DS0000005101.V285025.R01.S.doc Version 5.1 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 Roughcote Hall Farm DS0000005101.V285025.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The home has assessments of service users’ needs, which enable staff to support them appropriately. EVIDENCE: During the previous inspection in September 2005 a random sample of three service users’ files were inspected. This included a service user who had been recently admitted to Roughcote Hall Farm. Appropriate care management assessments were in place. Roughcote Hall Farm DS0000005101.V285025.R01.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8 & 10 Service users’ health needs are satisfactorily met, however, risks relating to mobility need to be addressed to ensure service user safety. A service user spoken with felt that the staff respect her privacy and dignity. EVIDENCE: The healthcare needs of all service users were discussed with the manager who demonstrated a good understanding of their needs and of how the needs were being met. Two service users’ files were examined. There was evidence that appropriate appointments had been made and that service users had been supported to attend the necessary appointments. The dates and outcomes of each appointment had been recorded. It was noted that one service user’s mobility had deteriorated and that she was now using a walking frame. The service user’s bedroom is upstairs and although there is a chair-lift in place the service user uses the stairs. A risk assessment was not in place. The need for a risk assessment was discussed with the manager who was also advised to discuss this issue with the service user and social worker.
Roughcote Hall Farm DS0000005101.V285025.R01.S.doc Version 5.1 Page 10 Two service users were spoken with. One service user was asked about the healthcare support that she receives from staff within the home. The service user confirmed that staff assist her to attend appointments and support her with her medication needs. A member of the care staff was asked about practice within the home to ensure that service users are treated with dignity and that their privacy is respected. The staff member demonstrated a good value base and was able to discuss in detail how she manages personal care issues ensuring the service user’s dignity at all times. The care staff member was observed to knock a service user’s door before entering. She stated that this was standard practice within the home. The staff member also confirmed that mail is handed to service users unopened. However, she said that if requested by the service users that they do assist to read the mail that they receive. A service user confirmed that staff treated her well and that the staff were always polite. Roughcote Hall Farm DS0000005101.V285025.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14 & 15 Service users take part in a range of activities in the community appropriate to their assessed needs. Service users are happy with the meals served and are able to choose what they would like to eat. EVIDENCE: The manager stated that the service users take part in a range of activities, which are appropriate to their assessed needs. One service user has a very structured week and has activities planned for six days of the week. These activities include dancing, cooking and crafts, college courses, helping at a farm and meals out and shopping. Three other service users have a less structured week but do also go to dance, arts and crafts and have meals out and shopping. Two service users also have frequent contact with family members whom they visit on a regular basis. Two service users’ files were examined and there was evidence that social activities are recorded within each file. A member of staff was spoken with who confirmed that service users do take part in a range of activities. Two service users were spoken with about the meals in the home. The views expressed were positive. A member of staff said that they talk with the service
Roughcote Hall Farm DS0000005101.V285025.R01.S.doc Version 5.1 Page 12 users on a daily basis about what they would like to eat. These discussions were observed during the inspection. The staff member said that a hot meal was generally served at lunch time with a choice of sandwiches available at tea time, and that fruit and snacks are always available. The service users have a meal out on Saturdays. The larder, fridge and freezer were well-stocked and fresh fruit and vegetables were available. A menu was in place, however, the manager stated that they don’t tend to stick with it as they listen to what service users want. A record is kept within the home of all meals which have been served. This was examined. There was evidence that a varied range of meals is offered to service users. Roughcote Hall Farm DS0000005101.V285025.R01.S.doc Version 5.1 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 The completion of staff training will enhance the adult protection system within this home. EVIDENCE: Two staff personnel files were examined. It was noted that each staff member had been given a booklet on identifying and reporting adult protection issues. Appropriate vetting checks were in place. The manager said that she is enrolled on a course to cover this on the 8th March 2006. She stated that three staff members will also be doing this via the LDAF induction process. Two service users were spoken with both said that they were ‘happy’ at Roughcote Hall Farm and that they felt safe. Roughcote Hall Farm DS0000005101.V285025.R01.S.doc Version 5.1 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 The home offers a good standard of accommodation to the service users. EVIDENCE: Roughcote Hall Farm is set in a rural location and provides a spacious and comfortable environment that has been adapted to provide suitable accommodation and facilities. There is a pleasant patio area with seating situated close to the conservatory and the expansive grounds surrounding the home are also accessible to service users. The environment is very homely and domestic in nature, being shared by residents and the Registered Proprietor/ Manager who lives on the premises. The service users spoken with said that they were happy living at the home and liked their bedrooms. There are presently two bedrooms on the ground floor, one of which has en-suite facilities. There are two staircases to access the bedrooms on the first floor one of which has a stair-lift. The proprietor has submitted a proposed variation to CSCI to make some alterations to the premises to increase the number of residents from three to
Roughcote Hall Farm DS0000005101.V285025.R01.S.doc Version 5.1 Page 15 six. The manager has discussed her proposals with the CSCI and has sought advice from the fire authority regarding these changes. The adaptations to the building are presently taking place with ongoing discussions between the proprietor, CSCI and fire authority in respect of this proposal. Roughcote Hall Farm DS0000005101.V285025.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 28 The service users’ needs are met by appropriate staff numbers. EVIDENCE: The home has a registered manager and three members of staff. The manager stated that all staff members have achieved awards of NVQ2 or above. The care staff all have previous experience of working in a care setting. One staff member was spoken with - she confirmed that she had NVQ3 and had worked within the home for nearly four years. The staff member demonstrated a good value base and a clear understanding of the individual needs of the service users and of the routines and systems within the home. The manager confirmed that there is always at least two staff on shift when all the service users are at home. The manager was advised that in respect of the variation request for an increase in numbers the manager will need to review the amount of staff that work within the home and cover each shift. Roughcote Hall Farm DS0000005101.V285025.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 & 33 The manager is competent and experienced to run the home, however, completion of the appropriate management qualification would further help in this process. A quality assurance system based on seeking the views of service users is now in place to measure success in meeting the aims set out in the statement of purpose and to aid further development. EVIDENCE: The Registered Proprietor/Manager, Mrs Yvonne Pointon has nearly 20 years of experience in running a small care home as well as previous nursing and management experience. Mrs Pointon advised the Inspector that she intends to pursue the Registered Managers Award in 2006. Roughcote Hall Farm DS0000005101.V285025.R01.S.doc Version 5.1 Page 18 The manager has recently implemented a quality assurance system. The documentation, which includes seeking views from service users, relatives and professionals, was seen. It is recommended that this is now implemented fully and any outcomes acted upon. Roughcote Hall Farm DS0000005101.V285025.R01.S.doc Version 5.1 Page 19 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 3 x x x x x x x STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x x x x x Roughcote Hall Farm DS0000005101.V285025.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP8 Regulation 13(4)(c) Requirement Timescale for action 26/02/06 2. 3. OP38 OP9 23(4)(d) 18(1)(i) A risk assessment must be in place in respect of the use of the stairs for the service user identified at the time of the inspection. All staff must receive fire training 31/03/06 (previous timescale 20/11/06 not met). All staff who administer 08/03/06 medication must receive medication training (previous timescale 19/09/05 not met). 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 2 Refer to Standard OP33 OP31 Good Practice Recommendations The quality assurance system should be fully implemented and outcomes recorded. The manager should ensure that she undertakes the relevant managers qualification. Roughcote Hall Farm DS0000005101.V285025.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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