Inspection on 26/07/05 for Rowan Court Nursing & Residential Home

This inspection was carried out on 26th July 2005.

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

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

Other inspections for this house

Rowan Court Nursing &... 13/12/06

Rowan Court Nursing &... 14/02/06

Rowan Court Nursing &... 08/03/05

Rowan Court Nursing &... 27/09/04

Rowan Court Nursing &... 12/02/04

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

CARE HOMES FOR OLDER PEOPLE Rowan Court Nursing & Residential Home Silverdale Road Newcastle Staffordshire ST5 2TA Lead Inspector Yvonne Allen Announced 26 July 2005 09.30hrs The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Rowan Court Nursing & Residential Home Address Silverdale Road Newcastle Staffordshire ST5 2TA 01782 622144 01782 625301 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Southern Cross Healthcare Services Limited Mrs Rachel Lisa Simpson Care Home with nursing 76 MD(E) OP PD PE(E) Category(ies) of 19 registration, with number 76 of places 42 76 Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 42 PD aged 60 years and over Date of last inspection 08 March 2005 Brief Description of the Service: Rowan Court is a care home providing personal care including nursing care for up to 76 elderly service users. This includes personal care of service users with a mental disorder over 65 years of age and care of elderly service users who have physiacal disabilities.The home is owned by a company – Southern Cross Healthcare Services Limited.The home is located within walking distance to the Staffordshire town of Newcastle-Under-Lyme with its array of amenities. The home is relatively new having been purpose built in recent years and consists of two floors served by a passenger lift. There is ample car-parking facility at the entrance car park. Gardens are accessible around the home to service users including wheelchair users.The accommodation provides for single bedrooms, all of which have en-suite facilities. There is ample provision of communal and seating areas throughout the home. There are three units within the home. On the ground floor there are two units – one which accommodates service users needing personal care and the other accommodating service users with personal care including mental health care needs. The second floor accommodates service users requiring nursing care. All units are staffed and managed separately. Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was carried out by two inspectors over 7 hours. During the tour of the home inspectors spoke with several residents, staff members and some visitors. Relevant records and documentation were examined and the tracking of care was undertaken. Discussions were also held with the managers and operations manager and verbal feedback was given at the end of the inspection What the service does well: The home offers good standards of personal and nursing care in pleasant surroundings, which have been suitably adapted to meet individual needs. The home was purpose built a few years ago and accommodation is offered in a hotel style, benefiting from single rooms with ensuite facilities. The environment is clean, well decorated and furnishings are of a good quality. The home is very well maintained. Staff training is on going and staff have the necessary skills and experience to care for the residents. Care staff receive NVQ and other training in line with their job roles. The nurses are skilled and clinically updated and offer a high standard of nursing care. Privacy, dignity and autonomy are upheld for the residents as much as is possible in a nursing home environment. The standard of care planning is good and residents’ needs are regularly evaluated. Health care needs are monitored and GP support for the home is good. The programme of activities and entertainment was good and the two dedicated activities co-ordinators worked hard to oversee that individual residents were offered activities and trips out on a regular basis. The meals provided by the home were wholesome varied and nutritious. Residents always had a choice at each meal. Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 6 The home was very well managed by the two managers and unit managers. Regular meetings are held with staff, residents and relatives and suggestions in relation to the running of the home are taken seriously. The residential units on the ground floor offer very comfortable surroundings in hotel style accommodation. The dedication of the managers on these units and the pride with which they run the units and the attention and care afforded to the residents there is commendable. The programme and organisation of formal staff supervision is good and staff feel supported. What has improved since the last inspection? 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. Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, 4 and 5 Residents and their representatives could be assured that the home would be able to meet their assessed needs on admission. EVIDENCE: Each resident accommodated in the home had undergone an assessment of his or her needs. These pre-admission assessments were seen contained in care plans and formed the basis of the care plan assessment. A representative of the home had carried out these assessments. This was usually one of the managers or unit managers. Evidence of assessments had been carried out, where necessary by other professionals such as social workers, doctors and consultants. Discussions with residents, confirmed that they had been given the opportunity to visit the home before choosing to stay. Residents were clear that they knew that there needs would be met by the home before they went to live there. Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 9 Following discussions with several members of care staff it was clear that they all possessed a good sound knowledge of the residents in their care. They were able to inform the inspector about individual requirements such as who was in bed poorly, needed bed rest in the afternoons and who required wheelchair/transfer assistance. It was evident, by direct observation, examination of records and discussions with residents and staff, that individual needs of the residents were being met by the home on a continuous basis. Where needs had changed, reviews and reassessments had been organised and undertaken with involvement of representatives and residents had been placed accordingly. Movement between units did happen but only after the required reassessment had taken place. On occasions, the home was no longer able to meet assessed individual needs and residents had moved to another home. This was usually when mental health (nursing) was required. Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10 and 11 The assessed health and personal care needs of residents were well documented and good standards of care were being provided. Residents were treated with dignity and respect, and staff observed and supported their need for privacy. EVIDENCE: Samples of resident’s plans were examined during the inspection. Those seen were comprehensively developed, identifying the health and personal care needs of the individuals and showing the action to be taken and the expected outcomes. The home had long and short terms care plans in place. There was evidence of ongoing health monitoring through regular assessments of tissue viability, nutrition and continence. Care plans and nursing interventions were adjusted to meet changed needs. Records showed that the elements of the care plans were being regularly evaluated. Files evidenced that risk assessments were completed in respect of mobility and falls and for the safe movement of all residents. Relatives were involved in the care planning and review process. Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 11 Records also evidenced visits to the home by health professionals when required, and of hospital appointments made and attended by residents with support from staff. A local GP surgery made weekly planned visits to the home to see any resident in need of a medical review. This arrangement was working very well. Residents also had access to their own GP subject to the GP’ s agreement and geographical location. Care staff explained the personal hygiene care practices within the home and how they ensure service users receive a bath at least once a week, more often if required. There is a system in place that records/identifies when any form of personal hygiene is required. Care staff maintain these records and handover clearly to the oncoming shift if there have been any changes made to the programme. The staff stated that chiropody requirements are always met. Some chiropody is undertaken on an NHS basis but private chiropody is available on request. The home had a policy and procedures document, which covered the receipt, recording, storage, and administration of medicines. Self -administration of medication is available to support individuals willing and able (as per risk assessment) to take charge of their own medication. The medication room on the nursing floor was inspected which is also kept locked and had acceptable hand washing facilities. The room housed the medication fridge, the mobile drugs trolley and excess stock cabinets, one of which contained the controlled drugs cabinet. The room was clean and well organised. All MAR sheets examined were completed in line with NMC requirements. The home have recently changed their dispensing chemist and had found the new system working very well. The dispensing chemists, within their contractual agreement, currently met the new legislation regarding the disposal of medicines from nursing homes. The temperature of the drugs room was 24.C and the staff explained that they had difficulty at times to keep the temperature below the required 25.C. It is hoped to move this room to a decommission bathroom, when permission has been granted by the Commission. Observed practice on the day of inspection was appropriate and showed respect for the residents. Contact with significant others is encouraged by the home and facilitated for where possible. Visitors are able to meet residents in their bedrooms or the lounge/dining rooms, which offer privacy when not being used. Residents can also have landline or mobile phones of their own if they wish. Residents spoken to during the inspection confirmed that staff treat them with respect and they felt that their privacy and dignity was maintained. One of the residents spoken to stated that staff were always mindful of maintaining her dignity and always treated her respectfully. She had previously been a teacher and stated that this was very important to her. Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 12 Another gentleman stated that staff always knock on his door before coming in to his room. The home has a policy and procedures on the care of the dying and death. One member of care staff spoken to had recently encountered experience with deceased residents and showed a great deal of empathy and understanding. She stated that she had learned how to deal with dying and death during her induction and throughout her employment in the home and she stated ‘ this training enabled me to better support residents and relatives’. The inspector was also informed that staff like to attend funerals where possible. The home keeps a record of resident wishes concerning care of the dying, spiritual preferences (if requested) and death. A comment received from a relative included –“My wife has nursing care……… the care she receives is excellent. I attend relatives meetings and find them very useful. The nurses are most helpful despite the enormous amount of time they spend recording what is being done.” Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14 and 15 Residents were satisfied that their lifestyle in the home matched their expectations and preferences. The catering service within the home was professionally managed and delivered a range of balanced and nutritious meals. EVIDENCE: Service user’s interests, religion and likes and dislikes were recorded in the care plans. The home employs two part time activities co-ordinators that organise activities for residents, fundraising and planning entertainment. Relatives and residents spoken to stated that they felt there were sufficient activities available to them. The activity timetable shows that the time is divided between the two floors and evidence seen on the day shows that the activity co-ordinators are constantly reviewing their programmes to find different ways of improving the service offered to residents. The staff and relatives confirmed that residents do take part in some activities. At the time of inspection, a volunteer entertainer was singing and playing an accordion to the residents on the top floor. This sing-a-long was witnessed and was very well received by residents/relatives and staff alike. Discussion with staff indicated that there was great awareness with regards to promoting choice. Bedrooms are appropriately personalised and residents are able to take their personal possessions into the home. Where residents are capable of managing their own affairs the home facilitate this. Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 14 All residents spoken to by the inspector said that they were very satisfied with the meals and choices available. The staff explained that fresh, good quality food served daily. Four relatives engaged in conversation confirmed that there was a wide range of choice for their loved ones. The two dining rooms were clean and one room was set up with tablecloths and cloth napkins on each of the tables. The inspection officers were offered sandwiches and cakes at lunchtime, which had been freshly prepared by the kitchen staff. The cream cakes served were all homemade to a professional standard. Staff were asked to comment on the food and they responded by saying ‘ excellent’ ‘beautiful’ ‘it what the residents want’. There were no menus on display in on the nursing unit and it was recommended that large wipe able/chalk boards are put in to place so that residents, relatives and staff are aware of the choices and daily menus available. Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17 and 18 Residents could be assured that their concerns would be listened to, that their rights as citizens would be protected and that the systems in place at the home would help to protect them from harm. EVIDENCE: There was a clear and accessible complaints procedure in place at the home. Unit managers usually dealt with concerns. Complaints were addressed by the managers within the allocated timescale and records were maintained of the investigation, outcome and action taken (if required). Discussions with some of the residents and one of the visitors identified that they would know who to go to if they had any concerns. The CSCI had received one complaint since the last inspection. The complainant had not been happy with the outcome of the complaint, which had been addressed by the managers of the home. This complaint had been investigated by the CSCI and partly upheld. The issues were mainly related to infection control and staff attitude. The inspector met with this complainant at the time of the inspection and spent a considerable amount of time discussing the issues. Staff were very carefully selected to work at the home and policies and procedures were in place to help protect the residents from harm or abuse. When questioned, staff were aware of the procedure in relation to the reporting of abuse and protection of vulnerable adults. Examination of records revealed that new staff received some training in this are during induction and further training was undertaken at a later date. Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 16 The Care Manager stated the home contacts the local Advocacy Schemes if any resident needed their services. An advocate had visited a resident the day prior to the inspection and this had been recorded in the residents care plan. Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 22, 24, 25 and 26 Residents live in a comfortable clean environment, which has been adapted to suit their needs. EVIDENCE: A tour of all three units was carried out where all the communal rooms and some of the bedrooms were inspected. The residential units were very clean and well presented. Some redecoration had taken place since the last inspection on the mental health unit. This had included redecoration of the corridors and dining room. The colour scheme was attractive and enhanced the presentation of the unit. The unit manager took great pride in the appearance and cleanliness of this unit. The cleanliness and presentation of these units were a credit to the unit managers and the staff who worked there. The inspector spoke with one of the domestic assistants and complimented her on achievements. The maintenance person had also worked very hard to fit in redecoration to such a high standard as well as his own maintenance of the home. Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 18 There were sufficient communal areas on the nursing floor with two lounges and two dining rooms and residents had the choice of these areas. All bedrooms were single en suite, with 4 singles having adjoining doors to accommodate couples wishing to share a room. There were ten additional lavatories and three separate shower rooms and two assisted bathrooms. The managers stated that they would like the one unassisted bathroom, which is never used due to safety reasons, to be decommissioned and replaced as a clinical/medicines room. The operations manager is to present written proposals to this effect to the Commissioning for consideration in the near future. The bedrooms were clean and homely with satisfactory fittings and furnishings. Residents had many of their own possessions in their rooms and comments from relatives were very positive about their loved ones environment. Two lady relatives stated that their Aunts room was ‘ very comfortable, light and airy’. They went on to say that in three years they had no complaints with the overall cleanliness of the home. The dependency levels of the residents were very high and at the time of the inspection no one wanted a key to their room. This would be facilitated on request All rooms have a lock on the door and a lockable facility in the room itself. The staff stated that at times during the summer the heat on the nursing floor (top floor) was ‘unbearable at times’. It was recommended that ceiling fans were installed in the lounge and dining rooms to circulate the air making the environment more comfortable. Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 Residents are cared for by an adequate number of carefully selected staff who have the necessary skills and expertise to meet their needs. EVIDENCE: On the residential mental health unit there were 19 residents accommodated. There was a unit manager on duty together with two other care staff. There was usually three care staff on this unit all day including one senior and two care staff at night. Staff commented that, on occasions, they had to work with two care staff due to sickness and this was insufficient. This was discussed with the managers who stated that this was very rare and that staff sickness was being addressed throughout the home. Evidence was seen in relation to this in the form of back to work interviews and monitoring of sickness forms. On the residential unit there were 15 residents accommodated. Two care staff worked together all day and one at night. The unit manager was settling in to her new role and stated that she was enjoying this very much. On the nursing unit there were thirty-nine residents accommodated at the time of the inspection. There were two trained nurses on duty all day and night. From 8am – 2pm there were nine care assistants on duty and from 2pm – 8pm this number dropped to 6. Throughout the night there were 2 care staff working alongside the nurses. Some staff preferred to work from 8am – 8pm. Qualified staff attend a 15minute handover period at each shift changeover. The staffing rotas are prepared well in advance and there were no care staff under the age 18 years working in the home. Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 20 The managers job shared and worked supernumery, one working two and the other three days. The acting administrator was still in post as the permanent administrator was on long-term sick leave. A housekeeper directs the domestic team. A hostess is employed on the nursing floor to serve food and assist during meal times. Two-activity co coordinators work from 10.30 am – 5pm Monday to Friday and these hours are split between them. The Maintenance man works full time and also tends to the gardens. He remains on call and is directed by the care managers in the home. The head cook had left and been replaced by another cook in the kitchen. She was settling in to her new role very well and was supported by a second cook and kitchen assistants. There was an effective team of domestic and laundry staff employed at the home A new member of care staff who was undertaking her third shift in the home, was engaged in conversation and she explained that she had been given 18 hours of supernumerary time when a senior member of staff had supervised her. The inspector then examined her personnel file and this evidenced, that new employees complete an application for employment form prior to employment, sign a criminal disclosure, provide two written references, photo ID and a copy of their birth or marriage certificate and medical details. CRB and POVA checks are always undertaken by the home and all staff are thoroughly vetted before commencing employment. The home manager confirmed that all staff are in receipt of a contract/statement of terms and conditions, as well as a job description. Staff spoken to confirmed this. NVQ training was on going at the home with 33 of care staff trained to NVQ level 2 and above. This will need to be further developed further in order to reach the target of 50 . There was a well-organised staff training programme and records had been maintained of individual training undertaken. As well as mandatory training, Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 21 sessions had included care plan training, dementia training, and safe handling of medicines, wound care and infection control. New staff undergo induction training and completed records of this were seen. One staff member who had not been employed for very long stated that she had received induction training and worked alongside a mentor. Following initial induction, TOPPS induction is undertaken. Three staff spoken to on the nursing unit confirmed that they had received comprehensive recorded induction training. They also confirmed that in-house briefing on manual handling; fire safety and care practices had taken place during this induction. All 5 staff spoken at length confirmed that they received 3 paid days training per year. It was pleasing to note that the managers have introduced an ‘employee of the month’ award. Residents, relatives, visitors are all encouraged to vote for their favourite member of staff who are then awarded £10. Staff were asked what they thought was best about the home the responded ‘Good atmosphere’ ‘nice staff’ ‘good communication with the residents’. When asked what was the worst thing about the home they stated ‘ not having enough time to spend with residents’. Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36, 37 and 38 Staff and residents benefit from the skills and management style within the home. Quality auditing of the service provided was on going. Appropriate supervision of care staff was in place and a healthy and safe environment was maintained. EVIDENCE: There had been no changes to the registered managers since the last inspection. Two managers job share the role of registered manager, each working part time and this works very well. This also means that when one manager is on holiday, then the home is still covered. There is a requirement for the registered managers to commence the Registered Managers Award or equivalent without delay. Each unit has a manager and senior staff. Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 23 Several members of staff commented on how approachable unit managers were and how they felt able to discuss confidential matters with them. They all felt that their views were listened to and acted upon where necessary. The managers hold regular staff team meetings and these are recorded. The unit managers explained that they hold relatives meetings but that these are not well attended. They intend to follow the next planned meeting with a race night and cheese and wine in the hope that this bring about more interest and offer the relatives an opportunity to enjoy a social event once the business of the meeting is concluded. An agenda is to be displayed offering the relatives to add any other business, which they would like to discuss on the night. Three care staff confirmed to the inspector that two monthly supervision had been carried out and that they were provided with a copy of this record. There was evidence of structured and recorded staff supervision. One unit manager stated that she would like to be more involved in the recruitment of staff for her unit. It is recommended that unit managers are involved in the recruitment and interviewing of staff for their units. Quality auditing is carried out at company level and by the home managers. There was a quality review tool seen contained within care plans involving the key workers, the resident and their representative. Auditing of medication is undertaken by GPs. Accidents are audited within the home and at company level. Maintenance records were examined and revealed that staff mandatory training was updated on a regular basis. This included moving and handling, fire safety and drills, infection control, food hygiene, first aid and COSHH. Records had been well maintained in relation to the maintenance and servicing of equipment, testing of fire alarms, hot water, emergency lighting and other tests. There was an up to date gas safety test in place, a legionella test certificate, PAT testing and visual inspection of electrical appliances. Mobile and fixed hoists, including bath hoists had been regularly examined and serviced, as had the passenger lift. Accidents had been recorded and reported and audited as required. Bedrails were only used after a suitable risk assessment had been carried out. Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 4 3 x 3 x 3 3 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 2 4 3 x x 3 3 3 Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 25 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 31 Regulation Requirement There is a requirement for the registered managers to commence the Registered Managers Award or equivalent without delay. Timescale for action To commence by 26/9/05 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. 3. Refer to Standard 31 and 29 15 25 Good Practice Recommendations It is recommended that unit managers are involved in the recruitment and interviewing of staff for their units. It is recommended that large wipe able/chalk boards are put in to place so that residents, relatives and staff are aware of the choices and daily menus available. It is recommended that ceiling fans are installed in the lounge and dining rooms to circulate the air making the environment more comfortable. Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection Stafford - 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 © 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 Rowan Court Nursing & Residential Home E51-E09 S26963 Rowan Court V237427 260705 Stage 4.doc Version 1.40 Page 27 - 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. 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