Inspection on 02/06/05 for Rowan Garth

This inspection was carried out on 2nd June 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 Garth 04/12/07

Rowan Garth 26/07/06

Rowan Garth 09/01/06

Rowan Garth 07/02/05

Rowan Garth 13/07/04

Rowan Garth 10/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Rowan Garth 219 Lower Breck Road Liverpool Merseyside L6 0AE Lead Inspector Jeanette Fielding Unannounced 1&2 June 2005 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 Garth F52_F02_s25187_RowanGarth_v230531_010605_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Rowan Garth Address 219 Lower Breck Road Liverpool Merseyside L6 0AE 0151 263 9111 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) Bupa Care Homes Ltd Ms S Kennedy CRH N 150 Category(ies) of OP - 120 registration, with number DE(E) - 30 of places Rowan Garth F52_F02_s25187_RowanGarth_v230531_010605_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1) 30 OP (PC - Beech House) 2) 28 OP (N - Oak House) and 2 named male persons under 65 years of age(N- Oak House) 3) 13 OP and 2 named male persons aged under 65 (N- Clover House)16 persons aged 55 years and over (N -Intermediate Care - Clover House), within an overall total of 30 Beds. 4) 29 DE/E (PC Moss House) and 1 named male person DE (under 65 years of age) (PC Moss House) 5) 30 OP (N Heather House) Date of last inspection 7 February 2005 Rowan Garth F52_F02_s25187_RowanGarth_v230531_010605_Stage 4.doc Version 1.30 Page 5 Brief Description of the Service: Rowan Garth is a purpose built home and is registered to provide nursing and personal care for up to 150 older people. The home is divided into five separate houses, each providing specific care. The houses are generally laid out in a similar manner but each provides the facilities to meet the needs of the service users accommodated. The home has an acting manager and each house has a care manager.The home is located in well maintained grounds, in a residential area, close to shops and local amenities. The home is registered to provide care for 30 older people who have dementia and for 120 older people. Rowan Garth F52_F02_s25187_RowanGarth_v230531_010605_Stage 4.doc Version 1.30 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted over two days and took a total of 17 hours. During the inspection, the views of service users, visitors and staff in each of the five houses were obtained to gather information regarding the day to day running and activities. Care files were inspected in each house together with information and records relating to health and safety and the management of the home. What the service does well: 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 Garth F52_F02_s25187_RowanGarth_v230531_010605_Stage 4.doc Version 1.30 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 Garth F52_F02_s25187_RowanGarth_v230531_010605_Stage 4.doc Version 1.30 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, 6 Detailed pre admission assessments are undertaken on service users to ensure that the home can meet their identified needs. EVIDENCE: Comprehensive assessments are undertaken on service users prior to their admission using a dedicated format for gathering information. The forms used identify all social, health and medical history together with individual preferences. Necessary equipment for the provision of care is identified and gives the home the opportunity to obtain this equipment in preparation for the service users admission to the home. Care files for service users recently admitted to the home were inspected in each of the houses and all records were found to be detailed, informative and up to date. Rowan Garth is also registered to provide intermediate care for up to 16 persons in one of the 30 bed houses. Service users who are provided with intermediate care are accommodated in one side of the house to ensure that the high turnover of these people does not impact on those service users accommodated for long term care. Staff have been given appropriate training Rowan Garth F52_F02_s25187_RowanGarth_v230531_010605_Stage 4.doc Version 1.30 Page 9 to meet the needs of those persons accommodated for intermediate care and all specialist equipment is provided according to each persons assessed needs. Designated specialists are employed within the house to provide service users with rehabilitation to enable them to progress. Rowan Garth F52_F02_s25187_RowanGarth_v230531_010605_Stage 4.doc Version 1.30 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 The health needs of service users are well met with evidence of good multi disciplinary working taking place on a regular basis. The staff have good understanding of the service users’ support needs. This is evident from the positive relationships which have been formed between service users and staff. The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure service users medication needs are met. EVIDENCE: Individual care plans have been prepared for each service user. The care plans are detailed and informative and include risk assessments and risk management plans. All care staff are encouraged to read the care plans to enable them to be fully aware of each service users needs and preferences. Service uses or their relatives sign the care plans to provide evidence that these have been discussed and agreed by them. Rowan Garth F52_F02_s25187_RowanGarth_v230531_010605_Stage 4.doc Version 1.30 Page 11 Records are held to provide evidence of visits to and by GP’s and other health care professionals. This includes the dietician, optician, chiropodist and Tissue Viability Nurse. Occupational Therapists and Physiotherapists provide a more specialist service to those persons accommodated for intermediate care and advice from these staff is available for all service users as necessary. The community nursing service provides nursing care to those persons who are accommodated for personal care. Pressure relieving mattresses and cushions are provided for the prevention and treatment of pressure sores. Medications are dealt with according to the home’s policy and procedures. All medications were found to be ordered, stored, administered, recorded and disposed of as required. Information on the medications administered to service users is held and medications can only be administered by designated persons. Additional staff within the units for personal care, particularly night staff, should be given training on the administration of medication. Personal care is given to service uses in the privacy of their bedroom or in the bathroom as appropriate. All bedrooms are for single occupancy to promote privacy and staff were seen to knock on doors prior to entering. Service users may meet with their visitors in their bedroom or in one of the communal areas as they wish. Small private rooms are also provided in each house for service users who choose to use these. Rowan Garth F52_F02_s25187_RowanGarth_v230531_010605_Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15 Dietary needs of service uses are well catered for with a balanced and varied selection of food available that meets service users tastes and choices. EVIDENCE: Service users spoken to confirmed that the staff strived to provide a flexible lifestyle to meet their individual preferences. They confirmed that they could go to bed and get up at a time of their choosing and that staff respected their preferences. Ministers of religion visit the home on a regular basis to provide services to meet the service users religious needs. Few service users maintain links with the local community due to their age and frailty. Activities and social stimulation are provided for service users on a regular basis and details of planned activities are displayed in each house. Relatives and friends are free to visit the home at any time and those visitors spoken to said that they were always made welcome by the staff. Some service users are taken out by their relatives. Rowan Garth F52_F02_s25187_RowanGarth_v230531_010605_Stage 4.doc Version 1.30 Page 13 The records held in the home provide evidence that choices are offered and individual preferences are recorded on care plans. Meals are prepared in the central kitchen and are transported and served from heated trolleys and satellite kitchens. The central kitchens and satellite kitchens were found to be clean, organised and well maintained. Service users are offered a choice of meals and special diets can be catered for. Meals can be taken in the dining room or in service users own bedroom, as they prefer. The menus provide evidence that a varied and balanced diet is provided. A record is held in the central kitchen of special diets and service users individual preferences. Rowan Garth F52_F02_s25187_RowanGarth_v230531_010605_Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 – 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18 The home has a satisfactory complaints system with evidence that service users views are listened to and acted upon. Staff have a good knowledge and understanding of Adult Protection issues which protects service users from abuse. EVIDENCE: The home has a robust complaints policy and procedure. This is line with BUPA corporate policy. No complaints have been received by CSCI since the last inspection. The complaints procedure is displayed within the home and is also detailed in the Statement of Purpose. Leaflets on how to complain are freely available throughout the home. Training has been given to staff on the various types of abuse during their induction training and this has been reinforced during additional training session. Staff spoken to were aware of the procedure to be followed, and the people to be contacted, in the event of abuse being suspected. Appropriate checks are made on all staff prior to them commencing work at the home to further ensure the protection of service users. Rowan Garth F52_F02_s25187_RowanGarth_v230531_010605_Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 26 The overall quality of the furnishings and fittings is good to provide a homely environment for service users to live in. EVIDENCE: The home is generally well maintained and décor is acceptable throughout. All areas are fully accessible as each house is single storey and has ramped access. A small number of maintenance issues and improvements were identified during the inspection. Oak House. The water in WC 26 was found to be excessively hot. Appropriate measures are to be taken to ensure that service users are not placed at risk of scalding. Some of the over bed tables have become damaged and shabby and consideration should be given to replacing these. Beech House. The carpet in bedroom 18 is badly stained despite a rigorous cleaning. This carpet should now be replaced to improve the room for the service user. The carpet in room 24 is lifting and is presenting as a trip Rowan Garth F52_F02_s25187_RowanGarth_v230531_010605_Stage 4.doc Version 1.30 Page 16 hazard. Appropriate action is to be taken to remove the trip risk. The carpet in room 39 is stained and has been repaired with a patch. This does not provide the standard of environment that the staff try to achieve and should be replaced. The lounge carpet is stained and is sticky. This is cleaned monthly but this process has not proved effective. This carpet should now be earmarked for replacement within the home’s improvement programme. The smoking room has not been fitted with a door resulting is smoke permeating into the main lounge and dining area. The room has inadequate lighting. Appropriate action is to be taken to improve this area by ensuring that smoke does not permeate into other areas of the home and the provision of adequate lighting. Moss House. New bedroom chairs and commodes have been provided since the last inspection and demonstrate that the programme of improvement is effective. The over bed tables were found to be worn and damaged and should now be replaced. The damaged door to the wardrobe in room 23 should be repaired. Bathroom 16 was found to be extremely dark due to inadequate lighting. This is to be improved. Heather House. The bath panel in bathroom 10 is damaged and requires replacement. The water in bathroom 40 was found to be excessively hot. Appropriate measures are to be taken to ensure that service users are not put at risk of scalding. Three extractor fans were found not to be working and require repair. These are Sluice B, Sluice G and WC 24. It is recommended that each house manager take responsibility for identifying maintenance and improvement issues within their own area. It is evident that staff work with service users to personalise their rooms and to provide a homely environment. The home was found to be generally clean throughout and appropriate measures are in place to dispose of all waste products. Rowan Garth F52_F02_s25187_RowanGarth_v230531_010605_Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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, 29, 30 The relationship between service users and staff is good and creates a supportive and caring atmosphere. The home has a robust recruitment procedure to ensure the protection of service users. EVIDENCE: Vacancies for senior care staff currently exist, particularly at night, although all shifts are covered. Staff are employed in sufficient numbers and qualified staff are employed in those houses that provide nursing care, although staff are obtained from agencies to cover vacancies, sickness and annual leave. A programme of staff recruitment is currently taking place. The home has a robust recruitment procedure. Applicants are required to complete an application form, attend for interview and have references, POVA checks and CRB checks undertaken as part of the recruitment process. All new staff undertake a full induction programme and evidence of this is held on the staff files. A programme of NVQ training continues to take place. Some staff training needs were identified as being necessary to enable the staff to meet the changing needs of service users. Training in the administration of medications is necessary for night care staff to prevent the day staff having to stay after their shift has finished to deal with these. Rowan Garth F52_F02_s25187_RowanGarth_v230531_010605_Stage 4.doc Version 1.30 Page 18 The service user files identify that an increased number of service users suffer from dementia related health problems, although their primary need for care is one of general nursing. Identified training needs for staff includes dementia care, diversional techniques and managing challenging behaviour. Rowan Garth F52_F02_s25187_RowanGarth_v230531_010605_Stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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, 33, 35, 38 The management of this home is good and records are well managed. This ensures the protection of the service users. EVIDENCE: A new manager has recently been appointed to the home and an application to register the manager is currently being processed by CSCI. She is a qualified nurse and an experienced manager. Discussion with service users and staff established that the best interests of the service users has been prioritised. The records show that the needs and preferences of each individual are met. Service users confirmed that staff were kind and helpful and would do anything they could for them. Most service users have their finances dealt with by family members or advocates. Other service users have an individual bank account and are Rowan Garth F52_F02_s25187_RowanGarth_v230531_010605_Stage 4.doc Version 1.30 Page 20 invoiced for any costs incurred i.e. hairdressing and newspapers. Full records are accessible by the home of the individual accounts and these are audited on a regular basis. Monthly reports are prepared following visits by a representative of the Registered Person and a copy is held by the home. Copies are also submitted to CSCI. Evidence is held in the home of safety checks made by staff and all safety certificates were found to be in place and up to date. Rowan Garth F52_F02_s25187_RowanGarth_v230531_010605_Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 4 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 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 x 3 3 x 3 x 3 x x 3 Rowan Garth F52_F02_s25187_RowanGarth_v230531_010605_Stage 4.doc Version 1.30 Page 22 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 19 Regulation 13 Requirement The Registered Person must ensure that the temperature of the hot water within the home is not excessive. The Registered Person must ensure that stained carpets are cleaned or replaced. The Registered Person must ensure that the carpet presenting as a trip hazard is repaired. The Registered Person must ensure that the facility for service users who smoke is adequately lit and does not impact on other rooms or service users. The Registered Person must ensure that all repairs are addressed. The Registered Person must ensure that all staff are given training appropriate to the work they are to perform and to meet the needs of the service users. Timescale for action 08/7/05 2. 3. 19 19 23 13 26/8/05 08/7/05 4. 19 23 29/7/05 5. 6. 19 30 23 18 08/7/05 29/7/05 7. Rowan Garth F52_F02_s25187_RowanGarth_v230531_010605_Stage 4.doc Version 1.30 Page 23 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 19 Good Practice Recommendations A programme of replacing damaged and shabby over-bed tables should be implemented. Rowan Garth F52_F02_s25187_RowanGarth_v230531_010605_Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Liverpool Area Office 3rd Floor 10 Duke Street Liverpool, L1 5AS 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 Garth F52_F02_s25187_RowanGarth_v230531_010605_Stage 4.doc Version 1.30 Page 25 - 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!