Inspection on 09/01/06 for Rowan Garth

This inspection was carried out on 9th January 2006.

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 02/06/05

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 Inspection 9th January 2006 01:00 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 Rowan Garth DS0000025187.V277824.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. Rowan Garth DS0000025187.V277824.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Rowan Garth Address 219 Lower Breck Road Liverpool Merseyside L6 0AE 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) 0151 263 9111 0151 260 4511 www.bupa.com BUPA Care Homes (CFHCare) Limited Susan Margaret Kennedy Care Home 150 Category(ies) of Dementia - over 65 years of age (30), Old age, registration, with number not falling within any other category (120) of places Rowan Garth DS0000025187.V277824.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 30 OP (PC - Beech House) 28 OP (N - Oak House) and 2 named male persons under 65 years of age (N- Oak House) 12 OP and 3 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. 29 DE/E (PC Moss House) and 1 named male person DE (under 65 years of age) (PC Moss House). 29 OP (N Heather House) and one named male person under 65 years of age. 1st June 2005 4. 5. Date of last inspection 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 DS0000025187.V277824.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted over two days. Discussions were held with the Responsible Individual, Registered Manager, Care Managers, care and ancillary staff to obtain their views of the service provided. Discussions were also held with service users and family members to gather further information. Records relating to the care required by and afforded to service users were inspected and were found to be comprehensive, informative and up to date. Staff records provided evidence that all safety checks had been made and of the training undertaken by each individual. A tour of the premises was made to ensure that the physical standards were maintained and it was evident that considerable improvements had been made since the last inspection. No requirements are made following this inspection. 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 DS0000025187.V277824.R01.S.doc Version 5.1 Page 6 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 Rowan Garth DS0000025187.V277824.R01.S.doc Version 5.1 Page 7 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, 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. Training has been given to all staff who undertake assessments to ensure they are completed correctly and accurately. Rowan Garth is registered to provide intermediate care for up to 16 persons in Clover House. Service users who are provided with intermediate care are accommodated on one side of the house to ensure that the high turnover of Rowan Garth DS0000025187.V277824.R01.S.doc Version 5.1 Page 8 service users requiring this service does not impact on those people accommodated for long term care. Staff have been given appropriate training 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 DS0000025187.V277824.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): 7, 8, 9, 10 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. EVIDENCE: Individual care plans are 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 they have been discussed and agreed by them. 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 and who require nursing intervention. Rowan Garth DS0000025187.V277824.R01.S.doc Version 5.1 Page 10 Pressure relieving mattresses and cushions are provided for the prevention and treatment of pressure sores and are used where necessary following a risk assessment. 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. Arrangements are being put in place for the disposal of unwanted medications and secure facilities are being provided for the storage of these items. 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. Service users spoken to during the inspection confirmed that their privacy was respected at all times and that the staff were caring and helpful. Rowan Garth DS0000025187.V277824.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, 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 preferences. 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. Some service users spoken to said that there was insufficient activities and that they became bored. Staff strive to provide stimulation although this is on an ad-hoc basis whenever time became available. A review of activities provided may prove beneficial prior to preparing new plans and timetables of events. Rowan Garth DS0000025187.V277824.R01.S.doc Version 5.1 Page 12 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 on a regular basis. 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. The meals are served directly from the trolleys to meet individual preferences and meal size. Service users are offered a choice of meals and special diets can be catered for on the advice of the dietician, GP or as the service user requests. 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. Dedicated catering staff are employed to attend to all catering needs. Rowan Garth DS0000025187.V277824.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): 16, 18 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. The complaints procedure is displayed within the home and is also detailed in the Statement of Purpose. Leaflets on how to complain, and who to complain to, 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. The manager was able to demonstrate that she is knowledgeable of the complaints reporting process of the action to be taken. 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 DS0000025187.V277824.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, 26 The home continues to improve to provide pleasant and homely environment for the service users. 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 and addressed during the inspection. Improvements have been made within the home since the last inspection. New armchairs, dining furniture and over bed tables have been provided in Moss House and considerably improve the environment for service users. New armchairs and dining furniture has been provided in Heather House together with new carpets in all corridors and communal areas. New linens have been provided throughout the home and each house has a different colour scheme for the linens. Rowan Garth DS0000025187.V277824.R01.S.doc Version 5.1 Page 15 In Clover House, some bedside cabinets were noted to be damaged although the inspector was advised that this issue was being addressed. In Oak House, two bathrooms were out of order, one due to a new shower facility being installed and one due to a problem with the toilet. Assurances were given that the problem with the toilet was being addressed and both rooms would be made available for use within a short timescale. The home was found to be clean throughout and appropriate measures are in place to dispose of all waste products. Rowan Garth DS0000025187.V277824.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, 29, 30 Staff morale is good resulting in an enthusiastic workforce that works positively with service users to improve their quality of life. EVIDENCE: Staff are employed in sufficient numbers and qualified staff are employed in those houses that provide nursing care. The home has a bank of staff to cover vacancies, sickness and annual leave although staff are employed from agencies to cover occasional shifts. 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. Qualifications and training are required to be evidenced by all applicants and gaps in employment history are questioned. 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. Training has been given to staff on dementia care and dealing with challenging behaviour and these training courses have been accredited by the Alzheimer’s Society. Additional training has been requested on dealing with challenging behaviour for all care staff. Rowan Garth DS0000025187.V277824.R01.S.doc Version 5.1 Page 17 Qualified staff are required to demonstrate that they have continued their professional development to meet the criteria laid down by the Nursing and Midwifery Council and the home provides these opportunities for staff. In addition to the nursing and care staff, the home employs a dedicated team of housekeeping, catering, maintenance and administration staff. Appropriate records are held on these staff and evidence of training undertaken is recorded. Rowan Garth DS0000025187.V277824.R01.S.doc Version 5.1 Page 18 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, 35, 38 The management of this home is good and records are well managed. This ensures the protection of the service users. EVIDENCE: The registered manager of the home is a qualified nurse and an experienced manager. The home is owned by BUPA Care Homes Ltd which provides a structured management system for support to the home’s manager. Most service users have their finances dealt with by family members or advocates. Other service users have an individual bank account and are 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. Rowan Garth DS0000025187.V277824.R01.S.doc Version 5.1 Page 19 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. Health and safety issues are the responsibility of the manager and the maintenance staff to attend to issues as soon as they are reported. Tests on fire detection equipment are made on a regular basis and are duly recorded. Fire training is given to all staff and a record of this is held in the home. Tests are made on all equipment and certificates were found to be up to date. Records held in the home provide evidence that the health and safety of all service users and staff is promoted. Rowan Garth DS0000025187.V277824.R01.S.doc Version 5.1 Page 20 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 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 Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 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 3 X 3 X 3 X X 3 Rowan Garth DS0000025187.V277824.R01.S.doc Version 5.1 Page 21 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. Standard Regulation Requirement Timescale for action 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 OP12 Good Practice Recommendations Consideration should be given to reviewing the activities programme to ensure that it meets the needs and preferences of each individual. Rowan Garth DS0000025187.V277824.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 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 DS0000025187.V277824.R01.S.doc Version 5.1 Page 23 - 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. 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