Inspection on 23/02/06 for Rowan House

This inspection was carried out on 23rd February 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rowan House 05/11/07

Rowan House 14/12/06

Rowan House 13/12/05

Rowan House 08/03/05

Rowan House 16/11/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Rowan House Church Lane Doddinghurst Brentwood Essex CM15 0NJ Lead Inspector Mr Ron Reeves Unannounced Inspection 23 February 2006 09:30 rd Rowan House DS0000018115.V278580.R01.S.doc Version 5.1 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 House DS0000018115.V278580.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rowan House DS0000018115.V278580.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Rowan House Address Church Lane Doddinghurst Brentwood Essex CM15 0NJ 01277 823853 01277 822722 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) rowan.house@achuk.com Aitch Care Homes Limited Mrs Trudy Jane Hunter Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Rowan House DS0000018115.V278580.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 13th December 2005 Brief Description of the Service: Rowan House is owned and managed by AITCH Care Homes. It provides care and accommodation for six service users who have a moderate to high level of learning disability. Rowan House is situated on the edge of a small village, with local shops and amenities nearby. Public transport does present some difficulty for staff and visitors. The home has its own transport to support service users to access community facilities. The building is a spacious mock Georgian family house. Service user bedrooms are provided on two floors in all single accommodation. There is a separate lounge and dining room on the ground floor. Rowan House has developed two rooms, one as a music/art activity room and one as a sensory room. There is an enclosed garden at the rear of the property, which is mainly laid to patio and a gravel parking area at the front of the property. Rowan House DS0000018115.V278580.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection, which took place on the 23rd of February 2006 and lasted 3.5 hours. Opportunity was taken to tour the building, examine records and policies, talk to staff and observe residents. None of the residents had any significant speech. The inspection was managed well by the senior support worker on duty and the inspector would like to thank the Senior Support worker and the two staff on duty for their cooperation and help throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: The homes must recruit more staff to ensure staff on duty can fully meet residents assessed needs. Medication stock records needs to ensure all medication is recorded and that temperatures of the storage remains below 25oC. There was no evidence to show that the home’s staff induction programme has been upgraded to meet “Skills for Care” standards. The location of the home’s laundry still remains a problem. It is appreciated that the home has recently had a change of proprietors and the problem will be discussed at the next inspection. Rowan House DS0000018115.V278580.R01.S.doc Version 5.1 Page 6 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 House DS0000018115.V278580.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rowan House DS0000018115.V278580.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 & 5 The home provides appropriate written information to prospective residents and their families enabling informed choices. The home operates a thorough admission process. EVIDENCE: The home has an appropriate state of purpose and service users’ guide which has been developed into a pictorial and sign format. Each resident’s file contained a contract with the sponsoring authority and a contract with the resident, detailing the terms and conditions of residence. Care plans examined revealed comprehensive transitional assessment from the resident’s previous placement, a full social worker assessment and an assessment by the home, which is in a picture and sign format. Rowan House DS0000018115.V278580.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6-9 Resident’s needs are being met by the home. Staff encourage residents to make choices and maintain their independence. EVIDENCE: Care plans sampled were seen to be to a high standard and provided clear and comprehensive details of action to be taken by staff to meet residents’ needs. Care plans were seen to be regularly reviewed. Residents’ limited abilities restrict their involvement in the day to day running of the home, however care plans evidenced that residents are encouraged and supported by staff to maintain their independence. This continues to be managed through a comprehensive risk assessment process. Rowan House DS0000018115.V278580.R01.S.doc Version 5.1 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11-17 The home provides a wide range of appropriate educational leisure and social activities both within the home and in the local community. However, the home must ensure these are not reduced due to staffing shortages. The provision of meals was to a good standard. EVIDENCE: Residents are encouraged and supported to access a wide range of Educational and leisure activities. Each resident has fully developed programme based on needs and personal choice. Outings are arranged to local pubs, restaurants and leisure facilities in the local community and each resident enjoys an annual holiday. From discussions with staff and examination of care plans, it was evident that residents, according to their abilities are enabled to develop their daily living skills. Family involvement is encouraged by the home. Three residents regularly spend time with their relatives at weekends. The home’s menu is planned on a four week basis. Healthy eating is encouraged, menus are planned taking into account residents likes and dislikes. Detailed nutrition records are maintained. Rowan House DS0000018115.V278580.R01.S.doc Version 5.1 Page 11 It was noted that on the day of the inspection, the proprietors had arranged a staff training day. This resulted in the activities arranged for that day to be severely restricted. Rowan House DS0000018115.V278580.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18-20 Residents’ personal and health care needs are being met by the home. EVIDENCE: Care plans detail how the residents like their personal care needs to be met and those residents are supported to access all local health care facilities. No resident has been assessed to manage their own medication. Each resident has their own medication plan. Medication administration record (MAR) were seen to be appropriately completed. However, medication remaining in stock after a 28 day period should be brought forward on the next period if not returned to the pharmacist. All staff have received training in medication administration. The home must monitor the temperature of the office where medication is stored to ensure it remains below 25oC. Bottled medication should be marked with the date of opening. Rowan House DS0000018115.V278580.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22/23 The home has appropriate policies, procedures and staff training in place for responding to residents’ concerns and protecting them from abuse. EVIDENCE: The home’s complaint procedure was seen to be available in pictorial format. No complaints have been received by the home since the last inspection. The Adult Protection policies were adequate to protect residents from harm or abuse. All staff have received training for the protection of vulnerable adults and have been given copies of the Essex County Council’s Adult Protection procedures. Rowan House DS0000018115.V278580.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24-28 & 30 The home provides a good standard of accommodation for the residents. EVIDENCE: The home has the appearance of a large family detached house. The home is generally well decorated, furnished and well maintained throughout. Residents’ bedrooms were personalised to individual residents taste. There are adequate bathing, showering and toileting facilities located on both floors. Communal areas are large and comfortably furnished. There is a snoozelum on the 1st floor and a music/activities room on the ground floor. The kitchen is large, domestic in style and well equipped. The homes’ laundry accessed through the kitchen. All laundry is put in special bays before taking through the kitchen. The manager is aware of the need to review the laundry facilities. The home was clean, tidy and odour free. Rowan House DS0000018115.V278580.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35, 36 Residents are well supported and enthusiastic staff team who are well trained and supported. Staffing levels need to be reviewed to ensure resident’s needs are met. EVIDENCE: The homes’ staff rota evidenced that the home is struggling to meet its staffing levels of 4 staff during the day plus one on a 9.00am-5.00pm shift. During the weekend staffing levels are reduced to 3 during the day as at least 2 residents go home at weekends. On the day of the inspection due to training day only 3 staff were on duty and the residents activities planned for outside the home could not take place. Staff rota indicated only 10 support staff employed by the home during the day. This is insufficient to meet the staffing requirements unless overtime or long days are worked by staff. Cooking and domestic duties are carried out by support staff. A strength of the home is the staff training programme, which enables staff to access a wide range of training including NVQ training. There was no evidence that induction training was to ‘Skills for Care” standards. Staff supervision is organised by the manager and deputy who have received training supervision. An annual supervision programme is displayed in the office. Rowan House DS0000018115.V278580.R01.S.doc Version 5.1 Page 16 Staff commented that they had a good staff team, who communicate well and support each other. From observations it was clear that staff are knowledgeable of residents needs and were sensitive and unhurried when caring for the residents. Rowan House DS0000018115.V278580.R01.S.doc Version 5.1 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 40, 41 The home is well managed who provides good support and guidance for the staff. EVIDENCE: The manager was on a training course on the day of the inspection. She has managed the home for 4 years and has brought about changes that have benefited the residents. Staff spoken with said the manager is very knowledgeable and supportive and does work hands on with the staff and regular basis. A sample of policies and records were examined and found to be generally well maintained and up to date. Rowan House DS0000018115.V278580.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 X 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 X 3 3 X X Rowan House DS0000018115.V278580.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? NO 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 YA33 Regulation 18 Requirement The home must ensure that all times suitably qualified. Competent staff are working in the home in such numbers as are appropriate for the health and welfare of the resident. The home must make arrangements for the recording, handling, safe-keeping, safe administrators and disposal of medicines received by the home this includes:(1) Adequate stock records maintained. (2) Liquid medication marked with date of opening. (3) Temperature of storage room remains below 25oC. Timescale for action 31/03/06 2. YA20 13(2) 23/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000018115.V278580.R01.S.doc Version 5.1 Page 20 Rowan House 1. 2. Standard YA30 YA35 The access to the laundry via the kitchen to be considered. The staff induction programme should meet the Skills for Care Standards. Rowan House DS0000018115.V278580.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 House DS0000018115.V278580.R01.S.doc Version 5.1 Page 22 - 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!