Inspection on 20/03/07 for Rowan House Care Home

This inspection was carried out on 20th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 House Care Home 06/01/09

Rowan House Care Home 10/01/08

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Rowan House Care Home 4 Lower Port View Saltash Cornwall PL12 4BY Lead Inspector Elaine Bruce Key Unannounced Inspection 20th March 2007 08:45 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 House Care Home DS0000069072.V334306.R01.S.doc Version 5.2 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 House Care Home DS0000069072.V334306.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rowan House Care Home Address 4 Lower Port View Saltash Cornwall PL12 4BY 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) 01752 843843 M & C Care Limited Pearl Corden Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Rowan House Care Home DS0000069072.V334306.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user between the age of 60 - 65 years of age may be accommodated within the overall registered numbers of 20. Date of last inspection Brief Description of the Service: Rowan House is a care home providing personal care and accommodation for twenty service users. The home is located near the centre of Saltash overlooking the River Tamar. Some of the bedrooms have pleasant views over the river. Accommodation to include communal areas and bedrooms is on the ground floor with bedrooms also available on a lower ground floor and second floor. Access to the lower ground floor bedrooms and second floor bedrooms is by the use of a stair lift if required, although there are two steps to negotiate without this facility. Sixteen of the home’s bedrooms are single and two of the bedrooms are registered as double rooms. The home has a garden with seating available and car parking is available in the grounds of the home. Rowan House Care Home DS0000069072.V334306.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 20th March 2007 over five and a half hours and was carried out as an unannounced key inspection. The home changed ownership at the end of January 07. This is the first inspection following that process. Service users were spoken to during the course of the inspection and some staff members. Case tracking took place with four service users. All the service users spoken to expressed very positive comments on the standard of care at the home. They were aware that the home had changed ownership and had been pleased to meet the new owners on their recent visits to the home. An inspection of the premises took place and care records and associated documentation were inspected. The newly registered manager was on annual leave at the time of the inspection but came in to facilitate the inspection process following a telephone call to her from a senior staff member. Prior to the inspection a completed pre-inspection questionnaire was received. In addition three relative/visitors comment cards were received expressing complete satisfaction with the care at the home. Three service user comment cards were also received. One stated: “I like living at Rowan House, it is my home”, another one stating: “Very good home” What the service does well: Following the very recent change of ownership at the home it is too early at this time to state what the home does well. It is though important to emphasise that all the service users at the home are very satisfied with the standard of care that they are receiving. Rowan House Care Home DS0000069072.V334306.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Rowan House Care Home DS0000069072.V334306.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rowan House Care Home DS0000069072.V334306.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered manager assesses all service users prior to admission to the home to ensure that the home will be able to meet their care needs. EVIDENCE: The registered manager is involved in the assessment process of the service users prior to admission to the home. Where the service user is coming from out of county, information is gathered on the telephone prior to admission. The home aims to have all service users visit and spend time at the home prior to admission. A detailed pre admission assessment document is completed by the registered manager prior to a new service user admission to the home. Some of the Rowan House Care Home DS0000069072.V334306.R01.S.doc Version 5.2 Page 9 service users have received care in the community from Rowan House prior to admission to the home and this is seen as positive in helping people settle into the home. In the absence of the registered manager a senior staff member will undertake the pre admission assessment process. It is recommended that an admission policy and procedure is developed to guide staff in good admission practice. Rowan House Care Home DS0000069072.V334306.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements are required to care planning to continue to evidence that the care needs of the service users are being met at all times. Medication arrangements were found to be unsatisfactory on the day of the inspection. EVIDENCE: Care plans are in place for each service user and are completed by the senior staff in the home. It was noted that although reviews of the care needs are taking place the original care planning documentation is now considerably out of date. The daily records for day and night are detailed and informative. All staff are involved in this recording. Each service user is registered with a general practitioner of their choice. Service users are supported by the community service if required. MultiRowan House Care Home DS0000069072.V334306.R01.S.doc Version 5.2 Page 11 disciplinary record sheets evidence when health care professionals have attended a service user (for example chiropody). Service user are being regularly weighed and dietary needs are identified. On the day of the inspection medication was found to be “potted up” out of the blister packs for administration a considerable number of hours before it was due. This is very poor practice and increases the risk for error in administration to the correct individual. In addition the medication administration records were signed as though the medication had been taken which again is very unsatisfactory. All the staff who have medication administration responsibilities have received accredited medication training and would therefore be fully aware that this practice is not acceptable. Service user spoke positively during the course of the inspection about the good standard of care they are receiving at the home. This includes references to being treated: “with respect and dignity”. Where service users are sharing a bedroom a screen is provided for privacy. Rowan House Care Home DS0000069072.V334306.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning and daily recording evidences that the social care needs of the service users are identified and being met. The home is very welcoming to all family/friends and visitors and encourages them to stay in touch with their relative. The meals provided at the home are good with special diets catered for and a choice offered at all meals. EVIDENCE: Care plans and daily records evidences that the social care needs of the service users are identified and being met. Care planning also includes information on religious and cultural needs of the service users. Holy Communion takes place regularly in the home. A number of activities take place regularly in the afternoon to include bingo and quizzes. There are plans for outings out locally when the weather is Rowan House Care Home DS0000069072.V334306.R01.S.doc Version 5.2 Page 13 warmer. Advocacy services are available for service user without a representative All visitors to the home are asked to sign into the home using the visitors’ book which is available in the entrance of the home. Most of the service users receive visitors and visitors are encouraged into the home. The daily records evidence each service users visitors. The daily routines at Rowan House are flexible to include the times of rising and going to bed for example. The service users spoken to during the course of the inspection expressed positive comments on their flexible routines. Records are maintained of all meals provided at the home to include any special diets required. The home employs two cooks both of whom are trained to undertake their duties. The meals are mainly traditional with an alternative choice always available. The menu is displayed for the service user (and visitors to the home to see). The main meal of the day on the day of the inspection was sausage casserole with broccoli, cauliflower, peas and carrots, followed by apple pie and custard. The evening tea was to be bacon and tomatoes. An alternative choice of meal is always provided. Rowan House Care Home DS0000069072.V334306.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure provided to the service users (and their representatives) in the service user guide. Staff are provided with adult protection training to raise awareness and ensure the safety and well being of the service users at all times. EVIDENCE: The home has in place a complaints policy and procedure that meets the requirements of The National Minimum Standards. The policy and procedure is available for the service user (and their representatives) in their service user guide. Staff also have a copy of this document in their staff handbook. The home has in place an adult protection policy and procedure that also includes information on whistle blowing. Information is also included in the policy and procedure from the local Adult Social Care Department. All staff (apart from two new staff) have now received adult protection training. Rowan House Care Home DS0000069072.V334306.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Rowan House is a homely home with a comfortable environment. To maintain standards at the home it is appropriate for some internal decoration to take place. The standard of cleanliness in some of the bedrooms was found to be unsatisfactory on the day of the inspection. EVIDENCE: Rowan House is a comfortable and pleasant home. It is situated close to all the local facilities of Saltash in a residential area. Car parking is available in the grounds of the home. Some of the bedrooms at the home have pleasant Rowan House Care Home DS0000069072.V334306.R01.S.doc Version 5.2 Page 16 views across the River Tamar. Bedrooms are available on all floors of the home and access to some of the rooms is by a stair lift. Communal facilities include a spacious lounge, separate television lounge and dining room. It is noted that some of the paintwork could be updated to ensure that the environment continues to be of a good standard. The standard of cleanliness on the day of the inspection was noted to be unsatisfactory in bedrooms. A number of bedroom carpets were dirty, required vaccuming and rubbish bins were overflowing. Some hand basins also needed cleaning. The laundry was not inspected on this occasion. It is noted that the care staff undertake all laundry duties. Rowan House Care Home DS0000069072.V334306.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels were found satisfactory to meet the care needs of the service users on the day of the inspection. Recruitment procedures for employing staff must be followed at all times to ensure the safety and well being of the staff. Staff training is up to date thereby ensuring that the staff have the skills to meet the care needs of the service users. EVIDENCE: Staff on duty on the day of the inspection were as per the staffing rota. All staff are included on the rota (care staff, domestic and cooks). The home employs a senior management team, one of whom is now the registered manager. These senior staff members take a turn at being the sleeping in member of staff who the waking staff member can call on if required. There are anticipated changes with these arrangements as the manager is to be changing her hours as requested by the registration process. There is evidence of two written references being taken prior to the employment of new staff and job application forms are completed Rowan House Care Home DS0000069072.V334306.R01.S.doc Version 5.2 Page 18 appropriately. One staff member had been recently recruited without a criminal records bureau check. This must be looked at to ensure that at a minimum a protection of vulnerable adults check has been made. There are plans for an improved induction training to take place along the good practice guidance re “Skills for Care”. More staff should be encouraged to undertake NVQ 2 training in care to ensure that this standard is met. Rowan House Care Home DS0000069072.V334306.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registration process for the manager has requested that her hours at the home be reviewed to ensure a continuity of care management. This process has not taken place yet. EVIDENCE: The recently registered manager is a long standing experienced staff member. At present she is working over a three day period with sleeping in duties. She is supported in her duties by two other senior staff members. During the registration process it was identified that her hours must be increased and varied over the week which at this time is not happening. To support this Rowan House Care Home DS0000069072.V334306.R01.S.doc Version 5.2 Page 20 change of hours it is anticipated that another senior sleeping in staff member will be required. The manager has recently completed her NVQ 4 qualification in care and it is anticipated that she will commence studies to obtain the registered managers award after Easter. At this time the new owners are visiting the home weekly and meeting their requirements under legislation by providing a written report of their visit to the CSCI. A minimum of service users money is looked after at the home. The service users are encouraged to do this with the support of friends/family/representatives. Where money is held on the premises this is secure and all records and receipts are maintained in respect of all financial transactions. Policies and procedures are in place to guide staff on good practice and safe practice in regard to health and safety procedures. Rowan House Care Home DS0000069072.V334306.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 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 2 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 x x 3 Rowan House Care Home DS0000069072.V334306.R01.S.doc Version 5.2 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 OP9 Regulation 13(2) Timescale for action The registered person shall make 30/04/07 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. Requirement 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. 4. Refer to Standard OP3 OP7 OP26 OP29 Good Practice Recommendations To develop a good practice admission policy and procedure. To update all the service user care plans. To ensure that previous high standards of cleanliness are maintained. Recruitment procedures for employing new staff must be followed at all times to include criminal record bureau checks. Rowan House Care Home DS0000069072.V334306.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Care Home DS0000069072.V334306.R01.S.doc Version 5.2 Page 24 - 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!