Inspection on 06/01/09 for Rowan House Care Home

This inspection was carried out on 6th January 2009.

CSCI found this care home to be providing an Good service.

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 10/01/08

Rowan House Care Home 20/03/07

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 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Rowan House Care Home 4 Lower Port View Saltash Cornwall PL12 4BY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mandy Norton     Date: 0 6 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Rowan House Care Home 4 Lower Port View Saltash Cornwall PL12 4BY 01752843843 01752843843 rowan.house@virgin.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): M & C Care Limited Name of registered manager (if applicable) Mrs Pearl Corden Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 20. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Rowan House is a care home registered to provide care and accommodation for up to twenty people who have care needs within the categories of Old Age, not falling within any other category (OP). The home does not have the specialist categories to provide care for people with significant dementia or mental frailty needs. The home does not provide intermediate care and it is not registered to provide nursing care. The home is located near the centre of Saltash overlooking the River Tamar. Some of the bedrooms have views over the river. Accommodation to include communal areas and bedrooms is Care Homes for Older People Page 4 of 25 care home 20 Over 65 20 0 Brief description of the care home on the ground floor with bedrooms also available on a lower ground floor and first 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 homes 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. Additional charges to the weekly fee include hairdressing, chiropody, toiletries, newspapers, magazines, journals etc, all charged at commercial rates. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection took place from 11:40am to 4.30pm on 6th January 2009. The inspection was conducted with the manager. The provider was available for part of the day. This report contains information taken from the completed Annual Quality Assessment (AQAA) document (a self assessment document required to be submitted annually) and Service User surveys submitted to the Commission prior to the insepction. A tour of the home also took place during which a number of residents and staff were spoken to and observed. Care Homes for Older People Page 6 of 25 Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service or wish to use the service have information about the home in order to make an informed decision about whether it is the right place for them. The personalised needs assessment means that peoples diverse needs are identified and planned for before they move to the home. Evidence: The manager said that people are always assessed prior to moving into the home to ensure their needs can be met (a number of completed pre admission forms were seen during the inspection). If people are to be admitted they and their representatives are given as much up to date information about the service as possible, invited to look around and spend some time at the home and ask any questions they may have. If they are to be offered a place at Rowan House a letter of confirmation that the home Care Homes for Older People Page 10 of 25 Evidence: can meet their current needs is sent to the person (a number of these letters were seen on file). There is a copy of the up to date Service Users Guide on display in the home and one in each room. The current fee level ranges from 308.95 to 400 pounds per week (correct January 2009). Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The practice regarding the planning and delivery of care means that people can be sure that their health and personal care needs will be fully met. Evidence: The manager said that all of the care plans have been updated since the last inspection so that care staff can use them to refer to when caring for people and document ongoing progress. They now include bruise charts and diet and fluid charts where applicable.The care plans seen were up to date and contained a lot of relevant information about the person and their health, personal and social care needs. The manager showed evidence that she is asking people about their hobbies and interests and adding that to the care plans to make them more individual. The care staff complete daily records about a persons welfare and detail what care has been provided. Information was included about visits made by or to health care professionals such as GPs, district nurses, opticians and dentists. A tour of the home showed that equipment necessary for the promotion of tissue Care Homes for Older People Page 12 of 25 Evidence: viability and prevention of pressure sores is available to meet peoples current needs. The manager said that they have enough equipment and any specialist equipment is provided by the community nursing services as required. The home uses a blister pack system for administration of medicines. They are kept in a locked trolley in the dining room. The drugs fridge is kept in the office and at the time ofthe inspection contained eye drops only. The manager was reminded that the fridge should have its temperature measured and recorded daily. The manager said that only the senior staff administer medication and they have all had medicationss administration training. Evidence of this was seen in staff files examined. The procedure for receipt, storage and disposal of unwanted medicines was explained and is in accordance with laid down legislation. Staff were heard and observed interacting with people appropriately and providing care and support in a discreet manner. Staff were knocking on doors before entering and doors remained closed whilst personal care was taking place. There are screens in the 2 double rooms to ensure privacy when personal care is being carried out. The AQAA states that all residents are treated with respect and are given their privacy but are encouraged to be as independent as possible in their daily routine and are involved in any decisions that are made regarding their needs. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A range of activities within the home and the local community mean that people have opportunities to participate in stimulating and motivating activities. Meals and mealtimes are not rushed and staff are available to help make them an enjoyable and social occasion for people. Evidence: The manager said that people are encouraged to exercise choice in how they spend their time and activites are offered individually or in groups and are facilitated by care staff. Information seen displayed in the home detailed upcoming entertainments available including a trip to the theatre to see the pantomime. The care plans are now including information about peoples interests and hobbies which is helping to develop more individual care. The AQAA states that we offer a range of daily activities and entertainment so keep our residents stimulated. They have a choice of projects available and are given the option to attend The Kimberly Day Centre (owned and run by the provider of Rowan House) twice a week. Visitors are welcomed at anytime and number were seen coming and going during the inspection. There are small mature gardens at the rear of the home which is accessible to people who are mobile and Care Homes for Older People Page 14 of 25 Evidence: those who have mobility aids. Garden furniture is available for people to use during good weather. Five (5) of the eight (8) completed surveys indicated that there are usually activities arranged by the home, two (2) indicated thast there always are and one (1) that there are sometimes activities arranged for them. Most people have their meals in the dining room, but can have their meals in their oom if they wish. People are asked weekly what they would like for their meal and there is always a choice available. Three (3) of the completed surveys indicated that they always like the meals at the home and five (5) that they usually do. One comment was that I enjoy most foods supplied but sometimes there is something I dont like but Im always offered something I do like by the home. Drinks and snacks are available 24 hours a day. The manager said that staff are available at mealtimes to give people any help or support they may need. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Formal complaints and safeguarding policies and procedures are in place and are available to staff at all times. All staff undertake safeguarding training. This means that people who live at the home are adequately safeguarded. Evidence: The complaints procedure was seen displayed in the home and is included in the Service Users Guide (of which there is one in each room). It is comprehensive and gives options about who to contact and timescales for responses to be made. There have been no complaints made to the Commission or the home since the last inspection. The manager said that people are seen by senior staff daily and hopes that any issues or concerns would be bought up at then. Six (6) of the eight (8) completed surveys indicated that they know how to make a complaint. The manager and staff files seen show that staff attend safeguarding training regularly and they also have information about safeguarding when doing National Vocational Qualification (NVQ) training and during induction training. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have a comforatable, homely and safe environment in which to live. Evidence: Rowan House is currently registered to take up to 20 older people. On the day of the insepction 19 people were resident at the home. A tour of the home showed that peoples rooms are personalised with furniture and momentos they bought in with them. The manager showed that windows are restricted on the first and ground floors and people are able to open them themselves. If they inadvertantly lock them the staff have access to a key which is always kept in the office. People spoken to said they were happy with their current accommodation. Communal space consists of one small lounge and one larger lounge and a dining room. There is also access to the garden at the rear of the house. During a tour of the home it was noted that there are enough assisted bathrooms and toilets for the people who currently live at the home. The home is divided into three floors and there are stair lifts for people to use between the floors. There were a number of hold open devices on doors throughout the home where people like to have their doors open. Following the last insepction an outside company has completed a Care Homes for Older People Page 17 of 25 Evidence: fire risk assessment and they also carry out a variety of fire safety checks on a three monthly basis. There is a routine inspection by a fire officer taking place in the near future. The Environmental Health Officer had made a routine visit in December 2008 and had made no recommendations. On the day of the insepction the home was clean, tidy and generally hygeinic. The manager was advised to provide sopa dipensers in communal toilets and bathrooms and shared rooms to take the place of bars of soap that may harbopur infection. The laundry contains one washing machine and one tumble dryer that the manager said meet the current demand, she added that the care staff do the laundry once they have completed their care duties. One (1) of the completed surveys said that even though their clothes are named they do not always get the right laundry returned, especially underwear items. Policies and procedures around infection control are available to staff at all times. All eight (8) of the completed surveys indicate that the home is usually fresh and clean. The manager said that a domestic is employed for 6 hours every day. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing levels and skill mix are satisfactory meaning peoples needs are being met at all times. The robust recruitment procedure means that people who live at the home are being looked after by appropriate staff and their welfare is not at risk. Evidence: The manager and care staff are supported by catering, domestic and maintenance staff. The manager said that staffing levels have been increased since the last inspection ensuring that there are sufficient numbers of staff on duty at peak times of activity. There is currently still one waking and one sleeping member of staff overnight. The manager thinks that the provider will review this situation once she has retired at the end of January 2009. The manager was able to demonstrate the induction process by showing partially completed induction documentation belonging to a member of staff who had been in post for four weeks. It covers health and safety, fire safety, safeguarding and basic care procedures. The AQAA states that all staff are currently studying for or have completed their NVQ. We encourage all members of staff to attend courses that are non mandatory but vital and important to their job role. Care Homes for Older People Page 19 of 25 Evidence: The home have a robust recruitment procedure that includes having 2 written references and a CRB check. The staff files examined (4) had all the required information in them. New care staff work with experienced staff until they are competent and confident to work independently. Seven (7) of the eight (8) completed Service User surveys indicated that the staff listen to and act upon what they say and one (1) stated that they sometimes do. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The systems and procedures now in place are designed to meet the needs of the service as they strive to improve the service the home offers to the people that live there. The attitude to health and safety shown by the providers, care and anciliary staff means that people generally live in a safe and well maintained environment. Evidence: The manager has been at Rowan House for over 20 years and he has achieved a registered managers award and says she is always trying to keep up to date with current good practice. This was demonstrated by information she had available in the office and by certificates seen in her staff file. The AQAA states that the registered manager inspires the staff and encourages good practice, positive dispositions and a pleasant atmosphere to work in as well as maintaining a level of professionalism. Care Homes for Older People Page 21 of 25 Evidence: Staff files examined show that staff have mandatory training in manual handling, fire safety and food hygeine as required. The accident book examined was completed as required and the manager has informed The Commission about incidences as required by the regulations. During a tour of the home it was noted that all hazardous substances are now kept in a locked cupboard in the laundry area. This area is not frequented by residents but accessible to all staff. A variety of maintenance and servicing documents were seen during the insepction that confirmed work is carried out as required. The manager said that a formal quality assurance system has been introduced that consists of givng surveys to people who live at the home and sending them to relatives and health and social care professionals who may visit the home. She said that she had not had many returned but will continue with the system. She said that herself and the senior staff have an open door policy and are happy to hear any concerns or issues as they arise and are then able to act on them immediately. The manager demonstrated the system in place for managing residents money. Records are kept of income and outgoings and receipts are kept as evidence of the transactions. Residents have access to their money at all times. The maintenance man checks the faults book regularly and carries out repairs as requested. He also carries out ongoing in house and outdoor routine maintenance tasks. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 9 26 The manager should ensure that the drugs fridge temperature is measured and recorded daily. The manager should replace bars of soap with soap dispensers in communal toilets and bathrooms and in shared rooms to reduce the risk of infection. Care Homes for Older People Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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