Inspection on 10/11/05 for Rowan Lodge

This inspection was carried out on 10th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Rowan Lodge 09/08/07

Rowan Lodge 09/01/07

Rowan Lodge 13/04/06

Rowan Lodge 29/04/05

Rowan Lodge 15/10/04

Rowan Lodge 14/05/04

Rowan Lodge 14/10/03

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

CARE HOMES FOR OLDER PEOPLE Rowan Lodge 36 Keble Close Northolt Middlesex UB5 4QE Lead Inspector Paula Eaton Unannounced Inspection 09:15 10 November 2005 th 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 Lodge DS0000027762.V258151.R01.S.doc Version 5.0 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 Lodge DS0000027762.V258151.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Rowan Lodge Address 36 Keble Close Northolt Middlesex UB5 4QE 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) 0208 423 9095 020 8423 9095 Mr Ramnarain Dyanan Sham Mr Ramnarain Dyanan Sham Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (0), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (0), Old age, not falling within any other category (0) Rowan Lodge DS0000027762.V258151.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Accommodation on ground and first floors only. Date of last inspection 29th April 2005 Brief Description of the Service: Rowan Lodge is a care home providing support for three older people, who are over sixty-five years of age, and have past or present mental health needs. All of the current service users are female. The home was first registered in 1991. The Registered Provider owns another larger home in Harrow. The home is situated in a quiet road in Northolt and there is easy access to local shops and to a bus route. The accommodation for the service users consists of a goodsized lounge/dining area, a kitchen and a small utility area on the ground floor. Two bedrooms are located on the first floor and one bedroom is located on the ground floor. There is a small paved area to the front of the home and a goodsized garden to the rear of the house. Rowan Lodge DS0000027762.V258151.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over three hours as part of the annual inspection process. The Registered Manager and all three service users were spoken to and records policies and procedures were examined. 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 Lodge DS0000027762.V258151.R01.S.doc Version 5.0 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 Lodge DS0000027762.V258151.R01.S.doc Version 5.0 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 The home carries out satisfactory assessments of service users prior to admission to ensure the home is able to meet their needs. EVIDENCE: There are three service users living at the home all of whom have been at the home for some time. The pre-admission documentation for all three service users was examined at the previous inspection. The home had carried out appropriate assessments of service users to ensure the home is able to meet their needs and a copy of the Care Management assessment had also been obtained. The Care Management assessment and the home’s own assessments are used to develop service users care plans. Rowan Lodge DS0000027762.V258151.R01.S.doc Version 5.0 Page 8 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 and 10 Assessed needs had been incorporated into individual plans of care. Health care needs had been assessed and were being met. The systems for administration of medication were satisfactory. Service users were being treated respectfully. EVIDENCE: Each service user had an appropriate detailed plan of care in place. These were being reviewed on a monthly basis. Daily records are also maintained for each service user. Service user records confirmed that health care needs were being assessed, monitored and met. Risk assessments are completed for falls and the risk of pressure ulcers developing. One service user now has to use a catheter and the records showed that a District Nurse has been visiting weekly to monitor this. A community psychiatric nurse visits the home on a regular basis and a dentist also visits the home. All service users are registered with a local GP. Medication was being appropriately stored in the home and the medication administration record sheets were completed and in order. There were no controlled drugs in the home and none of the service users were selfmedicating. The Registered Manager said that one of the services users was Rowan Lodge DS0000027762.V258151.R01.S.doc Version 5.0 Page 9 not complying with her medication, this was clearly recorded and it was evident from the records viewed and from speaking to the Registered Manager that this matter was been appropriately addressed with the relevant health care professionals. All three service users have a key to their bedroom so they can lock their doors if they wish to. There is a cordless telephone available so that service users can make private telephone calls in their bedrooms. The staff member on duty was observed treating the service users respectfully and sensitively during the inspection and the service users said that the staff treated them well. Rowan Lodge DS0000027762.V258151.R01.S.doc Version 5.0 Page 10 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 and 15 Activity provision in the home could be improved to include more integration into the local community including consideration of the religious and cultural needs of service users. Maintaining contact with family and friends is encouraged. The meals in the home are satisfactory but more variety could be provided. EVIDENCE: All three service users attend a day centre run by Age Concern one day a week. An activities programme was displayed and included activities such as reminiscence, discussion, a visiting pianist, dominoes and baking. Service users are involved in some household tasks and consulted about the day to day running of the home. The service users spoken to said that they did not get to go out of the home very often. One service user said she would like to go out more, she said she didn’t mind where. It was recorded in another service users records that her family had requested that she attend church on Sunday’s. The service user had attended church weekly prior to moving into Rowan Lodge and had not been able to do so since moving into the home. This was discussed with the Registered Manager who said that the family had been advised that there were not enough staff available in the home to accompany her to church and that the family would need to take her themselves. Rowan Lodge DS0000027762.V258151.R01.S.doc Version 5.0 Page 11 Since the last inspection the Registered Provider has acquired a mini bus that is shared by the two homes he owns. The Registered Manager said that service users had been out on trips to Windsor, different parks and that a trip to the theatre had been planned for the near future. Information regarding a forthcoming Christmas party was displayed on the notice board in the lounge. Visitors are welcomed at the home and the service users confirmed that they have visitors at the home. It was also evident from the visitor’s book that the service users receive regular visitors. Information regarding advocacy services such as Age Concern was displayed in the communal areas of the home. However, contact information such as addresses and telephone numbers were not displayed. Appropriate menus for the home were viewed and a record of all meals is maintained. Although the meals being provided were satisfactory there was not much variety being provided and one service user said that she would like to have Caribbean food to eat some times. Rowan Lodge DS0000027762.V258151.R01.S.doc Version 5.0 Page 12 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 and 18 The home has a satisfactory complaints system with information available to service users, staff and visitors to the home. The home has adequate systems in place for the protection of service users from abuse. EVIDENCE: The home has a satisfactory complaints procedure in place that provides all of the relevant information for someone wishing to make a complaint. The complaints record showed that there had not been any complaints since the last inspection. The home has satisfactory procedures in place for the protection of service users and clear guidelines for staff regarding the action they should take if they witness or suspect abuse is taking place or if an allegation is made. Rowan Lodge DS0000027762.V258151.R01.S.doc Version 5.0 Page 13 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, 20, 21, 22, 24, 25 and 26 The standard of the environment within this home is satisfactory providing people with a homely place to live. The home was generally clean, safe and comfortable for the people living there. EVIDENCE: There were no maintenance issues at the home at the time of the inspection. The Registered Manager said that the home was in the process of being redecorated and at the time of the inspection the laundry area was being refurbished. The Registered Manager said that the home now has a member of staff who is employed to carry out any maintenance workand also does the maintenance work for the Registered Provider’s other care home. There is a comfortably furnished lounge/dining room that is very homely. There is also a well-maintained garden to the rear of the house. All three of the service users bedrooms were seen. All of them were comfortably furnished and had a degree of personalisation. However, one of the service users said that she had not chosen the picture on the wall in her Rowan Lodge DS0000027762.V258151.R01.S.doc Version 5.0 Page 14 bedroom and wanted it taken down. It is important that service users are able to choose what is kept in their bedrooms and how they are decorated. There is a shower room on the ground floor and a bathroom on the first floor. It was noted that all of the service users had their toiletries in the ground floor shower room even though two of the service users have rooms on the first floor. The Registered Manager said that the service users prefer to have showers, however, it was also noted that there were no aids/grab rails in the bathroom. It may be that service users feel vulnerable or unsafe when using the bath. It is important that the bathroom facilities and the rest of the home are assessed to ascertain if any additional aids and equipment are needed to enable service users to move freely around the house and to maintain their independence. There was adequate lighting and heating in the home and plenty of natural ventilation. The water temperatures were being monitored regularly. The home was clean and tidy and there were no malodours detected. Rowan Lodge DS0000027762.V258151.R01.S.doc Version 5.0 Page 15 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 and 29 The numbers and skill mix of staff are sufficient to meet the needs of service users. The recruitment practices in the home are adequate to ensure the protection of service users. Staff receive adequate training and are competent to do their jobs. EVIDENCE: As there are only three service users living at the home there is only one member of staff on duty at a time. This restricts the amount of time service users can spend going out into the community. The Registered Manager said that extra staff are put on the rota when service users have appointments to attend but not to enable service users to go out in the community. Due to the staffing arrangements service users are restricted from going out in the community because all three service users have to go out together as they all require staff supervision. The member of staff on duty is also responsible for the cleaning and laundry. The Registered Manager said that all staff that work at the home are in the process of completing their NVQ level 2 training. It was difficult to confirm this as many of the staff that work at the home work between Rowan Lodge and the Registered Provider’s other home and their staff records were not available at Rowan Lodge. The staff rotas were examined. These were not satisfactory. A combined rota had been completed for the Registered Provider’s other home and Rowan Lodge with staff being allocated shifts at Rowan Lodge. Although the Rowan Lodge DS0000027762.V258151.R01.S.doc Version 5.0 Page 16 Registered Manager was able to explain who was covering each shift the actual rota was incomplete with not all shifts covered for the home. An accurate and complete rota for the home must be maintained. Staff employment records were examined. These were satisfactory and contained all of the required information. Rowan Lodge DS0000027762.V258151.R01.S.doc Version 5.0 Page 17 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 and 38 There are appropriate management arrangements in place for the home. The health, safety and welfare of service users and staff are promoted and protected. EVIDENCE: The Registered Provider has recruited a Registered Manager for the home. The manager in post in an experienced member of staff who has been working at the home for several years. However, it was noted that the Registered Manager had not yet been given a job description or contract for the post yet. The Registered Manager said that she was in the process of commencing her NVQ level 4 training. Health and safety maintenance and servicing records were viewed and were up to date and in order. Fire safety equipment is regularly tested and records maintained and regular fire drills had been taking place. Thermostatic valves have been fitted to the taps to ensure that the water temperature is at a safe Rowan Lodge DS0000027762.V258151.R01.S.doc Version 5.0 Page 18 level for service users and the home monitors the water temperatures on a regular basis to check that the valves are working efficiently. Rowan Lodge DS0000027762.V258151.R01.S.doc Version 5.0 Page 19 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 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 2 X 2 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X X X 3 Rowan Lodge DS0000027762.V258151.R01.S.doc Version 5.0 Page 20 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 2 Standard OP12 OP12 Regulation 16(2)(m) (n) 16(3) Timescale for action Service users must be enabled to 01/01/06 participate in activities in the local community. Service users must be enabled to 01/01/06 maintain their religious beliefs and attend local churches if they so wish. The food provided in the home 01/12/05 must meet the cultural needs/preferences of the service users The home must be assessed by 01/03/06 an appropriately qualified individual to ascertain if any additional aids and equipment are required. Service users must be consulted 01/01/06 and given a choice about the decoration and furnishing of their bedrooms. Staff rotas must be fully 01/12/05 completed for the home and kept up to date. The Registered Manager must 01/01/06 have a job description and contract of employment. Requirement 3 OP15 12(4)(b) 4 OP22 23(2)(n) 5 OP24 16(2)(d) 6 7 OP27 OP31 Schedule 4 7 Schedule 4 6 Rowan Lodge DS0000027762.V258151.R01.S.doc Version 5.0 Page 21 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 Refer to Standard OP14 OP15 Good Practice Recommendations The information regarding advocacy services in the home should include contact details for these services Service users should be consulted about the food in the home and provided with a greater variety of meal choices. Rowan Lodge DS0000027762.V258151.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection West London Area Office 58 Uxbridge Road Ealing London W5 2ST 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 Lodge DS0000027762.V258151.R01.S.doc Version 5.0 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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