Inspection on 29/04/05 for Rowan Lodge

This inspection was carried out on 29th April 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Rowan Lodge 09/08/07

Rowan Lodge 09/01/07

Rowan Lodge 13/04/06

Rowan Lodge 10/11/05

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 Announced 29 April 2005 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 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 Version 1.10 Page 3 SERVICE INFORMATION Name of service Rowan Lodge Address 36 Kelbe Close, Northolt, MIddlesex UB5 4QE Telephone number Fax number Email 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 Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 15/10/05 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 and is currently managing both homes. 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 consisits of a good sized 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 good sized garden to the rear of the house. Rowan Lodge Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over three and a half hours as part of the annual inspection process. The manager, one member of staff 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rowan Lodge Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Rowan Lodge Version 1.10 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 standard(s) 1, 2 and 3 Adequate information is provided to service users to enable them to make an informed choice about where to live. Each service user has a written statement of terms and conditions. The home carries out satisfactory assessments of service users prior to admission to ensure the home is able to meet their needs. EVIDENCE: The Statement of Purpose for the home was seen and has been updated since the last inspection so it now contains all of the information required. There is also a comprehensive Service User Guide that is given to service users on admission to the home. Each service user now has a signed copy of their terms and conditions on file. There had been two fairly recent admissions to the home. A pre-admission assessment had been carried out for both service users and there was also a care management assessment on file for them both. The third service users pre-admission documentation had been viewed at a previous inspection. Rowan Lodge Version 1.10 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 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. 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. The manager said that the local pharmacy used by the home had provided staff training in the administration of medication. There were no controlled drugs in the home and none of the service users were self-medicating. 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 Rowan Lodge Version 1.10 Page 9 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 Version 1.10 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 standard(s) 12, 13, 14 and 15 Activity provision in the home has improved. Maintaining contact with family and friends is encouraged. The meals in the home are good offering both choice and variety and catering for special dietary needs. 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. Visitors are welcomed at the home and the service users confirmed that they have visitors at the home. The service users have access to advocacy services such as Age Concern. The meals provided include culturally specific foods for the service user at the home who is from the Caribbean. The service users said that they were happy with the food provided at the home and said that they were given drinks throughout the day. The menus seen were varied and balanced. Rowan Lodge Version 1.10 Page 11 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 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 Version 1.10 Page 12 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 standard(s) 19, 20, 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 manager said that some redecoration was planned for later in the year. A programme of maintenance and renewal had been developed for the home since the last inspection. There is a comfortably furnished lounge/dining room that is very homely and a new television set had been purchased since the last inspection. There is also a well-maintained garden to the rear of the house and the service users were taking advantage of the sunny afternoon and sitting in the garden chatting and reading during the inspection. All three of the service users bedrooms were seen. All of them had been personalised and were comfortably furnished. Rowan Lodge Version 1.10 Page 13 There was adequate lighting and heating in the home and plenty of natural ventilation. The home was clean and tidy and there were no malodours detected. Rowan Lodge Version 1.10 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 The numbers and skill mix of staff are sufficient to meet the needs of service users. The recruitment practices in the home need to be improved 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. However, the manager said that he is often available so that staff can take service users out. As it is a small home the care staff are also responsible for the cleaning and also do the laundry. The staff records have improved since the last inspection. However, the references for one member of staff were incomplete and one member of staff did not have a form of identification on file. As a requirement had been made at the last inspection regarding staff records an immediate requirement was issued. The manager has since written to the CSCI and stated that the staff records are now up to date. This will be followed up at the next inspection. The amount of staff training provided at the home has steadily improved. Staff complete an adequate induction programme and the training records showed that staff had received training in fire safety, first aid, food hygiene, moving and handling and the administration of medication. Staff had also received Rowan Lodge Version 1.10 Page 15 training in areas specific to service users needs. For example, staff had received training in mental health awareness and managing diabetes. Rowan Lodge Version 1.10 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 35, 36 and 38 There is not sufficient management cover for the home at present to ensure sufficient monitoring of the homes systems. Service users financial interests are safeguarded by the homes systems. The health, safety and welfare of service users and staff are promoted and protected. EVIDENCE: The Registered Provider is still the Registered Manager for the home as well as his other registered home. This is not acceptable. A requirement was made regarding this matter at the previous inspection that had not been complied with therefore an immediate requirement was issued at this inspection. The Registered Manager has completed his NVQ level 4 training and shows a commitment to training the staff team. Rowan Lodge Version 1.10 Page 17 Monthly service user meetings are held and records maintained for these. There is some self-monitoring of the systems in the home, however, this could be improved. None of the service users manage their own finances. The home is only responsible for managing the personal allowances of service users, the records relating to this were up to date and in order and had been signed by service users. The staff records viewed showed that regular staff supervision is now taking place. 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. Although thermostatic valves have been fitted to the taps to ensure that the water temperature is at a safe level for service users the home still needs to monitor the water temperatures on a regular basis to check that the valves are working efficiently. Rowan Lodge Version 1.10 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x x 3 3 3 STAFFING Standard No Score 27 3 28 x 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 1 x 3 x 3 3 x 2 Rowan Lodge Version 1.10 Page 19 Yes 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 29 Regulation 19(1)(b) Schedule 4 6(a-f) Requirement Staff records must contain all of the information required under Schedule 2 and 4 of the care Homes Regulations 2001. (Timescale of 1/12/04 not complied with, immediate requirement issued) Satisfactory arrangements must be made for the day to day management of the home. (Timescale of 1/02/05 not complied with, immediate requirement issued). Hot water temperatures must be monitored on a regular basis. Timescale for action 27/05/05 2. 31 8(1)(b) (iii) 27/05/05 3. 38 13(4)(c) 27/05/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Rowan Lodge Version 1.10 Page 20 Commission for Social Care Inspection Ground Floor 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 Version 1.10 Page 21 - 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!