Inspection on 09/08/07 for Rowan Lodge

This inspection was carried out on 9th August 2007.

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

The inspector found 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 09/01/07

Rowan Lodge 13/04/06

Rowan Lodge 10/11/05

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 Jean Bovell Key Unannounced Inspection 9th August 2007 11:00 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.V342915.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 Lodge DS0000027762.V342915.R01.S.doc Version 5.2 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 F/P 020 8423 9095 laima200@yahoo.co.uk Mr Ramnarain Dyanan Sham Laima Bruzinskeine 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.V342915.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Accommodation on ground and first floors only. Date of last inspection 9th January 2007 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.V342915.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on 9th August 2007. The Registered Manager who also acted as care worker, and two residents were at the home. The Inspector was informed by the Registered Manager that one resident was attending a day centre. During the course of the inspection, the home’s policies, procedures and records were viewed. A tour of the building was undertaken, observations were made and two residents were spoken with. The requirements that were made at the last inspection and all key Standards were examined. The Registered Manager provided appropriate assistance throughout the inspection. What the service does well: What has improved since the last inspection? Seven of nine requirements made at the last inspection had been complied with. Specifically, all records including health and safety checks were satisfactory. The garden was well maintained and Regulation 37 forms are being submitted to the CSCI. Rowan Lodge DS0000027762.V342915.R01.S.doc Version 5.2 Page 6 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 Lodge DS0000027762.V342915.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 Lodge DS0000027762.V342915.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 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personal records of people were viewed and reflected that initial needs led assessments had been appropriately carried out prior to admission. EVIDENCE: The people who use the service have resided at the home from between three and eleven years. The personal files of three residents were viewed and it was evidenced that their separate personal, healthcare and social needs had been assessed prior to admission and that healthcare professionals, social workers and relatives, were appropriate, were involved in assessing the home’s capacity to meet specific identified needs. Rowan Lodge DS0000027762.V342915.R01.S.doc Version 5.2 Page 9 The home does not provide intermediate care, (Standard 6) Rowan Lodge DS0000027762.V342915.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 good. This judgement has been made using available evidence including a visit to this service. Care plans were appropriately drawn up and reflected that separate health care needs were being met satisfactorily. The home’s policy and procedures on medication were in place. People who were spoken with confirmed that their privacy and dignity were being upheld at the home. EVIDENCE: The care plans that had been drawn up in relation to three residents were examined. Separate personal, healthcare, dietary, religious/cultural and social needs were assessed and actions and goals had been put in place. Rowan Lodge DS0000027762.V342915.R01.S.doc Version 5.2 Page 11 All care plans viewed were signed by the respective resident and care worker, and were reviewed on a monthly basis. The separate healthcare needs of people who use the service were assessed. It was reflected that they received regular access to Community Psychiatric Nurses. General Practitioner appointments were arranged as required and people were accompanied during medical appointments. The home’s policy and procedures on Medication were comprehensive and the records indicated that medication training had been delivered to care workers. Medicines were being administered to all residents and were appropriately stored and accurately recorded. The Registered Manager who also acted as care worker at the time of the inspection, was observed being sensitive and respectful in her interactions with residents. People who were spoken with confirmed that their privacy and dignity were being respected at the home. Policies on Privacy and Dignity were in place. Rowan Lodge DS0000027762.V342915.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 adequate. This judgement has been made using available evidence including a visit to this service. The home has an open visiting policy and contact with relatives are encouraged and facilitated. It was evident that people received choice and were able to make decisions regarding their daily living routines. It was observed that varied and nutritional meals were being provided at the home. A requirement that made under Standard 12 regarding religious needs had not been complied with. Rowan Lodge DS0000027762.V342915.R01.S.doc Version 5.2 Page 13 EVIDENCE: It was indicated on care plans that the social interests of residents included listening to music and watching soaps on television. The Inspector was informed by the Registered Manager that a Church of England Cleric visited the home on a monthly basis and residents were entertained by an organ player each week. People had been taken on an outing to Windsor this summer and a barbeque was being planned. It was also confirmed that one resident attended a day centre on two separate days each week. Two residents that were at the home during the inspection were spoken with. One resident reported being depressed and indicated disinterest in the music played on the radio. He/she would like to attend a day centre but lacked confidence due to current mobility problems following a hip operation. Self taught exercise involving leg and arm movements while sitting in a chair was demonstrated to the Inspector and a desire to attend Church was expressed. A second resident informed the Inspector that that he/she had personally decided to cease attending a day centre which had been a regular weekly activity. Although capable of being independent within the community, difficulties arose due to back/leg problems. However, he/she enjoyed walking around the garden and watering the plants. No interest in religion was expressed. Both residents expressed the wish to be transferred to alternative residential placements or live independently. One resident was attending a day centre at the time of the inspection. No organised activity or meaningful communications were observed during the inspection. People were seen sitting in the lounge but there was little or no interaction between them. Although music played from a radio and the television was switched on after lunch, no interest from residents was observed. The environment seemed dull and void of stimulation. The Registered Manager confirmed that contact with relatives, friends and/or advocates are encouraged and facilitated at the home. People confirmed that they received visits and regular telephone calls from respective family members. Rowan Lodge DS0000027762.V342915.R01.S.doc Version 5.2 Page 14 People who use the service are able to move freely around the home and garden. They are able decisions regarding when they get up on mornings, retire at night, meals, activities, clothing and personal purchases. Personal interests and choices were also reflected in people’s separate bedrooms. Varied and wholesome meals were listed on menus and appealing and nutritious lunch options were provided during the inspection. People who were spoken with expressed satisfaction with the quality and quantity of meals, drinks and snacks they received at the home. Rowan Lodge DS0000027762.V342915.R01.S.doc Version 5.2 Page 15 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 good. This judgement has been made using available evidence including a visit to this service. The complaints procedure was in place and satisfactory. The records were viewed and indicated that people were being protected from abuse. EVIDENCE: The complaints procedure was clearly detailed and accessible to residents and relatives. No complaints had been made to the home following the last inspection. The Incident and Accident book was viewed and reflected that forms were appropriately completed and subsequently transferred onto individual files. Separate financial records relating to personal allowances were inspected and no discrepancies were identified. Policies and procedures on Health and Safety were in place and a Health and Safety poster was on display. Rowan Lodge DS0000027762.V342915.R01.S.doc Version 5.2 Page 16 The records indicated that staff training on the Protection of Vulnerable Adults had been delivered. Rowan Lodge DS0000027762.V342915.R01.S.doc Version 5.2 Page 17 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 good. This judgement has been made using available evidence including a visit to this service. The home is being well maintained and the atmosphere is calm and homely. EVIDENCE: A programme of Maintenance and Replacements was in place. It was observed during a tour of the building that the kitchen had been refurbished. Communal areas including hallways and residents’ bedrooms were freshly decorated and floor coverings/carpets had been replaced. The garden was adequately maintained. There were no issues regarding the laundry. Rowan Lodge DS0000027762.V342915.R01.S.doc Version 5.2 Page 18 Overall, the home was clean, hygienic and well maintained. The environment was bright, airy, calm and homely. Rowan Lodge DS0000027762.V342915.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The records were indicative of care staff being appropriately trained and qualified for meeting the needs of the people who use the service. The recruitment policy and practices are satisfactory. A requirement under Standard 27 relating to staffing had not been complied with. EVIDENCE: The staff rota was viewed and reflected that one care worker covered duty on each shift during waking hours and there was one sleep-in staff cover at night. The Registered Manager was also included on the rota and acted in the capacity of Care Worker. Additional staff for facilitating shared or individual out door activity at scheduled times were not indicated. Recruitment files were viewed at random and all contained the required documents such as application forms, references, photo-identification, signed contracts/statement of terms and conditions and CRB disclosure certificates. Rowan Lodge DS0000027762.V342915.R01.S.doc Version 5.2 Page 20 The Registered Manager confirmed that one care worker had achieved level 2 National Vocational Qualification and it was evidenced on Training Certificates that staff training delivered included Fire Safety, Moving and Handling, Protection of Vulnerable Adults, Health and Safety and Medication. A workshop on Dementia was presented to the staff group in 2006. The records also indicated that new care workers were inducted and that training on Mental Health Awareness was included within the induction programme. The Registered Manager was observed being competent in meeting the physical needs of residents. Issues surrounding appropriate activities for stimulating and meeting the social needs of residents were discussed. The Inspector was assured by the Registered Manager that these areas of concern would be appropriately addressed. Rowan Lodge DS0000027762.V342915.R01.S.doc Version 5.2 Page 21 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 good. This judgement has been made using available evidence including a visit to this service. The Registered Manager is appropriately trained and qualified. Systems for carrying out effective quality assurance are in place. Individual financial records of residents were inspected and it was reflected that their financial interests were safeguarded. It was reflected on health and safety records that the safety and welfare of people were being satisfactorily protected at the home. Rowan Lodge DS0000027762.V342915.R01.S.doc Version 5.2 Page 22 EVIDENCE: The Registered Manager has had four years experience as a care worker with the Company and has held her current position for six months. She is currently receiving training for achieving the Registered Managers Award. Systems for carrying out effective quality assurance were in place and it was evidenced that quality assurance processes for reviewing the quality of the service had been initiated. The separate financial records relating to the personal allowances of residents were inspected and no discrepancies were identified. All health and safety records were up-to-date. These included gas maintenance, portable electrical appliances and fire safety checks. Fire drills were regularly undertaken and environmental risk assessments had been carried out. Rowan Lodge DS0000027762.V342915.R01.S.doc Version 5.2 Page 23 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 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Rowan Lodge DS0000027762.V342915.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 OP12 Regulation 16(2)(n) Requirement The Registered Person must put into place a programme of regular and appropriate activities to ensure that people receive stimulation and their social needs are being met. Timescale for action 15/09/07 2. OP12 16(3) Service users must be enabled to 30/09/07 maintain their religious beliefs and attend local churches if they so wish. This is restated from the last three inspections previous timescales 01/01/06 and 30/06/06 and 30/04/07. The Registered person must ensure that staffing levels are appropriate for supporting service user participation within the community. This is restated from the previous two inspections. Previous timescales 30/06/06 and 15/02/07. 30/09/07 3. OP27 18(1)(a) Rowan Lodge DS0000027762.V342915.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Rowan Lodge DS0000027762.V342915.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Lodge DS0000027762.V342915.R01.S.doc Version 5.2 Page 27 - 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!