Inspection on 27/06/06 for Rowandale

This inspection was carried out on 27th June 2006.

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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rowandale 15/03/06

Rowandale 05/10/05

Rowandale 04/03/05

Rowandale 23/06/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Rowandale Back Lane Clayton le Woods Chorley Lancashire PR6 7EU Lead Inspector Val Turley Unannounced Inspection 27th June 2006 09:45 Rowandale DS0000045627.V295943.R01.S.doc Version 5.2 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 Rowandale DS0000045627.V295943.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 Adults 18-65. 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. Rowandale DS0000045627.V295943.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rowandale Address Back Lane Clayton le Woods Chorley Lancashire PR6 7EU 01772 620739 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) rowendale@tiscali.co.uk Dalesview Partnership Mrs Tina Diane Roberts Care Home 10 Category(ies) of Learning disability (9), Learning disability over registration, with number 65 years of age (1) of places Rowandale DS0000045627.V295943.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 10 service users to include: Up to 9 service users in the category of LD (Learning Disability not falling within any other category) needing personal care only. 1 Male service user in the category LD(E) (Learning Disability over the age of 65) needing personal care only. The registered provider should, at all times, employ a suitably qualified and experienced manager who is registered with the National Care Standards Commission. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the National Care Standards Commission regarding staffing levels in care homes. 15th March 2006 2. 3. Date of last inspection Brief Description of the Service: Rowandale stands in its own grounds and has open views to two sides. The building is a single storey purpose built establishment, with wide doorways and easy access throughout. The premises incorporate two homes, Rowandale and Hollydale, which share a common entrance, laundry and gardens. Rowandale accommodates ten service users with a Learning Disability. The home provides ten single bedrooms, two of which have en-suite facilities. The rooms have been decorated and furnished with specific service users in mind and are all individually furnished. The bathroom and shower room have been specifically designed to provide a suitable environment for assisting clients with physical disabilities. There is a large spacious lounge/dining room and kitchen that clients may access with relevant supervision. In addition there is a laundry and office. The gardens have been landscaped to the front and side and offer a sensory area. There is also large patio to the rear. The home is situated in Clayton-le-Woods on the perimeter of a housing estate. There is a range of facilities including a supermarket, library, leisure centre, public houses and park. These are within walking distance and service users from the home access them. Clayton-le-Woods is situated on the A6 which is the main road linking the city of Preston and the market town of Chorley. This means the service users also have access to the facilities offered in these towns. Rowandale DS0000045627.V295943.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection of a service takes place over a period of time and involves gathering and analysing written information. A site visit was also made to the home as part of the inspection process and this involved discussion with service users, discussion with and observation of the staff working there, an examination of records, policies and procedures and a tour of the premises. A questionnaire was completed by the manager prior to the site visit and a questionnaire was received from one service user and comment cards from six relatives, a care manager and a GP. These all provided information that was included in the report. As part of the inspection, the inspector used “case tracking” as a means of assessing some of the National Minimum Standards. This process allowed the inspector to focus on two of the service users living at the home. Records relating to those individual were inspected and discussion took place with the service user were possible. Fees at the home range from £600 -£1300 per week What the service does well: The home provides a comfortable and well-maintained environment for the benefit of the service users and support staff. Staff were enthusiastic and well trained and the home was generally well managed. The home had a good approach to admitting service users and ensured that they were able to provide an appropriate service before admission. The home had a person centred approach and encouraged and developed service users independence skills as far as possible. The service users enjoyed a flexible and relaxed routine with their individual support needs and preferences being identified within their care plan. Any risks were identified and minimised as far as possible to help ensure the safety of the service user. The health needs of the service users were monitored and concerns attended to appropriately and medication within the home was well managed. The service users were involved in worthwhile and appropriate activities and a record of these was kept to enable staff to decide how successful these were. Relationships with families and friends was supported and encouraged. Staff spoke appropriately to service user and included them in conversations and also recognised their rights to privacy. The home had good policies in place to protect service users and to ensure that any criticisms or concerns that they had were acted upon. Rowandale DS0000045627.V295943.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rowandale DS0000045627.V295943.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rowandale DS0000045627.V295943.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and standard 1 was partly assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had a good approach to admitting new service users ensuring that they had enough information before deciding whether they could meet their needs. EVIDENCE: During the course of the site visit discussions took place with a service user who had been recently admitted to the home. The service user said that he had chosen Rowandale because of the age range of the people who lived at the home and because he already knew some of the service users living there and the staff who worked there. He said he had been happy with the move and ‘I tell the staff what I need’. Discussion with and observation of the staff working with him confirmed this. The service user had moved from another home in the same group and that home had provided Rowandale with basic information about the service users support needs. The staff at Rowandale had identified additional support needs that they were beginning to address and intended to include these in the care plan. National Minimum Standard 1 was partly assessed during the inspection. It was noted that this needs to be updated to reflect the changes in the number of bathrooms that the home now has. Rowandale DS0000045627.V295943.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home encouraged and supported service users to develop and maintain independence skills and supported them to make informed decisions and choices. EVIDENCE: Discussion with one of the service user indicated that the home was sensitive in their approach and encouraged service users to decide their own routines. The service user said he made decisions himself about the support that he needed and how he wanted to spend his day, he had a choice of meals if he wanted one and could decide what time he wanted to go to bed. His care plan confirmed that this was the approach that the home had adopted and it was also confirmed in discussion with the support staff. Additional risks had been identified and the staff were in the process of determining how these risks could be minimised. The service user said that he had a person centred plan in place and that he had identified some goals that he wanted to work towards. This was also confirmed by members of staff and they were able to outline the work that had already gone on to help the service user achieve these goals. It was recommended that the service user be given the opportunity to join a selfRowandale DS0000045627.V295943.R01.S.doc Version 5.2 Page 10 advocacy group as this may help him to develop his confidence still further and that this would help in the person centred planning process. The file of a second service user was examined, this was also person centred in its approach and balanced the independence needs of the service user against any health and safety issues. Rowandale DS0000045627.V295943.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users enjoyed a varied lifestyle and were supported by staff to participate in and plan worthwhile activities. EVIDENCE: Discussion with staff and one of the service users indicated that the staff supported service users to become involved in worthwhile and enjoyable activities. These included activities within the home and activities in the community. A record was kept of the activities that the service users were involved in, enabling staff to determine how successful they were. On the day of the inspection one of the service users went out to the local pub for his lunch supported by a staff member. The possibility of a work placement was being discussed for one of the service users and a college placement for a second service user. Information from a service user and members of staff confirmed that the service users were supported to maintain contact with their families and friends. The homes policy regarding service users personal, family and sexual relationships had been recently reviewed and updated giving staff clearer guidance as to any appropriate support and advice they should provide. The service user also confirmed that staff spoke appropriately to him and to Rowandale DS0000045627.V295943.R01.S.doc Version 5.2 Page 12 other service users and that they were included in conversations. Service users were able to spend time alone in their rooms if they wished and were able to visit service users in the other units. Visitors could be received in private and the service users could lock their bedrooms if they wished and if they were able. Staff and service users said there was a choice of meals available and that the meals were good with service users needs and references being taken into account. Menus suggested that the meals provided were well balanced and nutritious. Wherever possible service users were encouraged to become involved in the preparation of meals. Rowandale DS0000045627.V295943.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The support staff had a good knowledge of service users preferences and personal care needs and provided personal support sensitively and in accordance with their wishes. EVIDENCE: There was information within the service users care plans to show that their health and personal care needs were being monitored and addressed and appropriate action was taken if there were any concerns. Those service users who were well established in the home had a health action plan in place that outlined the needs of the service users and the action required by staff to ensure that the plan was carried through. The service user who had been recently admitted had had a number of appointments with health care professionals and it was planned to develop a health action plan for him as the staff became more aware of his needs. The home should also introduce a method of enabling health appointments to be recorded in such a way that staff are able to have an overview of service user health support needs. Medication in the home appeared to be managed well. It was recommended that the guidance for medication which is administered as required (PRN) should be kept with the medication administration records (MAR sheets) to enable support staff to access this information easily. It was also recommended that any details written by hand on the MAR sheets be signed by Rowandale DS0000045627.V295943.R01.S.doc Version 5.2 Page 14 two members of staff to help prevent any errors being made. The homes medication policy had recently been reviewed and updated. Although in general the home was conscious of the need to respect the privacy and dignity of the service users, some thought should be given to how service user call for the assistance of staff during the night. They should be consulted to see if they wish to have the means to summon help from staff discretely, should they need help with their personal care. Rowandale DS0000045627.V295943.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had good policies and procedures in place in order to protect service users. EVIDENCE: The homes policies and procedures that deal with complaints, the restraint of service users and the protection of vulnerable adults had all been recently updated and contained good guidance for staff. Comment cards received from two families stated that they did not know how they could make a complaint if they wanted to. The manager said that she would ensure that all families received this information again. One of the service users spoken to on the day of the inspection was clear as to how he could make a complaint and who he would speak to. Rowandale DS0000045627.V295943.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Standard 27 was partly assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was clean and comfortable and provided a pleasant and safe environment for both the service users and support staff. EVIDENCE: The home was clean, bright and comfortable and provided service users and support staff with a homely and safe environment. The home was generally well maintained. Service users bedrooms were decorated and furnished with their needs and interests in mind. Since the previous inspection, the home had been inspected by United Utilities who had recommended that some work be undertaken to ensure that the home complied with the Water Supply, (Water Fittings) Regulations 1999. This work had been completed. Also since the previous inspection, the home had taken one of the bathrooms out of commission, enabling the home to install a macerator, which disposes of the homes clinical waste. The reduction in the number of bathrooms in the home means that the home does not meet the minimum standard which states that bathrooms should be shared by no more than three people. However, in practice, the manager stated that this does not affect the quality of care provided for the service users as the staffing arrangements within the home does not allow for more than two service users to be bathed or showered at Rowandale DS0000045627.V295943.R01.S.doc Version 5.2 Page 17 any one time. The installation of the macerator had improved the quality of life for the service users as clinical waste could be destroyed immediately and the need to store it on the premises had been removed. The Statement of Purpose and Service Users Guide must be reviewed and updated to reflect the change in the facilities provided. (See Standard 1) The laundry at the home was well equipped and met the needs of the service users living at the home. Rowandale DS0000045627.V295943.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home had a good approach to staff recruitment and training but this was not reflected in the staff recruitment policies and procedures. EVIDENCE: The staff spoken to on the day of the site visit were well motivated and enthusiastic about their role. They appreciated the need to balance the support that the service users needed against the risks that they sometimes needed to take in order to try new activities and experiences. They were observed to speak appropriately to the service users and appreciated the need to treat them with respect and maintain their dignity. The staff felt that there were plenty of training opportunities on offer and the homes training matrix confirmed that this was the case. The home had a good approach to recruitment and the most recently appointed member of staff had the necessary checks and in place before she commenced work in the home. The homes policy on recruitment did need to be updated to reflect current best practice, to provide staff with the correct guidance and help ensure that service users are protected as far as possible. Rowandale DS0000045627.V295943.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was well managed and ensured as far as possible that the home was run in the best interests of the service users. EVIDENCE: The registered manager was well established in her post and had the necessary skills and qualifications to fulfil her responsibilities. She had undertaken additional training to update her skills and knowledge. Staff were clear about their role and responsibilities and provided appropriate support to the service users. The home was well maintained with systems and equipment being inspected and serviced at appropriate intervals. Training in health and safety issues had been provided or had been booked for staff. The accident book had been completed and the reports filed in accordance with the data protection act. It was recommended that the home develop a system for identifying any patterns or trends in the incidence of accidents in the home and to take any appropriate action. Rowandale DS0000045627.V295943.R01.S.doc Version 5.2 Page 20 The manager had a number of quality assurance checks in place in the home to help ensure that the service users received appropriate care and attention. These ranged from checks on the environment to staff supervision and fire drills. The home received the Investors in People award, which is a quality assurance award, accredited by an external body. The home received monthly monitoring visits from the one of the companies senior members of staff and these reports were forwarded to the Commission for Social Care Inspection. A recent survey had been undertaken of the views of the service users families and these had been reported in the homes newsletter. Although this represented a good step forward the results of the survey could have been made clearer. The home had reviewed and updated a number of key policies and procedures over the last few months taking into account any changes in legislation and best practice. Rowandale DS0000045627.V295943.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X 3 X 2 X X 2 X Rowandale DS0000045627.V295943.R01.S.doc Version 5.2 Page 22 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 4,5 Schedule 1 Requirement The Statement of Purpose and Service User Guide must be amended to reflect the reduction in the number of bathrooms in the home. The registered manager should ensure that all service users representatives are provided with a copy of the Complaints Policy The homes recruitment policy and procedures must be reviewed an updated. Timescale for action 31/08/06 2. YA22 22(1) 31/08/06 3. YA34 13(6) 31/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA7 YA18 YA39 Good Practice Recommendations Service users should be supported to participate in selfadvocacy groups if they wish. The possibility of introducing a ‘nurse’ call system should be considered. The results of the survey of families’ views should be published more clearly. DS0000045627.V295943.R01.S.doc Version 5.2 Page 23 Rowandale 4. YA42 The home should develop a system for identifying any patterns or trends in the incidence of accidents in the home. Rowandale DS0000045627.V295943.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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. 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