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Inspection on 13/12/05 for Rowans Care Limited

Also see our care home review for Rowans Care Limited for more information

This inspection was carried out on 13th December 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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The Rowans cares for its service users very well. A relative of a service user who had been at the home for seven years described the home and its staff as "doing a great job". The relative said her daughter always looked cared for when she visited and that she was kept informed of any issues as they arose. Another relative visiting his grandson stated that the staff were "very dedicated" and that he was very pleased with the care his grandson received at the home. It was clear from discussion with staff that they were very aware of the individual needs of service users and how to best to meet these. The home had a relaxed and homely atmosphere, with each resident having their own bedroom. Staff training has been afforded a good deal of importance, with both NVQ and LADF training being pursued, as well as other courses relevant to the care of the service users.

What has improved since the last inspection?

Since the last inspection more staff training has been undertaken, covering a range of issues relevant to service users` needs, for example, moving and handling, protection of vulnerable adults and food hygiene. The premises have seen various improvements since the previous inspection. For example, various rooms have been redecorated and carpeted, the kitchen and dining room floors had been changed and some new furniture had been purchased. The home`s main bathroom had been retiled and refurbished, as required from the previous inspection report.

What the care home could do better:

Although the home had quality assurance policies and procedures, these had not been fully implemented and an action plan based on the results of surveys was not available. Care plans, whilst appropriate in design, did not always have up to date reviews carried out in line with the timescales that had been set.

CARE HOME ADULTS 18-65 Rowans Care Limited 50 Newbridge Road Tiptree Essex CO5 0HX Lead Inspector Steve Boyd Unannounced Inspection 13th December 2005 09:00 Rowans Care Limited DS0000060695.V266683.R01.S.doc Version 5.0 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 Rowans Care Limited DS0000060695.V266683.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 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. Rowans Care Limited DS0000060695.V266683.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Rowans Care Limited Address 50 Newbridge Road Tiptree Essex CO5 0HX 01621 819850 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) Rowans Care Limited Dr Taranga Vilasini D K Don Care Home 8 Category(ies) of Learning disability (8), Physical disability (8) registration, with number of places Rowans Care Limited DS0000060695.V266683.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Eight persons of either sex, under the age of 65 years, who require care by reason of a learning disability, who may also have a phsyical disability 11th March 2005 Date of last inspection Brief Description of the Service: Rowans is a detached chalet bungalow situated on the outskirts of Tiptree in a residential area, registered for eight individuals with learning disabilities, some of whom have physical disabilities. All the bedrooms are single occupancy on the ground floor. Five of the bedrooms have en suite shower facilities. The home also has a lounge, separate dining area and a relaxation room with sensory lights and music. Aids and adaptations have been installed in the property in order to meet the needs of the individual service users accommodated. There is a good sized garden at the rear of the property. The home owns a vehicle suitable for wheelchair users. Rowans Care Limited DS0000060695.V266683.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 on one day in December 2005. The inspector was assisted during the inspection by the registered manager, Dr Taranga Don, and was also joined by two of the company representatives, Mr Edward Don and Mr Mark Don. Three service users were seen on site during the inspection and two relatives were spoken with at length. The inspector also spoke with two staff members. Various records and documents were seen during the inspection and a tour of the premises was undertaken. Eighteen out of twenty Standards assessed were found to be met. What the service does well: What has improved since the last inspection? Since the last inspection more staff training has been undertaken, covering a range of issues relevant to service users’ needs, for example, moving and handling, protection of vulnerable adults and food hygiene. The premises have seen various improvements since the previous inspection. For example, various rooms have been redecorated and carpeted, the kitchen and dining room floors had been changed and some new furniture had been Rowans Care Limited DS0000060695.V266683.R01.S.doc Version 5.0 Page 6 purchased. The home’s main bathroom had been retiled and refurbished, as required from the previous inspection report. 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. Rowans Care Limited DS0000060695.V266683.R01.S.doc Version 5.0 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 Rowans Care Limited DS0000060695.V266683.R01.S.doc Version 5.0 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. Assessments of prospective users’ needs and aspirations are made. EVIDENCE: Since the previous inspection the home has admitted one new service user. Evidence of assessments made prior to admission to the home were seen on the service user’s file. Assessment visits were made to the previous care setting by staff. Rowans Care Limited DS0000060695.V266683.R01.S.doc Version 5.0 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 and 9. Service users have assessed and changing needs reflected in individual care plans with clear goals emphasised, however these are not always reviewed within planned timescales. Service users are supported in assessed risk taking. EVIDENCE: The inspector sampled various service users’ individual care plans. These were found to take a holistic approach to service users’ needs. They had clear goals outlined, with strategies on how to meet these goals. The inspector found that reviews were not always carried out to the planned timescales. Service users were found to have risk assessments available with clear management strategies on how to minimise risks and allow service users as much independence as possible. The risk assessments were found to have been reviewed periodically. Rowans Care Limited DS0000060695.V266683.R01.S.doc Version 5.0 Page 10 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, 14 and 17. Service users take part in appropriate activities and are engaged within the local community. Service users enjoy a healthy diet. EVIDENCE: None of the service users are assessed as being able to hold jobs of any sort due to the level of their disabilities. Service users take part in activities such as swimming, snoozelum, shopping and cooking. Local community facilities and shops are utilised and the home has its own minibus for transportation. Although service users were not able to offer comments on the quality of food on offer at the home, relatives who had regular meals there said they were “very good”. Menus suggested a variety of food was on offer and food stocks were seen to be plentiful during the inspection. Rowans Care Limited DS0000060695.V266683.R01.S.doc Version 5.0 Page 11 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): 19 and 20. Service users’ needs are met. They are protected by the home’s policies and procedures in respect of medicines and their administration. EVIDENCE: Evidence was seen on service users’ files of their physical and emotional health needs being met. Records of appointments with various health professionals and their outcomes were recorded. Relatives stated that the care given to service users at the home was very good. None of the service users at Rowans is assessed as being able to selfadminister medication. The home operates a monitored dosage system of medicine administration which was checked and found to be working appropriately. Staff have received training in medicine administration and what various medications are used for. Rowans Care Limited DS0000060695.V266683.R01.S.doc Version 5.0 Page 12 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. Service users and their advocates’ views are listened to and acted upon. The home takes the protection of service users from abuse, neglect and selfharm in a serious and professional manner. EVIDENCE: The home has a complaints policy and procedure, although this had not been required to be utilised since the previous inspection. The inspector advised that the policy needed to be changed to reflect the NCSC has changed to the Commission for Social Care Inspection. Relatives spoken to during the inspection did not voice any concerns about the operation of the home and said they were always listened to by staff and the manager when they raised any issues. The home has not had any POVA investigations or issues since the previous inspection. The home has a policy and procedure in respect of the protection of vulnerable adults and staff have had training on the protection of vulnerable adults since the previous inspection. Rowans Care Limited DS0000060695.V266683.R01.S.doc Version 5.0 Page 13 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, 27 and 30. Service users live in a homely and comfortable environment. Toilets and bathrooms offer privacy and meet individual needs. The home was clean, safe and hygienic during the inspection. EVIDENCE: A homely atmosphere was seen to be provided at The Rowans. Preparations were underway for Christmas with decorations being put up. Since the previous inspection some new carpeting and flooring had been provided in various rooms, such as the dining room and kitchen. The home’s main bathroom had been retiled and refurbished since the previous inspection and the bathroom met service users’ needs with an overhead hoist being provided. The home was found to be clean and tidy and there were no obvious odours or apparent safety hazards. Rowans Care Limited DS0000060695.V266683.R01.S.doc Version 5.0 Page 14 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. Service users benefit from competent and qualified staff who are appropriately recruited and trained. EVIDENCE: A good deal of staff training had been undertaken since the previous inspection, including further NVQ and LADF training. Individual courses had been also pursued which included challenging behaviour and autism, nonviolent crisis intervention, food hygiene, fire safety and protection of vulnerable adults. Staff spoken with said they felt well supported by the home’s management and confirmed a range of training opportunities had been made available. The home’s recruitment practices and procedures were examined during the inspection and evidence was seen of application forms being completed, references being undertaken and CRB checks being progressed for new staff. Rowans Care Limited DS0000060695.V266683.R01.S.doc Version 5.0 Page 15 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. Service users benefit from a well run home with their health, safety and welfare being promoted and protected. Review and development of the home’s operation needs to be pursued and made transparent. EVIDENCE: Dr Don has been the manager of The Rowans for seven years and has a number of professional qualifications, including RMNH. She had commenced the Registered Manager’s Award but has had to look for a new provider half way through this course. The home’s proprietors are very involved in the day to day operation of the home. Mark Don, company representative of The Rowans, advised that quality assurance is being undertaken by way of surveys and audits, although nothing tangible was able to be seen during the inspection. Rowans Care Limited DS0000060695.V266683.R01.S.doc Version 5.0 Page 16 Various safety certificates were seen, including gas, electricity, fire equipment, hoists, etc. COSCH assessments were seen to be carried out, as well as general risk assessments for inside and outside of the home. No obvious safety hazards were apparent at the time of inspection. Rowans Care Limited DS0000060695.V266683.R01.S.doc Version 5.0 Page 17 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 x x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X 3 X X 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Rowans Care Limited Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 X 1 X X 3 X DS0000060695.V266683.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? No 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 YA6 Regulation 15(2)(b) Requirement The registered provider must ensure that each service user’s individual plan of care is regularly reviewed. The registered provider must ensure a system of quality assurance is established and maintained with the outcomes of review, monitoring and audit being available for inspection. Timescale for action 31/01/06 2 YA39 24 28/02/06 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. Refer to Standard YA37 Good Practice Recommendations The registered manager should complete the Registered Managers Award as soon as practicable. Rowans Care Limited DS0000060695.V266683.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Rowans Care Limited DS0000060695.V266683.R01.S.doc Version 5.0 Page 20 - 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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