Inspection on 27/02/06 for Rowans Care Limited

This inspection was carried out on 27th February 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rowans Care Limited 31/08/06

Rowans Care Limited 13/12/05

Rowans Care Limited 11/03/05

Rowans Care Limited 26/11/04

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Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

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Paradise Lodge

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Upaya Ananda

15 Bramble Close

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

CARE HOME ADULTS 18-65 Rowans Care Limited 50 Newbridge Road Tiptree Essex CO5 0HX Lead Inspector Steve Boyd Unannounced Inspection 27th February 2006 09:00 Rowans Care Limited DS0000060695.V281611.R01.S.doc Version 5.1 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.V281611.R01.S.doc Version 5.1 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.V281611.R01.S.doc Version 5.1 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.V281611.R01.S.doc Version 5.1 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 13th December 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.V281611.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place in one day in February 2006. During the inspection the Inspector spoke with a number of staff including two of the proprietors, Mark and Edward Don and the manager Dr. Taranga Don. Interaction between service users and staff was observed and a couple of relatives of service users was spoken with on the telephone. A tour of the premises took place and various records and documents were looked at. Fourteen out of sixteen standards assessed were found to be met. What the service does well: What has improved since the last inspection? Since the previous inspection clear plan review dates had been set for service users. A review of one service user’s care had taken place in line with the review date set. The Rowans new service user continues to settle in well in the home with improvements seen in their behaviour issues from previous placements. Rowans Care Limited DS0000060695.V281611.R01.S.doc Version 5.1 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. Rowans Care Limited DS0000060695.V281611.R01.S.doc Version 5.1 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.V281611.R01.S.doc Version 5.1 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): These standards were not assessed at this inspection. EVIDENCE: Rowans Care Limited DS0000060695.V281611.R01.S.doc Version 5.1 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): 6,8 and 10 Service users assessed and changing needs are reflected in individual care plans. Information regarding service users is handled appropriately. EVIDENCE: Service users plans were found to be comprehensive taking a holistic approach to service users needs. Care plans objectives are clearly linked in with daily reporting and since the previous inspection review dates are clearly indicated. Service users level of learning disabilities do not always allow them to be consulted on and participate in all aspects of life within the home. However, where possible this occurs and it is clear from discussion with relatives on aspects of service users care this takes place regularly. The home has a policy on confidentiality and records were seen to be kept in a secure and safe manner. Rowans Care Limited DS0000060695.V281611.R01.S.doc Version 5.1 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): 15 & 16 Service users are able to maintain appropriate personal and family relationships. Service users rights are respected. EVIDENCE: All of the eight service users at the Rowans have some contact with relatives. One service user’s contact with relatives is fairly minimal, however, others generally see their main relatives at least once a month. It was clear from speaking with relatives during the inspection the home facilitates contact between service users and relatives by encouraging phone calls and making arrangements for visits to people’s homes. Service users rights are eluded to within care plans and risk assessments and within the home’s policies and procedures. As far as possible service users are encouraged to help out within the home if they are able. Rowans Care Limited DS0000060695.V281611.R01.S.doc Version 5.1 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): 18 Service users receive care in a way they prefer and require. EVIDENCE: Service users care plans go into a good deal of detail regarding how they prefer and require personal support. For example, regarding bathing and dressing and also support whilst out of the home. Service users looked well cared for during the course of inspection and the interaction seen between service users and staff was relaxed, friendly and supportive. Rowans Care Limited DS0000060695.V281611.R01.S.doc Version 5.1 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): These standards were not assessed at this inspection. Both scored (3) at the previous inspection and the Inspector was advised that no complaints or protection of vulnerable adult issues had been raised since the previous inspection. EVIDENCE: Rowans Care Limited DS0000060695.V281611.R01.S.doc Version 5.1 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): 25,26,28 & 29 Service users bedrooms are individualised and promote their independence. There is adequate communal space for service users to utilise. EVIDENCE: Bedrooms seen during the inspection were all individually decorated and had clear evidence of service users own interest such as drawings, pictures, photographs and music equipment. Bedrooms were suitably sized in order to allow for any specialist equipment and assistance by staff. Within the home there are three areas of shared space, those being a lounge, dining room and a snooze/quiet room. These ensure that there is always somewhere where service users can generally be alone or together in small groups. The home was found to have the necessary specialist equipment to meet service user’s needs such as hoists and bathing equipment. Rowans Care Limited DS0000060695.V281611.R01.S.doc Version 5.1 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): 31,33 & 36 Service users benefit from the good staff team at the home who have clear roles and responsibilities. EVIDENCE: A comprehensive job description for support workers at the home was seen to be available. Staff spoken to during the inspection understood their role within the home and that of other team members. Staffing levels at the Rowans was for five staff including management on the morning shifts and then four including management on the afternoon/evening shifts. There are two staff at night time. The only issue of concern regarding the staff team was that on occasions staff worked long shifts back to back for two or three days on a row and the inspector would recommend that two days in a row is not exceeded even during times of staff shortage or holidays. Staff supervision takes place on a regular basis and evidence of this was seen on two staff files which were sampled. Written records of sessions are kept and these clearly included the views and issues of staff members. Staff spoken to during the inspection said they felt well supported and raised no areas of concern. Rowans Care Limited DS0000060695.V281611.R01.S.doc Version 5.1 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): 39,41 and 43 The home still needs to introduce a quality assurance and monitoring system. The home has appropriate record keeping facilities and procedures. Up to date financial information needs to be kept in the home for inspection. EVIDENCE: The issue of adopting a quality assurance system was raised at the previous inspection and although some work had taken place to do so, it was clear that the process was not completed. Inspectors saw a number of records during the inspection and these were maintained in an appropriate manner. Records seen included staff rotas, staff recruitment information and service user records. At the time of inspection there were no up to date budgets or cash flow forecast for the home available on site. One of the proprietors, Edward Don advised that this would be rectified in conjunction with the home’s accountants. A current certificate of employer liability insurance was seen to be available. Rowans Care Limited DS0000060695.V281611.R01.S.doc Version 5.1 Page 16 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 X 2 X 3 X 4 X 5 CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No 24 25 26 27 28 29 30 Score X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X 3 X 3 X 3 3 X 3 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 16 17 STAFFING Standard No Score 31 3 32 X 33 3 34 X 35 X 36 3 3 3 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 DS0000060695.V281611.R01.S.doc Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 Rowans Care Limited Score 3 X X X X 1 X 3 X Version 5.1 Page 17 21 X 43 2 Rowans Care Limited DS0000060695.V281611.R01.S.doc Version 5.1 Page 18 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 YA39 Regulation 24 Requirement The registered provider must ensure a system of quality assurances are established and maintained with the outcomes of reviewand audit being available for inspection. (This is a repeat requirement). The registered provider must ensure current financial information is available so an assessment on the viability of the home can be made if required. Timescale for action 30/04/06 2. YA43 25(2)(3) 30/06/06 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. Refer to Standard YA37 YA33 Good Practice Recommendations The registered manager should complete the Registered Manager’s Award as soon as practicable. The registered provider should ensure that staff do not work excessive continuous hours within the care home. Rowans Care Limited DS0000060695.V281611.R01.S.doc Version 5.1 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.V281611.R01.S.doc Version 5.1 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. 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