Inspection on 12/02/09 for Rowden House

This inspection was carried out on 12th February 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rowden House 05/02/08

Rowden House 18/12/06

Rowden House 04/01/06

Rowden House 18/08/05

Rowden House 29/03/05

Rowden House 28/10/04

Rowden House 16/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 27/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Rowden House 2 Vallis Road Frome Somerset BA11 3EA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jane Poole     Date: 1 2 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Rowden House 2 Vallis Road Frome Somerset BA11 3EA 01373462271 01373454494 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Somerset Care Limited care home 39 Number of places (if applicable): Under 65 Over 65 39 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 Rowden House is situated in Frome, close to local shops and facilities. The house is a Grade II listed building that has been extended to provide further accommodation. There are three lounges on the ground floor that are accessible to people with all levels of mobility. There are also furnished patio areas at the front and rear of the home, which are used by people living at the home and their visitors. Rowden House is registered with the Commission for Social Care Inspection to provide care for up to 39 people over the age of 65 years who require assistance with personal care. The Registered Manager is Mrs Rebecca Culblaith. The home is owned by Somerset Care Ltd. Care Homes for Older People Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience Good quality outcomes. The focus of this inspection visit was to inspect relevant key standards under the Commissions Inspecting for Better Lives 2 framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are:- excellent, good, adequate and poor. This inspection was carried out by one inspector over a one day period. During this time we, The Commission, were able to talk with people living, working and visiting the home, observe care practices, eat lunch with people living at the home, tour the Care Homes for Older People Page 5 of 27 building and view records. All records requested were made available and we were given unrestricted access to all areas of the home. The following is a brief summary of the inspection findings and should be read in conjunction with the whole of the report What the care home does well: What has improved since the last inspection? What they could do better: Generally people living at the home were happy with the care that they received. There is currently no activities organiser and many people commented that they would like to see more activities and entertainment. The home needs to look at activities and occupation that will provide social stimulation to everyone, not just people who enjoy large group activities. During the inspection it was noted that some staff appeared task focused and at least 3 people living at the home commented that they only had contact with staff when they were physically assisting them. The home would benefit from a more person centred approach to care which would increase social stimulation for people. Care Homes for Older People Page 7 of 27 There is limited storage at the home meaning that large items such as wheelchairs and walking aids are often stored outside communal areas making these rooms uninviting. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People wishing to move to Rowden House receive adequate information about the home to help them to decide if it is the right place for them. Everyone has their needs assessed before they move in to ensure that the home is able to meet their specific needs and expectations. Evidence: The home has a colour brochure, service user guide and statement of purpose that enables people to gain information about the home before making any decisions about moving in. In addition to full residential care the home also offers day care and respite care to allow people to spend extended periods of time in the home before taking up residence. People spoken with during the inspection said that they or their representative had Care Homes for Older People Page 10 of 27 Evidence: visited the home before they moved in. One person said that they had stayed for two weeks respite to get the feel of the place before they decided to move in on a permanent basis. Everyone wishing to move into the home has their needs fully assessed by a senior member of staff, this ensures that the home is able to meet their needs. The home also obtains copies of assessments carried out by other professionals. Copies of assessments were seen in care plans. Rowden House has two step up, step down beds which provide intermediate care for people either to prevent a hospital admission, or to offer a period of rehabilitation after a hospital stay. People using these beds have access to all the facilities that the home offers and to professionals outside the home. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to healthcare professionals according to their individual needs. Medication policies and procedures promote safe practice. Evidence: Since the last inspection all care plans have been computerized. 6 of these care plans were sampled. All had been personalised to the individual and contained clear information about the person and their needs. There was some information about personal preferences and lifestyle choices but this could be further expanded to ensure that people receive support in their chosen manner. Assessments are carried out in respect of physical health such as nutrition, skin care and moving and handling. Specialist equipment is made available where required. Records of personal weights are maintained and referrals are made to appropriate professionals where there are significant losses or gains. One care plan seen showed that the person had lost weight and there were records to show that the GP had been Care Homes for Older People Page 12 of 27 Evidence: consulted with. Records are kept of all appointments with outside healthcare professionals. People living at the home said that they were able to see GPs, District Nurses and a Chiropodist at the home. One person had recently been referred to a Community Psychiatric Nurse to seek advice to ensure that staff at the home were able to appropriately support the person. The home uses a Monitored Dosage System for medication. There is appropriate storage for medicines including those that require refrigeration. Only senior staff administer medication and they have all received training in this area. Medication Administration Records were viewed. These were well maintained and correctly signed when administered or refused. All medication is signed into the home to ensure a clear audit trail. Records of controlled drugs sampled correlated with stocks held at the time of the inspection. The home carries out a comprehensive monthly audit of medication to ensure safe practice is maintained. People spoken with during the inspection said that their privacy was respected and they were treated with dignity. People said that they were free to spend time in the communal areas of the home or in the privacy of bedrooms. It was observed that staff knocked on doors before entering and post was delivered to people unopened. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are no strict routines in the home and people are able to make choices about how, and where, they spend their day. Visitors are welcome at anytime. Evidence: The Annual Quality Assurance Assessment (AQAA) demonstrates that the manager has a commitment to listening to people who live and the home and providing choices for everyone. People living at the home said that they are able to choose what time they got up, when they went to bed and how they spent their day. The home offers a day care service and a dedicated worker is employed to support these people for part of the day. There is currently no activities worker at the home and at the time of the inspection the day care worker was making activities available to anyone in the home who wished to join in. Care Homes for Older People Page 14 of 27 Evidence: There is an activities programme displayed in the home that lists the weeks organised groups. Many people spoken with stated that they missed having a dedicated worker and felt that there were now less opportunities for social stimulation that there had been. It was observed during the inspection that there was limited social stimulation for people who were unable to occupy their time without support. On the morning of the inspection the day care worker held a quiz in the lounge and in the afternoon some people did word searches. Other activities include a small reading group which one person said that they particularly enjoyed. There is a church service held at the home each week, which is open to all, and people are free to see representatives of all religious denominations at the home. A hairdresser visits the home on a regular basis. There is a small shop selling basic provisions and a drinks trolley which enables people to have alcoholic or soft drinks. Library books are available in the lounge and people said that they were able to have newspapers and magazines delivered. The manager of the home stated that a new activity worker has been employed who will begin work shortly. Everyone asked said that they were able to have visitors at any time. Each floor has a small kitchen area where people can make drinks for friends and relatives. These kitchen areas are not clearly visible and many people living at the home said that they did not know that they had the use of these facilities. To promote choice and independence the home should ensure that everyone is fully aware that they have use of the kitchen areas. The home operates a four week menu that has been designed by the company to promote a varied and healthy diet for everyone. There is a choice of food at each meal. There is a large pleasant dining room where most people eat meals. The main meal of the day is served at mid-day. The main course of the meal is served plated and each table has dishes of vegetables to allow people to help themselves and decide their portion sizes. On the day of inspection the main meal did not appear to be a social occasion with staff standing at the front of the room waiting to collect plates rather than interacting with people living at the home. People asked were generally content with the meals served in the home, one person Care Homes for Older People Page 15 of 27 Evidence: said meals were alright another said they were generally good. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are able to discuss any worries or concerns with the manager or a member of staff. Appropriate systems are in place to minimise the risk of abuse to people who live at the home. Evidence: The home has policies and procedures in respect of making a complaint, recognising and reporting abuse and whistle blowing. Staff have received training on issues of abuse and all asked were aware of the whistle blowing policy and the ability to take serious concerns outside the home. People living at the home said that they would be comfortable to approach the manager or a member of staff if they had any worries or concerns. All felt that they would be listened to and action taken to address any issues. The complaints procedure is displayed in the entrance hall. No complaints have been received since the last inspection. There is a robust recruitment procedure which minimises the risks of abuse to people Care Homes for Older People Page 17 of 27 Evidence: living at the home. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Rowden House Provides a comfortable homely environment for the people who live there. Standards of cleanliness throughout the building are good. Evidence: Rowden House is a large grade 2 listed building that has been extended to provide accommodation on three floors. It is set in extensive grounds with outside seating for people living at, and visiting, the home. All areas are fitted with a call bell and fire detection system. There are three communal lounges, one of which has a computer with internet access that people living at the home are able to use. In addition to the communal lounges there are various small seating areas around the home where people can spend time away from the main communal areas. A sample of bedrooms was viewed. Bedrooms vary in size but all seen were adequately furnished and decorated. People asked were happy with their personal rooms and it was noted that people could personalise their rooms with small items of Care Homes for Older People Page 19 of 27 Evidence: furniture, pictures and ornaments. This gives rooms a homely individual feel. Some bedrooms have en suite facilities and there are communal bathrooms and toilets around the home. To assist people to maintain independence various aids and adaptations have been fitted throughout the home, these include hand-rails, a passenger lift and assisted bathing facilities. It was observed that some bedrooms had aids and equipment to meet the specific needs of the individual. There is a shortage of storage around the home meaning that walking aids, wheelchairs and hoists are stored in public areas around the home. Many items are stored outside one of the communal lounges making it appear very uninviting. On the day of the inspection no one used this lounge. The home has a laundry which is appropriate to the needs and size of the home. To promote good infection control practices hand washing facilities are available throughout the home. All areas seen were clean and fresh and people spoken with were happy with the standard of cleanliness throughout the home. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are supported by a well qualified and competent staff team, but staff appear task focused leading to a lack of social interaction and support for some of the people who live there. There is a robust recruitment procedure that minimises the risks of abuse to people who live at the home. Evidence: The home employs 28 care staff, 23 (82 ) have a National Vocational Qualification (NVQ) in care at level 2 or above. In addition to care staff there is a large group of ancillary staff such as cooks, care support workers and a maintenance person. All staff undertake a thorough induction programme when they begin work at the home and complete some shadow shifts. On the day of the inspection one new member of staff was undertaking their first shadow shift, and it was observed that more long standing staff were assisting them to get to know the homes routines. To ensure that care practices are safe and reflect current good practice all staff receive regular training in health and safety issues and training specific to the needs of the people who live at the home. One member of staff commented that they had excellent Care Homes for Older People Page 21 of 27 Evidence: training opportunities that enabled them to gain knowledge and take on additional responsibilities. The recruitment files of 4 recently employed members of staff were viewed. These gave evidence of a robust recruitment procedure which included checking people against the Protection Of Vulnerable Adults (POVA) register, obtaining written references and undertaking an enhanced Criminal Records Bureau (CRB) check. The manager stated that they are beginning to involve people living at the home in the recruitment process and are hoping to further expand this practice. Generally staff and people living at the home felt that there were adequate numbers of staff on duty at all times. People said that they received the physical assistance that they required and that call bells were answered promptly. It was observed during the inspection that staff were quite task focused and more than one person said that they did not see much of the staff unless they were being supported with a physical task. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is effectively managed taking account of the views of the people who live and work there. To promote the health and safety of people living and working at the home the building is maintained to a good standard and all equipment is regularly tested. Evidence: The registered manager of the home is Rebecca Culblaith. She holds the Registered Managers Award (NVQ Level 4) and has many years experience of working with older people. Throughout the inspection the manager demonstrated that she keeps her knowledge up to date and has a commitment to ongoing learning. Prior to the inspection the manager completed an Annual Quality Assurance Assessment which gave clear information about the home and showed that the home is committed to ongoing improvement. Care Homes for Older People Page 23 of 27 Evidence: Policies and procedures within the home are regularly reviewed and up dated where appropriate. There are various systems in place to audit the quality of care and ensure that any changes made are in line with good practice guidelines and the wishes of people living at the home. There are annual questionnaires to seek the views of people living at the home and other interested parties. Results of the most recent questionnaires demonstrated a high level of satisfaction with all areas of the service. There are also regular meetings for people living and working at the home. People spoken with said that these are an opportunity to make suggestions and voice their opinions as well as information sharing. To ensure the health and safety of people at the home the building is maintained to a good standard and equipment is regularly tested and serviced. Staff receive training in health and safety issues and records demonstrate that refresher training is undertaken by all staff to ensure safe working practices. The home does not act as a power of attorney or financial appointee for anyone living there. There is a facility for people to deposit small amounts of money for safe keeping. Clear records are kept of all monies deposited. A sample of monies was viewed and records kept correlated with monies held at the time of this inspection. Up to date certificates of registration and insurance are displayed in the home. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 12 16 (2) [m][n] The manager must ensure that people are consulted about their social interests and ensure that appropriate activities are available to all. To make sure that everyone, including people who are unable to initiate activities, receives adequate social stimulation. 12/05/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 14 To promote choice and independence the manager should look at ways to make the small kitchens more noticeable. And ensure that everyone is aware that they have access to these facilities. The home should review the storage facilities for large items of equipment. 2 22 Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 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. 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