Inspection on 04/01/06 for Rowden House

This inspection was carried out on 4th January 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Rowden House 12/02/09

Rowden House 05/02/08

Rowden House 18/12/06

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Rowden House 2 Vallis Road Frome Somerset BA11 3EA Lead Inspector John Hurley Unannounced Inspection 4th January 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rowden House DS0000016013.V279732.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rowden House DS0000016013.V279732.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Rowden House Address 2 Vallis Road Frome Somerset BA11 3EA 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) 01373 462271 01373 454494 Somerset Care Limited Mrs Rebecca Jane Culblaith Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39) of places Rowden House DS0000016013.V279732.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th August 2005 Brief Description of the Service: 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 day rooms at the home; one of which has been designated as a smoking room. There are also furnished patio areas at the front and rear of the home, which are used by service users and their visitors. Rowden House is registered with the Commission for Social Care Inspection to provide care to up to 39 service users 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. Rowden House DS0000016013.V279732.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over five hours. The inspector spoke with five service users during the course of the visit, service users experience of living in the home being the main focus of this inspection. They also spoke with a number of staff including management. The inspector toured the premises when first entering the home and looked at most areas of the main building but not the grounds. They looked at a number of key documents relating to service user care plans, staffing files and Health and Safety policy documents. What the service does well: 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. Rowden House DS0000016013.V279732.R01.S.doc Version 5.1 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rowden House DS0000016013.V279732.R01.S.doc Version 5.1 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,6 The assessment documentation continues to be clear and concise and evidences the involvement of the service user and people important to them. EVIDENCE: The documentation relating to the last service user to take up residency contained good details relating to the individuals presenting issues as well as a good social history. Their assessed health and social needs are clearly recorded and evidences that health care professionals, care managers and the individuals family had been involved in the admissions process. The homes management also carry out their own assessment to ensure that they can meet the needs and aspirations of any prospective placement. These assessment include areas such as tissue viability, manual handling issues as well as individual risk assessments. The inspector considered that it would be helpful to weigh any new service user as soon as practicable to ensure that weight is benchmarked thus allowing it to be monitored effectively. Rowden House DS0000016013.V279732.R01.S.doc Version 5.1 Page 8 The inspector viewed the documentation relating to an individual who was receiving respite care. This was of similar quality but also give clear indications with regards to the objectives of the placement. The deputy manager confirmed that intermediate care is not offered at the home. Rowden House DS0000016013.V279732.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 The service users rights to self determination are met by a compassionate staff team. The system for recording medication is not robust EVIDENCE: The inspector spoke with two service users informally and also joined two small groups of service users after lunch to discuss their views of the home. From these discussions the inspector learnt that there is a key worker system in operation in the home. The service users told the inspector that the keyworker makes sure that they receive care in a way that they wish. They confirmed that they had been involved in their care plans and we knowledgeable with regards to there content. Some also explained how they have made changes to their plans when it did not suit them. The service users confirmed that they receive personal help when needed and that staff always encourage them to do things for themselves. Most felt that this was helpful but not all. One service user told the inspector that they had lived in the local area for most of their life, and as they were still mobile often go out alone into the community to visit friends or to go to the shops. They were able to tell the Rowden House DS0000016013.V279732.R01.S.doc Version 5.1 Page 10 inspector of the risks involved in going out and knew how to get help if needed. The records later observed by the inspector confirmed that risks had been acknowledged and minimised where possible. The inspector viewed the service user records and found that the care plans reflect the initial assessments and that reviews are being undertaken either when significant events take place or monthly. This are complemented by a yearly review. Whilst the medication was being administered that inspector looked at the records relating medication. The staff sign a pre printed record to indicate when a preparation is given to the service user. The inspector found that there was a number of dates when staff had not signed to say if the medication was given or not. These omissions could have serious implications for the service user, the deputy manager acknowledged this. Rowden House DS0000016013.V279732.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 The routines of the home are flexible enough to offer a degree of choice, but also offer a degree of structure that the service user appreciates. EVIDENCE: There are planned activities, which provide extra stimulation to the service user group. These range from singing and bingo, gentle exercise, and ball type games through to outings. Several service users told the inspector that they knew what activities were taking place, some they liked others they did not. Given that the home provides two good sized communal areas those who choose not to participate do not have too. The inspector was also informed by some of the service users that sometimes they like to be alone in their room to watch TV and relax, help being at hand by staff to assist them to their rooms. The service users explained that there is a call bell system so that if they become concerned or require help this can be requested by just pressing the bell. All of the service users the inspector spoke with confirmed that there had been no incidents, which they could recall, when a bell was rang and no member of staff attended. The service users confirmed that they go to bed when they wish, get up when they wish and felt there was sufficient staff available to facilitate these choices.(Although some service user considered the home could do with some Rowden House DS0000016013.V279732.R01.S.doc Version 5.1 Page 12 more staff at the weekends) They further confirmed that there are choices at meal times with regards to what to eat and where to eat their food, either communally or in their own rooms, the staff and menus supported these declarations. Rowden House DS0000016013.V279732.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These set of standards were met at the last inspection. As there have been no complaints raised with either the home or regulator these were not further assessed on this occasion. EVIDENCE: Rowden House DS0000016013.V279732.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,25 The homes management can identify risks poised by the environment, the organisation is slow to respond to these identified risks. EVIDENCE: The inspector toured the premises unaccompanied when they first entered the home inspecting a number of communal areas. They found that the home was generally clean in all areas observed. It was noted that all toilet and bathrooms were found to be clean and hygienic. The lack of cleaning staff did not appear to have had a significant impact on the cleanliness of the home. The laundry area was generally clean. The door to the laundry was still held open with a pair of tights appearing to compromise the effectiveness of the fire door. The window still does not open and the door to the outside was locked. The deputy manager confirmed that the organisation was dealing with this issue, the inspector was shown emails to support this. Rowden House DS0000016013.V279732.R01.S.doc Version 5.1 Page 15 During the inspection the deputy manager contacted the organisations person responsible for the building and arranged for the necessary equipment to be ordered and installed to effectively manage the fire door. As the home has a history of compliance with the regulations and action was taken before the inspector left a requirement relating to this issue has not been made. It would however be helpful if the organisation responded more robustly to the issues identified either through the risk assessment process of the home or through inspection activity to ensure that issues are dealt with promptly. Any future failure to do so may have more serious outcomes. As noted at the previous inspection several doors to the cellar storage area have been sealed off, notices on these doors warn of asbestos. As reported at the last inspection several of the plastic door covers/ seals have degraded over time and are no longer forming what appears to be an effective seal. The deputy manager informed the inspector that this matter was being taken up by the organisation, the previous comments on time scales also applies here. Rowden House DS0000016013.V279732.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 The service users are protected by the homes effective staff selection and induction procedures. The home must recruit and retain domestic staff. EVIDENCE: The staffing rotas examined evidenced that the numbers of care staff on duty meet the needs of the service user at this present time. The rotas also evidence that on the day of the inspection there was no domiciliary staff on duty to carry out the cleaning of the home, care staff and other support staff covering the shortfall. The deputy manager confirmed that getting domestic staff had been problematic and further interviews were planned to try and recruit into these posts. Whilst the inspector found the home to be clean and hygienic this is not a long-term solution as the ultimately care staff are employed to care and be with the service user. The deputy manager and registered manager acknowledged this. During the last inspection the inspector noted a deficit in the night care staff compliment this has now been rectified. The inspector briefly sampled the records relating to those who had been employed. The application forms demonstrated how the home protects the service user in line with its corporate policy. There was sufficient evidence on file to illustrate that the home verifies identity and takes up references. The interviewing officers complete an evaluation form relating to the interview process in line with good practice recommendations. The inspector was informed that there is a formal induction Rowden House DS0000016013.V279732.R01.S.doc Version 5.1 Page 17 which again is evaluated, the records observed demonstrate that formal supervision is taking place. The staff records set out their training needs. These range from industry standards such as health and safety and manual handling through to more targeted training such as dealing with aggressive behaviour. Rowden House DS0000016013.V279732.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 The home continues to be well managed and provides needs lead service. The accounts of the service users money are well maintained. EVIDENCE: Although the registered manager was only available for the later part of the inspection the deputy demonstrated that they have a good knowledge of Care Standard regulations along with the ability to put knowledge into practice. The staff appeared relaxed and confident in their roles and demonstrated good understanding and empathy with the service user. The feedback from the service user confirmed that they felt a sense of belonging living at the home and gave examples of how staff do that little bit extra to help out such as, doing the cleaning. The inspection randomly selected several service users financial accounts to audit. The records kept were found to be clear and accurate. Rowden House DS0000016013.V279732.R01.S.doc Version 5.1 Page 19 The inspector noted that the storage containers in the kitchenettes had been replaced following the last inspection. These areas were appropriately cleaned but the some of the food stuffs stored were out of date, a more robust system to ensure this food does not get used should be introduced. Rowden House DS0000016013.V279732.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 3 3 x x x x 3 x STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 2 Rowden House DS0000016013.V279732.R01.S.doc Version 5.1 Page 21 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 op38 Regulation 13(4) 23(2)(d) Requirement The registered manager must ensure that there are robust policies to ensure that food stocks are checked and stored in line with the homes policies The registered manager must ensure that any medication administered is recorded on the appropriate MAR sheets Timescale for action 31/01/06 2 OP10 13(2) 31/01/06 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 OP38 OP7 Good Practice Recommendations The organisation should consider taking steps to ensure that the arrangements made to ensure that any asbestos in the building is currently adequate. The registered manager should consider recording the weight of a new service user when they take up residency Rowden House DS0000016013.V279732.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Rowden House DS0000016013.V279732.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!