CARE HOMES FOR OLDER PEOPLE
Rowena House Old Road Conisbrough Doncaster South Yorkshire DN12 3LX Lead Inspector
Mrs Beryl Horton Unannounced Inspection 10th October 2005 09:45 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 Rowena House DS0000032204.V253392.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 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. Rowena House DS0000032204.V253392.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Rowena House Address Old Road Conisbrough Doncaster South Yorkshire DN12 3LX 01709 862331 01709 858383 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) Doncaster Metropolitan Borough Council Post Vacant Care Home 36 Category(ies) of Dementia - over 65 years of age (12), Old age, registration, with number not falling within any other category (24) of places Rowena House DS0000032204.V253392.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Day care places in the DE(E) unit must be limited to 1 when the unit is full with 12 residential service users. There is insufficient communal space to meet the required communal space standard when the number of service users goes above this limit of 13 persons. An additional member of staff should be provided when the number rises above 12. 26th April 2005 Date of last inspection Brief Description of the Service: Rowena House is a purpose built care home situated on Old Road Conisbrough and owned by Doncaster Metropolitan Borough Council. It is on the main bus route and close to local shops and a public house. The town centre of Conisbrough is near by. The home is divided into two units with elderly mentally infirm living on the ground floor. Access to the first floor is via a lift and stairway. Rowena House is set in pleasant gardens and includes an internal courtyard equipped with garden furniture, where the residents and their guests are able to sit on fine days. There is parking for several vehicles to the front of the home. Rowena House DS0000032204.V253392.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4.5 hours. The inspection included reading residents care plans and other documentation, speaking to a number of residents both collectively and individually and a range of staff and observation of the lunch-time period. The acting assistant manager assisted with the inspection. A tour of the home was undertaken at different times to observe residents’ activities and staff carrying out their duties, and to observe various rooms in the home. What the service does well: What has improved since the last inspection?
The home has responded to the requirements and recommendations identified in the report of the previous inspection. All residents have now been provided with a copy of the Service User Guide and new residents will be given a copy when they are admitted to the home. Organised activities take place within the home and notification of these events are posted on the notice board for the residents to see. The home has introduced a formal staff supervision programme. Rowena House DS0000032204.V253392.R01.S.doc Version 5.0 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. Rowena House DS0000032204.V253392.R01.S.doc Version 5.0 Page 7 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 Rowena House DS0000032204.V253392.R01.S.doc Version 5.0 Page 8 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): 1, 3,5 and 6 Prospective residents are given a Statement of Purpose and Service Users Guide so that they have the information they need to make an informed choice about whether to move into the home or not. Care assessments provide a range of information to enable the staff to determine if these needs can be met. To satisfy the prospective resident and their relatives that the home will meet their needs, they are invited to look around the home and spend time there maybe overnight in the care of the resident. Intermediate care is not provided at Rowena House. EVIDENCE: The Statement of Purpose and Service Users Guide was looked at during this inspection. The document contains all relevant information about the home set out clearly for residents and their relatives to understand.
Rowena House DS0000032204.V253392.R01.S.doc Version 5.0 Page 9 Care plans are developed from information obtained in the pre-admission assessment. A selected number of care plans were looked at. These showed that carers and residents were involved in identifying the needs and views of the residents with carers and residents signatures. One lady said that Rowena was, “a nice place to live” and was full of praise for the staff. Rowena House DS0000032204.V253392.R01.S.doc Version 5.0 Page 10 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): 10 Residents are treated with respect and their privacy is upheld. To ensure privacy of the individual the residents are seen by their G.P. in their own rooms. This also applies to any other personal treatment. EVIDENCE: During this inspection there were many examples of good practice. Staff were observed to knock on bedroom doors before entering and interact with the resident with respect. Residents were addressed using their preferred name. Residents spoken to said that they were happy with the care they were receiving and spoke highly of the staff team. Rowena House DS0000032204.V253392.R01.S.doc Version 5.0 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): 12,13 and 15 Organised activities take place within the home and notification of these events are posted on the notice board for the residents to see. Visitors are welcome at any time and residents are encouraged to maintain contact with family, friends and participate in local events should they so wish. Residents receive a choice of food at mealtimes to meet their nutritional needs. EVIDENCE: The home provides a good standard of communal facilities including dining areas and lounges. The atmosphere at the home was relaxed and staff were observed interacting with residents throughout the inspection. A care worker now has a lead role to develop activities. There was evidence that residents had books and daily newspapers available to them. Some people liked to watch television and others liked to spend time in their own rooms. Lunch was observed being served. It was well presented and looked appetising. Staff were observed to give assistance to those who needed it in a sensitive manner.
Rowena House DS0000032204.V253392.R01.S.doc Version 5.0 Page 12 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): 16 and 18 The home has an appropriate complaints procedure. It is accessible to staff residents and their relatives. The home has a procedure to protect residents from abuse. Training has yet to be arranged for staff with regard to this area. EVIDENCE: The complaints procedure was looked at. This procedure and the leaflet “Viewpoint” is given to residents and their families at the time of admission. It includes information on how to make a complaint with timescales, telephone numbers and addresses. Policies and procedures to protect residents from abuse including one on whistle blowing are given out to staff at meetings. Staff should be offered appropriate abuse training to enhance their skills and protect the residents. Rowena House DS0000032204.V253392.R01.S.doc Version 5.0 Page 13 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): 19,21,22 and 26 The home continues to make improvements in decoration and overall maintenance of the home to enhance the safety for the residents. The home appeared clean and free from adverse odours. EVIDENCE: On a tour of the home it was noted that there are handrails grab rails and lifting equipment provided as required. Improvements are to be made to a ground floor bathroom with the installation of a shower to ensure residents’ needs are appropriately met. There is a need to ensure the monitoring of hot water in bedrooms to improve the safety of the residents. Consideration should be given to repainting of doors and doorframes as many of these are deeply scratched and paintwork chipped, especially in the main corridor areas.
Rowena House DS0000032204.V253392.R01.S.doc Version 5.0 Page 14 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): 27,29 and 30 The staff team are hard working and aware of the residents needs. The home has a recruitment policy. EVIDENCE: Staff were observed to work efficiently but under pressure to complete their tasks. The staff rota was examined and staff discussed the care arrangements needed to safely meet the residents’ needs. Management have been aware of this pressure and on occasions an additional member of staff is placed on shift. Methods to quicken up the recruitment process should be applied, for instance by advertising in the more popular press, as there are several staff vacancies. The home should continue to offer training to care staff in NVQ level 2 to enhance their skills and the care provided to the residents Rowena House DS0000032204.V253392.R01.S.doc Version 5.0 Page 15 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 and 32 The present manager has been in post for approximately 6 months. On the day of inspection the Acting assistant manager was in charge of the home. The management and administration of the home protects the residents’ health safety and welfare. EVIDENCE: There was evidence that the manager has made a positive impact to improve resident’ care. Both residents and staff expressed their confidence in her. The manager has applied to the Commission for social Care Inspection to be registered. To date the Commission are awaiting references. The manager and deputy have applied for registered management training.
Rowena House DS0000032204.V253392.R01.S.doc Version 5.0 Page 16 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 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 2 3 X X X X STAFFING Standard No Score 27 3 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 X X X X X X Rowena House DS0000032204.V253392.R01.S.doc Version 5.0 Page 17 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 OP21 Regulation 13(4) Requirement The registered manager must ensure a written record is kept on water temperature checks in bedrooms (Previous timescale 23rd May 2005) The registered manager must arrange for staff training in prevention of abuse. (Previous timescale 25th July 2005) Timescale for action 16/01/06 2 OP18 18 16/01/06 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 30 28 Good Practice Recommendations Methods of quickening up the recruitment process should be applied, in order to fill the several vacant posts and alleviate pressure on existing staff/ 50 of care staff should achieve NVQ level 2 by 2005 Rowena House DS0000032204.V253392.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Doncaster Area Office 1st Floor, Barclay Court Heavens Walk Doncaster Carr Doncaster DN4 5HZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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