Inspection on 03/05/05 for Rowland House

This inspection was carried out on 3rd May 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Rowland House 11/12/08

Rowland House 24/01/07

Rowland House 21/07/05

Rowland House 14/09/04

Rowland House 10/06/04

Similar services:

Thorndene

Sutton Lodge Nursing Home

Wingham Court

Bethany Lodge

17 John Street

Red Oaks

Clare House Nursing Home

Broad Oak Manor Nursing Home

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

CARE HOME ADULTS 18-65 Rowland House 1a Lime Tree Avenue Weston Green Thames Ditton KT7 0NY Lead Inspector Ms S Magnier Announced 03 May 2005 08:30 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 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 Stationary 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. Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Rowland House Address 1a Lime Tree Avenue, Weston Green, Thames Ditton, Surrey, KT7 0NY Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208 972 9143 0208 399 8771 info@titleworth.com Titleworth Ltd. Mrs Debbie Jean Butcher CRH Care Home 6 Category(ies) of LD Learning Disability, 6 registration, with number PD Physical Disability, 6 of places Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age range of the persons accommodated will be 20-55 years. 2. Service users may be admitted in either the category LD (Learning Disabilities) or PD (Physical Disabilities). Date of last inspection 14 September 2004 Brief Description of the Service: Rowland House is set in a residential area of Surrey. The house has recently extended its accomodation and facilities to provide care for six residents with physical and learning difficulties. The accomodation is adapted to support people who use wheelchairs. The home has a lift to all three floors. The lower floor contains a physiotherapy and fitness centre, a Hydropool and sauna. The home has an extensivly landscaped rear garden that is purpose built for wheelchairs and is a prominent feature to the home. Each resident has their own bedroom three of which are en suite. The communal areas are spacious and bright and well decorated. Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Announced Inspection took place over seven hours. On the day of the inspection the Registered Manager advised the inspectors that she had resigned voluntarily. During the day a tour of the premises took place and the inspectors met with all the residents and the three care staff on duty. No visitors were in the home during the inspection. The Commission for Social Care Inspection (CSCI) has received comment cards regarding how people feel the care home is run. The inspectors looked at paperwork in the home that included residents care plans, risk assessments and also staff files and other records to make sure the home was operating safely. The inspectors have visited the home in March 2005 to investigate an anonymous complaint, a part of which remains ongoing. The staffing arrangements of the home have been reviewed and the home is currently deploying staff from a nursing home owned by Titleworth Ltd. A recent referral to the Surrey Multi Agency Protection of Vulnerable Adults has been made following a separate anonymous complaint, which is also ongoing. What the service does well: What has improved since the last inspection? What they could do better: • • • • Involve the residents in the improvement of their care plans. Improve the format of the Regulation 26 (monthly visits by the Responsible Individual) visits to include more emphasis on Health and Safety to improve the safety of residents in the home. Improve the recruitment and selection of staff procedures. Make sure that staff have the proper training they need to help them to support and meet the needs of the residents. H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 6 Rowland House 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. Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 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 standard(s) 5 The information that residents currently have was not evidenced as up to date. EVIDENCE: It would be helpful to residents if the information, which they currently have, was brought up to date including the terms and conditions of their residency within the home. One resident asked the inspectors if they would be able to have a pet in the home. Their copy of the service user guide was not up to date and did not specify if this was permitted. A Requirement has been made under Regulation 4 (1)(2) and 5 (1)(2) and Schedule 1 of the Care Homes Regulations (as amended) 2001 to meet the shortfalls identified. Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 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 standard(s) 6, 7,8,9,10. The care plans and risk assessments require further development to enable residents to express their aspirations, needs and continue to have opportunities in their lives. EVIDENCE: All persons resident in the home had a documented care plan. The care plans seen, were comprehensive and detailed yet did not include any evidence that residents had taken part or were consulted in the plan of their care. Several residents review notes were available on the files, which evidenced they had been in attendance and consulted on that occasion. The care plans were not signed by the residents or their representatives and were stored in the office and were not accessible to residents or staff, they had been updated last year. The inspectors were told that no staff on duty on the day of the inspection had read the care plans for the residents in their care. The home has developed risk assessments however there was little evidence seen to demonstrate that residents were aware of the documented risks in order to promote independence and control over their lives. Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 10 The care staff undertook the housekeeping duties and there was no evidence that the residents were involved in cleaning their rooms, assisting with dusting, meal preparation or laying the table for the midday meal as part of their development of daily living skills. It is strongly recommended that the service develops the care plans and risk assessments in order that the residents can be assisted to develop skills and abilities which are presently not being addressed. Requirements have been made under Regulation 15.(2)(b) of the Care Homes Regulations (as amended) 2001 to meet the shortfalls identified. Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 11 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 standard(s) 11,15,17 The resident’s lead busy lives and opportunities are available to them to continue contact with their family and friends. The staff on duty during the inspection were not observed to actively engage the residents in leisure activities or personal interest. The arrangements for the preparation and serving of food were inadequate and concerning. EVIDENCE: Comments received from resident’s friends and family were satisfied with the care provided to the residents. The home is a busy environment with residents attending various day centres and therapeutic sessions to assist in their specialist development. Residents are supported to visit family and friends, which also includes overnight stays and weekend breaks. One resident was excited about the prospect of going on holiday in the near future. Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 12 One resident said they would like to use their exercise bike; however it would not fit in their bedroom the opportunity for the bike to be available in the exercise area in the basement of the home was discussed with the General Manager following the inspection. During the course of the day the inspectors did not observe the staff members actively engaging with the residents with any leisure or activity to promote interest. MEALTIMES The Inspectors noted that food in the homes refrigerator and oven were not stored in compliance food hygiene standards and raised risk to the residents. Whilst speaking with staff during the course of the breakfast being prepared and served all staff on duty advised that they had not received training in Basic Food Hygiene training. The inspectors sampled the serving of breakfast and concerns have been raised regarding the following observed practice: • • • • • Staff members did not wear appropriate protective aprons and were not observed to wash their hands prior to food preparation. The breakfasts were served in a hurried manner with one resident stating they would leave home for the day without breakfast. Fresh fruit was not available to a resident on their request. The tables lacked any condiments or other table wear and residents were not supplied with napkins. A staff member served two residents with breakfast that was too hot. Staff spoken with during the inspection were unclear regarding the arrangements for the midday meal and meal preference cards were found for residents who not longer resided at the home. Requirements have been made under Regulation 16.(2) 12. (1)(4) 17.2 Schedule 4 14.(1) and 13.3 of the Care Homes Regulations (as amended) 2001 to meet the shortfalls identified. Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 13 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 standard(s) 19,20 Overall the health care needs of the residents continue to be met, and positive feedback was received by health care professionals The administration of the medication on the day of the inspection raised concern. EVIDENCE: Comment cards received from various Health Care Professionals noted: ‘ The home is very clean and homely and the care is of a high standard. The staff meet the clients needs and have achieved a lot with some of their complex cases.’ ‘Its always a pleasure to come to this home. Everything is well organised and I have had all the support and help during my sessions with patients’. ‘I have always been most happy with the service my client has been given’. The health care records for residents evidenced that regular appointments with the G.P District Nurse, and other health care professionals and annual reviews of care with residents are held. Ongoing therapeutic sessions e.g. physiotherapy and attendance to specialist day centres are also maintained on a regular basis. Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 14 A requirement has been made that one resident have an optician’s appointment to repair their spectacles, which had been broken for several weeks. One resident advised the Inspectors that a member of staff had cut their toenails. Although the member of staff had attended certificated training this specialised health care must be provided by an appropriate health care professional e.g. chiropodist/podiatrist. The inspectors observed the Registered Manager dispensing medication in a manner, which raised significant risk. Observations included the following: • secondary dispensing of medication. • leaving the medication sheets unsigned following administration of medication. The Inspectors found the home was administering medication in the form of aerosol spray and topical creams which were not prescribed for the recipient. One resident showed the inspector that their spectacles were broken and that they had been using a spare pair for several weeks. Requirements have been made under Regulation 13.2 of the Care Homes Regulations (as amended) 2001 to meet the shortfalls identified. Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 15 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 standard(s) 22,23 The residents have a knowledge and awareness of who to talk to if they are not happy with the care they receive. EVIDENCE: The home has been subject to two anonymous complaints. One of which was referred to the Surrey Multi Agency Protection of Vulnerable Adults. Staff files indicated that some staff had received training in the protection of Vulnerable Adults. One resident told the inspector that they wanted the staff to be more careful when they did the washing as often the chewing gum, which is accidentally left in their clothes, is lost. Another resident told the inspectors that they had spoken recently with the General Manager regarding an incident, which they were not happy about and which CSCI is waiting clarification of the outcome. It is recommended that the Responsible Individual attain a copy of the Department of Health, White Paper Valuing People in order that the values, rights and staff training specific to supporting people with learning disabilities are promoted within the service. Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 16 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 standard(s) 24,25,26,27,28,29,30. The home was clean and has a homely atmosphere. Requirements have been made that the major shortfalls identified regarding the health and safety in the home are rectified. EVIDENCE: Several comment cards noted: ‘Friendly, pleasant atmosphere’ and ‘Always a pleasure to visit this happy and clean environment’. The resident’s bedrooms provide a private space where each resident can spend time and take part in hobbies such as listening to music, using the personal computer and watching television. Each resident has his or her own possessions and furnishings and the communal lounge is spacious. The toilet and bathroom areas are adapted with equipment to suit the needs of the residents with physical disabilities, which include overhead hoists. There were several areas in the home that required attention and in need of repair and also did not promote the rights of residents to dignity, respect and confidentiality, which were as follows: Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 17 • • • • • • In one residents bedroom the inspectors noted that there were small holes in the wall that needed repair and redecoration due to the resiting of a grab rail. In several resident’s bedrooms and in the lounge furniture was broken and required replacing. Electrical leads, belonging to residents own equipment in resident’s rooms were viewed. Risk assessments must be implemented to ensure the safety of residents. The Inspectors found soiled laundry from a resident’s bed left discarded in their en suite bathroom causing an offensive odour. The Inspectors observed that a notice sited on the bathroom wall to assist a resident to use the toilet did not reflect their right to privacy and respect. Care and attention must be paid to the rights of residents to have their management of continence managed in a more dignified manner by the management and staff of the home. Continence aids must be stored discreetly to afford this respect and right to privacy. Requirements have been made under Regulations 23.2 16.2 13.4 12.4 of the Care Homes Regulations (as amended) 2001 to meet the shortfalls identified. Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,34,36 The recruitment and selection procedure for the home has identified major shortfalls. Staff training and supervision must be implemented to meet with current legislation. EVIDENCE: CSCI has been working closely with Titleworth Ltd in order to ascertain the eligibility of staff to work at Rowland House following a complaint received by CSCI in March 2005 regarding illegal workers. The Inspectors sampled several staff files and no evidence was available to confirm the working eligibility status of staff. The Responsible Individual has informed CSCI by letter 25th April 2005 and confirmed at the Announced Inspection that documentation has been received from the Home Office verifying person’s rights to remain and work in the United Kingdom. Several staff employed to work at Rowland House have had their hours reduced in keeping with their student visa eligibility. The Inspectors were advised that Titleworth Ltd has ceased the employment of all Agency care staff Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 19 and as part of the proactive response the home is currently redeploying staff from another Titleworth establishment. On the day of the inspection the staff on duty had not had access to the residents care plans or received a formal induction to the home. Staff records were available yet did not contain evidence to indicate a robust recruitment and selection procedure including lack of appropriate references. All staff being deployed to work at Rowland House must have CRB clearance and copies of the clearance must remain at Rowland House for the purpose of inspection The Home must ensure that staff undertake the statutory training and formal documented supervision is undertaken to ensure the safety and well being of residents and staff. Requirements have been made under Regulations 7, 9,17,18 & 19 of the Care Homes Regulations (as amended) 2001 to meet the shortfalls identified. Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,42,43 The Management of the home is under review in the absence of a named Manager. Significant concern was raised regarding issues of health and safety throughout the home. EVIDENCE: The Inspectors were advised that the current Manager Mrs D Butcher had recently resigned her post and would be leaving the home on May 9th 2005 (subsequently Titleworth Ltd brought the date forward to the 5th May 2005.) The atmosphere in the home during the inspection was calm and orderly. One comment card noted that the Inspection reports are locked in the office and not available after the Manager leaves the home at 4p.m. Inspection reports must be on available to residents and other persons upon request. Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 21 At the time of inspection the home was not in receipt of a current certificate of insurance and this must be displayed at all times. The Inspectors noted that attention must be paid to the conduct of staff regarding dress code, which could be misleading residents. The Inspectors sampled several water outlets within the home including bathroom and residents rooms. The water temperatures were found to be 49 degrees and raised risk of scalding resident’s and staff. No records to indicate a safe bathing policy had been implemented within the home and this must be put in place with additional individual risk assessments. The Inspectors noted that a bath mat, to ensure that residents do not slip in the bath was in a state of disrepair and must be replaced. In several areas within the communal areas of the home and in resident’s rooms electrical wires were noted to be trailing and not appropriately secured to afford safety. During the course of the inspection on several occasions staff were observed to lack sufficient awareness of hazards in the home including walking or kicking out of the way a trailing flex for a music centre in the kitchen and not familiar with the Control of Substances Hazardous to Health guidance and regulations. It was observed by the inspectors that in one residents room items were found on the top of a radiator. Titleworth Ltd has stated their commitment to meet the requirements set out by CSCI. Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x 1 Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 1 2 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 3 2 3 3 2 Standard No 11 12 13 14 15 16 17 2 x x x 3 x 1 Standard No 31 32 33 34 35 36 Score x 2 2 2 x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Rowland House Score x 2 1 x Standard No 37 38 39 40 41 42 43 Score 2 2 x x x 1 2 H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 23 YES 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 5 Regulation 4.(1)(2) 5.(1)(2) Schedule 1 Requirement Timescale for action 3.6.05 2. 6 15.(2)(a)( c 3. 6 15.(2)(b) 4. 11 12.(1)(a)( b) 5. 13,14, 16.(2)(n) The Registered Perpons must ensure that residents are in receipt of current up to date information regarding thier home including the statement of purpose and the service users guide. Copies of which must be forwarded to CSCI local Eashing office. The Registered Persons must 3.8.05 ensure that all residents care plans, risk assessments and subsequent revision of care needs are available to residents and or thier representatives. The Registered Persons must 3.6.05 ensure that residents care plans are kept under review every month. The Registered Persons must 14.6.05 promote and make proper provision for the health, welafre, treatment, education and supervision of residents and take into account wishes and feelings. The Registered Persons must 14.6.05. ensure that leisure activities for residents must be addressed in order to provide residents with appropriate stimulation, Version 1.30 Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Page 24 6. 17 12.(4)(a) 7. 17 17.2 Schedule 4.(13) 8. 17 18.(1) (c i 16. (2) i 9. 17 12.(1)(a)( b) 14.(1)(a) 10. 17 13.(3) 11. 20 13.(2) 12. 20 13.(2) engagement and further development to meet aspirations and goals. The Registered Persons must ensure that the preparation and serving of residents meals is conducted in a manner that respects the dignity of residents. The Registered Persons must ensure that a record of food provided e.g. menu must be maintained in sufficient detail (large print) and available to residents and staff on a weekly basis to offer choice and discussuion with residents and to enable any person inspectig the record to determine whether the diet is satisfactory. The Registered Persons must ensure that all staff supporting residents at mealtimes are suitably competent and trained in Basic Food Hygiene. The Registered Persons must ensure that all staff have an awareness of residents needs including the level of support and equipment required by them at mealtimes. The Registered Persons must ensure that suitable arrangements are provided for the safe storage of food in keeping with the Environmental Health guidance to prevent residents being harmed. All medication administered by staff to residents must have been authorised by the residents G.P. All medication must be administerred directly from the original container or blister pack to the resident and not placed in a secondary container for later administaration. Immediate 3.5.05 Immediate 3.5.05 3.8.05 Immediate 3.5.05 Immediate 3.5.05 Immediate 3.5.05 Immediate 3.5.05 Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 25 13. 19 13.(1)(b) 14. 24 23 (2)(b) 15. 16. 24 24 16 (2)(c 13.(4)(a)( b)(c) 17. 30 16.(2)(k) 18. 29 12.(4)(a) 19. 29 12.(4)(a) 20. 34 19.(1) The Registered Persons must make arrangements for residents to receive where , treatment advice and other services from any health care professional. The Registered Persons must ensure that all parts of the home are kept in a good state of repair externally and internallly. The Registered Persons must provide in rooms occupied by residents adequate furniture. The Registered Persons must ensure that all areas of the home to which residents have access are as far as reasonably practicable free from hazards to safety. The Registered Persons must keep the care home free from offensive odours and make suitable arrangements for the disposal of general and clinical waste. The Registered Persons must make suitable arrangements to ensure that the home is conducted in a manner which respects the privacy and dignity of residents in respect of use of the management of continence. The Registered Persons must make suitable arrangements to ensure that the home is conducted in a manner which respects the privacy and dignity of residents in respect of use of notices in the home the management of continence. The Registered Persons must ensure that the policies and procedures regarding recruitment and selection are met: this should include a check up on the employment rights of individuals to work in this country. 14.5.05 3.8.05 3.8.05 Immediate 3.5.05 Immediate 3.5.05 14.8.05 Immediate 3.5.05 Immediate 3.5.05 Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 26 21. 32 18 (1)(a)(b)( c)(i)(ii) The Registered Persons must ensure that at all times suitably qualified, competent and experienced persons are working (2)(a)(b)(i in the care home and have )(ii)(iii) of received structured induction and training for the work they are to perform to ensure the safety and welfare of the residents. 17(2)(f),1 8(2)(a) (b)(i)(ii)(ii i),19(1)(a ) 38 (2)(a)(b)( c)(d)(e) The Registered Persons must ensure that all staff receive formalised supervision and where neceassary staff must be supervised at all times within the home. Titleworth Ltd must submit a documented plan of action to CSCI local Eashing office detailing the proposed day to day management arrangements and staffing the home in order to ensure the safety and wellbeing of all the persons within the care home. The Registered Persons must attain and display within the Care Home a certificate of liability insurance. The Registered Persons must ensure that the home is conducted so as to encourage and assist staff to maintain good personal and professional relationships with the residents. The Registered Persons must ensure that all water outlets in the home are tested by a suitably qualified technician and water temperatures are reduced to the required safe limits to ensure the safety of residents and staff. The Registered Persons must ensure that all staff involved in bathing residents practice a safe bathing policy, individual risk Immediate 3.5.05 22. 36 Immediate 3.5.05 23. 37 Immediate 3.5.05 24. 37 25 (2)(e) Immediate 3.5.05 Immediate 3.5.05 25. 38 12 (5)(b) 26. 42 3 (4) (a)(b)(c) Immediate 3.5.05 27. 42 13 (4)(c) Immediate 3.5.05 Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 27 28. 42 23 (2)(c) 29. 42 13(a)(b) (c) 30. 42 17.2 Schedule 4 assessments for bathing residents and the checking of water temperatures before the resident enters the the bath water and the periodic monitoring, recording and auditing of the outlet temperature of the bath/shower water using a bath thermometer. The Registered Persons must ensure that equipment provided at the care home for use by residents or persons who work in the home is maintained in good working order. The Registered Persons must ensure that all parts of the home to which residents have access are so far as reasonably practicable free from hazards to their safety. The Registered Persons must ensure that the Inspection reports are avaiable to residents and others visitors to the home. Immediate 3.5.05 Immediate 3.5.05 Immediate 3.5.05 31. 32. 33. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 6&8 Good Practice Recommendations That the service develops the care plans and risk assessments in order that the residents can be assisted to develop skills and abilities which are presently not being addressed. That the service re affirm to the residents rights to let someone know if they are not happy about any aspect of care in home. The Regeistered Persons attain a copy of the Department H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 28 2. 3. 22 22 Rowland House of Health, White Paper Valuing People in order that the values, rights and staff training specific to supporting people with learning disabilities are promoted within the home. Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 29 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Rowland House H58_s13893_Rowland House_v217771_030505_stage 4.doc Version 1.30 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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