Inspection on 03/04/07 for Roxburgh House

This inspection was carried out on 3rd April 2007.

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

Roxburgh House 23/01/06

Roxburgh House 18/10/05

Roxburgh House 10/01/05

Roxburgh House 24/08/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Roxburgh House Roxburgh House Reddall Hill Road Cradley Heath West Midlands B64 5JE Lead Inspector Mrs Amanda Hennessy Key Unannounced Inspection 3 April 2007 10:45 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 Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 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. Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Roxburgh House Address Roxburgh House Reddall Hill Road Cradley Heath West Midlands B64 5JE 01384 411029 01384 565408 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) www.southerncrosshealthcare.co.uk Southern Cross Care Homes No 2 Limited Tracy Mancini Care Home 47 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (37) of places Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One service user accommodated at the home may be in the category of SI. This will remain until such time that the service users placement is terminated. 23rd January 2006 Date of last inspection Brief Description of the Service: Roxburgh is a large home providing accommodation for 37 residents who require personal care only and 10 residents who have dementia. It is owned by Southern Cross Healthcare Limited who own a large number of homes throughout the UK. Situated on the border of Old Hill, it is easily accessible by public transport from Dudley, Halesowen and Birmingham. The local amenities include a library, community centre, post office, shops and public houses. The home has two large lounges situated to the left and right of the main hall with dining areas off one lounge. Lenches unit ( the dementia care unit) has a large lounge/ dining room with incorporating a conservatory. The home has three double bedrooms and forty-one single rooms, three having en-suite facilities. Bedrooms are located on the ground and first floor and there is a lift available for residents to access all communal areas of the home. There are numerous toilets situated throughout the home and there are 3 assisted baths and 3 walk in shower rooms. A hairdressing room is also available. There is a small pleasant garden area accessible from Lenches unit that residents enjoy on fine sunny days. There is a car park situated to the front of the building that is quite reasonable in size. There are also smoking facilities for residents. Fees range from £335 to £535 depending on the needs of the service user and the room that they occupy. Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an inspection undertaken by 1 inspector between 10.45hrs and 18.00hrs, with the home being given no prior notice. The inspection included talking to the manager, talking to staff, talking to service users, examining records including the care records of five service users and three staff, a tour of the premises and a review of the pre inspection questionnaire completed by the Manager and comment cards that were forwarded to the Commission for Social Care Inspection before the inspection. Observations were made in the lounges of both units to try and determine life at the home. All three of the previous requirements were found to be addressed one new requirements were made as a result of this inspection. What the service does well: The home is pleasantly decorated and homely with friendly, welcoming and experienced staff. . Lenches has both facilities and memorabilia that aid services users recollection to maintain their physical and mental capabilities for as long as possible. Lenches is considered as a place of excellence where service users with dementia are cared for and have their health and mental well being promoted by its highly trained staff. All service users have a comprehensive assessment of their needs before the decision is made that the home is suitable for them. Service users receive personal support in the way they prefer and healthcare that meets their needs. Care plans are comprehensive and involve service users in their development and review. There are appropriate and safe systems for managing service users medication. Service users enjoy a programme of activities and a choice of tasty home cooked foods. The complaints policies and procedure ensure that service users are listened to and their concerns are appropriately and timely investigated. The homes adult protection and recruitment procedures also give assurance that service users are safeguarded and protected. The home manager provides has strong and effective leadership and ensures that the home is run to benefit the service users. Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 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 Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Prospective service users needs are comprehensively assessed prior to their admission to the home, this gives assurance their needs will be met. The home has an excellent dementia care unit that provides expert and innovative care for service users with dementia enhancing their quality of life. EVIDENCE: Services users have a comprehensive assessment of their needs by either the Home Manager or a senior member of staff before coming to live at Roxburgh. Residents and their relatives are involved in this assessment of their needs. The Home Manager writes to the prospective service users confirming that the home is able to meet their needs should they wish to come and live at Roxburgh and gives them additional information about the home. Lenches unit provides excellent facilities to aid its service users with dementia, aiding recollection that assists in the slowdown and deterioration of their Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 Page 9 mental health. The unit has a kitchenette enabling hot drinks to be made on the unit and service user an opportunity to take part in every day activities in times service users asked: “ Any washing up, let me know when there is some”. There is also a clothes airer and washing basket with staff planning to develop everyday tasks such as washing and pegging out their washing. Windows have been decorated with displays that service users can touch as well as look at and provide both a talking point and also increased recollection of memories themes include the seaside, music with a number of musical instruments. There are also clocks around the unit to try and give service users increased awareness of time a loss of which is often one of significant features of their illness. Staff ensure that the unit is well lit with an assortment of lights. A nursery display has also been developed which again service users can become actively involved in pushing the pushchair etc should they wish. Probably the most successful recent addition to the unit has been the unit kittens “Laurel and Hardy” who caused great hilarity with service users, staff and visitors and visitors both watching their antics and also enjoying it when they chose to sleep quietly on service users laps. The unit also has a “snoozelum” which provides a calm and quiet area for agitated service users or can stimulate service users senses when required. To enable the unit to be successful it relies on well-trained and motivated staff, which it also has. Staff have many ideas for the continuing development of the unit. Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The healthcare needs of service user’s are identified and met. Procedures in relation to medicines are satisfactory and safeguard service users. Service users are treated with respect and their right of privacy is upheld. EVIDENCE: Service users have a plan of their care and care risk assessments giving assurance that staff are aware of their needs and appropriate arrangements are in place to address them. Risk assessments include the risk of pressure sores, moving and lifting of service users, continence, nutrition and falls. Care plans and risk assessments are reviewed at least monthly with the service users or their representative involved in their care. Records seen shows that service users are able to access specialist medical and nursing services alongside dental, optical and chiropody services. Records were not clear whether staff had referred one service user to the chiropodist Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 Page 11 although it was later confirmed that appropriate action had been undertaken. Care records demonstrated, and relatives who returned comment cards confirmed, that they were informed that their relative had seen a Doctor or when there were changes to their health needs or treatment. The home has appropriate policies for the safe handling and administration of medicines. Medicines are administered to service users by qualified care staff that have received required training. The Staff have appropriate records of prescriptions that have been ordered, when the prescription has been checked and medicines that have been received. The drugs fridge temperature and treatment room temperature is checked daily. The storage and administration of controlled drugs was checked and all was found to be appropriate. The medication administration records were checked and were appropriately completed. Senior staff undertake regular and checks of medicines and medicine records, one minor omission was immediately addressed at the time of the inspection. Service users said that staff treat them with respect and preserve their privacy. Staff were seen to knock on toilet and bedroom doors before going in. Observations made and records seen demonstrated that staff think beyond service users immediate needs and even when they are outside their care. Staff made ambulance staff aware that one service user had a pressure sore and must not be left on a trolley, as this would cause the pressure sore to get worse despite staff being successful healing it. Staff also made sure that another service user who was visiting hospital had a packed lunch as she would be probably be away for lunch and also asked kindly: “Would you like a hot meal keeping for later as you won’t want sandwiches twice in one day”. Staff address service users by their preferred name, with a record of their preferred name made in care records. Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13, 14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities available meets service users social and recreational needs and expectations. Service users maintain contact with their family and friends as they wish and exercise choice over their life. Food provided is tasty, varied and homemade and is served in pleasant surroundings. EVIDENCE: The home has flexible daily routines to accommodate service users needs and choices. Records show that staff ascertain service users preferences such as what time they like to get up, go to bed or spend their day. Service users confirmed this saying: “ Staff know I like to have my dinner at the table and my tea in my chair”. Staff are ascertaining and developing resident’s life history, which includes their preferred leisure interests to ensure that activities meet their needs. The activity plan for the week is displayed in the reception area and is changed weekly. Staff also ensure that there is a seasonal display in the reception area. Service users were busy making Easter bonnets for Easter Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 Page 13 Sunday and were looking forward to the photographer from the local paper coming to take their photograph in their Easter bonnets for the newspaper. The home has an informative monthly newsletter informing them of any changes and forthcoming events. Families are encouraged to visit and attend social events that the home holds. Comments from service users “I take part when I want to”. Services users also go on trips to seaside towns during the summer, which they enjoy. The home has recently had two kittens for the dementia care unit who kept service users entertained during both recent visits and provided great hilarity. The home has a four-week menu with a choice available at each meal. On the day of the visit lunch was either beef casserole or cheese and potato pie with chocolate sponge the cheese and potato pie and chocolate sponge were tasted and were both tasty and delicious. Service users also said: “ Food is always very good and they there is always a choice “. Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has appropriate and comprehensive policies and procedures to highlight concerns and protect and safeguard its service users from potential abuse. EVIDENCE: The home has a detailed complaints procedure. The complaints procedure is displayed in the main reception area of the home and is also included in the service user guide. The home has received one complaint, which was appropriately investigated, undertaken within identified timescales and required actions undertaken as a result of the complaint. Residents and relatives who returned their comment cards said that if they had any concerns they would discuss them with their key worker or the Home Manager or both. The home also has a comprehensive adult protection policy that identifies required actions to be undertaken when allegations of abuse are made. Care staff have also had adult protection training and training in the management of violence and aggression. It was also positive that staff undertake an analysis of incidents of service users aggression and what were the contributing factors so wherever possible staff may be able to de-escalate problematic situations. Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 Page 15 The home does not currently notify the Commission for Social Care Inspection of incidents of aggression by service users to either other service users or staff, the manager confirmed that she would ensure that staff are aware of this requirement. Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is decorated and furnished to a high standard and is safe, pleasant, homely with no offensive odours and has a well-maintained garden for service users to enjoy. The home infection control procedures minimise the risk of cross infection to service users EVIDENCE: The home is clean and homely with no offensive odour and decorated and furnished to a high standard. The residential unit has two large lounges with a dining area off one lounge. The home has a full call system and a variety of aids and adaptations such as grab rails assisted baths and wheel in showers available for dependent service users. The home has a small well-maintained garden with garden furniture, patio planters and a water feature. Service users comments identified that were unhappy with the condition of toilets and Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 Page 17 bathrooms, when this issue was discussed with the manager she said that they had already been identified for refurbishment by September 2007. The home has appropriate infection control procedures that minimise the risk of cross infection. Kitchen staff should also be congratulated as they have been awarded the silver award for hygiene by Environmental Health. Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing numbers and skill mix at the home are appropriate to safeguard service users and meet their needs. Staff receive regular training to keep their skills updated and current to give them a greater insight into service users needs. Recruitment procedures also ensure that service users are protected as vulnerable adults. EVIDENCE: Staffing numbers and the skills and expertise of staff meet the needs of residents. The home is care staff numbers are as follows: General Residential 08.00-14.00 4 care 14.00-20.00 4 care 20.00-08.00 3 care Unit staff staff staff Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 Page 19 Lenches Unit- Residential Dementia Care 08.00-14.00 2 care staff 14.00-20.00 2 care staff 20.00-08.00 2 care staff The home also has domestic, laundry and catering staff employed daily. An activities organiser is also employed by the home. The home currently has all but four of its 26 care staff with a minimum qualification or currently undertaking National Vocation level 2. New staff are recruited in a safe manner that ensures that service users risk of harm is minimised. All staff have a comprehensive induction, which enables them to be able to meet service users needs and the aims of the home Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a highly competent and enthusiastic manager who provides effective and inspiring leadership for her staff. The home has a comprehensive quality assurance system that provides assurance that service users are listened to and required actions undertaken. As a result of this positive influences of the home by its Manager and staff the health, safety and welfare of service users is protected EVIDENCE: Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 Page 21 Tracey Mancini has been the Home Manager for approximately three years working at Roxburgh for fifteen years. She is highly competent and enthusiastic and provides effective and inspiring leadership for her staff. Under Mrs Mancini’s management the home was awarded as joint top for dementia care within all Southern Cross homes with previous success also as Manager of the year within Southern Cross. The home has an identified Quality plan giving assurance that the service users are listened to, the home is managed safely and service users have their care needs met. Quality audits of care plans, pressure sores, service users weights, accident statistics, vacancies and recruitment, the kitchen and a review of all regulation 37 notifications that have been sent to the Commission for Social Care Inspection (CSCI) are undertaken monthly with corrective actions identified, with a copy of the audit sent to both the Regional Manager and Regional Director. Required visits on behalf of the registered company are undertaken. The Manager and registered company proactively identify ways that requirements of Commission for Social Care Inspection will be met. The majority of service users money is managed by their families, although service users can manage their own finances if they wish to. Secure facilities are available for the safe keeping of service users personal money and valuables. Written records are available for all transactions which detail the reason for the withdrawal and two signatures, receipts are available as proof of purchases. External audits of service users personal money are undertaken with an audit undertaken the week before the inspection. All staff have regular supervision, which is recorded. The safe working practices within the home protects Service users. All staff have the opportunity to keep their knowledge and skills update by a comprehensive range of statutory training. The home is well maintained and complies with all relevant legislation. Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 Page 22 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 x 3 4 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 4 x 3 3 x 3 Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 OP18 Regulation 37 Requirement The home must notify the Commission for Social Care Inspection of incidents that affect service users health and well being including aggression by service users to either other service users or staff. Timescale for action 30/04/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA National Enquiry Line: 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 © 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 Roxburgh House DS0000041335.V332433.R01.S.doc Version 5.2 Page 25 - 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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