Inspection on 17/04/07 for Rugby Care Centre

This inspection was carried out on 17th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Rugby Care Centre 26/04/06

Rugby Care Centre 09/11/05

Rugby Care Centre 06/09/04

Rugby Care Centre 27/04/04

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 Rugby Care Centre 53 Clifton Road Rugby Warwickshire CV21 3QE Lead Inspector Jackie Howe Unannounced Inspection 17th April 2007 08: 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 Rugby Care Centre DS0000004292.V335459.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. Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rugby Care Centre Address 53 Clifton Road Rugby Warwickshire CV21 3QE 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) 01788 542353 01788 567941 rugby@ashbourne.co.uk Exceler Healthcare Services Limited Vacant post Care Home 29 Category(ies) of Dementia (9), Old age, not falling within any registration, with number other category (20) of places Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th April 2006 Brief Description of the Service: Rugby Care Centre is an established care home providing personal care for up to 29 residents, 9 beds form part of the newly registered dementia care unit. The home is a detached dwelling near to the town centre of Rugby, and is placed near to good bus and train services. The main shopping centre is only a few minutes walk from the home. Rugby Care Centre admits service users for respite and long term care. The care staff are supported by the benefits of a large well-established organisation. Accommodation is mainly single room accommodation over two floors, but the majority of rooms available on the ground floor form part of the dementia care unit. Two shared rooms are available on the top floor. The home has been changed significantly in the past year and now has a selection of lounges and dining and communal areas, which can serve a multi purpose, some of which look out over the garden. Service users are provided with three meals a day taken in either of the dining rooms or if they choose in their own room. District nurses visit the home to provide nursing care for service users in need of wound care or other nursing needs. The home is a ‘non smoking’ environment. Information about the home is available in the home’s ‘Statement of Purpose’ and the ‘Service Users Guide’. Current range of fees: £345 - £495 per week. Additional charges are made for hairdressing, private chiropody and personal items such as toiletries and newspapers. Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first inspection of the inspection year 2007/08 and was unannounced. It was undertaken over a period of one day, and was carried out between the hours of 08:55 am and 4:45 pm. The inspection focused on the outcome for residents of life in the home. The manager supplied the commission with a Pre inspection Questionnaire (PIQ) and a number of ‘comments cards’ completed by residents and relatives were received. Information from these has been used to make judgements about the service, and have been included in this report. The inspection process reviews the home’s ability to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision where improvements may be required. During the inspection, the care of two residents who live in the home was examined in detail. This included reading assessments, care plans and other documentation, observing care offered to them and that staff have the necessary skills to care for them. This is part of a process known as ‘case tracking’ where evidence is matched to outcomes for residents. Records including staff files, policies and procedures, health and safety / environmental checks and risk assessments were also read. The manager was present through out the day, and the inspector was able to tour the home, and spend time speaking with residents, and staff. The inspector ate lunch with the residents in the residential unit, and was able to observe care practices, and how staff interacted with residents in the home. The inspector would like to thank the manager, staff and residents for their cooperation and hospitality. Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? There were a number of requirements and recommendations for improvement made at the inspections, which took place in the last year. The majority of these have now been met. Training for staff to ensure that they have the skills required to meet the needs of the residents in the home, has shown a significant improvement, and staff are also receiving regular supervision from their line manager and the manager of the home. Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 7 The organisation has made a significant investment in regard to improving the environment. The new dementia care unit is well presented, bright, with areas of interest and is suitable for this client group. The entrance hall and communal areas have been redecorated, and are now clean, cheerful and welcoming. Systems for the safe administration of medication have vastly improved. 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. Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 8 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 Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 9 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): Standards 3 and 6. Quality in this outcome area is good. An initial care needs assessment takes place prior to admission and information is obtained from other professionals allowing the home to make an informed decision as to its ability to meet the needs of the residents. The Home does not admit people for intermediate care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The pre admission assessments undertaken on two residents in the home were read. Areas required for assessment in the National Minimum Care Standards are covered in the documentation and those read showed that a thorough assessment had taken place in aspects of personal and health care needs. Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 10 Residents and their families spoken with confirmed that this assessment had taken place either in their own home or in the hospital, and that an opportunity in most cases had been offered to see the home and try it out prior to making a firm decision to move in permanently. ‘They came to my home to answer my questions and to make a note of what I needed’. One family spoke about how they had come to the home and had a look around, and how the manager had been to the hospital to complete the assessment. They said how they found the manager to be ‘re assuring’ and communicated well with them. They confirmed that they had received information about the home, and felt that they had made the right choice. They said that the staff had been very welcoming and that staff had been ‘patient and caring’ which had really helped them during a difficult time. The home has developed a process for the assessment of residents being admitted to the dementia care unit of the home. The assessment read showed that staff were able to record areas of concern around the risks associated with some specialist needs and behaviours. There was evidence on both files read that information is sought by the home from care management assessments, and where appropriate, other health professionals. A family spoken with confirmed that they had received a contract and a copy of the rights and responsibilities, although one comment received, said that this had taken a few weeks to arrive. Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 11 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): Standards 7, 8, 9, and 10. Quality in this outcome area is good. Resident’s needs are documented in a care plan which guides staff in how to meet their health care needs, and assesses risks, but should be further developed to identify individual care needs. Systems for the safe storage and administration of medication are robust. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans of two residents identified were read, and their care ‘tracked’ during the inspection. Improvements have been noticed in the care planning processes and care plans generally are well documented and there is evidence that health care needs are assessed and regularly reviewed and that residents are given access to their GP and other health professionals. Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 12 Areas of risk are well documented, and there was evidence to show that nutrition, the development of pressure areas, the potential of falls, are assessed by the home, and reviewed in the event of changes. The manager ensures that all care plans are formally reviewed and that this is documented. One relative spoken with confirmed that she had had been involved with her mother in compiling the care plan, and wanted to be involved in the annual review when this took place. The care plans read, whilst addressing personal care and health care needs, should describe in more detail and with a ‘person centred’ approach to care, how individual care needs should be met. An example of this is: ‘Ensure that privacy and dignity is maintained’ and ‘encourage independence’. These statements are repeated in a number of care plans but they fail to say how privacy and dignity can be maintained for each person, and what a resident can do for themselves, to encourage a consistent approach from different staff and to ensure that residents are receiving care in a way that is personal to them. Daily records are completed by the care staff, but entries made lack the detail required to ensure that all staff are aware of daily changes and events. Comments received from relatives and residents in the home, confirm that residents have access to medical care and are supported to attend hospital appointments as required. ‘Staff acted very promptly when ……. became acutely ill and sent him to hospital. They also attend to his minor medical needs’. Comments received from a local GP practice were positive in regard to the homes care of the residents. The care manager was described as ‘helpful and sensible’ and that the home makes ‘appropriate requests for help’. Systems to ensure the safe administration, storage and receipt of medications are robust. The assistant manager closely monitors staff in administration procedures to ensure accuracy. Examination of Medication Administration Records (MAR) charts did not show any omissions in medication administration. Information kept on each residents file, contains a photograph to aid with identification, and information regarding self-medication, and the use of ‘homely medicines’. The storage and administration of controlled drugs was checked and found to be accurate. All records are maintained in a register, and regularly audited. Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 13 During the inspection it was noted that residents were cared for behind closed doors and spent time in their own room according to their personal wishes. Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 14 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): All of the standards were assessed during this inspection. Quality in this outcome area is adequate. A lack of current resources means that not all residents are able to maintain a social lifestyle, which meets their needs. Residents are able to maintain contact with families and friends, who are welcomed into the home. Residents receive a well balanced diet, with a menu, which is regularly reviewed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is currently without an activities organiser, which means that the availability of social recreation and entertainment is dependant on relatives, the care staff or outside entertainers. Staff are attempting to find time to provide some social events, and provide games, but this is limited due to other duties. Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 15 The manager is hoping to employ a new member of staff, and provide additional staffing resources to offer a variety, and also ensure that events can take place in both units of the home. On the day of the inspection, many residents were watching television either in lounges or in their own room, but there were a number of residents who spent time asleep in their chairs with limited stimulation. It was reported that a game had taken place in the afternoon, but this was not observed. There are books and games available, and those residents able to access their own newspapers, music CD’s and films for example are encouraged to do so. There is some recording in the care plan to show that residents attend activities, but the information is limited. Care plans and other documentation should show how individual residents benefit from attending activities and what staff need to do to promote well being. One resident spoke about how he used to go to church regularly, but had now ‘given up going’ and another that she used to be a cook, and really enjoyed gardening, but again, did not do this any more. There is a lack of ‘life history’ information available within the home, which would enable staff in the home to understand better the social and recreational interests of residents, and how they can continue to encourage and support residents in lifestyle choices. This was discussed with the manager during the inspection, and acknowledged as an area for improvement. Residents and relatives spoken with said that the food provision was ‘excellent’ and that they had plenty of choice. The menu is on display in the entrance hall of the home, and the organisation has invested in a system to ensure the nutritional good balance of the meals provided. ‘ The food is well balanced and healthy. I am very difficult about food, but I am given a fair amount of choice’. The inspector ate lunch with two residents in the residential unit of the home. All the other residents were eating their meal in their own room. The menu on the day of the inspection was Cottage pie, with green beans and courgettes, and gravy, or a choice of beef burgers. There is also an alternative daily choice of a salad, jacket potato or omelette. The sweet available was rice pudding with jam. The dining room is a pleasant environment, newly decorated and well furnished. The tables are laid attractively, with tablecloths and napkins, table flowers, salt and pepper and jugs of juice. The meal was served from a hot Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 16 trolley, and the menu choice was confirmed before the meal was served, and gravy offered not just placed on the meal. Residents spoken with said that they could not remember what they were having, but said that the food was always good, and that they never went without anything. They could not remember ever being involved in the development of the homes menu. Meal provision was not observed in the dementia care unit at this inspection. The dining room in this unit is part of the main lounge, and provides different tables to allow choice and staff to assist where this is required. There are a number of visual prompts to remind residents that it is a dining room. The care plan of a lady with distinct challenging nutritional needs was read. Whilst the care plan identified where there were areas of concern and a need for observation, there was little information to show that this was being monitored on a daily basis, with comments such as ‘ate well’. This lady had not been weighed on admission, although she had been weighed 2 weeks later. During the inspection visitors were seen coming and going from the home. Interaction with the staff and manager was noted to be good, and they were made welcome. One relative said that she felt that she was still involved in her husbands care, even though she was no longer able to do it fully for herself. One resident said that she felt she was still in control of her life and decisions as much as possible, which was something she appreciated. Other comments received included: ‘ The main thing I like is that they give me as much freedom as is possible, quite as much as I would have in my own home, which means a lot to me’. Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 17 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): Standards 16 and 18. Quality in this outcome area is good. The home had a complaints policy and procedure displayed and people are encouraged to report complaints and make their comments known. Systems are in place in the home to protect residents from abuse and training for staff has improved. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents spoken with confirmed that they understood the complaints procedure and knew who to go to with any concerns. Comments received also indicate that the majority of residents have not had a reason to complain and feel that they are asked if they are satisfied with the service provision. ‘So far I have not needed to complain, but I am very often asked if I need anything, and if I’m alright’. Relatives confirmed that they would feel comfortable should they need to complain, although one relative said that it would never get that far as the manager would have resolved any issues. Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 18 Since the last key inspection, one complaint was received by the commission in regard to the care provision of a resident. The manager demonstrated a very proactive response in regard to the handling of this complaint, and ensured that it was thoroughly investigated, meeting with the family to ensure that all concerns were resolved and took appropriate action in regard to staff practice where required. The home has in place robust procedures for responding to issues regarding safeguarding adults from abuse. The home’s individual policy is linked to the Warwickshire multi agency policy. Staff have received training in adult protection, and those spoken with were aware of the home’s ‘whistle blowing’ policy. Recruitment procedures show that the home is vigilant in seeking full working histories of new employees and that Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks have been undertaken. Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 19 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): Standards 19, 23, 24, 25and 26. Quality in this outcome area is adequate. The environment has been improved, and further developments planned, should enhance the home to make it more suitable and appropriate to the needs of the residents. Storage is limited in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the home was undertaken with the manager. Considerable changes and improvements have been made to the home’s environment since the last key inspection with the introduction of the new dementia care unit, and the increase in usable communal space. The garden area is secure, and provides a very pleasant outlook for a number of communal and personal rooms. Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 20 The entrance hall to the home is now bright and cheerful. Information about the home is displayed including a copy of the latest inspection report. The dementia care unit was recently registered by the commission, and this new environment provides a space which is appropriately decorated and furnished to meet the needs of the residents living there. Some of the communal areas in the residential unit, have been refurbished and decorated. Plans are in place for work to now be undertaken in the corridors and personal rooms. Due to the age and layout of the home some of the rooms are long and narrow, and the decoration makes them quite dark and dated in colour and design. The doors to some of these rooms are difficult for residents to use independently. Some of the bedroom doors were being held open by a wedge, and in one instance a cardigan, as the occupants of the rooms like their doors to be open. This practice was discussed with the manager during the inspection, and it was agreed that appropriate, safe door closures would be put on doors to these rooms as soon as possible. This must be in conjunction with a risk assessment. Bathrooms in this unit although clean are also a little dated and not homely in contrast to those in the dementia care unit. Residents living in the residential unit had a mixed response to their rooms. All had personal belongings, furniture and photographs, but some have very little view from the windows, and lack natural light. One resident had moved from her room over looking the garden, and whilst she understood the reasons to do this, she missed seeing the garden, flowers and birds. One resident with a large room on the top floor, said that she had been given an opportunity to move her room, and now enjoyed looking out at the comings and goings on the street below, and watching the children go to school. On the day of the inspection the home was found to clean and tidy with little evidence of unpleasant odour. The manager explained that this was an issue due to the care needs of some of the residents, in a couple of the bedrooms, but was confined to those areas, and systems are in place to keep this to a minimum. Staff were observed to wear protective clothing, and there are appropriate hand washing facilities available. The home has recently had an environmental health inspection, and has been awarded a gold award. Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 21 Storage continues to be an issue, and the manager and staff must ensure that the storage of wheel chairs and other equipment does not impede safe access, and does not block safety equipment. Currently there are a number of wheelchairs being stored by the back staircase, and the fire extinguisher was partly blocked. The manager said that the home was currently attempting to make additional storage space available. Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 22 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): All of the above standards were assessed during this inspection. Quality in this outcome area is good. The home ensures that all staff employed are of good character, and recruitment procedures are robust. Training to ensure that staff have the skills to care for the residents is available. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager said that whilst improvements had been made since the last key inspection to staffing provision in the home, it was at times still a matter of concern, and recently a number of staff have left due to personal circumstances, coupled with some long term sickness. The home is currently using some agency staff to ensure that staffing levels do not fall from a safe level, and the manager does her best to ensure that there is some consistency although this is not always possible. On the day of the inspection the manager was covering some of the available shifts with staff from another home within the organisation. Rotas seen show that the home is providing care staff in line with the agreed workforce model and that although staff are working overtime, this is not in excess, and does not contravene working time regulations. Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 23 As previously mentioned in the report, the home is currently without an activities coordinator, and there is currently no administrator, although the organisation is providing cover one day per week. This is putting some additional workload on to the manager, who is hoping the post will be covered as soon as possible. Staff records show that where new staff have been appointed, all the required safety checks have been undertaken. The manager has also conducted appropriate interviews, and received two written references. Verbal references where required, have been recorded and followed up in writing. Training in the home has improved, with the manager accessing both external and internal training opportunities. Mandatory training courses are available on a regular basis to ensure that all staff are able to attend. The manager has also reviewed the systems within the home to record training attended, which is a good management tool. Staff spoken with confirmed that they had attended training, and felt confident that their development needs would be addressed and that they could approach the manager to attend training courses as required. Systems for regular staff supervision have been introduced. Staff within the home are also given opportunities to attend training to become internal trainers, and one member of staff has recently undertaken a 12 month course on infection control. Residents and the relatives spoken with described the staff as being ‘patient’ ‘kind’, ‘attentive’ and said that nothing was too much trouble. Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 24 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): Standards 31, 33, 35 and 38. Quality in this outcome area is good. The manager is able to fulfil her responsibilities as manager of the home within an organised management system of policies and procedures. Residents and their families are given opportunities to make their opinions of the service known and the organisation has systems in place to monitor quality performance. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has now been in post for over a year, and her appointment has had a positive impact on the home. This is evident form the surroundings, the Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 25 atmosphere, the quality of care provision, and the management systems in place. The manager is not yet registered with the commission, although she said that she had completed the relevant paperwork. The manager is in the process of attaining the Registered Manager Award, but is also hoping to undertake a further management qualification at the local college. Comments received about the management team were very positive, from staff, residents, relatives, and medical practitioners. Systems are in place to safeguard the finances of the residents in the home. Personal rooms have a lockable facility, but residents are also given the choice of using the home’s safe. The system used by the home produces a receipt and keeps a running total of funds available. The organisation undertakes an annual quality assurance review. This is now slightly overdue, having been last undertaken last April. The organisation undertakes monthly internal quality assurance audits. Comments made about the home are recorded in a book in the reception. A number of comments have been made, the majority complimentary, but some expressing concern or suggestions for improvement. In order to show that the home responds to all comments made, it is recommended that the manager makes an entry into the book giving information of the actions taken in response. Residents and their relatives are also encouraged to attend the regular meetings held in the home when they are asked their opinion of the service and encouraged to make suggestions. The minutes of the last meting held were read during the inspection, and these are displayed on the notice board for those who were unable to attend. The home employs a ‘handyman’ and he tends to the upkeep and maintenance needs of the home. The organisation ensures that all other safety precautions and checks needed to protect the safety and welfare of the residents are undertaken on a regular basis. The home has a health and safety policy in place, and records show that staff have recently attended training in Health and Safety, Fire safety and Control of hazardous substances (COSHH). Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 26 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 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x 3 3 3 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 3 x 3 x 3 x x 2 Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 27 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 OP7 Regulation 17 Requirement The registered provider must ensure that care plans adequately guide staff on how each individual, based on a skills assessment, requires their care to be delivered, and how each resident is supported to retain strengths and abilities. This is particularly important in the dementia care unit. Daily records including night care, must contain sufficient detail to accurately report changes and incidents. Part of this requirement is outstanding from the last inspection to the home. The registered provider must ensure that residents are given opportunities for appropriate stimulation and recreation and that this is recorded in the care plan. The registered provider must ensure that the use of door wedges ceases and that appropriate, safe door closures are put on rooms in conjunction with a risk assessment. DS0000004292.V335459.R01.S.doc Timescale for action 31/07/07 2. OP12 15, 16 31/07/07 3. OP19 13, 23 31/05/07 Rugby Care Centre Version 5.2 Page 28 4. OP38 23 The registered provider must review the storage facilities in the home to avoid the storage of equipment in corridors. 31/05/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard OP7 OP12 OP15 OP31 OP33 Good Practice Recommendations Evidence of where residents are encouraged and supported to undertake positive risk taking activity should be assessed and recorded. Residents’ ability to contribute to activities of daily living should be assessed and recorded within a ‘person centred’ framework. Residents would benefit from an up to date menu being displayed in dining rooms, so that they can be reminded of the days meal. The manager should be registered with the commission as soon as possible. More informal records for reporting and responding to comments made about the service should be kept to demonstrate actions taken by the home in response. Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Rugby Care Centre DS0000004292.V335459.R01.S.doc Version 5.2 Page 30 - 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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