Inspection on 06/02/09 for Ruksar

This inspection was carried out on 6th February 2009.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ruksar 29/04/08

Ruksar 28/09/07

Ruksar 10/04/07

Ruksar 09/01/07

Ruksar 12/09/06

Ruksar 05/05/06

Ruksar 08/03/06

Ruksar 15/12/05

Ruksar 14/09/04

Ruksar 21/04/04

Ruksar 16/12/03

Similar services:

Aston Court Nursing Home

Breme

Ravenhurst

Westmead

Ashcroft Hollow Nursing Home

Bricklehampton Hall Nursing Home

Briar Hill House

Radbrook Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ruksar 26 Park Avenue West Park Wolverhampton West Midlands WV1 4AH     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Joy Hoelzel     Date: 0 6 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Ruksar 26 Park Avenue West Park Wolverhampton West Midlands WV1 4AH 01902420605 01902561199 mariamathet@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Mustak Jalal care home 27 Number of places (if applicable): Under 65 Over 65 27 physical disability Additional conditions: No number division between categories Date of last inspection Brief description of the care home 27 Ruksar is a care home registered to provide personal and/or nursing care, for up to 27 adults, of all ages, with physical disabilities. Located close to Wolverhampton City Centre the home benefits from easy access to local shops, pubs, parks, and other amenities. The property is a two-storey building with accommodation on both floors comprising bedrooms, communal rooms, bathroom, and toilet facilities. The first floor is accessed via a passenger lift, and there is provision of an access ramp to the front of the home. However, whilst the home enjoys a garden area to the rear there is limited access for wheelchair users. Information of the home and the provision of the service are available in the statement of purpose and a brief brochure. The service user guide is currently unavailable and as such it was not possible to determine the current level of fees for the service. The reader may wish to obtain more up to date information from the care service. Care Homes for Older People Page 4 of 27 Brief description of the care home Commission for Social Care Inspection reports for this service are available from the provider or can be obtained from www.csci.org.uk Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection for this service was conducted 29th April 2008. The home were not informed that we would be visiting on this occasion. A look around the home took place, which included a number of bedrooms as well as communal areas. The care documents of a number of people using the service were viewed including care plans, daily records and risk assessments. Other documents seen included medication records, service records, some policies and procedures and staffing records. Discussions were held with people living, visiting and working at the home. Some people were unable to fully comment about their experience of life at the home. Observations were made of how they spent the day and of the interactions offered by staff in an attempt to obtain an overview of how they may be feeling. Care Homes for Older People Page 6 of 27 Prior to this inspection we asked for our Have Your Say surveys to be distributed to people living in, working in and visiting the home. Three were returned from people living in the home and one was completed by a relative. The responses and comments are included in this report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that the care home can meet their individual care needs. This is because an assessment of their needs has been made. This tells the home all about them and the support they need. Evidence: Information on the service and what it offers is available in a statement of purpose and contains details of the aims and objectives of the service. It is reviewed annually to ensure that current and correct information is included. However on looking at the statement of purpose the details of how to contact us are incorrect. An amendment is needed to ensure that people have the information to be able to contact us should they wish to do so. A short colour brochure is available, designed to give people a quick guide and overview of Ruksar. The service users guide to the home was unavailable on this occasion and as such it was not possible to determine the level of weekly fees for the service. The information provided by the service ensures that Care Homes for Older People Page 10 of 27 Evidence: people can decide whether the care home can meet their support and accommodation needs. The case file of the person who recently moved into the home was looked at to see if information had been sought regarding this persons needs prior to moving in. Information had been gathered from the previous health care setting and a pre admission assessment was completed by the service. This person was unable to visit the home prior to moving in but documentation in the care plan shows the involvement of the family and relatives. Other case files looked at included a pre admission assessment by the home in addition to social worker reviews, assessments from Primary Care Trusts and community care services. This gathering of information ensures that the service can be confident of meeting a persons care needs. The home does not provide an intermediate care service. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is evidence in the care plan of health care treatment and intervention, and a record of general care information. There are some gaps in information but staff are able to think in a person centred way and are able to give a verbal update. Evidence: Each person has a written plan of their care that is based on the assessments of their care needs. Two plans were selected to be looked at in depth with other plans looked at briefly to follow up any observations made during the day. Each plan contained assessments for maintaining a persons safety and when a risk is identified it is linked with a corresponding plan of care. Some of the documents had been signed by the person or their representative as having been discussed and agreeing with the plan of care. Generally the plans contained the information and guidance for staff to ensure that the care needs of a person can be met. Where there was a gap in the information staff were able to describe the care provided to each individual. For example one plan did not include any reference for maintaining effective communication with the person even though it had been identified that this may be problematic. Staff explained that Care Homes for Older People Page 12 of 27 Evidence: many staff are able to speak with this person and that effective communication is maintained. During the day we observed staff discussing events and conversing with people in a way pertinent to their culture and ethnicity. The care plan contained a specific reference to gender issues and a persons preference for personal care being provided by male or female staff. This information is most important for ensuring that cultural and religious preferences are observed. This inspection has shown that some improvements have been made with documenting important information but further improvements and attention to detail is still required. Medication is administered to people by the registered nurses using a monitored dose system with additional boxes and bottles of medicines. The procedures were looked at, staff explained the processes and all evidence points to good arrangements being in place for the safe administration of medications Staff were observed during the day to be addressing people in a correct and respectful way and appeared to have a good knowledge of the care needs of each person All three people who completed our survey indicated that staff listen to them and act on their wishes. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are involved in daytime activities of their own choice and according to their individual interests, diverse needs and capabilities. The meals provided cater for the cultural and dietary needs of individuals. Care staff are sensitive to the needs of people who find it difficult to eat and give assistance with feeding. Evidence: Leisure and recreational activities are arranged by the staff in addition to their allocated duties. The home is very culturally diverse and as such many activities are arranged to suit cultural preferences and interests. Opportunities for religious observance continue to be available for people both within the home and in the community. Two people commented that they enjoyed listening to music and watching films and were quite content with this. The statement of purpose details the range of activities that are offered - monthly birthday parties, musical events, games, outdoor activities, trips and tours, books, arts and crafts programme. People stated that friends and families are able to visit at suitable times and that they found the arrangements very satisfactory. Care Homes for Older People Page 14 of 27 Evidence: The main front door is kept locked at all times for security reasons; a controlled circuit television camera is sited at the front door enabling staff to see the identity of the caller. No other doors within the home were seen to be locked with the exception of storage cupboards and the treatment room. People can have free access to all areas of the home if they so wish. During the day many people were seen to be moving from area to area around the home. Selections of English and Asian foods are available each day to suit peoples preferences and dietary needs. People are encouraged to use the dining facilities but are able to have their meals in their preferred place and at a time suitable for them. People spoken with stated that they enjoyed the meals provided, had plenty to eat and a very good variety. Staff were observed to be sitting with people who required help to eat and drink and were very patient, discreet and encouraging. Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a complaints procedure that is available and is displayed on the notice board in the home. Some people say they know how to make a complaint but others do not. Evidence: The statement of purpose includes details of the complaints procedure and states that all complaints are responded to within 28 days. Our contact details in the statement of purpose are incorrect and will need to be amended so that a person can contact us if they so wish. A complaints log is available to document any concerns that are raised with the home. Staff confirmed that no concerns have been made since July 2007. We, the commission, have received no concerns or complaints since May 2008, but we were informed of a recent referral made to the safeguarding adults team. This was regarding concerns of the environment and privacy and dignity issues. The investigation is ongoing and has yet to reach a satisfactory conclusion. In our recent survey all three residents indicated that they knew how to make a complaint with one person commenting - I can go to the nurse on duty. The survey completed by a relative indicated they were unaware of the complaints procedure. Some staff are currently receiving training in the protection of vulnerable adults with sessions arranged later this month. Care Homes for Older People Page 16 of 27 Evidence: Although not fully inspected on this occasion the senior staff confirmed that the home offers a facility for residents to deposit personal monies for safekeeping, and that records relating to this are maintained and fully receipted. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides an environment that meets the specific needs of the people who live there, and there are plans to further upgrade the premises and improve the standard of living. Evidence: Ruksar Nursing home is a large detached property in a residential area of Wolverhampton. It is close to local shops and community establishments. People who live at the home and are able regularly access the local shops and places of worship. The redecoration and refurbishment of the communal and private rooms continues on a rolling programme basis. The provider of the service discussed the plans for further upgrading the building and facilities. It is envisaged that most of the bedrooms will have an en suite facility, this will offer additional privacy for people. People we spoke with told us they were satisfied with the accommodation with one person stating - I love my room which has been decorated in my favourite colour, I am very happy to be here. During the tour of the home many of the bedrooms we looked at were highly personalised and all very different. All parts of the home appeared clean and hygienic. Our survey indicated that people thought the home was always kept clean. Care Homes for Older People Page 18 of 27 Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough qualified, competent and experienced staff to meet the health and welfare of people using the service. Staffing rotas take into account the needs and routines of the people using the service. Evidence: A duty rota is maintained on a weekly basis to identify the members of staff in the home at any one time. During the morning of the inspection the registered nurse confirmed that seventeen people were in residence and were being cared for by a staff team consisting of a registered nurse, three care staff and ancillary personnel. An additional care staff arrived at the home during the morning and had been called in due to the unexpected sickness of a colleague. People living at the home expressed a general satisfaction with the staff and the care that was provided. One person commented that she was well looked after and that the staff were very good, and she liked being at Ruksar as she realised that she is now unable to manage at home. People who were unable to comment or declined to do so appeared well groomed, comfortable and relaxed. General observations and discussion with staff suggested that staffing numbers and skill mix are suitable and sufficient to meet the care needs of the people living at the home. Senior staff confirmed that training for care staff continues with most staff now gaining Care Homes for Older People Page 20 of 27 Evidence: a National Vocational Qualification in care at level 2 or equivalent. The training and development needs of staff have been identified by the manager. Courses for the mandatory and specialist subjects are being accessed through out the year. Induction training for new employees continues to ensure that the staff are trained and competent to do their jobs. Three staff personnel files were requested for inspection and included different grades and length of employment. The files for two of the staff contained all the information and details required by regulation. The files for the newer employee were incomplete with the information required not available. The provider offered a reasonable explanation stating that the manager is in the process of collating the information and confirmed that all checks have been received. Nevertheless the necessary documents must be readily available for inspection to evidence a robust recruitment procedure is in operation. This will confirm and ensure that suitable people are employed to work with vulnerable adults. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is aware of and works to the basic processes set out in the National Minimum Standards. There are some areas that require improvement to ensure the Ruksar is a safe place in which to live. Evidence: Mrs Maricel Alaparaque continues in the position of registered manager and has been at the home since September 2007. Mrs Alaparaque was not on the premises during this inspection. A registered nurse was in charge of the home and offered her fullest cooperation with the inspection. There are good support networks in place with the providers who continue to be involved in the service regularly during the working week. Staff spoken with offered positive comments about the management arrangements all stated that they would have no hesitation to see the provider or manager if they had any concerns or worries. Staff and resident meetings continue to be arranged at regular intervals offering Care Homes for Older People Page 22 of 27 Evidence: people the opportunity to discuss and comment of how they find living and working at the home. Staff confirmed that the quality assurance and monitoring of the service continues with questionnaires distributed to residents and their families. It was not possible to determine the content, timing or result of the questionnaires, as the file was unavailable. Although not fully inspected on this occasion the senior staff confirmed that the home offers a facility for residents to deposit personal monies for safekeeping, and that records relating to this are maintained and fully receipted. Records, documents and certificates are available for inspection to ensure that the weekly, monthly and annual health and safety checks are being carried out. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 29 19 Essential documents for checking the suitability of people to work at the home must be kept on the premises and available for inspection. This will evidence that a robust recruitment procedure is operational to ensure the safety and protection of the people in residence. 28/02/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 The service users guide should be readily available and include details of the current level of weekly fees. This will ensure that people are able to access the information required to assist with making a decision to move into the home. The complaints procedure should be made available to all people to ensure they have the details of how to raise concerns. Page 25 of 27 2 16 Care Homes for Older People 3 19 The maintenance and programme for upgrading the premises should continue to ensure that the home provides a good standard of living for the people in residence. Training for staff in the mandatory and specialist topic areas should continue to ensure that staff are trained and competent to do their job. To ensure the home is run in the best interests of the people living at the home, an effective and efficient quality assurance and monitoring system should be developed. This should include regular audits and checks of the systems in place in addition to obtaining peoples views and opinions. 4 30 5 33 Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!