CARE HOMES FOR OLDER PEOPLE
Rushey Mead Manor 30 Coatbridge Avenue Rushey Mead Leicester LE4 7ZS Lead Inspector
Kim Cowley Unannounced Inspection 12th December 2006 11:00 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 Rushey Mead Manor DS0000064260.V321903.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. Rushey Mead Manor DS0000064260.V321903.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Rushey Mead Manor Address 30 Coatbridge Avenue Rushey Mead Leicester LE4 7ZS 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) 0116 2666606 0116 2660708 Midland Healthcare Ltd Mrs Linda Moody Care Home with Nursing 40 Category(ies) of Dementia (17), Mental disorder, excluding registration, with number learning disability or dementia (17), Old age, of places not falling within any other category (40), Physical disability over 65 years of age (5) Rushey Mead Manor DS0000064260.V321903.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. No one falling within category OP may be admitted into Rushey Mead Manor where there are 40 persons of category OP already accommodated within this home. No one falling within category PD(E) may be admitted into Rushey Mead Manor where there are 5 persons of category PD(E) already accommodated within the home. No person to be admitted to Rushey Mead Manor in categories MD or DE when 17 persons in total of these categories/combined categories are already accommodated in this home. No person to be admitted to Rushey Mead Manor in categories OP, PD(E), DE or MD when 40 persons in total of these categories/combined categories are already accommodated in this home. No person who requires nursing care are to be admitted into Rushey Mead Manor in categories OP, DE, MD or PD(E) when 20 persons in total of categories/combined categories are already accommodated in this home. 3rd May 2006 5. Date of last inspection Brief Description of the Service: Rushey Mead Manor is registered to accommodate forty older people in need or residential or nursing care. The home has a multicultural resident group and the staff team is also multicultural. Both English and Asian diets are catered for. There is a small temple and chapel situated in the building. Accommodation is on three floors with a lift and stairs for access. There are thirty-eight single bedrooms and one double bedroom. Two of the single bedrooms and the double bedroom have ensuite facilities. There are five lounges, two dining rooms, and one smoking room. The home is situated close to Leicester City Centre with good transport links and other local amenities. The weekly fees range from £270.00 to £376.00 depending on care needs. Rushey Mead Manor DS0000064260.V321903.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was a second key inspection this home has had in the 2006 – 7 inspection year. The home was re-inspected after concerns were raised with CSCI about the quality of the care provided there. Prior to the home visit, the inspector spent half a day reviewing the last inspection report, and information relating to the home received since that inspection. During the course of the inspection, which lasted four and a half hours, the inspector checked all the ‘key’ standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means the inspector looked at the care provided to five residents living at the home by meeting or observing them; talking with the staff who support their care; checking records relating to their health and welfare; and viewing their personal accommodation as well as communal living areas. Other issues relating to the running of the home, including health and safety and management issues, were inspected. The inspector also met other residents, the Acting Manager, senior carers, and other care and nursing staff. What the service does well:
Rushey Mead Manor provides homely and comfortable accommodation to a multicultural resident group. The staff team are also multicultural, and English, Gujarati, Punjabi, and Hindi, are spoken in the home. Some residents are local to the area, and others come from different parts of the country. One resident said, ‘We all get on very well here, the staff and the residents.’ Activities are provided to meet the cultural needs of residents. ‘Bhagans’, Bollywood films, and Punjabi, Hindi, and Gujarati television and radio are also popular. Some of the English residents enjoy singing and a member of staff has made them tapes of ‘old time’ English music hall songs. A Christmas party had been planned for the Friday after the inspection. Some residents are independent and visit the local shops unaccompanied. Others prefer to stay in the home and socialise with the other residents, or spend their time in their rooms. Staff encourage residents to determine their own lifestyles, based on what they feel most comfortable with. One resident told the inspector that she liked the home because she could make a cup of tea whenever she wanted. The home has two kitchens, one caters for an Asian vegetarian diet and the other for an English diet. Menus showed a varied diet being provided with hot
Rushey Mead Manor DS0000064260.V321903.R01.S.doc Version 5.2 Page 6 and cold items served at each mealtime. All residents interviewed said they liked the food. One resident said, ‘The food’s very nice,’ and another commented, ‘The cooks are good.’ Staff were observed treating residents with warmth and respect during the inspection, and relationships between residents and staff appeared good. Some residents prefer that only female carers meet their personal care needs and staff are able to accommodate this. All residents interviewed praised the staff team. Their comments included: ‘The staff do their best for us’, ‘It was my birthday and staff bought me a CD, a make up bag and some make-up’, and ‘The staff listen to us.’ What has improved since the last inspection? What they could do better:
Residents’ case files are in need of improvement and re-organisation. One resident did not have a risk assessment in place for a specific issue, this needs to be put in place. The home is currently without a Registered Manager and this needs addressing. The home appears to be without a Fire Risk Assessment, and the Fire Officer should be contacted for advice in producing one. Rushey Mead Manor DS0000064260.V321903.R01.S.doc Version 5.2 Page 7 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. Rushey Mead Manor DS0000064260.V321903.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 Rushey Mead Manor DS0000064260.V321903.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): Quality in this outcome area is good. Residents’ needs are assessed prior to admission to ensure the home is suitable for them. This judgement has been made using available evidence including a visit to this service. Standards 3 and 6 were inspected. EVIDENCE: All potential residents are assessed in their own homes or in hospital prior to admission. At present the Acting Manager or a senior carer carries out assessments for those in need of residential care. If the potential resident requires nursing care one of the homes RGNs carries out the assessment, accompanied by the Acting Manager or a senior carer. The Acting Manager said that before potential residents are assessed she finds out what language they prefer to communicate it. She can then choose staff with the appropriate language skills to take part in the assessment. Staff currently employed at the home speak English, Gujarati, Punjabi, and Hindi. Rushey Mead Manor DS0000064260.V321903.R01.S.doc Version 5.2 Page 10 All assessments are recorded. Residents’ files inspected contained assessments carried out by staff at the home, as well as by the social workers who made some of the placements. Standard 6: The home does not provide intermediate care. Rushey Mead Manor DS0000064260.V321903.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): Quality in this outcome area is good. Residents’ health and social care needs are met. This judgement has been made using available evidence including a visit to this service. (Standards 7, 8, 9, and 10 were inspected.) EVIDENCE: Residents’ case files are in need of improvement and re-organisation. Although those inspected contained the required information, it was difficult to find key documents easily. The Acting Manager said she was aware that the files need improving and was intending to carry out the work in January 2007 in conjunction with her line manager who works for the home’s Owning Body. Risk assessments were inspected and mostly found to be in order. One resident did not have a risk assessment for their sensory impairment. This was reported to the Acting Manager who agreed to put one in place. She also said she would check all residents’ files to ensure they had the full range of appropriate risk assessments. Moving and handling has previously been an issue at the home but the Acting Manager said this has been closely monitored and she is of the view that
Rushey Mead Manor DS0000064260.V321903.R01.S.doc Version 5.2 Page 12 moving and handling techniques have improved considerably. She said all staff, both care and nursing, had certificated moving and handling training on 23.10.06., and always use the hoist when transferring non-weight bearing residents. Although moving and handling was not witnessed during the inspection, one resident said she was happy with how staff helped her to get in and of bed. The Acting Manager and one of the senior carer, who have both completed a ‘Safe Handling of Medication’ course, oversee medication administration in the home. Nurses or senior corers give out medication. The home’s contract pharmacist provides advice on request. Staff were observed treating residents with warmth and respect during the inspection, and relationships between residents and staff appeared good. Some residents prefer that only female carers meet their personal care needs and staff are able to accommodate this. Rushey Mead Manor DS0000064260.V321903.R01.S.doc Version 5.2 Page 13 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): Quality in this outcome area is good. Daily life and social activities enable residents to lead purposeful lives. This judgement has been made using available evidence including a visit to this service. (Standards 12, 13, 14, and 15.) EVIDENCE: Activities are provided to meet the cultural needs of residents. The Acting Manager said ‘Bhagans’ (singing and praying in Hindu) are popular, with both Asian and English residents joining in. Bollywood films and Punjabi, Hindi, and Gujarati television and radio are also popular. An exercise to music class in held once a month with a visiting tutor. Some of the English residents enjoy singing and a member of staff has made them tapes of ‘old time’ English music hall songs. A Christmas party had been planned for the Friday after the inspection. Visitors are welcome at the home at any time and can see residents in their rooms or in one of the lounges. Some visitors were in the home at the time of the inspection. Although the inspector did not get the opportunity to talk to them, it was noted that they appeared to get on well with the staff team. Some residents are independent and visit the local shops unaccompanied. Others prefer to stay in the home and socialise with the other residents, or
Rushey Mead Manor DS0000064260.V321903.R01.S.doc Version 5.2 Page 14 spend their time in their rooms. Staff encourage residents to determine their own lifestyles, based on what they feel most comfortable with. One resident told the inspector that she liked the home because she could make a cup of tea whenever she wanted. The home has two kitchens, one caters for an Asian vegetarian diet and the other for an English diet. There are also two dining food where the different foods are served. Three cooks are employed with the skills to prepare culturally appropriate food for both Asian and English residents. Menus showed a varied diet being provided with hot and cold items served at each mealtime. All residents interviewed said they liked the food. One resident said, ‘The food’s very nice,’ and another commented, ‘The cooks are good.’ Rushey Mead Manor DS0000064260.V321903.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good. Residents feel able to talk to staff about any concerns they might have. This judgement has been made using available evidence including a visit to this service. (Standards 16 and 18 were inspected.) EVIDENCE: The home has a written complaints procedure, which is given to all residents (or their representatives) prior to admission. A copy of the complaints procedure is also displayed in the home. All the residents interviewed said they would have no difficulty in speaking out if they had a complaint. One resident commented, ‘If I had a complaint I’d tell my key worker straight away.’ Since the last inspection an individual has raised a number of concerns about this home. These were all followed up and addressed at this inspection. The procedure for safeguarding adults was discussed with the Acting Mananger and a senior carer. These staff members had a satisfactory working knowledge of what steps to take should an allegation of abuse be made. Residents’ files showed proper recording of unexplained injuries to residents, for example bruising, and follow-up action taken where appropriate. Rushey Mead Manor DS0000064260.V321903.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): Quality in this outcome area is good. Residents live in an environment that is safe and well maintained. This judgement has been made using available evidence including a visit to this service. (Standards 19 and 26 were inspected.) EVIDENCE: Rushey Mead Manor provides comfortable and homely accommodation to residents. All areas inspected were warm, clean, and tidy. However in some areas the décor shows signs of wear and would benefit from improvement. The Acting Manager said she was aware of this and has instructed the handyman to carry out an audit of the premises in conjunction with a senior carer to identify which areas need re-decorating. She said this will then be reported to the Owning Body and a request made for resources. Rushey Mead Manor DS0000064260.V321903.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is good. Well-trained and professional staff meets residents’ needs. This judgement has been made using available evidence including a visit to this service. (Standards 27, 28, 29, and 30 were inspected.) EVIDENCE: At present the staff team consists of the Acting Manager, three RGNs (one of whom is always on duty), three senior carers, care assistants, cooks, cleaners, a laundry assistant, a gardener, and a handyman. All residents interviewed praised the staff team. Their comments included: ‘The staff do their best for us.’ ‘(The Acting Manager) spends time with me. She’s my key worker.’ ‘It was my birthday and staff bought me a CD, a make up bag and some make-up.’ ‘I like the staff.’ ‘The staff listen to us.’ Staff files were inspected and found to contain all the necessary documentation including references, and POVA and CRB checks. This will help to safeguard residents. Rushey Mead Manor DS0000064260.V321903.R01.S.doc Version 5.2 Page 18 NVQs are in progress in the home via a local community college. The majority of the care staff have NVQ Level 2 and the Acting Manager is studying for Level 3. Training records showed that staff have attended courses in Manual Handling, Medication, Infection Control, Dementia, First aid, Food Hygiene, Safeguarding, Care Planning, and Pressure Sore Care. Rushey Mead Manor DS0000064260.V321903.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is good. Residents live in a home that is mostly safe and well managed. This judgement has been made using available evidence including a visit to this service. (Standards 31, 33, 35, and 38 were inspected.) EVIDENCE: At present the Registered Manager’s post is vacant and a senior carer has taken on the role of Acting Manager. She is an experienced staff member and in discussion was knowledgeable about the needs of the residents accommodated at the home. She is line-managed by one of the Owning Body’s Senior Managers who visits the home every week and is available by phone at other times. As the Acting Manager is expected to continue to work as a carer while being in charge of the home, she has only limited time to overseen the running of the home and attend to administrative duties. This is unfortunate as some
Rushey Mead Manor DS0000064260.V321903.R01.S.doc Version 5.2 Page 20 matters, for example residents’ files and health and safety documentation, are in need of attention. Although the home appears stable at present, a Registered Manager should be appointed as soon as possible. Records showed that residents’ views and their likes and dislike are central to the running of the home. The Acting Manager said the majority of residents have family who visit, and they are encouraged to talk to staff and comment on the care provided at Rushey Mead. Staff at the home do not look after residents finances, this is done by the residents themselves, their families, or social services. Systems are in place to maintain the health and safety of staff and residents at the home, and records showed the premises and equipment are maintained and serviced. The home’s Environmental Health Officer inspected the home on 16.03.06 and made a number of requirements and recommendations. Records showed that the previous Registered Manager wrote to the EHO on 15.05.06 to say these have been met. The Fire Officer inspected the premises on 11.03.05 and requested that a Fire Risk Assessment be produced. It was unclear from records whether or not this had been done, and a Fire Risk Assessment could not be found. The Acting Manager agreed to either find this or produce a new one, contacting the Fire Officer if necessary for advice. Rushey Mead Manor DS0000064260.V321903.R01.S.doc Version 5.2 Page 21 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 X 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 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 2 X 3 X 3 X X 2 Rushey Mead Manor DS0000064260.V321903.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations Residents’ case files are in need of improvement and reorganisation. One resident did not have a risk assessment in place for a specific issue, this needs to be put in place. Consideration should be give to redecorating the parts of the home in need of improvement. A Registered Manager should be appointed as soon as possible. 2 OP7 3 OP19 4 OP31 Rushey Mead Manor DS0000064260.V321903.R01.S.doc Version 5.2 Page 23 5 OP38 The Fire Officer should be contacted for advice on producing a Fire Risk Assessment. Rushey Mead Manor DS0000064260.V321903.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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
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