Inspection on 08/10/07 for Rushwell House

This inspection was carried out on 8th October 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Rushwell House 116 Wellingborough Road Rushden Northants NN10 9TD Lead Inspector Stephanie Vaughan Unannounced Inspection 8th October 2007 09:00 Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 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 Rushwell House DS0000069820.V347521.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 and Care Homes for Adults 18 – 65*. 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. Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rushwell House Address 116 Wellingborough Road Rushden Northants NN10 9TD 01604 717249 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) ninaroberts@mentaur.ltd.uk www.mentauruk.com Mentaur Limited Position Vacant Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission are within the following category: Learning disability (LD). The maximum number of residents who can be accommodated is 6. 2. Date of last inspection New Service Brief Description of the Service: The service is registered to provide personal care for six people with learning Disability. The home comprises two converted, semi detached, three bed roomed terraced houses within a residential location. Each resident has their own bedroom; these are fitted with washbasins and appropriate fixtures and fittings. There are three communal areas, which provide appropriate space. The home is well maintained and decorated throughout. Improvements are currently being made to the garden areas, however parking is limited. The home is close to the town centre and local amenities and there are good road links. Current fees range between £785:29 and £1,250:24 per week with additional costs for hairdressing, toiletries, clothing and other personal items. The Service ensures that information about the home is on display and is discussed at resident meetings. The management were able to confirm that this will also include Commission for Social Care Inspection reports. Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to this statutory inspection, a period of four hours was spent in preparation. This comprised reviewing the registration reports, the service history, pre inspection documentation supplied by the service and three comment cards from staff. No Comment cards were received from residents. Comment cards from staff provided very positive feedback abut the service. Since registration the Commission have received two concerns about the service. In both of these circumstances the concerns were referred back to the provider for investigation. The outcome of these was reviewed during the inspection. There have been no Safeguarding Adults allegations about this service. The Commission have a focus on Equality and Diversity and issues relating to this are included in the main body of the report. This site visit to the home was conducted over a period of six hours during which the inspector made observations and spoke to residents and staff. A limited tour of the premises was conducted which involved viewing the communal areas and a selection of the private accommodation. Case tracking is the method used during inspection where of a sample of two residents were selected and all aspects of their care and experiences reviewed, including individual plans of care and associated documentation. The Acting Manager and Service Manager were both present during this visit. What the service does well: The staff make sure that people who use the service have the right information about the home and that people who may wish to live there can make choices. The information is produced in easy read styles. The staff make sure that they have the right information before a new residents is admitted to make sure that they will be able to get on with the residents already living at the home and be able to care for them properly. New residents are able to visit the home on a number of occasions to meet the residents and staff and decide whether they would like to live there. Each resident has their own plan of care, which tells staff how the resident is to be cared for. The residents are involved in the writing and review of these plans. The staff make sure that they know about the residents past life, Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 6 interests and preferences so that they can help residents to lead their chosen lifestyle. There are regular meetings where residents decide about what should be on the menu, group activities and other decisions about the running of the home. Residents are able to take part in a range of activities, attend local day centres, clubs and local leisure facilities. They are also able keep in touch with their families and friends and practice their religion. Routines are flexible and residents are able to make choices in their lives. The residents and staff get on well together. Residents said that the staff were nice and that they treated them well. Residents said that they food provided by the home was good and there were always other things available if they did not wish to have what was on the menu. Residents said that they felt well cared for and that they were able make choices about their appearance. Residents are supported to stay as healthy as possible and staff make sure that they have the right health care services. Residents are supported to take their medication safely and the staff are looking at ways to help residents take more responsibility for their own medication. Residents said that they knew how to complain if they wished to do so. The staff make sure that any complaints are properly investigated and that things are put right if needed. Residents said that they were treated well by the staff and that they felt safe living at Rushwell House. The home is comfortable and safe. Residents said that they are able to make decisions about the decoration and furnishing in the communal areas and their own rooms. Residents can bring their own things to the home and arrange their rooms in the way that they wish. The garden areas are being improved so that they provide residents with a safe and pleasant outdoor space. The manager makes sure that there are enough staff on duty to look after the residents properly. The management make sure that the staff have the right checks done before they start working in the home. The staff have the right training and the manager checks that they are doing their jobs properly. Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 7 Residents and staff said that the home is well run and the manager has the right experience and training. The management do regular checks to make sure that everything is done properly in the home. The views of residents and their families are sought on a regular basis to make sure that they are satisfied with the service provided. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admissions to the home are managed well by ensuring that residents needs can be met and that the individual is able to make an informed decisions about whether or not they would like to live at the home. EVIDENCE: The service has a Statement of Purpose that complies with the criteria set out in Schedule One of the National Minimum Standards. There is also a Service Users Guide, which provides all of the required information to new and existing Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 10 residents. This document has been produced in a user-friendly format using large print and pictorial information. The standard of information and signage is very good throughout the home being produced in a user-friendly format. It is displayed in prominent positions to optimise accessibility and the inclusion of residents. There have been no recent admissions to the home and following changes to the ownership the service has been recently reregistered. However the Acting Manager confirmed that prospective residents are supplied with information about the home, such as the Service Users Guide. The Commission for Social Care Inspection Reports are to be made available to existing and prospective residents. There is an admissions policy, which specifies how admissions to the home are to be managed. The Acting manager confirmed that potential residents are fully assessed before being offered a place in the home, to ensure that the service is able to meet their needs. The Acting Manager is also keen to ensure that new residents are able to settle in and get on well with the existing residents. Urgent admissions are avoided to make sure that any new resident has the time and opportunity to visit the home on a number of occasions, meet the existing residents and staff and experience what it is like to live in the home before deciding whether they would like to live there. Following registration of the service all of the existing residents have had new contracts, which contain up to date information. Contracts are signed by the residents and are placed on file. Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14 and 33 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have control over their lives, which enable them to enjoy a lifestyle that promotes choice and independence. EVIDENCE: Each resident has an individual plan of care, which contains information about previous preadmission assessments; these are used to inform the care Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 12 planning process. Following changes to the ownership of the home the individual plans of care have been reviewed. These contain detailed and individualised instruction to staff about how the resident is to be supported with their personal and health care needs. Individual plans of care also contain evidence that specialist requirements are catered for and there is good detail about the management of challenging behaviour. There is evidence that residents are involved in the development of their individual plans of care and are consulted about the content. The service has developed a new format for individual plans of care to further develop the resident’s involvement and to support person centred care. There is good evidence that residents are consulted about their previous lifestyles, personal views and preferences, these are being recorded by the residents and staff in a workbook. The new documentation is produced in a clear user-friendly format. Each resident has an allocated key worker; residents were able to confirm that they felt well supported by their key workers and other staff. There is evidence that care plans are regularly reviewed. The daily records indicate that the care is given as specified and also demonstrate that residents are able to make short, medium and long-term decisions about all aspects of their lives. Potential restrictions are supported by risk assessments and are in the resident’s best interests. Individual plans of care demonstrated that residents have access to advocacy services and residents were able to confirm this. Residents are also able to participate in the running of the home through regular residents meetings where decisions are made such as the content of the menu and organised group activities. Residents are supported to take risks within their daily lives such as accessing the local community and use of the kitchen facilities for the preparation of food and drink. Basic risk assessments are in place to reduce and manage the associated the risks. However these could be further developed for activities such as swimming, falls and individual medical conditions and to ensure that these are in line with current best practice. Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. 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. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 14 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social activities and meals are both managed well, are creative and provide daily variation and interest for people living in the home. EVIDENCE: There is some evidence that residents have access further education opportunities through attendance at Adult Education Centres providing courses such as Musical Movement. There is also evidence that the service is currently reviewing further educational and employment opportunities with individual residents. Residents are also able to attend local day centres of their own choice including the day centre that is also run by the service in close proximity to the home. There is also evidence that residents are able to participate in the local community by the attendance at local groups, coffee mornings. Entertainment is available through the use of clubs, pubs, shopping and leisure facilities. The service is currently pursuing an opportunity to have a local allotment to enable residents to gain gardening experience and to grow some of their own food. There is evidence that the service supports the Equality and Diversity of residents through their commitment to person centred care and the development of individual routines and lifestyles. All residents are English speaking, white British. Individual plans of care contain information about the previous lifestyles of residents and the management are developing ways of supporting residents to reflect these in their current daily lives. Residents with limited physical ability have access to appropriate equipment such as wheelchairs and the home is accessible for those residents. Residents are supported to maintain their faith and have access to local churches and religious communities. The management are mindful of the need to ensure that the staff group reflects the age and gender of the existing residents. Relationships between existing residents appear to be good; there is evidence that residents are supported to maintain good relationships with each other and there are appropriate in house activities on a regular basis such as birthday parties and barbecues. The service pans to do hold some themed Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 15 activities to add variety to the resident’s lives support the culture and previous lifestyles of residents. Residents confirmed that they are supported to maintain links with family and friends and to receive their chosen visitors in the home. Individual plans of care contained evidence that residents are supported to celebrate important dates in their lives such as family events. Residents were able to confirm that they were able to make and sustain friendships with people outside the home. Routines within the home are flexible, residents are able to rise and retire to bed at their preferred times, within the constraints of their planned activities. There is some evidence that residents are offered a key to their room if they wish. Currently residents have chosen not to have this facility and there are no privacy locks fitted to the rooms. Residents are not currently offered a front door key, Management confirmed that there were valid reasons why this was not done however there is no evidence that this is judgement has been supported by formal individual risk assessments. Residents were seen to be going about their daily routines, choosing how and where to spend their time. Staff were seen to be respectful of residents privacy, relate well to residents and to refer to them by their preferred form of address. Residents confirmed that they enjoyed good relationships with the staff working in the home. Residents confirmed satisfaction with the food provided by the home. They confirmed that they were involved in the menu planning and that there were always alternatives available on the day should they not wish to have what is on the menu. The service has a photographic directory of the meals available within the home and continues to build on this resource. This enables residents to identify the meals that they would wish to have on the menu or their alternatives. Residents have a breakfast comprising cereal, toast, fruit juice and fruit on six days of the week. A full English breakfast is available on a Saturday. During the week the lunch is usually prepared in the home and served at the local day centre. This comprises a selection of sandwiches, during the warmer weather and hot dishes such as filled baked potatoes during colder periods. A traditional roast dinner is available on a Sunday. The evening menu offers a variety of home cooked food with occasional take away meal. The menu appears to offer a varied and balanced diet. Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) Service users retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicines. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have an individual plans of care of which demonstrates that they are treated as individuals and that their healthcare needs are fully met. EVIDENCE: Individual plans of care contain evidence that residents are supported to maintain their health and personal care. Daily records demonstrate that Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 17 residents are able to exercise choice on a daily basis in the way that they are cared for and that routines are flexible. The care plans provide detailed instruction to staff about the residents personal care needs such as oral care, shaving and other personal needs. The management stated that they are currently developing individualised pictorial prompts for residents to promote their independence. Residents appeared well presented and are supported to maintain their individuality through their choice of clothing and personal appearance. Residents were able to confirm that they felt well cared for. There is also evidence that the residents are supported to maintain their healthcare through access to appropriate equipment and specialist services. All residents have access to general practitioners, dentists, podiatrists, physiotherapists and opticians. Appropriate referrals are made to specialists such as hospital consultants, psychiatrists, Community Learning Disability Teams and behaviour management experts. Individual plans of care also evidence that residents have access to routine health care such as annual health checks and screening procedures. Medication is generally managed well. The home uses a monitored dose system supplied by a local pharmacy. Medication Administration Records were found to be in good order; there was one signature omitted for one occasion and a minor discrepancy with the remaining stock. However the Acting Manager investigated the circumstances during the inspection and was able to identify that the medication had been given as prescribed. The Medication Administration Records were updated and the slight excess of medication that had been carried over from stocks accrued by the previous owner were withdrawn from use for return to the pharmacy. Individual plans of care contain some evidence that the residents are considered for self-medication and residents have signed consent forms to enable the staff to take on this responsibility on their behalf. However the service has a commitment to developing resident’s independence through person centred care and are currently developing systems to assess residents and to provide the appropriate support if they are assessed as able and wish to manage their own medication. Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A comprehensive procedure for handling complaints and abuse is in place ensuring that residents are fully protected EVIDENCE: The service has a robust complaints procedure, which is included within the Statement of Purpose. Information about how to make a compliant is available in an easy read format throughout the home. Residents were able to confirm at they knew how to complain and that they were confident that their concerns would be addressed by the organisation. The service has received two complaints since registration, there is evidence that these have been fully investigated and that the appropriate responses have been made. A record of complaints is held on file in the home and there is evidence that changes are made as a result, when appropriate. Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 19 The service has obtained a copy of the new Local Authority Guidelines on the Safeguarding Adults. Staff have a good understanding of the types of abuse and the procedures necessary to ensure that any allegations are reported and managed appropriately. Residents confirmed that the staff treated them well and that they felt safe living at Rushwell House. There have been no allegations made about this service. Staff receive training in the Safeguarding Adults and management of challenging behaviour. Procedures are in place to ensure the safe storage of resident’s money. Each resident has a regular allowance; this is a small amount of cash to cover personal spending. This is stored in a securely in the home and is in individual locked containers. Each resident has a record of money paid in and money spent with a balance brought forward. Appropriate receipts are retained to evidence the expenditure. A spot check was conducted and there was a small deficit identified in the remaining cash for one resident. The Acting manager conducted enquiries during the inspection and it was established that the money had been taken out by staff over the weekend, at the request of the residents for a specific purchase. The records were updated during the inspection and the appropriate receipts retained. The provider has set up an umbrella account with a high street bank to enable larger amounts of money to be stored appropriately for residents. This account enables residents to have individual sub accounts, which accrue interest independently. The provider was able to supply copies of statements, which demonstrate that the accounts are individual and that the interest is calculated individually. It is intended that each residents will receive their own individual statement on a monthly basis. Residents are able to request the withdrawal of money from these accounts in addition to their regular allowance for specific use. This is a new initiative that ensures that residents are protected from potential financial abuse and identity fraud. There is evidence that this is an optional service offered by the provider and that the residents have consented to this arrangement. However residents are unable to make spontaneous direct withdrawals form the account, which has the potential to compromise the resident’s independence and empowerment. This was discussed with both the acting and Service manager who have agreed to review the arrangements to ensure that the service balances the protection of residents against fraud and financial abuse whilst maintaining their independence. Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment is good providing residents with a comfortable and safe place to live. Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 21 EVIDENCE: The premises are suitable for their stated purpose being two converted, semi detached, and three bed roomed terraced houses within a residential location. The home is close to the town centre, local amenities and there are good road links. The communal areas are spacious providing two sitting areas, a kitchen diner and a games room. The communal areas are well decorated and provide residents with a safe comfortable and pleasant place in which to live. Each resident has their own bedroom; rooms are fitted with washbasins and appropriate fixtures and fittings. There are no privacy locks to the bedroom doors at present; however there is some evidence that residents are consulted about their wishes to have these fitted. Residents confirmed satisfaction with the environment and were also able to confirm that they were involved in the decisions about the décor and choice of furnishings and fittings. There is evidence that residents are able to bring in their own personal possessions and also personalise their bedrooms. The home appears to be well lit, ventilated and heated, widow restrictors are in place. No hazards were identified, however the radiators in the home are not covered and have the potential to cause injury to less mobile residents. The premises appear to be well maintained, clean and hygienic. Appropriate laundry facilities are available and there are adequate supplies of hot water. Improvements to the garden areas are on going, with the removal of a garden shed, clearing of overgrown vegetation and replacement fencing. Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service employs appropriate numbers of inducted and trained staff to ensure that the residents needs are appropriately met. EVIDENCE: Staffing levels in the home appear to be good. There are currently four residents living at the home. There are always two staff on duty throughout Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 23 the daytime shifts in addition to the Acting Manager. There is one waking member of staff on duty throughout the night who has access to on call support. Staffing levels are monitored with additional staff being made available for specific activities and as the need arises. Both residents and staff spoken to confirmed that there are adequate numbers of staff working in the home. Staff files evidence that appropriate recruitment procedures are in place, including the receipt of two references and appropriate Criminal Records Bureau Clearances prior to the commencement of employment. There is evidence that new staff have access to induction training and all staff have the opportunity to undertake appropriate National Vocational Qualifications in Care. Following changes to the ownership of the service a training audit has been conducted and a programme developed to ensure that all staff have the appropriate mandatory training and that this is renewed in a timely fashion. There was evidence that staff have received training in First Aid, Fire Safety, Safe Administration of Medication, Basic Food Hygiene, Health and Safety, Safeguarding Adults and Movement and Handling Training. Further training is scheduled to update staff in these subjects and to include training in Infection Control and training specific to the needs of individual residents such as the management of challenging behaviour. There is evidence that staff also receive appropriate formal staff supervision to ensure that they are carrying out their roles and responsibilities appropriately. Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 25 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate guidance, leadership and direction means that the home is managed in the best interests of residents. EVIDENCE: The acting manager has appropriate experience of caring for residents in a residential care setting. She has obtained appropriate qualifications including the National Vocational Qualification in Care level 4 and the Registered Managers Award. She has previously been registered with the Commission as the Registered Manager for another service within the area. She is now four months into her probationary period with the new employer and intends to seek registration with the Commission on completion of the probationary period on two months time. Both staff and residents spoke well of the acting manager and were able to confirm that she provides good leadership within the home. Following changes to the ownership base line audits have been conducted to identify areas for development in the home. Quality assurance processes have been established and regular audits are conducted on systems such as medication, care plans and residents money. The Service Manager conducts monthly visits to monitor all aspects of the service provision. The management were able to confirm that a recent survey had been conducted to monitor residents and their representatives satisfaction about the service provided, the results are currently being analysed and are to be used to inform service development. Safe working practices are ensured by access to appropriate staff training, staff supervision and maintenance of safe environment. Information about Health and Safety is displayed in appropriate areas. An audit of the service policies and procedure are currently being conducted. A Fire Officer has recently inspected the home and the associated recommendations are being implemented. Regular checks are made to the fire safety systems. Rushwell House DS0000069820.V347521.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 Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 4 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT Standard No Score 37 3 38 X 39 3 40 X 41 X 42 3 43 X 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Rushwell House Score 3 3 3 X DS0000069820.V347521.R01.S.doc Version 5.2 Page 27 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 YA9 Good Practice Recommendations Appropriate risk assessments should be developed to ensure that any potential risks to resident’s wellbeing are reduced and managed and are in line with current best practice. Any restrictions on resident’s freedom, such as the ability to hold a key to the front door should be supported by an appropriate risk assessment. The management of residents’ money should be reviewed to ensure that the service is able to balance the protection of residents against fraud and financial abuse whilst maintaining their independence. Individual Risk assessments should be conducted to reduce and manage the risks associated with the exposed high surface temperatures. 2 3 YA16 YA23 4 YA24 Rushwell House DS0000069820.V347521.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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. 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