Inspection on 05/08/08 for Rutland Home

This inspection was carried out on 5th August 2008.

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:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Rutland Home 46 West Street Reigate Surrey RH2 9DB Lead Inspector Debbie Sullivan Unannounced Inspection 09:15 5 August 2008 th 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 Rutland Home DS0000071686.V369308.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. Rutland Home DS0000071686.V369308.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rutland Home Address 46 West Street Reigate Surrey RH2 9DB 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) 01737 232188 01737 223341 raypark@btconnect.com Care Homes of Distinction Surrey Ltd Vacant Care Home 18 Category(ies) of Dementia (0), Mental disorder, excluding registration, with number learning disability or dementia (0), Old age, not of places falling within any other category (0) Rutland Home DS0000071686.V369308.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Mental disorder, excluding learning disability or dementia (MD) Old age, not falling within any other category (OP). 2. The maximum number of service users to be accommodated is 18. Date of last inspection Not applicable as this is a new service. Brief Description of the Service: Rutland home is located a short distance from the centre of Reigate on the main A 25. It is a large attractive converted period property with a very good sized, pleasant and secure garden Accommodation for service users is on two floors; there is a stair lift to the first floor. Some bedrooms are en suite and others have wash handbasins, there are toilets and a bathroom on each floor, one bathroom has a Parker bath. A number of bedrooms have been attractively refurbished since the home was registered in March 2008. Communal areas are a lounge/dining room on the ground floor and an upstairs lounge. The garden has an accessible patio area and paths. There is parking for several cars at the front of the house. The home is staffed by a manager, senior carers and carers and there is a chef, cleaner and maintenance man. The current fees for the service range from £450 to £700 per week Rutland Home DS0000071686.V369308.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place over six and a half hours. During the visit time was spent with service users, the registered provider, the homes’ caretaker manager, care staff and the care supervisor and the head chef. A tour of the home took place and a range of documentation including care plans, staff records, daily recording and policies and procedures were read. The homes AQAA (Annual Quality Assurance Assessment) document also provided information for this inspection and relative was spoken with on the telephone so that their views on the service could be gained. During the visit staff and service users were helpful in providing information and in assisting with the inspection. The quality rating for this service is 2 star. This means that people who use the service experience good quality outcomes. What the service does well: Since the home was registered in March 2008 the provider and senior staff have concentrated on making changes to and developing the service. The outcomes in all areas are good and further improvements are planned. Those managing the home are to be commended on the quality of all the written information seen during the inspection and the level of investment that has been put into it’s development. Although there have been no new admissions since March new pre admission and admission documentation has been put into place that is thorough and will identify the needs of potential service users. There is good quality information about the home available and new ways of presenting it are being worked on. The care needs of service users are well documented and risks are assessed. Medication procedures are thorough. Meals are well balanced and nutritious and importance is given to monitoring the nutrition of service users. Staff are well trained and supported and knowledgeable about service users needs. Staff are cheerful, friendly and attentive towards service users. Rutland Home DS0000071686.V369308.R01.S.doc Version 5.2 Page 6 The environment is very pleasant and homely and bedrooms and other areas are decorated and furnished very attractively. 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. Rutland Home DS0000071686.V369308.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rutland Home DS0000071686.V369308.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4 and 5 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Information about the home is available to prospective service users and their representatives. The home undertakes a full assessment of each prospective service user’s needs and service users will only be admitted if their needs can be fully met. EVIDENCE: Rutland Home DS0000071686.V369308.R01.S.doc Version 5.2 Page 9 The six service users currently living at the home have all been there for some time and there had been no new admissions since it changed hands in March 2008. The home has a good quality statement of purpose and service user’s guide and is preparing a colour brochure with photographs that can be made available with other information. The provider said that a website giving information about the home is also being developed. The home is now working on making links with health and social care agencies to inform them of the service it can provide. The caretaker manager visits all prospective service users at home or in hospital and a pre admission/admission document has been devised that allows for a large amount of information on the prospective service user to be gained. The home also liaises with relatives and health and social care professionals. Visits to the home by prospective service users are encouraged and they can stay for a meal or spend time there before making their decision about moving in. The provider gave an example of a potential service user who had spent time at home during a weekend. On admission there will be a month’s trial period. The home is meeting the needs of those already living there and the pre admission process is in place to make sure that admissions only take place when they can be fully met. The home does not provide intermediate care. Rutland Home DS0000071686.V369308.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Care plans are in place that accurately reflect the personal and health care needs of service users and health and personal care needs are well met. The homes’ medication policies and procedures protect service users. Staff treat service users respectfully and maintain their privacy. EVIDENCE: Each service user has a care plan, new care planning documentation has been introduced that has been successfully used in the organisations’ other services Rutland Home DS0000071686.V369308.R01.S.doc Version 5.2 Page 11 and gives comprehensive information that is easily accessible about individual needs. Work is continuing on transferring information and the old records are still available. The care plans of all the service users were read, the information in each included background personal information, risk assessments, personal hygiene needs and preferences, health monitoring charts such as for weight and nutrition, a record of any visits by the GP and keyworker reports reviewing needs. Any changes in health or behaviour were thoroughly noted. Some recording is held on a computer database that all care staff can access. Where concerns about health had been identified they had been swiftly referred to the GP or specialist help sought such as from a continence advisor. A district nurse visited during the inspection. Medication policies and procedures are in place and there is a signed risk assessment and agreement in place with medication records and on the care plan of a service user who self-administers one of their medications. Medication is safely stored, a new cabinet had been purchased and a service level agreement set up with Boots for the supply of medications. Medication records seen were completed properly and all staff who administer it have had medication training. During the visit staff treated service users with dignity at all times and respected their privacy, staff were attentive to needs they noticed when one service user seemed a little agitated and went to speak to them to establish the cause. Staff were aware of the best ways to communicate with a service user who has hearing loss and were using cue cards to help with this. Rutland Home DS0000071686.V369308.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has developed an activities programme and service users are encouraged to take part in activities they enjoy. Contact with relatives is promoted and supported. Meals are freshly cooked, varied and nutritious and nutritional intake is monitored. EVIDENCE: As there has been no change to the group of people living at the home for some time staff were familiar with their likes and dislikes and interests. Staff who had transferred to the home from another of the organisations’ services had had time to get to know them and the activities they preferred. An Rutland Home DS0000071686.V369308.R01.S.doc Version 5.2 Page 13 activities programme has been complied and a part time activities coordinator is employed. It is intended that the range of activities be extended and some community activities arranged. A vehicle that could be shared between the organisation’s three homes may be purchased for outings. The activities programme includes quizzes, painting and drawing, karaoke, gentle exercises and book club. Staff led a karaoke session in the morning, participation from service users varied, one service user who had not been interacting at first after a while became interested and joined in choosing songs and talking about who had originally sung them, they were praised for being more knowledgeable than staff about this. Others watched and appeared to enjoy the singing. Another service user was reading the paper and staff had time to chat with people. A hairdresser who regularly visits the home was present part of the time and some service users had their hair done. All the service users have relatives who keep in contact with them, the home supports this and visitors can call at any time, there is space available for visits other than service user’s bedrooms. A relative spoken with on the telephone said they visited regularly when possible and were very happy with the service. Due to the needs of service user the majority require encouragement to join in an activity and the staff were providing this without being overbearing. Service users can make choices about their daily lives for example they can choose their meal, where to eat, to move around the home and spend time with others or alone. The head chef has worked at the home for a long time and knows people’s likes and dislikes, there is a six-week menu and meals are freshly cooked. The menu is varied and service users are being consulted about meals at residents meetings. The provider has changed the supplier of fruit and vegetables and meat to improve the quality. The main meal on the day of the visit was toad in the hole with potatoes and vegetables and jam sponge pudding and custard meal options were available. Assistance with eating is offered if it is needed. The chef also prepares supper and as it was a service user’s birthday a very pretty cake had been freshly made for the occasion. The wishes of a service user who has chosen to eat meals in their room are respected; they said they had enjoyed the meal. Nutritional intake and the weight of service users is monitored and advice sought from health professionals if there are concerns. Rutland Home DS0000071686.V369308.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users and others have access to the homes’ complaints procedure and can feel confident that any complaints will be taken seriously. The homes safeguarding policies and procedures protect service users from abuse. EVIDENCE: The home has a complaints procedure and process. No complaints had been recorded since the service was registered. A service user spoken with said that they had not had cause to complain but would if necessary and would go to staff. The complaints procedure is included in the service uses guide. Service users are consulted about their views and have opportunities to voice concerns at service users meetings that are held and recorded. All staff have been on POVA training provided by an external trainer and the home has clear safeguarding procedure. Information on the safeguarding process is displayed for staff in the office and there is an up to date copy of the Rutland Home DS0000071686.V369308.R01.S.doc Version 5.2 Page 15 Surrey Safeguarding Adults Multi Agency Procedure. Staff are subject to CRB and POVA checks before they start work at the home. There have been no safeguarding alerts made regarding the service. The home does not manage any money for service users, they all have appointees. Rutland Home DS0000071686.V369308.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 and 26 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home provides a clean, comfortable, safe and homely environment for service users to live in. Recent improvements have enhanced the environment for service users and made it better suited to efficient working. Individual bedrooms meet needs and reflect the personalities of service users. EVIDENCE: Rutland Home DS0000071686.V369308.R01.S.doc Version 5.2 Page 17 Considerable improvements have been made to the environment over the last few months; these include the redecoration and refurbishment of several bedrooms, repairs to the roof, a new security alarm system and the upgrading of the office. A new staff work station area has been arranged. The garden has been tidied up and made safer for service users to enjoy. The home is clean and well maintained. Some occupied and some unoccupied bedrooms were visited, the occupied rooms were all a good size and homely, a number are very spacious, some have views of the large garden and all are well decorated. Service users had brought pieces of furniture and personal items with them and there were family photos, pictures books and other items that reflected individual interests. Some rooms are ensuite and all have wash hand basins. Unoccupied rooms that had been redecorated have all been very attractively and individually refurbished; one was in the process of being redecorated. There is a stair lift to the upper floor. There is an upstairs bathroom with a Parker bath and another bathroom downstairs, both were in good order. One service user said they liked their room, as it was quiet and comfortable. There is an attractive upstairs lounge that was not much in use due to the low numbers of service users at present and the main downstairs lounge/dining room. During the visit most service users were spending time in the lounge, one had chosen to stay in their room and others were accessing other areas freely. The garden is very large, it is secure and has been made safer to use, there is a patio area and flat lawn and paths make other parts of it accessible. Communal areas are safe and there is equipment such as handrails, ramps and raised toilet seats to aid independence and mobility. Rutland Home DS0000071686.V369308.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. A competent and well-trained staff group meets the needs of service users. Staff are well supported and the organisation’s recruitment procedures serve to protect service users. EVIDENCE: The staff group comprises of senior care and care staff, the head chef, cleaner and maintenance man. Three staff were on duty during the morning of the visit including the care supervisor, this was sufficient for the number of service users. Some staff have remained at the home since it changed hands and some more experienced staff including the care supervisor have transferred from another of the organisation’s homes to provide a high standard of care and support to service users whilst the home has been in transition, and to support other carers. The home was fully staffed and the staff group is diverse reflecting a number of nationalities. Rutland Home DS0000071686.V369308.R01.S.doc Version 5.2 Page 19 The provider intends to review the staff ratio dependant upon changes in the number of service users living at the home. Staff were friendly, courteous, and cheerful and were observed to have good relationships with service users, they were attentive and knowledgeable about needs. Service users were at ease with them. A relative who was spoken with on the telephone said “it is very easy to talk to staff” and that they were very happy with their relative living at the home. Staff were competent and efficient and there are over 50 of the care staff who hold an NVQ in care. No agency staff are used so that there is consistency of care. A staff training and development plan is in place and training needs are tracked. Since registration the home has provided staff with POVA training and other core and training appropriate to their roles such as infection control, health and safety and Mental Capacity Act. No completely new staff have joined the home but in preparation for this induction processes are in place that include the Skills for Care Common Induction Standards. Staff have had appraisals and a supervision structure and programme has started, currently the care taker manager does all supervisions. Staff meetings are held bi-monthly for all staff and care staff meet monthly, the meetings are well documented. Staff files seen contained all the necessary information, organisational recruitment procedures are used, one CRB number was still held at head office and faxed through during the visit. The home had taken up the CRB in addition to one having been taken up by a recruitment agency. Rutland Home DS0000071686.V369308.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,37 and 38 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is well run in the best interests of service users and staff. The views of service users are sought and there s an open and inclusive atmosphere. Record keeping and other documents are of a high standard. EVIDENCE: Rutland Home DS0000071686.V369308.R01.S.doc Version 5.2 Page 21 The caretaker manager who is experienced and has temporarily transferred from another of the organisations’ services currently manages the home. The caretaker manager works closely with the provider and care supervisor and there is an organisational management team. Since the home was registered those responsible for the management of the service have put into place structures, working practices, documentation, a training programme, environmental improvements and other measures to enhance and develop the service. There is a corporate business plan and an individual plan for the home. The home has an open and friendly atmosphere and there is a clear commitment to involving service users in decisions and planning. During the takeover of the home consultation took place with service users, relatives and other stakeholders. Quality assurance forms are prepared although they have not yet been widely circulated, one form completed by a relative was positive about the home and a relative spoken with on the telephone said that the home was now “improved out of all recognition” and they would give it “ten out of ten”. The AQAA (Annual Quality Assurance Assessment Document) completed by the provider provided clear and comprehensive information on the home as it was when the document was completed in June 2006 and what developments were then planned, the inspection evidenced that some improvements then planned had been done such as those to the laundry. The provider is regularly at the home and is recruiting for a permanent manager; they were advised this process must not be protracted. Safe working practices were observed during the visit and any potential risks are assessed. A new fire risk assessment has been written and fire equipment is regularly tested. The home does not manage the monies of any service user and this is the policy of the service. The standard of documentation relating to service users, staff and the service overall is of a high standard and all information is very well organised and easy to access. Rutland Home DS0000071686.V369308.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 3 4 3 Rutland Home DS0000071686.V369308.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No, this is the first 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 OP13 Good Practice Recommendations It is recommended that the activities offered include more activities in the community and that service users be consulted about community activities. Rutland Home DS0000071686.V369308.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Rutland Home DS0000071686.V369308.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. 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