Inspection on 05/09/06 for Rutland Residential Care Home

This inspection was carried out on 5th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Rutland Residential Care Home 09/12/08

Rutland Residential Care Home 13/12/07

Rutland Residential Care Home 24/01/06

Rutland Residential Care Home 06/09/05

Rutland Residential Care Home 11/03/05

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Rutland Residential Care Home Rutland Residential Care Home 51 Marlings Park Avenue Chislehurst Kent BR7 6RD Lead Inspector Sue Meaker Key Unannounced Inspection 5th September 2006 10:30 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 Residential Care Home DS0000061324.V297623.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 Residential Care Home DS0000061324.V297623.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rutland Residential Care Home Address Rutland Residential Care Home 51 Marlings Park Avenue Chislehurst Kent BR7 6RD 01689 821 560 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) mavand@ntlworld.com Mrs Mavis Fleming Mr Andrew Albert Fleming Mrs Mavis Fleming Care Home 4 Category(ies) of Old age, not falling within any other category registration, with number (4) of places Rutland Residential Care Home DS0000061324.V297623.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th January 2006 Brief Description of the Service: Rutland Residential Care Home is a large, well- maintained, detached house that is sited on a corner plot in a quiet residential area in Chislehurst, close to shops, leisure facilities and has good access to public transport. The interior of the home provides accommodation for four elderly residents in well decorated and furnished en-suite bedrooms; there is also a well-equipped separate bath and toilet facilities on the ground floor. The home has a stair lift to the first floor giving easy access for the residents. The home has a spacious sitting room, a dining room and a well-equipped domestic style, kitchen. The home has a secluded garden to the rear, with a variety of shrubs and plants and a lawn area; there is also a patio with garden furniture easily accessible to the residents and their visitors. There is ample car parking space to the front of the property with an in and out driveway. Rutland Residential Care Home DS0000061324.V297623.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a statutory unannounced inspection that took place over five hours; comprising of a discussion with the owners of the home Mr and Mrs Fleming, and the member of staff on duty with them. Currently there are four elderly ladies residing in the home. Questionnaires were given to the four ladies to complete and questionnaires were sent to their next of kin and to all the healthcare professionals who visit the home. The personal files of all the residents were inspected, as was the daily diary, medication recording was checked and the certificates relating to health and safety matters were inspected. Four care plans were seen and the medication administration records were inspected. Unfortunately there were no relatives or friends in the home at the time of the inspection; however the community nurse was visiting two of the ladies, she was very complimentary about the home and the quality of care they provide. Questionnaires received indicated that the home provides good quality of care to their residents; and that the ladies are happy with the care they receive stating that Mr and Mrs Fleming and their staff are very caring and sensitive to their needs. This was a very satisfactory inspection and Mr and Mrs Fleming were both present during the inspection. What the service does well: It was evident from speaking to the residents that they were very comfortable in the home, they said that they were well cared for, that the facilities the home offered were very good especially their rooms that were decorated and furnished and maintained to a high standard; they also praised the quality and portions of food they enjoyed and said they were always involved in the planning of the weekly menu. The home provides a comfortable, homely safe and protected environment for its residents. Mr and Mrs Fleming clearly understand the personal, health and social needs of their residents and are very experienced in the care of the elderly; they also employ a registered nurse and an experienced carer trained to NVQ standards. This home is to be congratulated on the high standard of care it provides for its residents who clearly expressed their appreciation of the care they receive and the environment of the home. ` ` ` ` ` ` ` ` ` Version 5.2 Page 6 Rutland Residential Care Home DS0000061324.V297623.R01.S.doc 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 Rutland Residential Care Home DS0000061324.V297623.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. Rutland Residential Care Home DS0000061324.V297623.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 Rutland Residential Care Home DS0000061324.V297623.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have their personal, health and social care needs assessed prior to moving into the home, so that they can be assured that the home can meet their identified needs. EVIDENCE: Currently the home has four female residents; all of whom have been referred to the home by Bromley Social Services. The assessments for each of the residents, were seen, this documentation identified their specific needs and gave details of how these needs were to be met. The assessment documentation received from Social Services about the residents is kept in an individual personal file; this file includes information relating to the health and well being of the resident, a comprehensive assessment of their personal, health and social care needs, financial circumstances and a contract with the home detailing the service provided, the terms and conditions and the cost. Rutland Residential Care Home DS0000061324.V297623.R01.S.doc Version 5.2 Page 10 The owners of the home also assessed the residents before they came into the home therefore making sure they were able to care for them. Residents confirmed that they were well cared for and that the owners and staff at the home were kind and looked after them well ensuring that their personal social and healthcare needs were met. Rutland Residential Care Home DS0000061324.V297623.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available including a visit to this service. All four residents have care plans identifying their personal, health and social care needs and what action needs to be taken to met them. EVIDENCE: All the care plans were seen, information given made sure that the staff in the home could meet the identified needs of the residents. The staff keeps a daily report for all the residents and they also keep a diary for all the residents appointments including GP, podiatry, optician, dentist and physiotherapist. Every resident has a personal file and all information about the resident was documented, signed and dated. One of the residents had recently been in hospital for an operation and all the relevant correspondence was on file including all the follow up treatment required including visits from the physiotherapist and outpatient appointments. At the time of the inspection the district nurse was visiting two of the residents who required some wound care; she stated that the home was very good and that the residents appeared to be very happy in their environment and two ladies she was visiting had said Rutland Residential Care Home DS0000061324.V297623.R01.S.doc Version 5.2 Page 12 how much they enjoyed living in the home and that the owners and staff were very kind to them and looked after them very well. Questionnaires received from relatives and advocates said that the care in the home was very good, that the residents were well cared for, comfortable and happy in the home. It was evident during the inspection that the owners and staff at the home knew the residents very well and were more than capable of meeting their identified needs. None of the residents in the home self medicate; medication is administered by trained staff, one staff member is a trained nurse and one has NVQ 3 and received safe administration of medication training in her previous employment. Prescribed medication is supplied by the local pharmacy; the medication is clearly labelled with the residents name, dosage and time. All the medication is stored in a locked cupboard and can only be accessed by the owners and their two staff members. Medication given is recorded, and signed by the administering staff member. The home does need a policy and procedure relating to the safe administration of medication and should also have a copy of the guidelines from the Royal Pharmaceutical Society; these two documents should be kept in the medication file. During the inspection it was noted that the owners of the home and the staff member on duty, treated the residents respectfully fully aware of the rights of the residents relating to privacy and dignity. The residents confirmed that they were well treated and that their wishes in regard to personal, health and social needs were listened to and acted upon, any concerns raised were dealt with in a professional and sensitive manner. Rutland Residential Care Home DS0000061324.V297623.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The home is able to offer the residents a variety of appropriate activities; residents are also encouraged to keep in touch with family and friends. The home offers a choice of meals that are healthy and nutritious. EVIDENCE: The residents in the home are encouraged to pursue their hobbies and interests these include reading the daily newspaper and discussing with the other residents and staff interesting items in the news; watching films and listening to music a couple of the ladies really enjoyed listening to the proms on the BBC. During the good weather the residents have been able to spend time in the very pleasant garden and they have really enjoyed having their meals outdoors. The home encourages the residents to invite their relatives and friends to the home, the ladies go out to lunch on a regular basis in the local area. The ladies appear to interact very well with each other, the owners of the home and the staff and there is a very friendly atmosphere in the home. Often the owners of the home spend time, with the residents individually reminiscing about the past and discussing general topics relating to their personal, health and social care needs; it was evident that residents Rutland Residential Care Home DS0000061324.V297623.R01.S.doc Version 5.2 Page 14 appreciated these one to one conversations and they felt they could express any concerns or personal worries knowing these matters would be dealt with confidentially; they also felt that any suggestions they made were listened to and discussed and often put into place. The ladies are able to go the local church if they wish or the local vicar will visit the home; the ladies are also able to have their hair styled and have beauty treatments such as manicures; the ladies also take part in armchair exercises and walks around the garden and there are also opportunities to visit the local library and shops. The home provides a weekly menu that is discussed with the residents taking into account their individual likes and dislikes; the menu also incorporates elements of healthy eating making sure the residents have a balanced, nutritious and varied diet. Mealtimes are a social occasion and the ladies often eat with the owners of the home and staff members in the spacious kitchen diner. Hot drinks and snacks are provided throughout the day at the residents’ request. Rutland Residential Care Home DS0000061324.V297623.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The home has protocols in place to protect the residents ensuring that they feel safe in their home environment. EVIDENCE: The home has a complaints policy and procedure available to residents, family members friends and advocates; residents are aware of how to complain if necessary, and confirmed that any concerns they had were discussed with the staff and owners of the home and subsequently actioned appropriately and resolved. There have been no complaints at the home since the last inspection and no complaints have been made to the CSCI about this service; in fact residents, relatives, advocates and health professionals have been very complimentary about the high quality of care provided by the home. The owners of the home and staff members demonstrated that they have a good understanding relating to the Protection of Vulnerable Adults and the POVA register; staff had received training relating to these issues in previous employment. The home has a copy of the London Borough of Bromley’s Adult Protection Policies and Procedures and are aware of the agencies they would need to contact if an allegation or incident of abuse occurred. Rutland Residential Care Home DS0000061324.V297623.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The outcome in this area is good. This judgement has been made using available evidence including a site visit to this service. The home provides a clean, comfortable, safe and well-maintained, homely environment for the residents making sure they feel safe and protected. EVIDENCE: This is a family home that is maintained to a high standard; the house is well decorated and furnished providing the residents with a home from home atmosphere. The furniture and soft furnishings are domestic in style and succeed in providing a homely setting for the residents. The communal spaces for example the kitchen/diner, the lounge and garden areas are maintained to a high standard. The four residents have spacious, single bedrooms with en suite facilities; furnished and decorated to the residents’ choice incorporating their own small pieces of furniture, ornaments, pictures and photographs. Rutland Residential Care Home DS0000061324.V297623.R01.S.doc Version 5.2 Page 17 The home is clean, tidy and free from odours; thereby making sure that the residents live in a homely, comfortable and pleasant environment. Rutland Residential Care Home DS0000061324.V297623.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. The outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. The owners of this home and the two staff members are experienced and skilled in caring for their residents, they provide a high standard of care enabling the personal, health and social care needs to be met. EVIDENCE: Although the home does not have a written rota, the owners and two part time staff provide the four residents in the home with care 24 hours a day, seven days a week. The owners are very experienced in the care of the elderly and were approved as carers by the local authority in 1987; the home employs two part time staff one of whom is a trained nurse and the other is trained to NVQ 3 level. The home does not have a written policy and procedure relating to the recruitment and selection of staff, one member of staff now has a personnel file but some documentation required by schedule 2 of the National Minimum Standards is still missing and a file should be set up for the trained nurse The owners are working towards compliance with this standard. Currently the home owners do not provide any training for the staff; however the staff have received training in their previous employment and are able to demonstrate they are experienced in the care of the elderly. It is necessary for all staff employed in a care setting to update their mandatory training relating to moving and handling, first aid, food hygiene, Rutland Residential Care Home DS0000061324.V297623.R01.S.doc Version 5.2 Page 19 fire and health and safety; it is understood that there would be difficulties in staff leaving the home to undertake this training; the owners of the home could explore the possibility of trainers coming into the home or if the staff could undertake distance learning via the local colleges or via Bromley Social Services. It is understood that it is the responsibility of the trained nurse to keep their prep up to date and the home should keep a record of this training on file in the home. The home has the required number of staff trained to NVQ standard as specified in the National Minimum Standards. However the home needs to be looking towards having a Registered Manager who has completed the Registered Managers Award, it is understood that the owners of the home are exploring this possibility and are in the process of obtaining information relating to this issue. The home should keep records of any training undertaken and update on a regular basis and there should be an annual training plan in place. Rutland Residential Care Home DS0000061324.V297623.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The owners of the home demonstrate that they are experienced, have the skills and are competent to effectively manage this residential home thus providing a stable, safe and comfortable home for their four residents. EVIDENCE: It was evident during the inspection that the owners and staff were aware of how to meet the needs of their residents and that they are experienced in the care of the elderly, they work as a team to provide a good quality of care. It was confirmed by the member of staff on duty during the inspection that the owners of the home were aware of the need to create an open and positive atmosphere within the home making sure that the residents, their relatives Rutland Residential Care Home DS0000061324.V297623.R01.S.doc Version 5.2 Page 21 and staff felt comfortable with their aims and objectives and philosophy of the home. The home employs two members of staff on a part time basis, there is no structured supervision or annual appraisal, however this is done on an informal basis as the staff work closely with the owners of the home, it is recommended that the home owners record when these discussions take place and that a short annual appraisal be completed for the two members of staff, a diary could be used for this purpose. When looking at the care plans for the four residents it was found that moving and handling risk assessments need to be completed for each resident. All financial transactions undertaken on behalf of the residents are receipted and recorded in the residents’ personal file; residents are encouraged to manage their own monies and sometimes their family or advocate will manage their financial affairs usually under the auspices of the Power of Attorney. Each resident has a personal pocket money account and all monies are held in a locked facility in the home. The home complies with health and safety legislation and has provided certificates to show that they have the correct insurance cover, electrical and gas certificates, fire safety records and insurance with Thames water relating to central heating, plumbing and the drains. Accidents and incidents are recorded correctly and the CSCI is notified under regulation 37. Rutland Residential Care Home DS0000061324.V297623.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Rutland Residential Care Home DS0000061324.V297623.R01.S.doc Version 5.2 Page 23 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 OP3 Good Practice Recommendations It is recommended that the home either receives or undertakes pre admission assessments for all prospective service users. It is recommended that a medication policy and procedure be formulated and kept in the medication administration file. It is recommended that the home set up personnel files for the two part time staff employed; to include information required by Schedule 2 0f the National Minimum Standards. It is recommended that the home obtains a relevant Policy and procedure relating to recruitment and selection. It is recommended that the home accesses mandatory DS0000061324.V297623.R01.S.doc Version 5.2 Page 24 2. OP9 3. OP27 4. 5. OP29 OP30 Rutland Residential Care Home training relating to moving and handling, fire safety, food hygiene, first aid and Protection of Vulnerable Adults; this training be to be documented on the individual personnel file. 6. 7. OP33 OP36 It is recommended that the home implement a quality assurance system. It is recommended that all informal staff and management discussions be documented and an annual appraisal be undertaken and documented. It is recommended that the home reviews their record keeping and obtains policies and procedures applicable to the home. It is recommended that a moving and handling risk assessment be undertaken for each resident; and a fire risk assessment be undertaken by the home. Fire alarm testing, fire training, fire fighting equipment and fire drills to be carried out and documented on a regular basis. 8. OP37 9. OP38 Rutland Residential Care Home DS0000061324.V297623.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH National Enquiry Line: 0845 015 0120 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 Residential Care Home DS0000061324.V297623.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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