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

This inspection was carried out on 6th September 2005.

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

Rutland Residential Care Home 09/12/08

Rutland Residential Care Home 13/12/07

Rutland Residential Care Home 05/09/06

Rutland Residential Care Home 24/01/06

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 Unannounced Inspection 6th September 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rutland Residential Care Home DS0000061324.V252043.R01.S.doc Version 5.0 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.V252043.R01.S.doc Version 5.0 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) 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.V252043.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th March 2005 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.V252043.R01.S.doc Version 5.0 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, conversations with all the four residents and the member of staff on duty. The four care plans were seen and the medication administration records were inspected; the preparation and serving of lunch was observed, and a tour of the house and garden was undertaken. Unfortunately there were no relatives or healthcare professionals to speak to during the inspection, however complimentary letters were seen at the home, these were from relatives of the residents currently in the home. This was a very satisfactory inspection and Mr and Mrs Fleming were both present during the inspection. What the service does well: What has improved since the last inspection? The home has been actively working towards compliance with record keeping particularly around recruitment and selection and training requirements. Rutland Residential Care Home DS0000061324.V252043.R01.S.doc Version 5.0 Page 6 There is still some work to be done in these areas and recommendations have been made regarding these issues. Health and safety issues raised in the last report have been addressed and resolved, these issues will be monitored at the next inspection, these identified issues concern moving and handling assessments for the residents and a fire risk assessment for the house. 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. Rutland Residential Care Home DS0000061324.V252043.R01.S.doc Version 5.0 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 Residential Care Home DS0000061324.V252043.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 and 5. The home provides a Statement of Purpose/Service User Guide giving detailed information relating the home, plus undertaking a comprehensive assessment of need, enabling residents and their relatives to make an informed choice about whether the home can meet their assessed needs. EVIDENCE: The home has a Statement of Purpose/Service User Guide, this document gives a brief history of the home, details about the owners of the home and their staff and a description of the facilities offered to the residents. The document also gives details of the fees payable, a Statement of Terms and Conditions, the quality of care residents can expect from the home, the facilities the home can provide, details concerning visitors to the home, record keeping by the home, details of meal times and the complaints procedure. The home has a Statement of Terms and Conditions that is comprehensive and clearly states the responsibilities of the home to the resident, this document also includes details of the trial period of four weeks. Rutland Residential Care Home DS0000061324.V252043.R01.S.doc Version 5.0 Page 9 Prospective residents are admitted to the home via the social services care management team; an initial assessment is completed by the designated care manager before a referral is made to the home. An assessment is then undertaken by the home and a place offered, if the home is able to meet the needs of the prospective resident. Prospective residents and their relatives are invited to view the home prior to admission. A resident had been admitted to the home since the last inspection, and it has since transpired that the home cannot meet the specific needs of this resident and they have referred the placement back to the relevant social services care management team for reassessment and a more appropriate placement, subsequently this resident has since been admitted to hospital and will be reassessed by the hospital discharge team. Rutland Residential Care Home DS0000061324.V252043.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 The home is able to identify the personal, health and social needs of the residents via the assessment process, ensuring that these needs are met through the care planning system in place. EVIDENCE: The care plans for all the residents were seen and were found to contain relevant information to met their needs. It was evident during the inspection that the owners and staff of the home knew their residents and their needs very well; the residents spoken to said that they were comfortable in the home and that they were well cared for, any concerns they raised were quickly dealt with and resolved. The home maintains a dairy of events for each service user, detailing significant events, hospital, dental, optician and chiropody appointments. All the residents are registered with the local GP ensuring access to all primary care services. The residents medication is stored in a locked cupboard in the kitchen ensuring that it is safe and secure; medication is clearly identified with the residents name, the name of the medication and the prescribed dose. The medication administration records were seen and were completed correctly; all medication Rutland Residential Care Home DS0000061324.V252043.R01.S.doc Version 5.0 Page 11 received by the home is clearly recorded and all medication returned to the pharmacist is now recorded. There are no residents in the home who self medicated. On speaking to the staff member present during the inspection it was evident that she had received comprehensive training relating to the administration of medication and was competent to administer, the other member of staff employed in the home is a qualified nurse and is also competent to administer medication. The medication policy for the home should be available to the staff and it is recommended that the policy be part of the medication file for easy reference. It was evident during the inspection that the owners and staff of the home are aware of the residents rights relating to privacy and dignity, the residents confirmed that they are treated with respect and that their choices are considered in all aspects of their personal, healthcare and social needs. Rutland Residential Care Home DS0000061324.V252043.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Residents are encouraged to participate in appropriate activities, to maintain contact with relatives and friends enabling them to pursue their chosen lifestyle within the home. The home offers a comprehensive, nutritious menu with an emphasis on eating healthily making mealtimes a social occasion for the residents. EVIDENCE: The residents in the home are encouraged to pursue their interests and hobbies within the home and within their capabilities. During the inspection the four residents were sitting in the comfortable lounge area reading and discussing news items from their newspapers, on speaking to the group it was evident that they enjoyed this social interaction, they also said that they enjoyed watching television and watching films from their extensive video collection, they also listened to music on a regular basis. The owners of the home made a point of having individual conversations with the residents reminiscing about the past and discussing general topics relating to their personal, health and social needs, it was evident from speaking to the residents that they appreciated these one to one conversations and that they felt that they that considerable input into the day to day running of the home. Rutland Residential Care Home DS0000061324.V252043.R01.S.doc Version 5.0 Page 13 The residents enjoy having hair and beauty treatments from Mrs Fleming including hairstyling and manicures. The owners of the home welcome visitors at any reasonable time during the day and evenings. Visits to the home by the local church and visits to the local church can be arranged; also trips to the local shops or library can also be arranged. The inspection incorporated observing the preparation of lunch, the residents commented on how much they enjoyed their meals and that they helped to plan the menus for the week taking into account individual likes and dislike; the menu incorporated a healthy eating element making sure that the residents received a balanced, nutritious diet; the owners and staff eat with the residents in the spacious kitchen/diner creating a homely environment where meals are enjoyed and therefore became a social event. Hot drinks and snacks are provided throughout the day at the residents’ request. Rutland Residential Care Home DS0000061324.V252043.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 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, relatives and staff; residents spoken to during the inspection were aware of how to complain if necessary, but stated that any concerns they had were discussed with the owners and staff at the home and subsequently quickly actioned and resolved. There have been no complaints at the home since the last inspection and there have been no complaints made to the CSCI about this service in fact residents and relatives are very complimentary about the high quality of care provided by the home. The staff at the home are aware of the Protection of Vulnerable Adults and the POVA register; staff had received training in previous employment relating to these issues; the home also has a copy of the London Borough of Bromley’s Adult Protection policies and procedures and are aware of who they would need to contact and inform if an allegation relating to Adult Abuse is made. Rutland Residential Care Home DS0000061324.V252043.R01.S.doc Version 5.0 Page 15 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): 19,23,24 and 26. The home provides a safe, comfortable, clean and well- maintained homely environment enabling residents to enjoy their preferred lifestyle. 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 is in a domestic style and well suited to the needs of the residents. The lounge, dining/kitchen area and the garden are maintained to a high standard. All the residents have spacious, single bedrooms decorated and furnished to their choice incorporating their own small pieces of furniture, ornaments, pictures and photographs. The house is clean, tidy and free from odours, giving the residents a homely, comfortable and pleasant environment in which to live. Rutland Residential Care Home DS0000061324.V252043.R01.S.doc Version 5.0 Page 16 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 owners and two members of staff are experienced and skilled in caring for the elderly in a residential setting and are able to provide a high standard of care to the residents meeting their personal, health and social needs. EVIDENCE: Although the home does not have a written rota, the owners and the two part time staff provide the residents 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 registered nurse and one who is an experienced carer trained to NVQ 3 standards. The home does not have a written policy and procedure relating to the recruitment and selection of staff, however the owners are aware of the documentation, specified in the National Minimum Standards, relating to this issue and is working towards compliance. The home needs to have copies of this documentation on file in the home and it is recommended that personnel files are set up for the two part time members of staff. Currently no training is provided by the home, both members of staff have previous training and previous experience in the care of the elderly, however mandatory training and the relevant updates should be available and could possibly be accessed via Bromley Social Services; a record needs to be kept in the home relating to this training ensuring that this training is in date; particularly relating to moving and handling, first aid, food hygiene and fire training. Rutland Residential Care Home DS0000061324.V252043.R01.S.doc Version 5.0 Page 17 Rutland Residential Care Home DS0000061324.V252043.R01.S.doc Version 5.0 Page 18 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): 31,32,36 and 38. It was demonstrated at the inspection that the owners of the home have a caring approach to the management of the home enabling them to provide a stable, homely and domestic environment for their residents. Rutland Residential Care Home DS0000061324.V252043.R01.S.doc Version 5.0 Page 19 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 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. Not all elements of this standard were assessed during this inspection, but it was found that moving and handling risk assessments need to be completed for each resident and that a fire risk assessment needs to be undertaken, this will be monitored at the next inspection. Rutland Residential Care Home DS0000061324.V252043.R01.S.doc Version 5.0 Page 20 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 3 2 3 3 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 3 3 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 3 X X X 2 X 2 Rutland Residential Care Home DS0000061324.V252043.R01.S.doc Version 5.0 Page 21 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 2 3 Refer to Standard 3 9 27 and 28 Good Practice Recommendations It is recommended that comprehensive assessments be undertaken for prospective residents prior to admission to the home. It is recommended that the medication policy and procedure be kept in the Medication Administration Record for ease of reference. It is recommended that the home sets up personnel files for the two part time staff employed; to include information required by schedule 2 of the National Minimum Standards. It is recommended that the home writes its own policy and procedure relating to the recruitment and selection of staff. It is recommended that the home accesses mandatory training relating to moving and handling, fire safety, food hygiene and first aid; this training needs to be documented on the individual staff personnel file. DS0000061324.V252043.R01.S.doc Version 5.0 Page 22 4 5 29 30 Rutland Residential Care Home 6 7 36 38 It is recommended that all informal staff and management discussions be documented and that a sort annual appraisal be undertaken and documented. 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. Rutland Residential Care Home DS0000061324.V252043.R01.S.doc Version 5.0 Page 23 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.V252043.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!