Inspection on 05/03/09 for Rutland Residential Home

This inspection was carried out on 5th March 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Rutland Residential Home Sheffield Road Chesterfield Derbyshire S41 7LL     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Nancy Bradley     Date: 0 5 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Rutland Residential Home Sheffield Road Chesterfield Derbyshire S41 7LL 01246275003 01246236512 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Leyton Healthcare (No 3) Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 40 Number of places (if applicable): Under 65 Over 65 0 dementia Additional conditions: 40 The maximum number of users who canbe accommodated is: 40 The registered person may provide the following category of service only: Care Home only - Code PC To service users of the following gender: - Either Whose primary care needs on admission to the home are within the following categories: Dementia - Code DE, maximum number of places, 40 Date of last inspection Brief description of the care home The home is purpose built and registered to provide care and accommodation for up to 40 elderly people, this includes residential care for up to twenty elderly people who have dementia as their primary care need. The home is located close to Chesterfield town centre and a range of local amenities. The building is set back from the main road and has an accessible patio sitting area at the rear of the building. Accommodation is spread over two floors. All bedrooms are single occupancy and twenty eight of these have en suite toilet facilities. There are assisted bathroom and toilet facilities on both floors. A shaft lift is in use for residents and a call system is Care Homes for Older People Page 4 of 27 Brief description of the care home fitted throughout the building. There are also good-sized lounge areas available to residents and a separate dining room on the ground floor. The home provides some day care places and a respite care service.The fees do not cover hairdressing, chiropody, and toiletries. Information about the service including inspection reports is provided in the Service User Guide and the Statement of Purpose and in the reception area of the home. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This was an unannounced key inspection and took place over a total of five and half hours. We spoke with the acting, care staff and people living at the home. The inspection activity during this site visit was to assess the service against the key National Minimum Standards and these are identified through the report. We looked at all the information that we received or asked for, since the last key inspection. This included the following: The annual quality assurance assessment Care Homes for Older People Page 6 of 27 (AQAA) that was sent to us by the home. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the home. Three people living at the home were case tracked. Case tracking is a method used to track the care of individuals from the assessments undertaken before they are admitted to a service through to the care and support they receive on a daily basis. This includes looking at care plans and other documents relating to that persons care, talking to staff regarding the care they provide and if possible talking to the person. Additionally, time was spent in preparation for the visit, looking at the service history and the registration report. Records were examined relating to the people living there and the general running of the home. We sent out Have Your Say questionnaires and we received four completed questionnaires from family and relatives. They confirmed they were very happy with the home, their relatives liked living there, they had no complaints and are always included in the decision made about their relatives care. At the time of this site visit the home had thirty-seven people in residence. We received five completed questionnaires from care staff. All were happy working at the home, and made very positive comments about the new owners. One staff member stated they help people in vulnerable situations and give them both practical and emotional support. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements are in place to ensure peoples needs are fully assessed prior to moving into the home, this ensures that all peoples holistic needs are appropriately met. Evidence: The three files examined contained assessments that provided sufficient information to enable the staff team to find out what people needed in order to provide the required level of support and care. These showed that the home undertakes a suitable pre admission assessment of the needs of people and includes information on a range of physical and emotional health needs. There was also evidence of care plans and assessment documentation obtained from Social Services Departments and health services, which help to inform subsequent planning. The home has documentation that provides initial information on personal preferences, daily living routines and social interests, which are obtained from people or their families. Areas of potential risk are also identified so that relevant risk assessments can be developed. Care Homes for Older People Page 10 of 27 Evidence: Discussions with families indicated they had been encouraged to visit the home and were provided ad received up to date information prior to moving in to the home. One relative spoken with stated they like the home when they came to look around as people looked busy, where moving around not just sitting. The three files examined contained assessments that provided sufficient information to enable the staff team to find out what people needed in order to provide the required level of support and care. These showed that the home undertakes a suitable pre admission assessment of the needs of people and includes information on a range of physical and emotional health needs. There was also evidence of care plans and assessment documentation obtained from Social Services Departments and health services, which help to inform subsequent planning. The home has documentation that provides initial information on personal preferences, daily living routines and social interests, which are obtained from people or their families. Areas of potential risk are also identified so that relevant risk assessments can be developed. Discussions with families indicated they had been encouraged to visit the home and were provided ad received up to date information prior to moving in to the home. One relative spoken with stated they like the home when they came to look around as people looked busy, where moving around not just sitting. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are involved in decisions that affect their lives and have an active role in the planning of their care, which ensures their personal, physical, emotional and social welfare is enhanced. Evidence: The care records of three people living at the home were viewed in depth. The care plans within the files viewed provided sufficient detail to ensure that the staff could meet the needs of the people they were looking after. Information within these plans included details of what the each person was able to do independently, encouraging people to be as independent as possible. There was information concerning people individual routines, their likes and dislikes in relation to social activities and to dietary requirements There was also details of the contact maintained with family members, and people important to them. There was written evidence on the care plans to support that people living at the home or their relatives Care Homes for Older People Page 12 of 27 Evidence: had been involved in their development, and this was also confirmed in discussions with them. People from the home and their relatives confirmed that they have access to health care professionals when needed, and attended routine or specialist healthcare screening appointments. People confirmed that they are consulted about the monthly review of their care plans and are involved in any changes made to their care plan. The records contained the required assessments to identity any risk and support requirements in relation to moving and handling, tissue viability, nutrition and falls. All of these were completed in adequate detail to guide and direct the staff team, and all were reviewed regularly by the home. If equipment was required to support a person living there this was clearly recorded within the assessment to enable the staff team to be aware of what equipment to use. Additionally monitoring tools were in place when any other need was identified or if a persons well being required monitoring, for example if someone needed their fluid intake monitoring. People spoken with during the visit stated they enjoyed living at the home and that the staff team were caring and always treated them with dignity and respect. Staff were observed knocking before entering peoples bedrooms and checking out people needs at mealtimes. People indicated that they were able to make choices about how they spend their day. Also their preferred routines and dress styles are respected. The medication administration practices of the home were viewed. The home has a contract with Boots The Chemists, who do regular audits and checks on the medication practices at the home. All staff members who administer the medication had undertaken a course and the acting manager observed their practices as part of her day-to-day management of the home Several care assistants had also undertaken the training as a back up, just in case the senior staff members were not available. At present there is no one living at the home who can be responsible for or administer their own medication. The Medication Administration Records (MAR sheets) viewed were satisfactory. There were photos of all people on the medication, in order to identify them and prevent any errors being made. Systems were in place for the ordering, receipt and return of any medication. The home has a dedicated medication fridge and a daily record of the temperature to ensure the required temperature for storing of medication is maintained. Several of the people living at the home have an end of life plan. Care Homes for Older People Page 13 of 27 Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The planned activities and contact with families and friends enables people living at the home to have choice and control in their lives, and maintains their wellbeing. Evidence: Information detailing the daily activities the date and which staff are on duty is displayed on a board in the reception area. A pictorial format was used to inform the people of the daily living at the home. This information enables the people to orientate themselves and to be informed about important aspects of the day, this board was amended daily. Rutland employs two-activity coordinators who work between twenty-four to thirty hours per week. An activity programme has been developed to suit the needs of the people living at the home. The coordinators stated they often work with people on a 1:1 basis and has, in conjunction with families, compiled personal histories on people who live at the home. One of the activities coordinators has recently completed a chair based activities course and is looking to complete training in dementia. The home arranges entertainment on a regular basis. The home has clear policies Care Homes for Older People Page 15 of 27 Evidence: regarding equality and diversity, though there were no people with specific cultural needs currently living at the home. There is respect for peoples religious interests as recorded in peoples individual care plans. Visiting hours at Rutland were flexible and people living at the home are able to receive their visitors within the communal areas of the home or within their privacy of their own room which ever they preferred. Relatives spoken with confirmed that they are made welcome by the home. Any restriction on contact is clearly recorded in peoples care records. We were invited to join the people from the home for lunch. People spoken with during lunch indicated they were happy with the meals and that the meals provided met their preferences and that choices were available at all times. People also enjoy a glass of sherry with their meals. Catering staff had a good knowledge of the dietary needs of the people at the home. Catering staff indicated that any person with specific cultural requirements is catered for. The menus in place were devised in consultation with the people from the home and the cook ensures that a balanced and nutritional diet is provided. A brief tour of the kitchen was undertaken, this is in the process of being refurnished. A temporary menu is in place to cover the three days during the refurbishment. At present the home is not maintaining a daily record of all meals taken by the people living at the home. The cook and assistant cook have undertaken all the necessary training. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements are in place to safeguard peoples welfare and ensure that their concerns are listened to and acted upon. Evidence: The complaints procedure was displayed in the main entrance area. Relatives confirmed that they received information on the homes policy at the point of admission. Relatives spoken with stated they would feel comfortable in raising any issues with the management at the home, either at relative meetings or individually. The homes complaints records were viewed and indicated any concerns raised had been addressed. There have been no complaints made to us since registration. The home had appropriate policies in place concerning the safeguarding and protection of vulnerable adults. Staff spoken to confirmed that they have received awareness training in this area and evidence was also seen on individual training records and provided by way of the AQAA. The safeguarding policy is a corporate policy for Leyton Care and did not show the contact details for the local social services office. Completed questionnaires and discussions with staff confirmed they would report any concerns they had to the registered manager. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The implementation of the refurbishment programme will enhance the independence of the people who live there. Evidence: We carried out a full tour of the home accompanied by the acting manager. All communal areas were viewed together with staff facilities. Peoples bedrooms were viewed with their agreement and all rooms were being decorated and furnished to their personal choice. However several areas were starting to look worn. The new owners Leyton Health Care have carried out a full maintenance and general health and safety check of the home. Areas requiring work were identified and recorded in the providers monthly regulation 26 visit. As a result they are now carrying out an extensive improvement and refurbishment programme. The acting manager stated it would take a few months for this to be completed. The home was clean and free of any unpleasant odours on the day of the site visit. The home has its own laundry, which is satisfactorily equipped and maintained. The new owners have provided new laundry equipment. The laundry area was seen and provided sufficient equipment to ensure peoples Care Homes for Older People Page 18 of 27 Evidence: clothing could be laundered suitably and to meet with infection controls and standards. Peoples clothing appeared well laundered and they were happy with the laundry services provided. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected from any potential risks, by the homes robust recruitment procedures. Staff receive the appropriate training to ensure the safety and welfare is maintained, of the people living at the home. Evidence: Families and people who live at the home were positive about the standard of care delivered by the staff team and felt that their needs were more than met. The staff also spoke positively about the standard of care, the new management and that there was a positive atmosphere in the home. Information in the AQAA and from discussions with the acting manager indicated that there were sufficient staff to meet the needs of the people who live there. The home has six care staff, plus the acting manager, activities coordinators and ancillary staff in the day and three on over night. The staff team confirmed that they had a good knowledge of individuals needs, and staff expressed their commitment and enthusiasm toward ensuring people had a good quality of care. Information in AQAA and from training records indicated that the home has ninety-five pert of its staff trained to either a NVQ level 2, or equivalent and above. Robust recruitment procedures are in place, which ensures that staff appointed are Care Homes for Older People Page 20 of 27 Evidence: suitable to work with vulnerable people. Several staff personnel records were examined which confirmed that thorough employment checks were carried out. All new staff are required to provide two references, a full employment history, have a clear Criminal Records Bureau clearance and complete a probationary period. As part of providing a full employment history new applicants were providing a chronology of their employment history, which included the days date month and year. The acting manager is looking to provide a written record of all staff interviews undertaken. From discussions with the Manager and from examination of records it appears the home is providing good training and development opportunities. Details are recorded in the AQAA and in individual staff training records. All staff have a personal development plan. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is effectively managed and run in the best interests of the people who live there. Peoples health and safety is safeguarded and monitored. Evidence: At present the home has an acting manager the registered manager has recently left the company. We have not been officially informed of the registered manager status. The acting manager is in the process of submitting her application to us for registered manager, and is completing a recognised registered mangers award. Information in the AQAA also indicates that the deputy will also be undertaking a recognised manager award. People who live at the home, their relatives and staff spoke highly about the acting manager and the new owners. The acting manager has a number of years experience in the care sector and working at Rutland Residential Home. The acting manager has overall responsibility for the planning and development of the home, and is supported by the deputy manager. Care Homes for Older People Page 22 of 27 Evidence: The home undertakes regular quality assurance exercises and questionnaires are sent to people living at the home, their relatives, and the staff team in order to obtain feedback. The home does not currently seek views from stakeholders or organisation within the community. The home then undertakes an analysis of these findings and produces a written report of the outcomes. However the report findings are not made public. The acting manager stated this is an area they are looking to develop. The Registered manager and the deputy both audit all of the systems in place at the home to ensure that all paperwork is up to date and in accordance with the National Minimum Standards and current procedures. The acting manager confirmed that a representative of the registered person visits the home regularly and completes a report. We viewed several copies of the registered providers regulation 26 visits confirming their visits. The home is responsible for handling peoples finances and a detailed secure system is in place. This was viewed and found to be satisfactory. Some of the amounts being held by the home were substantial and the acting manager agreed to address this . Discussions with staff and completed questionnaires confirmed that staff receives regular supervision. The AQAA indicated that that safe working practices were in place at the home. Records showed that portable electrical appliance tests, waste disposal contract, bacteriology and legionnaires tests, service certificates for moving and handling equipment and electrical wiring certificates were in place. The AQQA was completed to a satisfactory level. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 15 15 The home must maintain a comprehensive record of all meals provided. This is to ensure that people have a balance diet and the home has a full record of all meals provided. 30/04/2009 2 19 23 The Registered Provider must continue with the refurbishment programme and ensure this is fully completed. This is to ensure that people in the home can assess all parts of the home and live in a clean comfortable environment. 31/07/2009 3 33 24 The home views of stakeholders and the wider community must be sought as part of assessing the homes quality of care. This is to ensure the home is achieving its goals. 29/05/2009 Care Homes for Older People Page 25 of 27 4 35 16 The home must ensure that monies kept on behalf of people living at the home is within their financial regulations. This is to ensure the financial interest of the people living at the home. 30/04/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 18 The homes Safeguarding policy should show the contact details for the local Social Services office or Call Derbyshire. The home should record maintain a record of all staff interviews. The acting manager should complete and submit her application for registered manager status. 2 3 27 31 Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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