Inspection on 14/03/07 for The Rookery

This inspection was carried out on 14th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

The Rookery 17/03/08

The Rookery 16/03/06

The Rookery 17/11/05

The Rookery 20/01/05

The Rookery 25/08/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Rookery Milnthorpe Road Holme Carnforth Lancashire LA6 1PX Lead Inspector Diane Jinks Unannounced Inspection 14th March 2007 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 The Rookery DS0000022623.V325263.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. The Rookery DS0000022623.V325263.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Rookery Address Milnthorpe Road Holme Carnforth Lancashire LA6 1PX 01524 782304 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 Rose Ann Savage Mrs Rose Ann Savage Care Home 3 Category(ies) of Old age, not falling within any other category registration, with number (3) of places The Rookery DS0000022623.V325263.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 3 service users to include: up to 3 service users in the category of OP (Old age, not falling within any other category) 16th March 2006 Date of last inspection Brief Description of the Service: The Rookery provides care and accommodation for three older people. The home is a two-storey house situated in a quiet location on the outskirts of the village of Holme near Carnforth. The detached property is set in pleasant grounds with a small parking area to the front of the home and accessed by a short driveway. The home is within walking distance of the village where there is a post office, public house, churches and other amenities. There is a bus stop at the end of the driveway for the bus service to Kendal, Lancaster and points in between and beyond. The home has a large lounge, kitchen/diner, and visitors’ lounge and downstairs toilet. A stair lift allows for easy access to the first floor where there are three bedrooms for residents on the first floor, one of which has ensuite facilities and there is a separate bathroom. The proprietor also has accommodation on the first floor. The maximum weekly fees for this home are currently £363.00 per week (March 2007). The Rookery DS0000022623.V325263.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The assessment of this service included an unannounced visit to the home, discussions with the manager as well as meeting and talking to the residents. Comments about this home and the service were received from residents, their friends and relatives as well as healthcare professionals. During this visit all the key standards of the National Minimum Standards were assessed. The registered manager had completed a pre-inspection questionnaire prior to this visit. This assisted in verifying information throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: The manager needs to ensure that care needs assessments are safely stored on the care files of residents. These documents provide a baseline for the provision of care and support of residents. The manager also needs to develop a training plan to ensure that staff at the home have up to date skills and knowledge in order to continue to meet the current and changing needs of residents. The Rookery DS0000022623.V325263.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Rookery DS0000022623.V325263.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Rookery DS0000022623.V325263.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 is not applicable. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users needs are assessed by the home, prior to permanent admission, although written records of assessments are not always kept. EVIDENCE: The owner indicates that personal care needs assessments are usually obtained from the social services department although there are no recorded details of these assessments on the individual care files of service users. People wishing to live at this home are able to visit prior to admission. Residents are admitted to the home, initially, on a month’s trial period. This timescale helps the manager to assess the service user on a daily basis and helps to ensure that the home is able to fully meet the needs of service users. The home is a small ‘family style’ home and the manager also takes into consideration the wishes, feelings and needs of the people already living at the home. The Rookery DS0000022623.V325263.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their relatives are treated with respect and dignity. EVIDENCE: People living at this home have an individual plan of care. The care plan is monitored and reviewed regularly to ensure that they continue to meet the needs of residents. The plans include information about the level of ability and independence of each resident and identify what the person can do for themselves and where they may need some help or assistance. There is an element of risk assessment included in the care plan but this does not include information in relation to the administration of medication. Brief information is available on the nutritional needs of residents and regular monitoring of weight is undertaken. Where concerns are identified, the resident’s doctor or the district nurse has been contacted for advice and assistance. Religious beliefs are recorded in the care plan and service users are visited by the priest if they wish. Information is recorded with regards to resident wishes when they reach the end of their life. Comments were received from one person whose relative had recently passed away; ‘My relative died recently at the Rookery. Their last weeks and death could not have been better – even at their own home. The consistency of care The Rookery DS0000022623.V325263.R01.S.doc Version 5.2 Page 10 and the concern and affection of the owner and support team could not have been equalled. My family were also part of this and were included and supported’. Daily records are kept and significant events in the life of the residents are recorded. These records show that residents have access to doctors, district nurses, chiropodists, dentists and audiologists where appropriate. The home has a safe place for the storage of resident’s medication. Medication administration records are kept and the records are signed when the medicine has been given to the resident. Records are kept of any medication that is returned to the pharmacy. Staff at the home have received training in the administration of medication and the manager has obtained a copy of the guidelines from the Royal Pharmaceutical Society to help ensure that medicines are stored and administered safely. The Rookery DS0000022623.V325263.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run in a flexible and homely manner. People living at the home are able to make choices and decisions about their daily lives. EVIDENCE: Personal files and records indicate that residents are encouraged to maintain their independence as much as possible. Contact with their friends, relatives and the community is evident. The residents spoken to during the visit indicated that they liked to go out for rides in the car and out for meals. In the home they were content with activities such as reading, watching the television, chatting and listening to the radio. Books, newspapers and magazines are available. There is a lovely garden at the home which service users access during the summer. One resident is regularly visited by the priest and receives communion. Details about service users interests and hobbies are recorded in their personal files together with information about their life history. Meals are planned daily and activities are flexible. The lunchtime meal was served during this visit. The meal was served in the kitchen and the residents all sat together in a warm and homely environment. Residents were helped to the table with sensitivity and encouraged to be as independent as possible. The meal was of good portion size and service users were able to help themselves to condiments etc. as they pleased. One resident particularly likes The Rookery DS0000022623.V325263.R01.S.doc Version 5.2 Page 12 a glass of wine with her meal and this was available for her. Residents said that the food was very good. They indicate that they are able to choose what they would like and if they ask for something in particular it is usually provided. Where concerns regarding nutrition are identified the doctor and district nurse are contacted for advice. The nutritional guidance produced by CSCI was also drawn to the attention of the manager to further assist. The Rookery DS0000022623.V325263.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are confident that their concerns will be listened to, taken seriously and acted upon appropriately by the manager and staff at the home. EVIDENCE: The manager and the member of staff have received some training in the safeguarding of adults, but this was some time ago and consideration should be given to further training. The home has a copy of the latest guidance produced by the local authority on the process for reporting and responding to allegations or suspicions of the mis-treatment of vulnerable adults. There is a procedure in place to help residents or their families make complaints if they wish. The manager has not received any complaints and all of the people participating in this inspection visit indicate that they are very satisfied with the service they have experienced so far. People spoken to during the visit are aware of whom they should address any concerns to if necessary. They indicate that they are satisfied with the service and that they would have no hesitation in telling the manager if they were worried or concerned about anything. The Rookery DS0000022623.V325263.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in safe, clean, pleasant and comfortable surroundings. EVIDENCE: The home is a family style home. It is maintained, furnished and decorated to a high standard. The home is clean and fresh and the external grounds are kept safe and tidy. The residents have their own room. One of them is en-suite. They are able to bring in some of their own possessions if they wish and this helps to personalise their own private space. The main bathroom at the home is equipped with both a bath and separate shower. Equipment is in place to assist residents to access these facilities in safety. There is a chair lift to the first floor of the house. The equipment in place at the home is maintained and kept in a clean condition. The owner employs a housekeeper and a handyman to help ensure that the home is maintained to high standard throughout. The Rookery DS0000022623.V325263.R01.S.doc Version 5.2 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff at the home generally have the skills and experience to meet the current needs of the people living at the home. EVIDENCE: The home is staffed by the manager/owner, one part time care assistant, a housekeeper and a handyman. The manager has not employed any new staff since 2003. Recruitment records were looked at during the visit and found to be in order. There was evidence to confirm that the care assistant has undertaken some training. Much of this is out of date and would benefit from refresher training. Brief records of supervision are kept. This is undertaken by the manager on a regular basis. Supervision includes discussions about various aspects of work including, food hygiene, care of the dying and care of the sick person. The local community nurse has also provided some instruction on manual handling techniques and the use of some handling equipment. The current needs of the people living at the home are generally met. The manager should consider undertaking some training in the care of people with dementia. This may be needed in the near future to ensure that the needs of service users continue to be met appropriately. The Rookery DS0000022623.V325263.R01.S.doc Version 5.2 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 35(not applicable) and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service is generally run in the best interests of service users. EVIDENCE: The manager is experienced and skilled in running the home and managing the current needs of the current residents. She has not undertaken any recent training. Consideration should be given to participating in some training. This will help to ensure that the knowledge and skills of the manager are kept up to date in order to meet the changing needs of service users. The manager is not responsible for any of the personal finances of service users. People living at the home are encouraged to manage their own finances and where applicable they are assisted with this task by their relatives. There are brief health and safety policies and procedures in place at the home and staff are given instruction on the content. Supervision records indicate that health and safety, food hygiene and infection control procedures are The Rookery DS0000022623.V325263.R01.S.doc Version 5.2 Page 17 discussed with staff. This helps to ensure that they are reminded of their responsibilities. Equipment and central heating systems at the home are regularly checked and maintained. There is fire fighting equipment in place at the home. Brief risk assessments have been developed and meet the current needs of the people living at the home. Accidents are recorded but the manager does not always ensure that notifications are sent to the Commission for Social Care Inspection (CSCI) when necessary. Staff at the home have been employed there since 2003. The staff record does not indicate that formal induction or foundation training has taken place. There is an uncompleted National Training Organisation induction book, the topics of which are discussed in supervision. The Rookery DS0000022623.V325263.R01.S.doc Version 5.2 Page 18 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 2 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 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X N/A X X 2 The Rookery DS0000022623.V325263.R01.S.doc Version 5.2 Page 19 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. 1. Standard OP3 Regulation 14 Requirement The registered person must ensure that the needs of service users have been assessed by a suitably qualified or suitably trained person and that a copy of that assessment is obtained, prior to the admission of the service user to the home. The registered person must ensure that arrangements are in place for the recording and safe handling of medication. This includes ensuring that clear information is recorded in the service user care plan. The registered person must ensure that there is a staff training and development plan in place. This must ensure that staff fulfil the aims of the home and keep up to date in order to meet the changing needs of service users. The registered manager must undertake appropriate training/refresher training to DS0000022623.V325263.R01.S.doc Timescale for action 30/04/07 2. OP9 13(2) 30/04/07 3. OP30 18 30/06/07 4. OP31 10 30/06/07 The Rookery Version 5.2 Page 20 ensure that she has the experience and skills necessary for managing the care home and meeting the needs of service users at the home. 5. OP38 37 The registered person must ensure that the Commission is notified of any event, which adversely affects the well-being or safety of the service user. 30/04/07 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 OP18 Good Practice Recommendations It is recommended that the registered person reviews the arrangements that are in place to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. This should include the arrangements for training for staff. It is recommended that the registered person review the staff supervision system to ensure that clear and adequate records are kept. This will help to identify any gaps in staff training and development. 2. OP36 The Rookery DS0000022623.V325263.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Rookery DS0000022623.V325263.R01.S.doc Version 5.2 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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