Inspection on 17/03/08 for The Rookery

This inspection was carried out on 17th March 2008.

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

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 14/03/07

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 28/09/2008.

CARE HOMES FOR OLDER PEOPLE The Rookery Milnthorpe Road Holme Carnforth Lancashire LA6 1PX Lead Inspector Diane Jinks Unannounced Inspection 10:00 17 March 2008 th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Rookery DS0000022623.V356847.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.V356847.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.V356847.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) 14th March 2007 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, 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 en-suite 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.V356847.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The assessment of this service could not follow the Commission’s normal format. Attempts were made to conduct an unannounced inspection of the premises on 13th and 14th March 2008. However, there appeared to be nobody in residence. Subsequently the Commission learned that, for personal reasons, the proprietor had closed the home (we understand on a temporary basis). The registered person did not comply with the statutory requirements to inform the Commission of this major change in circumstances. This has meant that we have not been able to fully reassess our judgement of this service. However, in preparation for the inspection and to help obtain the views and experiences of people who use this service we had sent out surveys to the people who lived there. We also sent them to their relatives, people who work at the home and to health and social care professionals that may visit the home. The manager completed a self-assessment questionnaire (the AQAA) that was submitted to us on 13th December, 2007. These actions took place before the home was closed. The information gathered from the AQAA and the surveys helped us to make a judgement about this service, and the operation of the home before its temporary closure. We also received written assurances from the provider about improvements that she has made as a result of the requirements and recommendations made by the Commission in the inspection that took place in March 2007. However, because our quality rating process is based on outcomes for people who use the service, we use a range of evidence, which includes a visit to the home, to make our judgements. Therefore, on this occasion are unable to make any changes to the individual and overall quality ratings that were made in the 2007 inspection. What the service does well: In the past the home provided a warm, comfortable and family home environment for the people that lived there. Everyone participating in this assessment indicated that they were very satisfied with the standard of care provided by the home. One of the community nurses who has visited the home said ‘The manager always acts promptly to alert the necessary professionals and alters the plan of care appropriately. This is an individual residential home. The residents are always very happy and well cared for.’ One relative said ‘the manager is very caring and treated my father as she would a friend. We have always been completely satisfied with my father’s care, and when he needed time in hospital were always keen for him to return to The Rookery where the standard of care was better.’ Another person whose relative attends The Rookery for respite care commented; ‘we are so thankful The Rookery DS0000022623.V356847.R01.S.doc Version 5.2 Page 6 to have peace of mind. Our breaks are important for those we care for day to day - so we all benefit enormously.’ Comments from one of the residents included; ‘I get all the care and attention I need. Anything I need I only have to shout or ring the bell even at night and someone is there. I have never had any complaints I am quite happy.’ What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Rookery DS0000022623.V356847.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.V356847.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): Quality in this outcome area is adequate. This judgement has been made using available evidence. In the past people using this service have an assessment of their health and social care needs prior to moving into the home and there is no evidence to suggest that this will not be the case in the future. This helps to ensure that the home will be able to meet their needs and expectations appropriately EVIDENCE: The registered person has stated that trial visits can be arranged prior to someone making a decision to move into The Rookery. During the assessment process the home tries to include family and friends if the prospective resident wishes. She has stated that she obtains detailed assessments and care plans. People using this service often start by going to the home for short stays and then decide to stay permanently. The registered person has also stated that further improvements could be made to the assessment process currently in use by the home. The Rookery DS0000022623.V356847.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): Quality in this outcome area is good. This judgement has been made using available evidence. In the past, the people that live in this home have had access to health care professionals. This helps to ensure that their well-being is promoted and their healthcare needs met. EVIDENCE: Comments from people taking part in the assessment of this service confirm that the people who use this service had plans for the management of their care needs. A community nurse says that ‘The manager always acts promptly to alert the necessary professionals and alters the plan of care appropriately. This is an individual residential home. The residents are always very happy and well cared for.’ One of the people that lived at the home said ‘My own doctor can visit here if needed and the district nurse visits’. Comments received from one of the members of staff at the home included, ‘Outside help can always be obtained for advice and equipment, for example doctors, nurses, social workers and continence advisors. The Rookery provides excellent care in a very homely and comfortable setting - the residents are all treated as individual people with respect and dignity.’ The Rookery DS0000022623.V356847.R01.S.doc Version 5.2 Page 10 The wide variety of opinions helps to confirm that in the past, people using this service have access to health and social care professionals when needed. The registered person says that there is a process in place to help ensure that medication is stored safely and that records are kept. The Rookery DS0000022623.V356847.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): Quality in this outcome area is good. This judgement has been made using available evidence. People using this service are likely to have access to a wide range of activities that interest them. This means that they will be able to make choices about their lifestyle. EVIDENCE: The registered person has said that people using this service are encouraged and supported in maintaining their interests and contact with social groups they belong to. Social activities are also arranged by the home. Examples are musicians visiting and trips to various local attractions. She has said that requests for repeat activities have often been made. Family members of residents have often joined in the various outings and activities. The registered person has said that by continuing to listen to the views of people using this service, improvements will be made to ensure a stimulating and varied programme of activities are provided in the future. The people that lived at the home and some of their relatives confirmed that there are stimulating activities. One person said ‘people who are well enough have opportunities to go out for lunch or visits. The care is tailored to the individuals needs.’ The Rookery DS0000022623.V356847.R01.S.doc Version 5.2 Page 12 People that have used this service say that the meals are very good and that they ‘always get enough’. The service is run in a homely manner. People using this service usually gather round the family table in the kitchen at mealtimes. The Rookery DS0000022623.V356847.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): Quality in this outcome area is good. This judgement has been made using available evidence. The procedures in place at the home help people using this service to express their views or any concerns that they may have. EVIDENCE: The registered person says that there is a detailed, written complaints procedure, which is made available to people living at the home and their relatives. Any complaints would be followed up and investigated. The home has not had any major complaints. People living at the home were able to express their satisfaction or otherwise, directly to the registered person Relatives of people that lived at the home say that the registered ‘was always very patient even when my relative was extremely difficult. She listened and tried to resolve problems’; another person said ‘neither myself or my friend have ever needed to raise concerns because at all times there has been plenty of communication.’ One of the community nurses commented ‘we have close contact with the manager and residents and have no concerns whatsoever. The care is very individual.’ Staff are subject to police checks before they commence their employment. They are also made aware of the complaints process at the home. These measures help to ensure that people can raise issues confidently in the knowledge that they will be listened to. The Rookery DS0000022623.V356847.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): Quality in this outcome area is good. This judgement has been made using available evidence. The home provides a comfortable and safe environment for people to live in. EVIDENCE: The home offers family style accommodation. Past inspections have shown that it is maintained, furnished and decorated to a high standard. People who use this service have their own room, one of which has en-suite facilities. The main bathroom at the home is equipped with both a bath and a shower. There is equipment in place to help people access the facilities in safety. People using this service have described The Rookery as a ‘home from home’ and were very satisfied with the accommodation and environment provided. The Rookery DS0000022623.V356847.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): Quality in this outcome area is adequate. This judgement has been made using available evidence. People using this service are supported and cared for by staff who know and understand their needs well. EVIDENCE: There is only one care worker employed at the home. She assists the registered person in providing the care and attention to people who use this service. The registered person has not informed us that she has recruited any new staff since our last visit to this service. Previous visits have confirmed that she carries out all the necessary checks on prospective employees. This helps to make sure that only suitable people are appointed. Comments received from the care worker indicate that she is aware of people’s care needs and that these are recorded in care plans. She also says that she has received some training and states that she ‘has been given training books which I have found very interesting.’ The care worker is aware of the outside help that is available for advice and equipment. She added ‘The Rookery provides excellent care in a very homely and comfortable setting. The residents are all treated as individual people with respect and dignity. I enjoy my work at the rookery - compared to some homes I have worked in - it is 100 right, the residents are made to feel special and individual needs are taken care of.’ The Rookery DS0000022623.V356847.R01.S.doc Version 5.2 Page 16 The Rookery DS0000022623.V356847.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is adequate. This judgement has been made using available evidence. The home is run and managed in the best interests of the people that live there. EVIDENCE: The registered person is experienced and skilled in running and managing the home. She ensures that people using this service have access to health care professionals and notifies us of anything that might affect their health and well-being. The care worker has said that she meets regularly with the registered person and receives supervision. This helps to ensure that she maintains safe working practices and any problems are quickly addressed and dealt with. At the last inspection of this service, some requirements were made to make improvements to the service. The registered person gave us an action plan of the things she would do to ensure improvements were made. We have been The Rookery DS0000022623.V356847.R01.S.doc Version 5.2 Page 18 unable to visit the home to carry out an assessment of their implementation and any impact that this has had on the outcomes for the people who use the service. The Rookery DS0000022623.V356847.R01.S.doc Version 5.2 Page 19 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 2 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 X 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 3 X X X X 2 X X The Rookery DS0000022623.V356847.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? Not known. 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. (Unable to assess compliance at the time the report was prepared due to the home being closed). 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. (Unable to assess compliance at the time the report was prepared due to the home being closed). The registered person must ensure that there is a staff training and development plan in place. This must ensure that DS0000022623.V356847.R01.S.doc Timescale for action 31/07/08 2. OP9 13(2) 31/07/08 3. OP30 18 31/07/08 The Rookery Version 5.2 Page 21 staff fulfil the aims of the home and keep up to date in order to meet the changing needs of service users. (Unable to assess compliance at the time the report was prepared due to the home being closed). 4. OP31 10 The registered manager must undertake appropriate training/refresher training to ensure that she has the experience and skills necessary for managing the care home and meeting the needs of service users at the home. (Unable to assess compliance at the time the report was prepared due to the home being closed). 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. (Unable to assess compliance at the time the report was prepared due to the home being closed). 31/07/08 5. OP38 37 31/07/08 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 DS0000022623.V356847.R01.S.doc Version 5.2 Page 22 The Rookery being harmed or suffering abuse or being placed at risk of harm or abuse. This should include the arrangements for training for staff. (Unable to assess compliance at the time the report was prepared due to the home being closed). 2. OP36 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. (Unable to assess compliance at the time the report was prepared due to the home being closed). The Rookery DS0000022623.V356847.R01.S.doc Version 5.2 Page 23 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.V356847.R01.S.doc Version 5.2 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. 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