Inspection on 19/04/07 for The Rookery Care Home

This inspection was carried out on 19th April 2007.

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

The Rookery Care Home 20/04/06

The Rookery Care Home 28/02/06

The Rookery Care Home 27/09/05

The Rookery Care Home 08/03/05

The Rookery Care Home 17/01/05

The Rookery Care Home 10/02/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE The Rookery Care Home 130 Church Street Eastwood Nottingham NG16 3HT Lead Inspector Richard Ramsden Key Unannounced Inspection 19th April 2007 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 The Rookery Care Home DS0000008801.V335407.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 Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Rookery Care Home Address 130 Church Street Eastwood Nottingham NG16 3HT 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) 01773 713176 01173 770258 Lightdawn Limited Mrs Joanne Lesley Elizabeth Craig-Humphreys Care Home 30 Category(ies) of Dementia (30), Old age, not falling within any registration, with number other category (30) of places The Rookery Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal care for residents of both sexes whose primary needs fall within the following Categories Older people ( Not falling within any other category). Thirty (OP 30) Dementia (DE 30) The total number of persons for whom accommodation and care is provided shall not exceed Thirty (30) 14th September 2006 2. Date of last inspection Brief Description of the Service: The Rookery Care Home is an extended converted detached house. It is located on the outskirts of Eastwood town centre within a residential area. It is close to local facilities such as shops, banks and the medical centre. There are good local public transport links. The accommodated is over two floors. There are 24 single and 3 double rooms. Both stair lift and passenger lift are provided. Care is provided for older people and people who have dementia. The weekly accommodation charges are from £283 to £350. A copy of the last Inspection Report was available within the home. The Rookery Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One Inspector completed this unannounced visit over one-day, it took approximately 8 hours. It included the inspection of care and other records a discussion with the registered manager and two members of care staff. The inspector spoke with four residents and five visitors to the home. A partial tour of the building was also completed. Three residents were Case tracked, which means that their care plans were examined against the actual care they receive. Prior to completing this visit the inspector assessed the homes service history and the last two inspection reports. Two completed residents satisfaction questionnaires were also provided during the inspection. What the service does well: People living at The Rookery appear very satisfied with the services provided by the home. The residents who are able to express an opinion said that the staff are always friendly and respectful and ensure that their privacy and dignity is maintained at all times. The observed interaction between residents and staff was of a very good standard. All of the visitors who were spoken with confirmed that they could visit their friends or relations in the home at any time. They said that the staff are always friendly and welcoming and that visitors are always offered refreshments. One visitor stated that she is always kept fully informed about her mother-in-laws health and welfare. Two residents said that they are very satisfied with their bedrooms and confirm that they had been encouraged to personalise them with small items of furniture photographs etc. The registered person had installed a cat flap in the exterior door of one bedroom so that the resident could bring her cat into the home with her. (This flexibility is good practice.) Two residents, a member of staff and the visitors spoken with during the inspection said that the manager is very approachable and that she seeks their views about the way in which the home is run. The Rookery Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 6 All aspects of health and safety that were checked during this visit had been satisfactorily maintained. There were many aspects of good practice highlighted in the main body of this report. 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 Rookery Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 7 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 Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Rookery Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. The homes staff ensures that they can meet the assessed needs of prospective residents by obtaining full written assessments prior to their admission to the home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three residents records were assessed as part of this inspection. All of the records contained preadmission assessments, which had been completed by health service staff, social workers, or the homes staff. The Rookery Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 10 The manager stated that residents are never admitted without a preadmission assessment. The Rookery Care Home does not provide intermediate care. The Rookery Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Residents individual care plans appeared to contain sufficient information and are updated frequently enough to ensure that staff are always aware of what support and assistance each resident requires. The homes medication is generally well managed and residents are treated with respect. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three residents care plans were viewed as part of this inspection, the care plans appeared to address the issues highlighted in the resident’s assessment process. The Rookery Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 12 All of the care plans had been reviewed and where necessary amended each month. A monthly summary had also been completed for each resident, which identified the reasons for any changes to the care plans. (This is good practice). The manager stated that where possible residents or their representatives are involved in the care planning and review process. However the home did not have any evidence to support this. The residents spoken with could not remember if they had been included in the care planning process. One visitor to the home confirmed that she had been encouraged to read and make comments on her relatives care plan. Records showed that residents’ health care needs are being appropriately met; this was confirmed by one of the relatives spoken with during the visit. A District Nurse who was in the home at the time of this visit, confirmed that staff make appropriate referrals, where medical intervention is required. The homes medication systems have generally been very well maintained. None of the current residents have been assessed as safe to administer their own medication. The records of receipt and disposal of medication have all been well maintained and staff were able to demonstrate that they seek advice from medical practitioners if they have any concerns about new medication prescribed for residents. (This is good practice). The medication is stored securely and an air-conditioning unit has been fitted to ensure that it is stored at an appropriate temperature. One resident’s medication administration records showed that she had not been given one of her tablets on three consecutive days. When the disposal of medication records were checked, the medication had not been returned to the pharmacist. It is therefore likely that this is an administrative error and that the medication had actually been given to the resident. The registered person must ensure that staff always sign the medication records each time the medication is given to the resident for whom it is prescribed. All of the other medication records checked during the inspection were well maintained. All of the residents spoken with, who were able to express an opinion, said that the staff are friendly and respectful and ensure that their privacy and dignity is maintained at all times. This was also confirmed by one of the relatives spoken with during the inspection. The observed interaction between staff and residents was of a good standard. The Rookery Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. The lifestyle experienced in the home appears to match the residents’ expectations and preferences. People are encouraged to maintain contact with their family and friends and the food provided appeared wholesome and nutritious. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home provides an impressive range of activities and entertainment to provide stimulation to the residents. The programme of activities is prominently displayed in the homes ‘quiet’ lounge. None of the residents who were spoken with were able to confirm whether the activities provided met to their individual needs and aspirations. However the relatives who were spoken with said that they regularly see the residents participating in and enjoying a variety of activities. The Rookery Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 14 Residents and their relatives confirmed that visitors are made welcome at any time. One resident said that she could see visitors in her bedroom or use one of the communal areas if she wished to speak to them in private but does not wish to use her bedroom. All of the visitors stated that the staff are very friendly. The manager stated that she tries to provide an environment, which encourages residents to make choices. Individual residents care plans also give details of how residents can be encouraged to make decisions about their daily lives. All of the residents have external contacts such as family or friends who can offer them advice and support should they require it. The lunch on the day of this inspection appeared wholesome and nutritious. One resident stated that she is very satisfied with the food provided by the home. She confirmed that there is always a choice of food and that if she does not want the meal suggested on the menu an alternative will be provided. None of the current residents require a liquefied meals but several people do need assistance from staff, to it is their meals. The Rookery Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. The home has a robust accessible complaints procedure and staff are ensuring that residents are protected from abuse Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector was informed that all residents have been provided with a copy of the homes complaints procedure. This procedure is also displayed in the main entrance hall. The homes complaints records show that the home has only received one formal complaint, since the last inspection. This was appropriately investigated and found to be a misunderstanding. One resident confirmed that she would contact the manager if she had any concerns or complaints. The visitors spoken with during the inspection all stated that they would discuss any concerns or complaints with the registered manager. They all believed that she would deal with their concerns appropriately. The Rookery Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 16 There are copies of the local Vulnerable Adults Procedure available in the home. There are also copies of a Whistle Blowing Procedure. The member of staff spoken with during the inspection was clear about her responsibility to report any incidents of abuse. There has been one allegation of abuse at the home since the last inspection. This incident was dealt with appropriately and was not substantiated. Staff records show that a number of people have received training in safeguarding adults. The Rookery Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 17 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): 19,26. The accommodation has been maintained to a good standard. However the Registered Person must ensure that staff can always hear and respond to the emergency call system. The home was clean, pleasant and hygienic at the time of this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A partial tour of the premises was completed as part of this visit. The adapted and extended accommodation had been maintained to a good standard. Many areas of the home had been redecorated since the last inspection. The Rookery Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 18 The residents’ bedrooms were comfortably furnished and people had clearly been encouraged to bring personal possessions such as photographs, ornaments and small items of furniture. It was noted that a cat flap had been fitted in one bedroom so that the resident could bring her cat into the home with her. (This flexibility is good practice). There were several call bells, which would not be accessible to residents who were lying in bed. The manager rectified the situation during the inspection by providing cord extensions where necessary. When the call bell system was checked the staff did not answer it. It became apparent that if staff are busy in certain areas of the home they cannot hear the call system. The registered person must ensure that staff can always hear and respond to the emergency call system. Note-: the manager had already identified this problem and was resolving the issue as part of the homes development plan. The laundry is situated in the basement; it is well equipped and has washable floor coverings. A lock has been fitted to the door leading to the basement to ensure that resident’s health and safety is not put at risk. The home has an extensive Infection Control Policy. The Rookery Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 19 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): 27,28,29,30. Sufficient staff are being employed to meet the assessed needs of the residents, the homes recruitment policies and practices are generally supporting and protecting residents. The registered person was able to demonstrate a commitment to staff training and development. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The rota provided prior to this inspection and those viewed for the week of this inspection showed that sufficient staff are being provided to meet the assessed needs of the residents. The visitors spoken with during the inspection stated that although the staff appeared busy they do respond promptly when residents require assistance. All new members of staff complete an appropriate induction-training programme. The manager was reminded that staff must not assist residents with their mobility, including the use of a hoist, until they have received appropriate training. The Rookery Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 20 The staff training records show that out of a total of 20 care staff 9 people had completed NVQ level 2 or above. On the day of inspection there was a meeting with the new NVQ training providers to enrol the remainder of the staff on the NVQ course. (This is good practice). The information provided by the registered person, prior to this inspection indicated that one member of staff had commenced employment with a POVA First clearance but that a completed Criminal Records Bureau clearance had not been received. The manager stated that the appropriate forms had been submitted and that she had contacted the Criminal Records Bureau to ascertain why there had been a delay. A letter from the Criminal Records Bureau was received on the day of this inspection, detailing the reasons for the delay. The personal records of two members of staff were assessed as part of this visit. Both of the records contained all the required information. The Rookery Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 21 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): 31,33,35,38. The home is well managed and run in the best interests of the residents. Where checked the health and safety of residents and staff are promoted and protected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The homes manager is a very experienced. Residents, staff and visitors to the home said that the manager is very approachable and that she seeks their views about the way in which the home is run. The Rookery Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 22 Quality monitoring systems are in place and the manager has used the information gathered to produce an individual business and development plan for the home. The registered person stated that the homes staff do not manage any residents personal finances. She stated that if residents require money or services this is paid for by the home and then periodically the residents or their representatives are invoiced. Appropriate records of this process have been maintained. The aspects of health and safety, assessed as part of this visit had been satisfactorily maintained. Health and safety risk assessments are completed each year. (This is good practice). The Rookery Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The Rookery Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 24 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 OP9 Regulation 13 (2) Requirement It is required that staff sign medication administration records every time the medication has been given to the resident for whom it was prescribed. If the medication is not given for any reason an explanation must be provided. (The use of codes is acceptable for this purpose.) It is required that the registered person ensures that staff can always hear & respond to the emergency call system. Note the manager had already identified that this issue needs to be addressed as part of the homes development plan. However it must be dealt with as a matter of priority. Timescale for action 19/04/07 2. OP19 23 (2) (n) 04/06/07 The Rookery Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 25 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. Refer to Standard OP7 OP7 Good Practice Recommendations It is recommended that the home provides evidence that residents & where appropriate their relatives are involved in the care planning & review process. It is recommended that residents “daily records” more accurately reflect their individual lifestyles within the home and detail the services actually provided by the home. The Rookery Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Care Home DS0000008801.V335407.R01.S.doc Version 5.2 Page 27 - 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. 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