Inspection on 14/03/06 for The Rowans

This inspection was carried out on 14th March 2006.

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 Rowans 20/01/09

The Rowans 02/02/07

The Rowans 27/09/05

The Rowans 08/02/05

The Rowans 17/09/04

The Rowans 29/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE The Rowans 31 Goonown St Agnes Cornwall TR5 0UY Lead Inspector Ian Wright Announced Inspection 14th March 2006 9:30 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 Rowans DS0000008936.V276896.R01.S.doc Version 5.1 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 Rowans DS0000008936.V276896.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Rowans Address 31 Goonown St Agnes Cornwall TR5 0UY 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) 01872 552147 01872 552147 Mr Ian Hirsch Mrs Rosemary Hirsch Mr Ian Hirsch Care Home 7 Category(ies) of Old age, not falling within any other category registration, with number (7) of places The Rowans DS0000008936.V276896.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 7 adults of old age (OP) Total number of service users not to exceed a maximum of 7 Date of last inspection 27th September 2005 Brief Description of the Service: The Rowans is registered to provide care for seven elderly residents. The home is a large Victorian house set in a well-maintained secluded garden, at Goonown, St Agnes. The registered providers Mr and Mrs Hirsh live next door to the care home. The accommodation comprises seven single bedrooms on two floors. There is a chair lift to the first floor. The ground floor is wheel chair accessible. There is a pleasant lounge /dining room. The home operates a no smoking policy. Care is provided within a relaxed and friendly atmosphere. Socialising and visitors are actively encouraged. The Rowans DS0000008936.V276896.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place just under five hours. The inspector was able to speak to many of the service users. The inspector also met with Mr and Mrs Hirsh (Registered Providers). The inspector examined the care and business records, and inspected the building. What the service does well: 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 Rowans DS0000008936.V276896.R01.S.doc Version 5.1 Page 6 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 Rowans DS0000008936.V276896.R01.S.doc Version 5.1 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 The registered providers have developed a suitable statement of purpose and service user guide. Suitable measures e.g. a pre admission assessment, and links with external professionals have been developed, to assist the registered provider to meet the needs of service users. EVIDENCE: Copies of the home’s statement of purpose and service user guide were inspected. A copy of the service user guide is available by the front door. Pre admission assessments are completed before the service user comes to live in the home. Copies of recent assessments were observed. The registered providers said they have developed suitable links with district nurses and social workers. There are also suitable links with GP’s, chiropodists, dentists and opticians. The Rowans DS0000008936.V276896.R01.S.doc Version 5.1 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 The registered providers have a suitable care planning system to help ensure service users’ care needs are met. Suitable arrangements are generally in place to ensure health care needs are met, although manual handling risk assessments need to be developed for all service users. Medication procedures and practices are satisfactory to ensure service users medication is managed safely. EVIDENCE: Care plans inspected were comprehensive to enable staff to provide service users with appropriate care. Mrs Hirsh said care plans are regularly reviewed and there is documentary evidence of this. Links with medical professionals appear appropriate. No service users currently have pressure sores. Accident records were inspected which were satisfactory. Manual handling risk assessments need to be developed for all individual service users. This may help to minimise the number of falls for service users who are at risk of falling. The medication system was inspected and is satisfactory. Administration records appear to be accurate. Most staff have received suitable training regarding the handling of medication. The Rowans DS0000008936.V276896.R01.S.doc Version 5.1 Page 9 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 15 Routines and activities are tailored according to individual service users needs. Meals provided for service users are to a good standard. EVIDENCE: Service users said they could get up and go to bed when they wished, and have autonomy how they organised their time. No formal activities are arranged. The registered provider said she has tried to arrange these but service users have been reluctant to participate. Service users the inspector spoke to say they were quite happy to occupy themselves and did not get bored. There seemed a lot of interaction between service users and staff. Religious ministers visit some of the service users as requested. Service users said meals are to a good standard. Breakfast is available from 0800 until 1000. The main meal is served at lunchtime. Staff will vary the meal according to individual wishes. Special diets are catered for. Hot drinks are available throughout the day. An evening tea is provided at 1800, this includes a hot and cold alternative. A snack and hot drinks are available in the evening. The Rowans DS0000008936.V276896.R01.S.doc Version 5.1 Page 10 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 The Rowans has a suitable complaints procedure. Service users legal rights are protected. EVIDENCE: A suitable complaints procedure was inspected. The registered persons or Commission for Social Care Inspection have not received any complaints regarding the care provided. Mrs Hirsh said appropriate arrangements are in place to enable service users to vote. Suitable information is also provided regarding advocacy services e.g. in the service user guide. The Rowans DS0000008936.V276896.R01.S.doc Version 5.1 Page 11 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, 24, 26 The Rowans provides suitable accommodation to meet the needs of service users living there. The home is clean, pleasant and hygienic. EVIDENCE: The property is suitably maintained, appears to be safe, is comfortable and homely. Furnishings and decorations are to a good standard. The home has a large lounge / dining room. A new carpet is recently been fitted to the lounge / diner and though out the hallways, which looks very nice. There are suitable bathroom and toilet facilities. The kitchen has recently been refurbished which seems very pleasant. The home was clean and hygienic on the day of inspection. The Commission is currently determining an application for two additional bedrooms. The facilities are to a high standard. The Commission is awaiting confirmation from the environmental health department, building control, and the fire and planning authorities that the bedrooms meet their standards. The Commission will then need to reinspect the bedrooms before they can be used. A new certificate increasing the number of registered bedrooms will then be issued. The Rowans DS0000008936.V276896.R01.S.doc Version 5.1 Page 12 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 Suitable staffing levels are provided to care for service users. Suitable information is obtained regarding the recruitment of staff. The registered provider has a suitable approach to assist staff to train for a National Vocational Qualification. EVIDENCE: Suitable staffing is provided. Rotas show: • There is a minimum of two staff on duty between 0800 and 1400 • Between 1400 and 1700 there is one member of staff on duty. • Between 1700 and 2200 there is 2 members of staff on duty. • There is one sleep in member of staff on duty. Night staffing must be kept under review, and a waking night member of staff should be considered as service users needs change. Before the application for two additional bedrooms is approved, the registered providers may need to consider additional staffing. Staff turnover is low; there has been just one new member of staff since the last inspection in September 2005. Satisfactory information required by regulation has been obtained for the person employed. For example an application form, two references, a criminal records bureau check etc. The registered providers outlined a suitable approach for staff to obtain a National Vocational Qualification. Five out of seven staff have an NVQ. The Rowans DS0000008936.V276896.R01.S.doc Version 5.1 Page 13 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 34, 37, 38 The registered providers have suitable skills, experience and knowledge. However one of the registered providers must complete a National Vocational Qualification in Management (at level 4). The registered providers have a suitable quality assurance policy, which is effectively implemented. Financial management seems appropriate. Record keeping, and policies and procedures are satisfactory. Health and safety precautions are appropriate. EVIDENCE: Management is good but either Mr or Mrs Hirsh need to complete a National Vocational Qualification in management (at level 4). Suitable financial accounts are kept and an accountant finalises the business’s accounts. The registered provider has suitable insurance cover. The registered provider operates a suitable quality assurance policy. This includes asking service users and other stakeholders to complete an annual The Rowans DS0000008936.V276896.R01.S.doc Version 5.1 Page 14 satisfaction questionnaire. As the survey was last completed over a year ago, Mrs Hirsh said the survey would be completed again shortly. The inspector spoke to the majority of service users who all expressed high levels of satisfaction with care given. People the inspector spoke to all felt they could confidently talk to Mrs Hirsh if they had any problems with the care received. Records examined regarding the management of the home, and regarding service users care are appropriate. Policies and procedures appear satisfactory. Checks in regard to servicing of fire, electrical appliances, gas, and lifting equipment are satisfactory. However the registered provider should check with the Environmental Health Department whether it is satisfactory for the providers to complete portable appliance testing or whether this needs to be completed by a qualified electrician. Suitable health and safety risk assessments have been completed. The Rowans DS0000008936.V276896.R01.S.doc Version 5.1 Page 15 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 X 3 3 X X 3 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 3 X X 3 3 The Rowans DS0000008936.V276896.R01.S.doc Version 5.1 Page 16 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 OP8 Regulation 12 Requirement All service users must have a moving and handling assessment. These must be regularly reviewed. The registered manager must complete a National Vocational Qualification in Management (Level 4) Timescale for action 01/07/06 2 OP31 9 01/01/07 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 OP38 Good Practice Recommendations The registered provider should check with the Environmental Health Department whether it is satisfactory for them to complete portable appliance testing or whether this needs to be completed by a qualified electrician. The Rowans DS0000008936.V276896.R01.S.doc Version 5.1 Page 17 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Rowans DS0000008936.V276896.R01.S.doc Version 5.1 Page 18 - 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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