Inspection on 14/11/07 for The Rowans Care Home

This inspection was carried out on 14th November 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 Rowans Care Home 21/02/07

The Rowans Care Home 30/08/05

The Rowans Care Home 05/05/05

The Rowans Care Home 19/10/04

The Rowans Care Home 20/04/04

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 Rowans Care Home Owen Street Coalville Leicestershire LE67 3DA Lead Inspector Debbie Williams Unannounced Inspection 14th November 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 Rowans Care Home DS0000039579.V354305.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 Rowans Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Rowans Care Home Address Owen Street Coalville Leicestershire LE67 3DA 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) 01530 814466 01530 814455 rowans@schealthcare.co.uk www.southerncrosshealthcare.co.uk Southern Cross Care Homes No 2 Limited Vacant Care Home 54 Category(ies) of Dementia (30), Dementia - over 65 years of age registration, with number (30), Old age, not falling within any other of places category (24), Physical disability (54), Physical disability over 65 years of age (54) The Rowans Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. No one under the age of 50 years of category PD to be admitted into the home To be able to admit the person of Category LD(E) identified in correspondence with the previous registration authority dated 27th March 1998 No person under 55 years of age who falls within category DE may be admitted to the home The service users admitted to the home who fall within category OP may only be accommodated on the ground floor The service users admitted to the home who fall within the sole category of PD or PD(E) may only be accommodated on the ground floor. First Floor The service users admitted to the home who fall within category DE, DE(E) or dual disability DE/PD, DE(E)/PD(E) may only be accommodated on the first floor. Maximum number of service users accommodated on the first floor shall not exceed 30. Maximum number of service users accommodated on the ground floor shall not exceed 24. 21st February 2007 7. 8. Date of last inspection Brief Description of the Service: The fees for 2006/07 are £319-£650 per week. The most recent inspection report can be found in the reception area. The Rowans is a care home providing personal care and accommodation for up to fifty-four older people, which includes older people who have a physical disability and dementia. The home is owned by the Southern Cross group of care homes, who own other care homes in Leicestershire. The home is located close to the town centre of Coalville, close to shops, pubs, the post office and other amenities. The home is easily accessible by private or public transport. The home is a purpose built two-storey building with level entry access and access to both floors is accessible by use of the passenger lift or stairs. An adequate number of facilities are situated throughout the premise, namely washing, bathing and toilet facilities. The home has fifty-two single bedrooms, two with ensuite facilities and one double bedroom without ensuite facility. The home has a garden to the side and rear of the building which is well maintained and which is accessible to all The Rowans Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 5 residents. The Rowans Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting three service users and tracking the care they received through looking at their records, discussion, where possible, with them and care staff and observation of care practices. A short observational focused inspection was also carried out as part of this inspection. This involved observing three residents in the communal areas for two hours and observing their state of being and the level and quality of staff interaction. This type of inspection was primarily designed to use with people suffering from dementia. The outcomes of this short observational inspection were extremely positive; the residents observed appeared to be in a positive state of being for the majority of the time and staff interaction was frequent and mostly positive. Evidence from the providers Annual Quality Assurance assessment was also used. This was a positive inspection with good outcomes for residents being achieved in most areas. One requirement was made regarding the administration of medicines but otherwise medication policies and procedures were robust and being adhered to. The environment was judged as excellent and this was due to the accommodation on the first floor meeting the specific needs of residents with dementia. Residents and relatives spoken with were satisfied with the service provided. The inspection was unannounced and was facilitated by the homes acting manager. Since the last key inspection one complaint was made against the service and this was referred back to the provider to investigate. The complaint was regarding care practices and health and safety. The providers have taken appropriate action and conducted an investigation; this complaint has now been resolved. The Rowans Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? Since the last inspection care plans were much more detailed and were being reviewed on at least a monthly basis. A record of all complaints along with the action taken is maintained. Staff training regarding the protection of vulnerable adults was being provided and 34 out of 41 care staff had received this training. An acting manager was in place and an application was being made to the Commission for Social Care Inspection to become registered manager. Records of challenging behaviour were being maintained along with interventions required by staff. The Rowans Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 8 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 Rowans Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 9 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 Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 10 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): Standards 1,3 and 5 (standard 6 not applicable to this service) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People moving into the home have the information they require to make an informed choice. Resident’s needs are assessed prior to admission. EVIDENCE: A copy of the provider’s service users guide was on display in the reception area and there was also a copy available in each resident’s room. The service users guide is also given out with the provider’s brochure to prospective residents and their relatives. The service users guide was comprehensive and included all the required information. This guide was also available in audio. Information regarding the management team within the service users guide required updating in order to reflect the current management arrangements. All residents have their needs assessed prior to them moving into the home. The acting manager or deputy manager carry out this assessment. Assessment The Rowans Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 11 records were seen for three case tracked residents. Assessment records were detailed and included risk assessments. Residents are offered visits or respite stays prior to admission and a four-week trial period when moving into the home. One resident and relative spoken with confirmed that this was the case and that a needs assessment was undertaken prior to admission. The Rowans Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 12 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): Standards 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. Residents living at the home have their health, personal and social care needs met and are treated with respect. Residents were mostly protected by the provider’s medication policies and procedures. EVIDENCE: Care plans for three case tracked residents were inspected and found to be comprehensive. Care plans addressed all assessed needs and these included cultural and social needs. Records of challenging behaviour and actions to be taken by staff were maintained. Care plans were being reviewed at least monthly. Social services care plans were in place where applicable. Risk assessments were in place for pressure areas and records were maintained of interventions made by healthcare professionals. One resident The Rowans Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 13 spoken with confirmed that the community nurse was involved in their care and that a GP could be seen as required. Medication storage areas and administration records were seen. A monitored dosage system of medication administration was used. The providers had a contract in place with a pharmacist. Only senior care staff handle medication and all have done safe handling of medication training. There were comprehensive medication policies that were accessible to staff. There was also a policy in place for residents to handle their own medication but none of the residents living at the home at the time of this inspection were doing this. Medication procedures were part of the providers quality assurance and audit programme. Not all medication administration records seen were accurate, as one staff member had not signed for all medication given; a requirement was made regarding this. Interactions observed between staff and residents were extremely positive, this was noted throughout the inspection but particularly during the two hour observation which took place in the upstairs lounge and dining room, staff were respectful and interacted sensitively in order to meet the specific needs of these residents suffering from dementia. One resident and one relative spoken with described staff as very helpful and pleasant and confirmed that staff maintained their privacy and dignity. The Rowans Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 14 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): Standards 12 –15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s individual needs and preferences are met by flexible routines promoting choice and control and opportunities for residents to engage in meaningful activities. EVIDENCE: One visitor spoken with said that staff were always friendly and welcoming. One resident spoken with described the food provided as ‘brilliant’. One resident spoken with said that staff had taken them out shopping and out around the local town, this also included goings out for a pub lunch. Resident’s social and religious needs and preferences are recorded in their care plans. During this inspection many of the residents went to watch a film in one of the lounges, this was a regular feature of the activities programme. The Rowans Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 15 There is a games area in one of the ground floor lounges. Evidence was seen of recreational activities also being used for rehabilitation. The home employs a full time activities organiser. The activities organiser was observed interacting with residents in the upstairs lounge, reminiscence and singing was used to engage resident’s interest and encourage their participation, this was done in a sensitive and effective manner, residents appeared to respond to this and engaged with staff and each other. The quality of relationships between staff and residents appeared positive and respectful. Non-care staff also interacted with residents in a positive way. The home’s maintenance person came into the lounge and spoke about a recent holiday and showed the residents the photographs of the holiday. Residents were able to move around the home freely (key code locks between ground and first floor) and the atmosphere appeared relaxed and calm. A separate garden and lounge on the ground floor was due to be opened later in the year, this will provider further living accommodation and a safe and secure outside area for residents with dementia. There was a chime tree and a small aviary in the garden. The dining room on the first floor was congenial and attractive. The lunchtime meal appeared appetizing and nutritious, and a choice was offered to all the residents. One resident was able to sample both choices of desert. Some residents chose to have their meal in their room. Staff assisted residents with their meals when required to in a sensitive manner. The service uses a menu planner that calculates the nutritional vale of each meal and ensures that the recommended daily allowance of each food group is provided. Diabetic and vegan diets were being provided at the time of this inspection. The Rowans Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 16 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): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the providers polices and procedures and can be assured that any complaints or concerns would be taken seriously. EVIDENCE: The acting manager is trained to train staff in vulnerable adults and safeguarding policies and procedures. Two staff members spoken with had received training in vulnerable adults safeguarding polices and procedures and were able to demonstrate their awareness in this area. A copy of safeguarding adults policy and procedure was available in the office and accessible to staff. The acting manager said that 34 out of 41 care staff employed had completed protection of vulnerable adults training and that the remainder of staff would go on to complete this. The training pack for this was seen. Details of all complaints received are maintained along with the action taken by the providers and the outcome of the investigation. The Rowans Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 17 A copy of the complaints procedure was within the service users guide. Residents and relatives spoken with felt they could approach staff with any concerns or complaints and felt that they would be taken seriously and appropriate action taken. The Rowans Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 18 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): Standards 19,20,22 and 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, comfortable and homely environment that meets their specific needs. EVIDENCE: Staff spoken with confirmed they had received infection control training and were aware of the infection control policy. All areas of the home seen were clean, homely and appeared well maintained. Accommodation on the first floor was decorated and furnished following guidance from the company’s dementia consultant. Touch boards and objects from the past such as old telephones and old pictures were in the corridors and lounges. There were benches at the end of corridors in order to facilitate residents who may be wandering and need to rest. The signage on bathroom The Rowans Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 19 and toilet doors was pictorial in order to meet the needs of residents suffering with dementia. It was evident during the two-hour observation on the first floor that residents felt relaxed and moved freely around the communal accommodation and into their own rooms. Residents own rooms were personalised to suit their individual needs and preferences. One resident was in the process of decorating their room with Christmas lights. Another lounge and outside area was being developed to provide a secure and safe outside area for residents with dementia. There was a chime tree and small aviary in this garden. Information supplied within the provider’s annual quality assurance assessment stated that a maintenance and refurbishment programme was ongoing. A maintenance person and gardener were employed. The Rowans Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 20 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): Standards 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are met by the numbers and skill mix of staff and are protected by recruitment procedures. EVIDENCE: Residents and staff spoken with felt that staff were employed in sufficient numbers and were competent to do their jobs. The acting manager is a trained trainer in YTT (yesterday, today and tomorrow an Alzheimer’s society course), abuse and manual handling. Staff spoken with felt they received the training they required to do their jobs and had recently received safeguarding adults training, dementia awareness and infection control training. On the day of this inspection a new care assistant had commenced induction training and was being trained in fire safety and basic health and safety. Protection of vulnerable adults training had already been provided. The Rowans Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 21 Induction training is provided to all care staff. A new induction package has now been introduced and the acting manager said that existing staff would also work through this. 75 of care staff had a National Vocational Qualification in care or equivalent. 6 care staff were working towards this qualification. Staff files were seen for two staff members. All relevant references and checks were in place. Staff supervision records were seen. The Rowans Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 22 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): Standards 31,32,33,35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is well run and in the best interests of residents. EVIDENCE: The acting manager was waiting for clearance from the Criminal Records Bureau and then intended to apply to be registered as the home manager with the Commission for Social Care Inspection. The acting manager had relevant management experience. Residents, relatives and staff spoken with felt the management approach was open and inclusive. Regular residents/relatives and staff meetings are held; the minutes of these were available. The Rowans Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 23 The acting manager said that resident and relative satisfaction surveys were to be sent out at the end of the month. Residents, relative and staff meetings were being held. There was an in house quality assurance and audit programme. A monthly audit was carried out on documentation, pressure sores, complaints, health and safety, training, medication and accidents. Environmental audit records confirmed that maintenance tests were carried out for electrical equipment, fire alarms and lifts. Certificates were seen for water chlorination legionella control, gas installation and fire fighting equipment. Risk assessments were seen for fire risks and environmental risks. Each resident had individual risk assessments within their care plan. Transaction records were maintained for all transactions involving resident’s personal money. A maintenance person was employed at the home. The Rowans Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 24 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 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 N/A 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 3 3 4 x 4 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 3 3 x 3 x x 3 The Rowans Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? 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 The providers must ensure that arrangements be made for the safe administration of medicines. Timescale for action 14/11/07 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 OP1 Good Practice Recommendations The provider’s service users guide should be updated in order to reflect the current management arrangements at the home. The Rowans Care Home DS0000039579.V354305.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Rowans Care Home DS0000039579.V354305.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. 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