Inspection on 30/08/05 for The Rowans Care Home

This inspection was carried out on 30th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Rowans Care Home 14/11/07

The Rowans Care Home 21/02/07

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 Mrs Janet Browning Unannounced Inspection Tuesday, 30th August 2005 09:30 am 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 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 C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Rowans Care Home Address Owen Street Coalville Leicestershire LE67 3DA 01530 814466 01530 814455 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Southern Cross Care Homes No 2 Limited Vacant Care Home (CRH) 54 Category(ies) of Dementia - over 65 years of age (DE(E)) 30 registration, with number both, Physical disability (PD) 54 both, Physical of places disability over 65 years of age (PD(E)) 54 both, Old age, not falling within any other category (OP) 24 both, Dementia (DE) 30 both. The Rowans Care Home C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: No one under the age of 50 years of category PD to be admitted into the home. To be able to admit the person category LD(E) identified in correspondence with the previous registartion 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 th 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. Date of last inspection 5th May 2005 The Rowans Care Home C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 Page 5 Brief Description of the Service: The Rowans is a care home providing personal care and accommodation for 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 and is easily accessible by private or public transport. The home is a purpose built two-storey building with the first floor being a secure dementia care unit There is 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 residents in the home The Rowans Care Home C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on the 30th August 2005. The inspection commenced at 9.00am and finished at 5.00pm. The inspection mainly concentrated on the dementia care unit. When undertaking inspections, the Commission for Social Care Inspection (CSCI) focuses on the outcomes for clients living in a home. To support this, four residents living at The Rowans were ‘case tracked’. This means that the care records of four clients were checked; the clients themselves were spoken with where possible, as well as two members of staff supporting their care. Opportunity was taken to speak to six other residents in the home and seven relatives/visitors visiting the home at the time of the inspection and some of the home’s documentation was also examined. The recommendations and requirements arising from this inspection are a direct result of case tracking and other observations made by the inspector during and after the inspection. What the service does well: What has improved since the last inspection? All current staff have received training in dementia care and adult protection. The care plans are being up-dated using new documentation some of which had been completed and were of a very good quality. Residents now have regular access to a chiropodist. The Rowans Care Home C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 Page 7 Staff do not perform health related tasks without understanding what they are doing. 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 Care Home C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Rowans Care Home C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, 4 and 6. The new assessment process is of a good standard, but consultation with residents and/or their relatives/representatives in this process would provide further assurance that the home can fully meet residents’ needs. EVIDENCE: The care records can be conflicting and lacking in detail. However, the home is in the process of reviewing all of the care records due to new documentation from the new providers, Southern Cross. To this end a deputy manager from one of the company’s other homes is providing this service. She is also providing teaching for the senior members of staff, updating them on the admission process. The new care records that have already been completed are of a very high standard with detailed information collated during the assessment. What is still lacking is adequate information on life histories, individual choices and preferences and there was no indication in the records that either the service user and/or their representatives had been involved in this process. Relatives commented; • • • “We feel like we don’t count anymore.” “I’ve not been asked what she likes or dislikes.” “No-one has sat down and asked me.” C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 Page 10 The Rowans Care Home The home offers a specialised service for people with dementia. The staff have now received training on dementia care, and the indications are that staff do not work on this unit unless they have received adequate training. It was unclear for one resident if the home had accepted this person outside of the home’s registered category. The home have since determined that the resident does meet the home’s conditions of registration and will ensure that this is clear on the resident’s care records. The home does not provide intermediate care. The Rowans Care Home C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 9 It is unclear if changes in health needs are adequately reassessed to assure residents that the home can continue to meet their needs. The medication procedure is insufficient to protect residents from risk of harm. EVIDENCE: The older care plans lacked detail with some care plans having no plans for identified needs, such as diabetes and moving and handling. This is despite the records being audited in June and these shortfalls being identified. They had not been amended. As part of the new documentation that is being brought into the home, all the residents’ care plans are being reviewed. A deputy manager from another of the company’s home had already reviewed the care plan of one resident case tracked. This was of a high quality with very detailed descriptions of the care the resident required. It is hoped that once all the care plans are completed they will be of the similar high quality and the senior staff within the home continues this and residents and/or their representatives are involved in this. Contacts are maintained with the community mental health team and district nursing service with a consultant psychiatrist visiting the home during the inspection. However, the indications are that some of the residents have very high mental and physical needs and one resident did not receive a nurse’s visit The Rowans Care Home C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 Page 12 due to it being a bank holiday, which affected his well-being. Staff also have to request nurse visits in between the routine visits. Without immediate attention, the resident can be in some discomfort. The need for the home to be sure that it has the capabilities to meet all the residents’ needs and that any nursing needs can be met by community services, was discussed with the deputy manager. Diabetes is monitored by the staff but without clear care plans it was not sure if this was in agreement with and guidance from healthcare professionals. Residents have access to GP and all healthcare needs are met. The deputy manager stated that a dentist visits annually or as required. The local Primary Care Trust continence nurse provides continence assessments, which requires the staff to monitor residents to ensure that adequate continence aids are provided as assessed by the nurse. There had been a recent incident in the home whereby the incorrect medication was given and senior staff are currently undergoing accredited training for the safe administration of medication. However during the inspection a discrepancy was found whereby medication that was signed as being given was still present in the blister pack. The home was required to address this issue immediately. On the afternoon shift, there was one senior care assistant to administer the medication for all the residents in the home i.e. forty-two residents. Comments from residents and relatives about the staff were; • • • • • “The staff are very caring.” “They are gentle.” “I’m happy here, they don’t rush me.” “Carers are helpful.” “I’m not always sure they know what they are doing.” The Rowans Care Home C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14 and 15 Activities are varied, but insufficient in quantity to meet all the residents needs. The home provides varied choice of meals to meet residents’ preferences, but lack of adequate assistance could potentially put some residents at risk of not receiving sufficient nutrition. EVIDENCE: Southern Cross has a booklet with good examples of activities for people with dementia. The home has an activities organiser who works twenty hours a week who has good relationships with the residents. She was observed during the inspection obtaining residents’ point of views on trips out and also assisting one resident with dementia with a jigsaw for a short time. However the indications are that twenty hours may be insufficient to meet all the home’s category of residents’ social and recreational needs, as residents with dementia may require more one-to-one activities. The residents upstairs mainly sat in the lounge with the television on. The organiser did keep a book on what activities the residents had taken part in, but this was not kept updated nor did it have details for each residents likes and dislikes. A resident downstairs was taken shopping by a staff member who was not on duty. It is still not clear if residents are having a choice in their daily routine, as it is not always documented. For example, residents are still experiencing times The Rowans Care Home C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 Page 14 when they are left in bed for long periods with residents tending to fit in with staff routines. The staff minutes for April instruct staff that they must get at least five people up in the morning before the day staff come on duty with no indication of whether residents have a choice in this. Residents’ comments were; • • • “I got up late yesterday, but I don’t want to be any bother.” “I was late this morning; that happens quite a bit.” “It depends what time the girls (staff) are ready as to whether I get up.” Residents who were able to express a choice did so, but advocacy was not actively promoted and the deputy manager not fully aware of this process. The rooms seen during the inspection demonstrated that residents are able to bring in their own possessions. The food in the home is cooked downstairs, taken upstairs in heated trolley and served individually for each resident. There is a choice of hot meals at lunchtime, which each resident decides upon at the time it is served. Comments received from residents were; • • • “The food is beautiful.” “I like the food; I eat it all.” “The food is very good.” Relatives comments were; • • • “The food is good, but sometimes cold by the time it gets to this part of the building.” (Upstairs) “Sometimes the choice has gone by the time it gets here.” (Upstairs) “Good choice of food, it always looks good.” Staff were observed sensitively assisting residents with feeding in their own rooms but the indications are that due to the layout of the home and numbers of residents requiring assistance or prompting and numbers of staff available, this need is not always met adequately. During the inspection, the hot drinks did not come into the lounge until 11:20am, meaning that on a warm day, some residents had not been offered a drink since breakfast. Two residents were observed asleep when the drinks were served. One resident was woken by another resident and prompted to drink. The staff were busy tending to other residents and there were none available for prompting. One care record stated that a resident required prompting to drink to avoid dehydration. The Rowans Care Home C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The adult protection procedure protects residents from risk of harm, but improvements in the recording of complaints would further ensure that residents and relatives could feel confident that all their concerns will be listened to. EVIDENCE: The staff have received training in adult protection and reporting and the indications are that they know the correct reporting procedures. This was a requirement at the last inspection. There has been one complaint received via CSCI, which, at the time of this report, had not yet been resolved. The home kept records of letters sent regarding complaints in a file, but the ones shown were from last year. A complaint from this year was kept separate. The complaints are not documented to show a summary of the complaint, the investigation taken, the action taken and time limit. Therefore it was difficult to see if complaints are being handled appropriately. All relatives spoken to knew of the complaints procedure. The complaints procedure on the wall in reception could be updated as it does not have the correct name of the new home owners or the CSCI, and it does not display the CSCI contact number. The Rowans Care Home C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 Page 16 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 standard(s) 20, 24, 25 and 26. Generally the home is clean with residents having access to safe, comfortable surroundings. EVIDENCE: The home provides adequate communal space for residents both upstairs and down. The communal space upstairs has smaller, cosier rooms for the residents with dementia. However, the layout of the rooms upstairs is such that residents in the communal areas cannot always be seen or heard, if staff are working down another corridor. Outside there are very well maintained gardens, with patio and seating areas with access for all residents. There is a large dining room downstairs and smaller dining rooms upstairs which are homely in character. A relative commented; • “The home is well presented and looks inspiring.” All of the resident rooms seen during the inspection had the residents’ own possessions around them and all appeared tidy and clean. However, throughout the home there was an offensive odour especially upstairs. This The Rowans Care Home C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 Page 17 did not disappear even when the domestic sprayed air freshener. Adjustable beds were seen for residents requiring care in bed and bedrails were obtained and risk assessed by the community nursing service. A relative reported to the inspector that there was no hot water along one corridor upstairs and staff reported that this was the also the case along one corridor downstairs, and had been off for two weeks. It was noted that there was no hot water in some toilets. Discussions with the deputy manager demonstrated that arrangements had been put in place to provide hot water to residents. Evidence showed that following these instructions may be varied. A relative stated; • “The staff washed xxxx’s hands (which were soiled) with a hot flannel brought from another room and then left it into the wash basin. They didn’t bring a bowl of water.” A resident stated; • “They (staff) have been bringing a bowl in for washing.” The home was in the process of having a boiler replaced. There are adequate washing facilities but these are reduced due to the lack of hot water at present. Staff were observed wearing the appropriate aprons at the appropriate times. The Rowans Care Home C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 Page 18 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30. Although staff are suitably qualified, staffing levels are not adequate to meet all the residents’ needs. EVIDENCE: The home has two distinct areas for residents with distinctly different care needs. The dementia care unit upstairs is laid out along three corridors with small communal areas and rooms off the corridors. During the inspection three members of staff were deployed upstairs and three members down. This included a senior care assistant on each floor. On the afternoon shift, there was only one senior care assistant for the whole of the home. In the dementia care unit, there were high numbers of highly dependent residents, four of which required assistance with feeding and many more requiring a lot of prompting. There were indications that residents have been incontinent of urine because staff cannot get them to the toilet in time. It was evident from many aspects of this inspection, from a recent complaint received by the CSCI and from the Department of Health’s residential forum guidance, that the numbers of staff on this unit are not always adequate to meet residents’ needs. Comments from relatives were; • • • “One of the carers once had to go and do the washing up!” “Staffing appears lower at the weekend.” “xxxx has had to wait twenty minutes for someone to take her to the toilet.” The Rowans Care Home C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 Page 19 Staff indicated that they are told that gaps in staff numbers must be covered by themselves first whenever possible and if not successful, then to obtain agency staff. However the indications are that staff are sometimes told from management that they cannot have agency staff due to lack of funding, which can leave them short staffed. Staff felt frustrated that they are not always able to provide the care the residents require. Although staffing numbers downstairs did meet that recommended in the residential forum, comments from residents downstairs were; • • • “The girls are very busy.” “The staff really feel harassed.” “I sometimes wait a long time for the commode.” The home had recently advertised for new staff and interviews should be taking place shortly. Staffing levels were a problem at the last inspection. All staff have received appropriate training and do not perform tasks without the full knowledge of what they are doing. Managers from other homes have been supporting the staff whilst there is no manager. Training records were seen and there has been a training programme for the staff. The Rowans Care Home C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 Page 20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 35, 37 and 38. Generally the absence of a registered manager has the potential of not assuring residents that the home is being run effectively. Some working practices have the potential of putting residents at risk of harm. EVIDENCE: The acting manager has been under application to register with CSCI for quite a while and at the time of inspection had been absent from the home for seven weeks. The deputy manager had been in charge of the home with support from management of Southern Cross and experienced registered managers from other homes. It is evident from aspects of the inspection that the home needs a permanent registered manager to provide leadership, guidance and support for the staff who appear unsettled, although senior staff do feel well supported by the other managers who visit the home. The home conducts three monthly resident surveys, but this had not been performed since January 2005. Southern Cross management perform monthly The Rowans Care Home C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 Page 21 reviews of the home’s standards, which are sent to CSCI. The notes had been audited in June, but the recommendations not always acted upon. The home manages residents’ money adequately and money is kept safe and records are kept. One relative stated; • “I give the home a kitty and they pay for items such as the hairdresser. I get receipts.” Although some paperwork was in order and easy to read, some of the record keeping is confusing, but this may be because of the change in paperwork going on at the moment. An attempt to read the old daily records in the dementia care unit was not taken due to the disorganised way the records were stored in a filing cabinet. Records were stored in a locked room to maintain confidentiality. During the inspection two carers were observed transferring a resident with a hoist and the resident did not look safe in the sling and was at risk of slipping through. The care records contained a risk assessment for moving and handling but did not have detailed information on the type of sling to use. Accident records did not have documented any actions taken to reduce the risk of it reoccurring. Risk assessments are completed, with the use of bedrails being the community nurses’ responsibility. It was noted in the accident records that a resident had climbed over the bedrails and fallen. The home had not informed the community nurses so that they could perform another risk assessment. The deputy manager addressed this issue during the inspection. The incident of the lack of hot water was not reported to CSCI. The Rowans Care Home C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 Page 22 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 3 15 2 COMPLAINTS AND PROTECTION x 3 x x x 3 3 3 STAFFING Standard No Score 27 1 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 x 3 x 3 x 2 1 The Rowans Care Home C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 Page 23 Yes 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 4.1 Regulation 14.1 Requirement The home must provide evidence that the resident identified during the inspection meets the conditions of the homes registration. The home must ensure that care plans are in place for all identified health needs such as diabetes and are produced in conjunction with health professionals. The home must ensure that it makes proper provision for residents to receive the appropriate care at levels to meet their needs. Consultation must take place with relevant parties to establish if the nursing needs of residents with high dependency needs can be met within the care home. The home must ensure that medication is administered as prescribed and documented correctly. The home must ensure that the residents daily routine, especially in respect of times of getting up, takes in account the residents wishes and feelings. (Previous timescale 16/06/05) Timescale for action Immediate 2. 7.2 15 (1) 11/10/05 3. 8.11 12 (1) 11/10/05 4. 9.1 13 (2) Immediate 5. 12.2 12 (2) (3) 11/10/05 The Rowans Care Home C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 Page 24 6. 15.3; 15.9 16 (2) (i); (4) 7. 27.1 18 (1) 8. 27.4 18 (1) 9. 38.2 13 (5) 10. 38.7 37 The home must ensure that there are adequate numbers of staff to provide assistance and to prompt food and drinks to meet residents nutritional and hydration needs. The home must ensure that there are suitably qualified staff working in the dementia care unit in such numbers as are appropriate for the health and welfare of residents and lay out of the home. The home must ensure that there are adequate numbers of staff working at peak times of activity e.g. meals, medication, personal hygiene, to be able to meet all of residents needs. The home must ensure that safe working practices are followed for moving and handling residents and that exact details of the correct moving and handling techniques to be used are documented in the residents care plans. The home must report any incident which adversely affects the well-being or safety of any resident e.g. lack of hot water 11/10/05 11/10/05 11/10/05 Immediate 11/10/05 11. 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 3.1 7.1; 7.2 Good Practice Recommendations It is strongly recommended that residents and or his/her representative are involved in the assessment process. It is strongly recommended that the high quality of care plans being commenced in the home are maintained and continued by the homes staff. C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 Page 25 The Rowans Care Home 3. 7.6 4. 12.3 5. 6. 7. 8. 9. 10. 11. 12. 14.3 16.3 26.1 31 37.1 38.1 It is strongly recommended that care plans are drawn up involving the resident and/or their representative and they are signed by the resident whenever capable and/or representative. It is strongly recommended that the home ensures that the amount of hours provided for activities are adequate to meet the needs, preferences and capabilities of all residents with particular consideration given to those residents with dementia care needs and that residents interests are recorded. It is recommended that advocacy services are promoted in the home. It is recommended that a record is kept of all complaints made and includes details of investigation and any action taken. It is strongly recommended that the home is free from offensive odours throughout. It is srongly recommended that the registered managers application is completed as soon as possible. It is recommended that all records are stored in a way that promotes effective and efficient running of the care home. It is strongly recommended that the outcome of accidents are recorded in the accident record. The Rowans Care Home C51 C01 S39579 The Rowans V238900 300805 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection The Pavilions 5 Smith Way, Grove Park Enderby, Leicester LE19 1SX 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. 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