Inspection on 26/11/08 for The Royal Care Home

This inspection was carried out on 26th November 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

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Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Royal Care Home Queen Marys Road New Rossington Doncaster DN11 0SN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ian Hall     Date: 2 6 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: The Royal Care Home Queen Marys Road New Rossington Doncaster DN11 0SN 01302863764 01302869073 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Alyson Murphy Type of registration: Number of places registered: Ladhar Group Homes care home 57 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 57 The registered person may provide the following category of service only: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP Dementia - Code DE Date of last inspection Brief description of the care home The Royal Care Home is situated in the village of Rossington near Doncaster. It is within reach of local shops, a post office and a church. It is registered to provide both nursing and personal care for up to 57 people in the category of older people with dementia. This is a no smoking home. It is a two story purpose designed building. Accomodation is provided on both floors. There is a passenger lift to provide access to both floors. There are communal areas located on both floors. The kitchen and office Care Homes for Older People Page 4 of 26 Over 65 0 57 57 0 Brief description of the care home are situated on the ground floor. the laundry is situated on the first floor. There is a level and secure garden area to the rear of the building. Adequate car parking is available onsite. Information about the home and services available is detailed within the homes statement of purpose and service user guide. Currrent fees and any additional charges are available from the homes manager. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future if a requirement is repeated, it is likely that enforcement action will be taken. The unannounced site visit was the first inspection undertaken since the Royal Care Home was registered with CSCI. It commenced at 08:40 and concluded at 15:10 on Care Homes for Older People Page 6 of 26 the 26th November 2008. The inspection was conducted by the link inspector Mr I A Hall. The site visit included a tour of the building, reading records, discussions with people who use the service and observation of the meals provided. We also met with the manager and other members of staff. In addition the inspection took account of information received about the service. This included records of telephone conversations with staff, events notified to CSCI and records of management visits to the home. People spoken with were happy to assist with the inspection. Comments were positive when describing the care and motivation of the staff, these included: I like it at this home, I feel safe here, and the girls are lovely. At the end of the site visit verbal feedback was given to the manager. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service experience good quality outcomes in this area. This judgment has been made using available evidence including a visit to this service. The service provides people with detailed information to enable them to choose whether the home is the one for them. Detailed assessments ensure that peoples needs could be met prior to offering them a place. Evidence: An information pack was available that provides details of the standard of care and services available at the home. It includes useful information about staff, their qualifications, visiting the home, choosing meals, the laundry service and how to raise any concerns. We checked three case files. Each contained a detailed needs assessment. This Care Homes for Older People Page 10 of 26 Evidence: included aspects such as daily living, personal care, health care, social interests and areas of risk when appropriate. Whenever the need for specialized caring equipment had been identified this had been obtained prior to the person moving into the home. The assessment formed the basis of the initial care plan. Relatives said they had been able to discuss peoples needs and the type of help needed before the decision was made for their relative to live at this home. This was confirmed by written entries in the care files. Copies of contracts, social work referals and assessments were available and kept in the care file. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service experience good quality outcomes in this area. This judgment has been made using available evidence, including a visit to this service. Clear information is provided to guide staff meeting peoples needs. Staff ensure that people are able to access health services as they need them. Staff attitude and approach to care is based on respect for the person, this helps to safeguard and promote peoples rights and dignity. Staff work to the homes policies and procedures for the administration of medication, this promotes wellbeing of people who live at the home. Evidence: We examined three peoples care files. Individual care needs had been assessed. A range of recognized assessment tools were used to measure peoples needs. These included mobility, mental ability, state of nutrition, skin integrity and areas of risk such as falls. These had provided a baseline for staff to measure peoples progress or increasing level of need. This enables staff to plan the assistance and support people Care Homes for Older People Page 12 of 26 Evidence: need. There were care plans to tell staff how to meet these needs. These had been reviewed regularly. People we spoke to did not understand fully about their care plan. Relatives said they were kept informed of any changes and involved in peoples lives and care decisions whenever possible. The care plans detailed peoples cultural and religious needs and the gender of staff they prefer to support them with their personal care. Pen portraits of the person, their lives and interests provide staff with the background information to improve the care provided. Daily entries had been made of the care and services provided. This enables staff to review peoples health and wellbeing and change plans of care as necessary. There were records of visits by family doctors, community nurses and chiropodists. All people were registered with a family doctor. The manager reported they had good relationships with the doctors and district nurses. There were aids and equipment provided to meet peoples moving and handling needs. We saw that bathrooms and toilets were equipped with aids and adaptations so people can maintain their level of mobility and independence safely. We examined the homes medication policy, medication and administration records, and the storage and handling for medicines. We observed medicines being given to people after lunch. Staff were seen to help people appropriately, records were largely complete with few gaps within the record chart. This means there is a record kept of people receiving their medication as prescribed. People said they liked the staff and that they helped them all the time. relatives said staff promoted peoples privacy and dignity. We saw staff knocking on bedroom doors and waiting to be invited to enter. We saw interactions between staff and people living at the home. These were warm relationships with each person showing respect for the other. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service experience good quality outcomes in this area. This judgment has been made using available evidence, including a visit to this service. Suitable activities were provided to keep people occupied and stimulated. Visits from friends and relatives were encouraged so people kept in touch with people who were important to them. There was a good catering service which met peoples nutritional needs and food preference. People who live at the home were encouraged to eat a healthy and varied diet. Evidence: Three care files and care plans were checked. These show that people were involved in a number of social activities. People were reading, listening to music and watching television. One person visits the local shop each day, other people need the assistance and support of relatives or staff. Staff organize activities that stimulate people and encourage social interaction. People were encouraged to join in simple fitness and mobility exercises to maintain their Care Homes for Older People Page 14 of 26 Evidence: mobility and sense of wellbeing. Entertainers visit the home for peoples enjoyment. People said they were able to go to bed and rise as they chose. Peoples comments included, the foods good here, dads needs are well catered for, my mum says the meals are very nice and its her opinion that matters most. We saw the cook preparing cakes and buns. She said these were freshly made each day. People said they enjoyed them with their cups of tea and that theres always plenty to eat. The meals provided were appealing and smelled appetizing. People said they enjoyed their meals. They said they can choose other meals if they dont like the one provided. People were seen and heard to make choices at dinnertime. Staff were seen to help and encourage people with their drinks and meals. The mealtime was unhurried with extra portions provided as requested. Peoples personal likes and dislikes were documented and known to staff. Special diets were available as required. Staff said they sought the dietitians advice when they needed to. Drinks and snacks were available throughout both day and night time. Adapted cutlery was available to help people maintain their independence. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service experience good quality outcomes in this area. This judgment has been made using available evidence, including a visit to this service. The complaints procedure enables people to raise any concerns. Concerns and complaints received were dealt with promptly and changes made to improve the quality of peoples lives. Staff had been trained in the recognition and reporting of abuse and relevant checks were made prior to them starting work, this reduced the risk of harm to vulnerable people. Evidence: Visiting relatives and some people living at the home were able to say how they would raise any concerns they had with staff. They said any concerns they had were dealt with promptly and they were happy with the outcome. the complaints procedure was available for people living at the home, their relatives and staff. Their comments included, Ive never had any complaints and Im happy living here. Records showed that concerns raised with the manager had been investigated and concluded swiftly. Care Homes for Older People Page 16 of 26 Evidence: People who had no next of kin or advocate would be provided with access to advocacy services provided by Age Concern. Staff had been provided with training in adult safeguarding procedures to ensure people were safe, and to inform staff what to do if an allegation was made. The inspectors discussions with staff confirmed that they felt confident and able to respond to concerns or complaints effectively. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service experience good quality outcomes in this area. This judgment has been made using available evidence, including a visit to this service. The home was clean, tidy and well maintained ensuring that people live in pleasant and safe surroundings. The bedrooms were clean and reflected personal choice. Evidence: We saw that the home was clean and smelled fresh. Soft furnishings, pictures and ornaments had been used to provide a homely domestic setting. Bedrooms had matching curtains, bedding and soft furnishings. A range of colors had been used to individualize the rooms. A number of families had assisted with personalization of bedrooms with favorite items and memorabilia. Bedrooms were lockable with keys available for people who wished to exercise the choice to lock their own door. Each bedroom was equipped with en-suite toilet facilities. There was level access through out the home, the corridors were wide and were equipped with handrails to assist people maintain their independence and mobility. Care Homes for Older People Page 18 of 26 Evidence: A range of well equipped bathing facilities were available throughout the building. Toilets were equipped with safety aids and grab rails to help people maintain their independence and mobility. Appropriate seating had been provided in the enclosed level garden area for people who wanted to sit outside whenever the weather permitted. Staff confirmed they were provided with protective clothing if they needed it and that all equipment was in working order, being serviced as required. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service experience good quality outcomes in this area. This judgment was made using available evidence including a visit to this service. Staffing levels were maintained to meet peoples care and social needs. Staff had received training to meet general and specific needs. Appropriate support and guidance was provided to new staff, enabling them to safely care for people who lived at the home. Staff files included required information. The home operated a recruitment policy that promoted peoples protection. Evidence: We met with eight members of staff including the manager during the inspection. We observed staff working with people and noted that there was an atmosphere of mutual respect. Their conversations were relaxed and friendly. The staff group were well motivated and enthusiastic about their work. They said they were supported by the manager and encouraged to train and update their skills. A new member of staff we interviewed was able to provide evidence both written and verbal of their induction training and developing knowledge of people living at the home. They confirmed that they had to provide two satisfactory written references and Care Homes for Older People Page 20 of 26 Evidence: a Criminal Records Bureau check before commencing employment. Personnel files sampled confirmed that the home follows company staff recruitment procedures. Records of staff supervision and staff training needs were examined. We saw the staff training and development plan. Training courses completed and planned were seen. These included moving and handling and dementia care training. Many staff had achieved National Vocational Qualifications; the remaining staff were working to achieve the award. Skills for prevention of infection and fire as well as health and safety were updated regularly.This ensures staff were trained to meet peoples needs. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service experience good quality outcomes in this area. This judgment has been made using available evidence, including a visit to this service. Staff said the manager was supportive and approachable and there was a system of professional supervision. People were involved in making decisions about their care and had control over most issues that affected their lives. Systems were in place to protect peoples financial interests. Checks had been made on the major systems in the home such as fire and gas installations to ensure the home is safe for people. Evidence: We saw there was always a trained nurse on duty at the home with advice and support readily available. Responsibilities for day to day operations were shared between senior members of the team. Care Homes for Older People Page 22 of 26 Evidence: People said, I feel the home is well run, and : they have changed my dads life, hes improved so much since he came here. Staff said the manager was approachable, very professional and they felt confident in her. The manager had a job description that defines her role and responsibilities and staff were aware of her role. Staff had received management supervision at regular intervals; this is needed to develop staff and monitor care practices. The company manager visits the home to monitor care and standards at the home. A written report of their findings was available at the home. Management use a quality assurance system to measure standards of care and service provided. Questionnaires are used to seek the views of people and their relatives. Regular meetings are held for staff and people who live at the home. These give people living at the home and their advocates a voice and chance to say how the home should be run. People felt their views and opinions were taken into account by the staff. The manager handles money on behalf of some people, account sheets were up to date with receipts kept. A second person witnesses each transaction. Policies and procedures met the required standards. Records were mainly up to date and well ordered to ensure the best interests of people. No fire exits were obstructed and hazardous substances were securely stored. Statutory servicing and checks of equipment were complete. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!