Inspection on 17/03/06 for The Rubens

This inspection was carried out on 17th March 2006.

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

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

Other inspections for this house

The Rubens 23/10/07

The Rubens 07/03/07

The Rubens 26/09/06

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE The Rubens Pave Lane Newport Shropshire TF10 9LQ Lead Inspector Keith Salmon Announced Inspection 17th March 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Rubens DS0000064155.V280459.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Rubens DS0000064155.V280459.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Rubens Address Pave Lane Newport Shropshire TF10 9LQ 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) 01952 810400 01952 810400 United Care Ltd Mrs Jane Elizabeth Timmins Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places The Rubens DS0000064155.V280459.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: The Rubens is a privately owned Residential Home, which opened as a care home in 1987, and is registered to provide care and accommodation for up-to 26 older people. Situated in a semi-rural location, on the edge of the Shropshire Town of Newport, local amenities are available within a short drive. The Home is a conversion of a 19th Century building, with a purpose built extension added in 1999, and accommodation comprises mostly single bedrooms, 20 of which having en-suite lavatory and wash-hand basin facilities. There are a number of lounge/seating areas and one dining room. With pleasant gardens to the rear of the building many of the rooms benefit from extensive rural views. The Rubens DS0000064155.V280459.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Announced Inspection was undertaken by one Inspector, commenced at 09.30 am and took 4.0 hours. Present were Ms. Sally Williams, Area Manager United Care Limited, and the recently appointed Manager Ms. Debbie Aston. Being the second Inspection of 2005/06 it centred on ‘Requirements’ cited at the previous Inspection, held in May 2005, and ‘Key’ Standards not addressed at that time. This Report is based on observations made during a tour of the Home, a review of care related documentation, staff duty rotas, a range of other documents/records reflecting the general operation of the Home, and completed ‘Comments’ cards. The Inspector also held 1:1 discussions with a number of Staff, 14 Residents, plus a group discussion with a number of Residents and 2 Relatives/Visitors. What the service does well: What has improved since the last inspection? At the previous Inspection 5 ‘Requirements’ were cited, which related to various aspects of care, i.e. introduction of a new care plan design, an aspect of medicines administration practice, improving Residents’ input to activities programme development, ensuring Residents are enabled to vote, and to the recruitment of a suitably qualified/experienced Manager, who should apply to CSCI for formal approval and Registration. All ‘Requirements’ have been met. The Rubens DS0000064155.V280459.R01.S.doc Version 5.1 Page 6 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 Rubens DS0000064155.V280459.R01.S.doc Version 5.1 Page 7 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 Rubens DS0000064155.V280459.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These Standards were not fully assessed at this Inspection EVIDENCE: The Rubens DS0000064155.V280459.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. The model of Care Plan utilised by the Home is easy to follow and of effective design. It is diligently utilised in aiding the provision of care, which meets Residents’ assessed care needs. Practices relating to the storage, administration and disposal of medicines are in accordance with accepted good practice. Staff relate to Residents in a friendly and respectful manner. EVIDENCE: Review of Care Plans showed that the work needed to transfer all Residents to the ‘new’ model of documentation has been successfully completed. The documentation was well organised, easy to understand and up-to-date. Individual discussions with Residents, together with ‘Comment Cards’ completed by Residents and Relatives, confirmed Residents’ needs are being met, and they are treated in a considerate and respectful manner. Inspection of medicine storage provision, and related administration records, demonstrated the Home’s practices meet the guidelines of the Royal Pharmaceutical Society. Specifically, the practice employed for recording the administration of medication at breakfast time has been changed and is now acceptable. The Rubens DS0000064155.V280459.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,15. Where Residents’ capabilities permit, the Home works with Residents to enable good contact with family and friends and the continuation of religious practices. The ‘Standard’ relating to organised social and leisure activities is now met. Choice, preparation and presentation of meals are of high quality and the Inspector considers the Home and the Catering Staff are to be commended for the excellent quality of their provision. EVIDENCE: Since the Previous Inspection the Home has markedly increased the range/variety of programmed activities. The real ‘plus’ is the active involvement by Residents’ in the planning of the new programme – a process confirmed directly to the Inspector by both Residents and visiting Relatives. Activities include visiting entertainers, visits by ‘PAT’ dogs (very well received), Bingo, musical evenings, reminiscence sessions, quizzes and movement to music. Residents were very complimentary about the range, quality and choice of food provided, telling the Inspector it was of “excellent quality, well presented and of sufficient quantity.” The menu offers good overall variety with a choice each day. Residents may choose meals not itemised on the ‘menu of the day’ and are enabled take meals in their bedroom if they so wish. The Rubens DS0000064155.V280459.R01.S.doc Version 5.1 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17. A criticism made at the previous Inspection was some Residents who had wished to vote were not enabled to do so. This issue has now been satisfactorily addressed. EVIDENCE: Residents informed the Inspector, and records confirmed, that through direct discussion with Residents, the Home’s Management have actively addressed the issue of voting, and how best to enable Residents to cast their vote at Local and General Elections, should they wish to do so. In addition, arrangements were made for the local Member of Parliament, Mr. Andrew Eade, to visit the Home. A number of Residents told the Inspector they had enjoyed this visit very much. The Rubens DS0000064155.V280459.R01.S.doc Version 5.1 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 25. At the previous Inspection general environmental standards within, and around the Home, were found to be satisfactory. However, there are clear signs that the combination of new Owner and new Management is effecting further improvement in levels of décor. EVIDENCE: A tour of the Home demonstrated that since the previous Inspection attention has been given to redecoration/refurbishment – particularly in the older part of the Home. There is now an on-going redecoration/refurbishment plan in place, which is regularly reviewed (at least annually) with an up-to-date copy held at the Home. However, an area requiring urgent addressing is the lack of thermostatic controls to hot water taps on wash-hand basins in some of the bedrooms. The Rubens DS0000064155.V280459.R01.S.doc Version 5.1 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29,30. Recruitment and employment practices are consistent with the safeguarding of Residents. The Management ensures all Staff have the training opportunities necessary to enable them to gain the skills necessary to carry out their caring role(s). EVIDENCE: The Home has previously enjoyed a good reputation for affording Staff opportunities to undertake basic training and on-going personal development. Evidence observed in Staff Files, and in future training plans, suggested that this approach will continue. Particularly pertinent are arrangements already in hand to enable Staff to undertake a ‘food hygiene’ course to strengthen support for the Cook when this lady has her days-off/holidays. The Rubens DS0000064155.V280459.R01.S.doc Version 5.1 Page 14 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,38. The Home continues to provide satisfactory care, in an environment that is homely and generally safe, with the central purpose being ‘the best interests of the Residents’. Indications, evident at the previous Inspection, suggested that the lack of an experienced person, charged with formal responsibility for management of the Home, was leading to a decline in practices in some areas. This has been effectively addressed by the appointment of a new Home Manager, capably supported by the Parent Company’s Area Manager. EVIDENCE: Through the tour of the Home, discussion with the newly appointed Manager, Ms. Debbie Aston, and the Area Manager for United Care Limited, Ms. Sally Williams, together with comments from Residents and visiting Relatives, the Inspector considers the Home is benefiting from having a Manager in post who appears committed and enthusiastic. Radiators, situated in the original section of the Home have recently been brought back into use and are in need of protective covering, or replacement radiators with suitable ‘cool’ surfaces. The Rubens DS0000064155.V280459.R01.S.doc Version 5.1 Page 15 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 X X X X X X X 2 X STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 2 The Rubens DS0000064155.V280459.R01.S.doc Version 5.1 Page 16 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP25 Regulation 13(4)(a)(c) Requirement Timescale for action 30/04/06 2. OP25 13(4)(a)(c) 3. OP38 13(4)(a)(c) To introduce a ‘works’ programme to install thermostatic control valves to hot water taps on wash-hand basins in Residents’ bedrooms. (Proposed programme to be submitted to CSCI for agreement regarding timescale.) To complete a ‘risk assessment’ 30/04/06 survey of all hot water taps in Residents’ bedrooms to determine which Residents are most at risk from accidental scalding, and then to undertake the fitting of thermostatic valves to these bedrooms as a priority. To remove the risk of burning by 30/04/06 unprotected radiator surfaces by installing protective covering, or replacement with radiators, which have suitable ‘cool’ surfaces. The Rubens DS0000064155.V280459.R01.S.doc Version 5.1 Page 17 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Rubens DS0000064155.V280459.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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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