Care Home: Roberttown Nursing Home

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What the care home does well People living in the home told us that staff are kind and caring. Staff told us they like working at the home and that they work well as a team. What the care home could do better: The manager must make sure that people have a detailed assessment of their needs before they move in. This will make sure that a care plan can be formulated to inform staff what they need to do to make sure that person`s needs are met.The manager must make sure that all of the care plans and risk assessments are brought up to date. This will make sure people receive the care and support they need. Staffing levels in the home must be kept under review and increased as people`s needs change or more people are admitted to the home. This will make sure people`s needs are met on a consistent basis. Ensure that the providers monthly visit reports demonstrate their full assessment of the standards of care and conduct of the home. This will make sure any shortfalls are picked up and dealt with at an early stage. Staff must make sure that they inform us about things that happen in the home. This will make sure we are kept informed about the things we need to know about and can check that staff have taken appropriate action. Repairs, replacement and maintenance of equipment and services must be kept up to date. This will make sure that people living in the home are kept safe. Random inspection report Care homes for older people Name: Address: Roberttown Nursing Home Church Road Roberttown Liversedge West Yorkshire WF15 8BE two star good service 11/11/2009 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Paula McCloy Date: 0 4 0 5 2 0 1 0 Information about the care home Name of care home: Address: Roberttown Nursing Home Church Road Roberttown Liversedge West Yorkshire WF15 8BE 01924411600 01924408395 Manager.robertown@aermid.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) CSS Investments Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 29 Number of places (if applicable): Under 65 Over 65 29 old age, not falling within any other category Conditions of registration: 0 One specific service user under the age of 65, named on variation dated 20th November 2006, may reside at the home Date of last inspection Brief description of the care home Roberttown Nursing Home is purpose built and registered to provide nursing and personal care for up to twenty nine older people. The accommodation is arranged over three floors and all of the bedrooms are single occupancy. The home is located in its own grounds and there are adequate car parking facilities to the front of the home. The home is situated close to the facilities and shops in the village of Roberttown. The home is staffed twenty-four hours a day and there are wakeful night staff on duty. Care Homes for Older People Page 2 of 11 1 1 1 1 2 0 0 9 Brief description of the care home Care Homes for Older People Page 3 of 11 What we found: We looked at all the information that we have received, or asked for, since the last key inspection or annual service review. One inspector visited the home unannounced. During the visit we talked to people living in the home, the staff and the manager about their experiences of living and working at Roberttown Nursing Home. This is what we found: Some of the staff we spoke to told us that they do not always have enough information about people before they come in to the home or that people are admitted too quickly and there hasnt been time to put a care plan into place. To make sure people receive the care they need when they move into Roberttown the manager must make sure that no one is admitted without detailed assessment information. Peoples care plans are not up to date. The manager and nurses have started to update and re write these plans. We looked at one that had been completed and it gave clear information about that persons current needs and what action staff needed to take to make sure those needs are met. We also found some good risk assessments that clearly showed what the risk to that individual was and what action staff had taken in order to reduce that risk. When we last visited in November 2009 there was a key worker system in place, whereby, everyone living in the home had a named nurse and carer. These key staff were responsible for making sure that individual care plans were kept up to date and reviewed every month. This system has not operated for some time as nursing staff have left and the remaining nurses havent had time to keep the plans updated, hence the current situation. To make sure that this does not happen again, time needs to be built into the staff rota for the care plan reviews to take place. At the current time there are 20 people living in the home. Care staff told us that at the moment there were enough care staff on duty on each shift to meet peoples needs. However, they also said that the nurse on duty is always very busy, particularly in the mornings. They also told us that two of the nursing staff left, one about 7 months ago and one about 2 months ago and they havent been replaced. They also told us that the manager has been working a lot of the nursing shifts to provide the necessary cover. We talked to the manager about the staffing situation. She told us that a nurse has been recruited for the 35 hour per week post and is just waiting for a second reference before she can start. Head office have not authorised the other post for 21 hours per week to be advertised. In addition she has been told not to use agency staff. She explained that she had asked for additional nurse cover on a Monday morning, as this is always a very busy time and also for the day medication arrives and has to be checked in, this request was also refused. Staffing levels in the home must be kept under review to make sure that peoples needs are met on a consistent basis. As people become more dependent and when numbers in the home increase staffing levels must be adjusted accordingly. The organisation need to listen to the managers proposals as she is best placed to know how many staff she needs Care Homes for Older People Page 4 of 11 to make sure people receive a good and consistent service. The manager and nurses are working extremely hard to bring all of the care plans up to date. Once this has been achieved these documents need to be kept up to date and reviewed on a monthly basis. This means that the nurses will need allocated time to make sure this happens. There has been a deterioration in the service since we last visited in November 2009 with a break down in the care planning process. The manager is not currently supernumerary to the rota, is working long hours and is trying to train a new administrator. There doesnt appear to be any planned approach to bringing about improvements. We are also concerned that the manager does not appear to be well supported by the organisation in terms of them making resources available. Following our inspection we were contacted by a number of staff who raised concerns with us about lack of resources, infection control issues and poor communication from management. As a result of this information we have made a referral to the safeguaring team in Kirklees. The manager is not registered with us. She told us that she has the application form but has not completed it yet. This means there is no one legally responsible for the day to day management of the home. On 15 April 2010 one of the homes boilers broke down. It was the boiler that supplies hot water to the bathrooms and peoples bedrooms. The boiler that supplies hot water to the kitchen and laundry remained operational. The manager told us that she spoke to people in the organisation to try and get it repaired or replaced. The organisation did not respond quickly and people were without hot water for 7 days before a new boiler was fitted. The manager should have informed us about the situation but didnt. It is important that staff keep us informed about anything untoward so that we can check they are taking the right action to rectify the situation. We looked at some of the maintenance records and saw that a number of recommendations had been made following an inspection of the electrical services in October 2009. To the managers knowledge the recommended improvements have not been made. What the care home does well: What they could do better: The manager must make sure that people have a detailed assessment of their needs before they move in. This will make sure that a care plan can be formulated to inform staff what they need to do to make sure that persons needs are met. Care Homes for Older People Page 5 of 11 The manager must make sure that all of the care plans and risk assessments are brought up to date. This will make sure people receive the care and support they need. Staffing levels in the home must be kept under review and increased as peoples needs change or more people are admitted to the home. This will make sure peoples needs are met on a consistent basis. Ensure that the providers monthly visit reports demonstrate their full assessment of the standards of care and conduct of the home. This will make sure any shortfalls are picked up and dealt with at an early stage. Staff must make sure that they inform us about things that happen in the home. This will make sure we are kept informed about the things we need to know about and can check that staff have taken appropriate action. Repairs, replacement and maintenance of equipment and services must be kept up to date. This will make sure that people living in the home are kept safe. 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 2. Care Homes for Older People Page 6 of 11 Are there any outstanding requirements from the last inspection? Yes R No £ 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 33 26 The area manager must 31/12/2009 write a monthly report about her visits to the home. This will make sure that the manager gets written details about any action that she needs to take to improve the service. Care Homes for Older People Page 7 of 11 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, 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 1 3 14 The manager must make sure that people have a detailed assessment of their needs before they move in. This will make sure that a care plan can be formulated to inform staff what they need to do to make sure that persons needs are met. 30/06/2010 2 7 12 The manager must make 30/06/2010 sure that all of the care plans and risk assessments are brought up to date. This will make sure people receive the care and support they need. 3 27 18 Staffing levels in the home must be kept under review and increased as peoples needs change or more people are admitted to the home. This will make sure peoples needs are met on a consistent basis. 31/05/2010 Care Homes for Older People Page 8 of 11 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 4 33 26 Ensure that the providers 01/06/2010 monthly visit reports demonstrate their full assessment of the standards of care and conduct of the home. This will make sure any shortfalls are picked up and dealt with at an early stage. 5 38 37 Staff must make sure that they inform us about things that happen in the home, that are covered by this regulation. This will make sure we are kept informed about the things we need to know about and can check that staff have taken appropriate action. 31/05/2010 6 38 13 The organisation must make 30/06/2010 sure repairs, replacement, maintenence of equipment and services are kept up to date. This will make sure that people living in the home are kept safe. 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 1 7 The key worker system should be re-implemented so that every person has a named nurse and carer who make sure Page 9 of 11 Care Homes for Older People 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 plans are up to date and that the person themselves is getting the care and support they want. Care Homes for Older People Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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