Care Home: Romney Cottage Care Home

What the care home does well Romney Cottage provides a caring and supportive environment for the people who live there. They supported by a team who are caring and respectful towards them. Staff work positively with the service users to help them develop greater levels of independence and confidence. There is good leadership endeavouring to ensure the service continues to develop. The home has adequate personal and communal spaces to meet residents` needs. There is also a secure garden area. People living in the home are supported in maintaining contact with family and friends. What has improved since the last inspection? This was the first inspection since registration. CARE HOMES FOR OLDER PEOPLE Romney Cottage Care Home Madeira Road Littlestone New Romney Kent TN28 8QX Lead Inspector Geoff Senior Unannounced Inspection 10:15 30th May 2008 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 Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Romney Cottage Care Home Address Madeira Road Littlestone New Romney Kent TN28 8QX 01797 363336 01797 369155 RomneycottageRCH@aol.com 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) Dr Saravanamuttu Sivapalan Mrs Sarojini Sivapalan, Mr Kumarasamy Thanigasalan Vijayakumar, Mrs Mehala Vijayakumar Ms Maureen Gosbee Care Home 22 Category(ies) of Dementia (0), Mental disorder, excluding registration, with number learning disability or dementia (0) of places Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia, excluding mental disorder or learning disability (DE) 2. Mental Disorder, excluding learning disability or dementia (MD) The maximum number of service users to be accommodated is twenty-two (22). Date of last inspection Brief Description of the Service: Romney Cottage is registered to provide care and accommodation for up to 22 people for people with Dementia or Mental Disorder. It is a large detached home situated in a quiet residential area of the seaside village of Littlestone, New Romney. The premises benefit from adequate communal space and comfortable bedrooms, garden space to the rear and a close proximity to the seafront promenade. There is limited public transport and few community facilities within walking distance. The resident group has for the most part been quite stable for some time. There is a good blend of youth and experience in the staff team. Further information relating to the operation of the home and fee structure may be obtained by direct contact with the Provider and Management. Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit undertaken as part of the first key inspection of the service following a change of Registered Provider. The visit lasted for about five hours. The Manager, three staff members, a number of service users and two visiting relatives were spoken with during the visit. A range of records was viewed. The report also considers information forwarded to the Commission in the Annual Quality Assurance Assessment completed by the Manager. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. What the service does well: What has improved since the last inspection? This was the first inspection since registration. Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 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 summary of this inspection report can be made available in other formats on request. Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 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 Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6. People who use the service experience adequate quality outcomes in this area. Prospective residents or their representatives have information available to them to help them decide whether the home is able to meet their needs. Assessment of need is reportedly carried out with prospective residents prior to admission to the home. This should be clearly allied to, and reflected in, care plan documentation. Prospective residents have the opportunity of a trial period to assess the suitability of the home for their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 Page 9 The statement of purpose and service users guide is available to current and prospective service users at all times. It contains information to assist residents and their representatives to make an informed decision as to whether the home is suitable and able to meet their needs. The Manager reported that the Client age range on admission is changing by default (was over 55). As well as offering long term care the home is now tending to be a staging post for younger (50yrs) service users seeking a period of stability before returning to a more independent lifestyle. Pre-admission assessments are reportedly undertaken in the clients’ home environment as well as at Romney Cottage and aim to give staff accurate and relevant information about the resident and their support needs. Information is gathered from, care managers and, where possible, relatives. A copy of the joint assessment is obtained for people who are under the local social services care management team. The information is then brought together to decide whether or not the home will be ale to meet the assessed needs. Although assessment details were not seen at the time of inspection the feedback from service users and visiting relatives spoken with is of a positive, well-informed and supportive regime. Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7.8.9.10. People who use the service experience good quality outcomes in this area. Care plans are in place. They would benefit from clearer links to assessment and evidence user involvement. Staff indicated an awareness and commitment to the dignified care of the service users. The management and administration of medicines is satisfactory. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service user files are regularly reviewed and updated by the Manager and the key worker. A sample number of service user files were viewed; they broadly support people in a positive manner but do not clearly show what, if any, input service users have had. But when we spoke to some of the residents, they told Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 Page 11 us that they had agreed with the plans, and had a say in their support programmed. The care plans are orientated toward monitoring rather than supporting goals and aspirations in conjunction with the service users. The home has reportedly started to develop a more person centred approach to care. This is not yet clearly evidenced in files, but in practice this is happening, and an improvement would be to show it clearly in the documents. The service told us that there is a good relationship and liaison with community health services. All residents have access to NHS services. Daily records detail health and physical care, They describe the basic activities but not the demeanour of the person or what they actually got out of the day. Staff were observed generally assisting the residents in a caring and supportive manner and were seen treating them with patience and respect. Members of staff spoken to confirmed an understanding and commitment to this aspect of care. They displayed a good understanding of the service users right to make decisions and to be consulted on matters affecting them. Arrangements for storage and administration of medication was satisfactory and records seen were complete and up to date. There was no indication that any of the service users manage their own medication. There was no comment in the AQAA as to whether the home intends to accommodate and support the people who wish to self medicate. The manager agreed to consider this possibility using assessment. All staff administering medication have received training. The manager agreed to update her own training in regard to undertaking competency assessments of her staff. Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 People who use the service experience good quality outcomes in this area. The activity programme has improved and supports individuals’ aspirations and wishes. Family links are encouraged and maintained wherever possible. The home provides nutritious and varied meals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There has been some improvement in developing facilities and activities that are geared towards meeting needs, abilities and interests of the people who live at the home. Residents meetings are held so that service users have the opportunity to voice their opinions, thoughts and wishes. Changes made include: a computer for resident use, a TV freeview box for the sports Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 Page 13 watchers, more trips out. A number of service users spoken with said how much they enjoyed going for walks. It was not clear whether there are always sufficient staff available to help with this. Similarly there was little information forthcoming either verbally or on care records about involvement in the community or access to the community facilities. Relatives reported they are made to feel welcome at the home at all reasonable times and no restrictions are imposed. Residents are able to receive their visitors in the privacy of their own rooms or in the communal areas. The people at the home felt that they were able to have choice in regards to their day-to-day lives. Examples given were that they could get up and go to bed when they liked. They could choose what to eat and where to eat their meals. Generally they felt happy with the choices they are offered and feel there is a good and positive atmosphere in the home. There is information available for residents and their families on how to contact external agencies and advocates. The home provides a varied menu ensuring the residents receive a nutritious and balanced diet. A visitor commented, “we are made welcome and may stay for a meal if we wish.” Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. People who use the service experience good quality outcomes in this area. Written information is available service users/relatives/visitors and staff who may wish to express concern or complain. Staff have attended training in safeguarding vulnerable people from the risk of abuse. Records should show that Service users/relatives/visitors concerns are acted upon and responded to in a satisfactory and timely fashion. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure is available within the home. Residents, relatives and staff are aware of how to make a complaint. Service users confirmed they would be happy to use the formal procedure if necessary but were confident that staff and the manager would sort any problems quickly. Comments from a service user, “If I have a problem I would go and see the manager without hesitation Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 Page 15 The home has policies and procedures in place to protect service users from abuse. The majority of staff have now received training in safe guarding adults. They have an awareness of what constitutes abuse and reported that they would have no problem whistle blowing if the need arose. Staff spoken with would be happy to approach the manager or Provider if the need arose. There have been no complaints or concerns expressed to the Commission or Management about the home since registration. The manager has dealt with one issue raised by staff and, although copies of correspondence were kept, no formal record of the issue, action and outcome was made. Staff records show that required safeguarding checks are undertaken by the management prior to new staff commencing duties. Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26. People who use the service experience good quality outcomes in this area. The home provides a varied and comfortable environment in which to live and work This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents’ benefit from living in a home that is clean, pleasant, spacious and comfortable. Service users were seen to be using most parts of the premises and some were in the garden. There is a choice of two lounges to sit and take meals in. Individual rooms were adequately furnished and seen to contain items of furniture and ornament personal to the occupant. One service user passed Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 Page 17 comment that she was more than happy with both her room and the house as it’s ‘nice and homely, always clean and I feel safe here’. The garden is well maintained and has areas with tables and chairs, a summerhouse and a smoking shelter. The latter is however, limited in size and offers little protection from the elements. Laundry and catering facilities are reportedly adequate for the needs of the home. Separate staff are employed for cooking, cleaning and laundry. The AQAA told us that maintenance certification was satisfactory and up to date. The premises appeared to be clean, tidy and free from undue odour. Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience adequate quality outcomes in this area Residents’ needs are met by sufficient numbers of competent staff to ensure they are cared for appropriately. People living in the home are protected by the home’s recruitment policies and practices This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a core of long established staff who have built a mutual relationship of trust and understanding with the service users. They have a good awareness of their support needs and respond accordingly. The established rota pattern allows for 3 support staff each shift with additional catering and housekeeping staff in the mornings. There is the manager or a senior care worker on duty each day. Service users spoken with feel there are enough staff around most of the time. They would like to have more sometimes so they can have more 1-1 walks and outings. The training matrix and a number of staff training certificates were viewed. They showed that the training programme has addressed most statutory Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 Page 19 requirements but a lack of first aid training was noted. Only 3 of the staff are 1st aiders. There should be a first aider available at all times. We were informed that, of the 14 staff 4 have attained NVQ level 2 or above and a further 5 are undertaking or awaiting courses. In addition to Dementia Awareness the manager has tried to obtain training for staff in supporting people with Korsakoffs syndrome. There is a robust procedure in place that recognises the importance of effective recruitment procedures in the delivery of good quality services and for the protection of individuals. Staff files were seen to contain evidence of Criminal record Bureau checks being undertaken and references sought. We also saw that staff receive regular one to one supervision with the Manager. Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience good quality outcomes in this area The home is being well managed resulting in a caring and supportive service that promotes the health, safety and welfare of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager presents as a well motivated and informed individual who has worked hard to develop an open and inclusive atmosphere in the home. She has attained Level 4 NVQ and the Registered Managers Award and is keen to promote appropriate and relevant training for her staff. She is developing the skill of delegation in order that she can spend a reasonable amount of time at floor level as well as the completion of Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 Page 21 administrative and supervisory tasks. She is well supported by the providers who visit the home weekly. The AQAA made no mention of Quality Assurance systems or outcomes. Residents and staff stated however that they are regularly consulted and have ample opportunity to contribute to the decision making process. They feel that the home is run in the best interests of the people who live there. The health, safety and welfare of all is promoted and protected. Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x 3 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 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x x x x 2 Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 Page 23 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 OP38 Regulation 13 (4) c Requirement The Manager ensures safe working practices including: a qualified first aider at all times. 1st aid A record is kept of all complaints and includes details of any investigation and any action taken Timescale for action 31/08/08 2 OP16 Schedule (4 )11 31/07/08 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 OP33 OP30 Good Practice Recommendations Evidence effective QA systems are in place. Training to include service specific input – Korsakoffs. Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Romney Cottage Care Home DS0000071227.V361353.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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