Care Home: Roop Cottage

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What the care home does well People were observed relaxing in the lounges, dining rooms and in their own bedrooms There was a relaxed and homely atmosphere created and staff were observed treating people with dignity and respecting peoples wishes. To make sure the service can meet peoples personal care and health care needs these are assessed before coming to live in the home. The assessments include seeing if people have the ability to have a say in how they are cared for and supported. To make sure peoples needs are met there are care plans showing staff what they must do and how people want to be supported. The daily records show people have the opportunity to make choices and decisions about how they live their daily lives. People are protected by the way staff are recruited and selected and staff have training in how to care for people properly and keep them safe. There was enough staff available on the day of the visit to meet peoples care and support needs in a relaxed and unhurried manner. There are nurses always available to make sure peoples health care needs are met. Nurses have special training to make sure they can use specialist equipment. Those giving medicines are also trained in how to do this properly and safely. People are protected by the way staff are selected and recruited and they are trained in how to care for people safely. Most staff are qualified nurses or have a National Vocational Qualification. The homes returned quality assurance surveys show people and their relatives are happy with the support and services provided saying they thought the services are good or excellent. The menus show people have a choice from a varied and balanced diet and everyone has a nutritional assessment to make sure they have enough to eat and drink. Activities are organized on a daily basis for those people who want to join in. The record of complaints show what people say is taken seriously and is acted upon. What has improved since the last inspection? Since the previous visit there is now for the use of people living in the home a small conservatory adjoining the lower floor lounge. Various areas have been redecorated and include the lounges, corridors and some bedrooms. There is also a new corridor carpet on the first floor. To make sure peoples rights are upheld and promoted there are now mental capacity assessments to show if people can say what happens to them and how they want to be supported. There are also assessments to show if people are deprived of their liberty in any way to keep them safe. Some staff have also had training on the Mental Capacity Act and on the Deprivation of Liberty Assessments. This practice is to be commended. What the care home could do better: It is acknowledged that activities are arranged for people living in the home, however the record of activities does not show who took part in the activities or who chose not to participate. People are protected by the way medicines are dealt with in the home, however, the medicine administration systems have not been audited by a pharmacist for some years. Records show staff have Safeguarding training about how to protect people from any kind of abuse. However the records also show some staff have not had any Safeguarding update training for some years. People are protected by the Safeguarding policies and procedures, however, the policy shows it does not include the Wakefield Local Authority Protocols. Peoples views about the quality of the services provided is sought through satisfaction surveys and a report is provided.However, the report does not contain a lot of detail showing what people said about the home or any changes to the way the home runs as a result of their comments. Key inspection report Care homes for older people Name: Address: Roop Cottage Wakefield Road Fitzwilliam Pontefract West Yorks WF9 5AN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Tony Railton     Date: 1 5 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. that people have said are important to them: They reflect the things 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. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Roop Cottage Wakefield Road Fitzwilliam Pontefract West Yorks WF9 5AN 01977610918 01977610918 kana541@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Dr R R Kanani,Mrs M R Kanani care home 35 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Roop Cottage, a home providing accommodation and care with nursing for a mixed category of service users (Older People and Younger Adults), is situated on the outskirts of the village of Fitzwilliam, a small village 8 miles from the city of Wakefield. The home is not too far from a small number of local shops and a pub. The home is privately owned and registered for older people and for younger adults with a physical disability who are accommodated in dedicated units. The accommodation is provided over two floors, older persons being based on the upper floor, younger persons on the ground floor. The rooms are single occupancy and two rooms have en-suite facilities. The gardens are accessible and of a good size. The current fees for July 2007 are #373 plus a nursing care contribution per week per person. The service provider ensures that information about the service is available to prospective service users and the current service users by way of the home?s Statement of Purpose, the Service Care Homes for Older People Page 4 of 24 Over 65 35 0 0 13 Brief description of the care home User Guide and through CSCI inspection reports. Care Homes for Older People Page 5 of 24 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: Following this inspection visit the service has been given a Two Star rating which means people living in the home experience good quality outcomes. This visit started at 09:00 and ended at 13:00. During this visit there was the opportunity to meet and speak with most people living in the home. The Deputy manager assisted with the inspection visit and there was the opportunity to speak to the Nurses, Care staff, domestics, cook and kitchen staff the activities coordinator. A ample of three peoples records were checked and included, assessments, care plans, reviews, daily, medical an financial records. A sample of three staff records were also seen and included, application forms, interview records, references, police and POVA (Protection of Vulnerable Adult List), and health checks. Staff training records were also seen. The record of complaints was looked at and discussed with the Deputy Manager. A tour of the home was also undertaken. 15 returned service user surveys were considered and the homes Quality Assurance Report. Other information sent in by the service providers (the AQAA Annual Quality Assurance Assessment) was also considered along with the Care Homes for Older People Page 6 of 24 previous Inspection visit report and service history. This was a very positive visit and the inspector would like to take the opportunity to thank the Deputy manager, the people living in the home and the staff team for their hospitality and cooperation throughout the visit. Care Homes for Older People Page 7 of 24 What the care home does well: What has improved since the last inspection? What they could do better: It is acknowledged that activities are arranged for people living in the home, however the record of activities does not show who took part in the activities or who chose not to participate. People are protected by the way medicines are dealt with in the home, however, the medicine administration systems have not been audited by a pharmacist for some years. Records show staff have Safeguarding training about how to protect people from any kind of abuse. However the records also show some staff have not had any Safeguarding update training for some years. People are protected by the Safeguarding policies and procedures, however, the policy shows it does not include the Wakefield Local Authority Protocols. Peoples views about the quality of the services provided is sought through satisfaction surveys and a report is provided.However, the report does not contain a lot of detail showing what people said about the home or any changes to Care Homes for Older People Page 8 of 24 the way the home runs as a result of their comments. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 24 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 10 of 24 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. To make sure the service can meet peoples personal and health care needs these are assessed before coming to live in the home. The home does not provide a specialist service for intermediate care or rehabilitation. Evidence: To make sure the home can meet peoples personal and health care needs these are assessed before coming to live in the home. A sample of three peoples records show there are assessments of their care needs and their nursing care needs. To make sure their needs are fully met people also have a social history completed by them and their relatives. These assessments show peoples social needs and include their choices an preferences regarding how they want to be cared for and supported. The Deputy Manager says that a qualified nurse goes out to meet and assess peoples needs before they are offered a place in the home. The Deputy Manager also confirmed that the home does not provide a specialist service for intermediate care or rehabilitation. Care Homes for Older People Page 11 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and health care needs are met and they are supported to make decisions about how they live their daily lives. People are also protected by the way medicines are dealt with in the home. Evidence: To make sure peoples care and support needs are met these are set out in their individual plan of care. Records show these are looked at regularly and changed to reflect peoples current personal and health care needs. To protect people living in the home there are Moving and Handling Assessments and risk assessments against falls. Some people requiring bed care have turning charts to record when they are moved to prevent pressure sores. To make sure people get enough to drink there are also records of how much they have to drink. Records show people have a Nutritional Assessment to make sure they have a proper and balanced diet. To make sure people receive their prescribed medicines some peoples medicines were checked and found to be correct. People are protected by the way medicines are dealt with as they are properly stored, administered and recorded. To protect people living in the home the Records show the medicines are checked regularly by the Registered Manager. Care Homes for Older People Page 12 of 24 Evidence: However, the Deputy manager says the medicines have not been audited by a Pharmacist for some years. Peoples records show they have their health care needs met by ordinary community based health care services, including General Practitioners, District Nurses, Chiropodist, Dentist and Optician. Discussion with people living in the home found they are happy with the care and support provided. People were observed being treated with dignity and having their wishes respected. Discussion with the nurses and care workers found they have a good understanding of the needs of older people. The homes returned satisfaction surveys show people living in the home and their relatives are happy with the support and services provided. It was noted that one person living in the home suffers with Huntingtons Chorea and staff training records show some have had specialist training in this area. Records also show some staff have had Mental Capacity Act training and also Deprivation of Liberty Training. Records show that people entering the home have a Mental Capacity Assessment and a Deprivation of Liberty Assessment this is to make sure peoples rights are upheld and their Independence is promoted. This good practice is to be commended. Care Homes for Older People Page 13 of 24 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. The lifestyle experienced by people living in the home matches their expectations and they are offered a choice from a varied and balanced diet. Evidence: Discussions with the Activities Organizer found that there are regular activities arranged for people living in the home. The record of activities confirms this and shows people can choose to join in a range of activities arranged on a daily basis. However the records do not show who chose to participate and who didnt want to take part. Records show there are Music, film and Craft sessions and more recently some people have completed Life Books giving a pictorial history of their lives and memories. A plan of activities is displayed on the notice boards for people and their relatives to see. The minutes of the residents meetings show they have the opportunity to comment on the activities and meals provided. The choice menus show people are offered a varied and balanced diet. Records show people living in the home have Nutritional Assessments and there are plans making sure people have enough to eat. Some people also have a Fluid Input Chart to make sure they have enough to drink. The Fifteen returned satisfaction surveys show people and their relatives are happy with the activities and meals provided saying they are either good or excellent. The report following a visit from the Environmental Health Inspectors gave the home Care Homes for Older People Page 14 of 24 Evidence: Four Gold Stars for the kitchen and food preparation. The cook said that it might have been Five Stars if not for the kitchen floor which is damaged and going to be replaced. People were observed having their meals in relaxed and pleasant surroundings and were assisted by staff in a relaxed and unhurried manner. Care Homes for Older People Page 15 of 24 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. What people say is taken seriously and is acted upon and people are protected by the Safeguarding Policies and Procedures. Evidence: People living in the home are protected by the Safeguarding Policy and Procedure telling staff how to recognize abuse and how to report any allegations of abuse. It is acknowledged that the home has a copy of the Wakefield Local Authority Safeguarding Protocols , however, this is not referred to in the homes Safeguarding Policy. To further protect people living in the home the staff training records show they have Safeguarding Training. However some of this training was done in 2005 . Discussion with care staff found they have a good understanding of the needs of older people and what constitutes abuse. What people say is taken seriously and is acted upon as the record of complaints show that a proper record is kept and prompt action is taken to put things right. A copy of the complaints policy and procedure is displayed in the home telling people how to complain. The service Care Quality Commission records show the home has not had to make any Safeguarding referrals to the local authority The history also shows there have been no complaints received about the care provided by the home. Care Homes for Older People Page 16 of 24 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 live in a home that is well maintained , well decorated comfortable, clean and safe. Evidence: People were observed relaxing in quiet and pleasant surroundings. People were socializing in the lounges, some talking and others watching television. Some were have breakfast in the dining rooms and some being cared for in their rooms. All areas of the home were clean and free from any unpleasant odors. All areas of the home are well decorated and well maintained. Discussion with the Domestic staff found they have all the equipment they need to keep the home clean. The Manager and staff team are to be commended for maintaining such high standards of cleanliness for people living in the home. It was noted that the ground floor corridor carpet was stained by flood damage as was the kitchen floor. The Deputy manager said these are going to be replaced over the coming months. The homes returned satisfaction surveys show people living in the home and their relatives are happy with the home and the services provided. People live in a home that is safe as the maintenance records show the emergency fire equipment is checked regularly.Records also show the hoists and passenger lift are also serviced and maintained regularly. Care Homes for Older People Page 17 of 24 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. Peoples care and support needs are met by trained and qualified staff and they are protected by the way staff are selected and recruited. Evidence: On the day of the visit there was enough staff available to met the needs of people living in the home in relaxed and unhurried manner. Positive relationships were observed being fostered between people i the home and those caring for them. People were treated with dignity and their wishes were respected. People are protected by the way staff are selected and recruited as a sample of three staff records show, references, police and Protection of Vulnerable Adult List checks are taken up before they are employed. To keep people safe records show staff have Moving and Handling, Fist Aid, Infection Control and Food Hygiene training. Those people requiring nursing care have their needs met by Qualified Nursing staff that have update training that includes, Pressure Care, the safe use of Syringe Drivers, safe Administration of Medicines. To make sue peoples rights re upheld and protected Senior staff have received Mental Capacity Act training and in particular the use of Deprivation of Liberty Assessments. This practice is to be commended. Care Homes for Older People Page 18 of 24 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 live in a well managed home that is run in their best interests and where their health , safety and wellbeing is promoted and protected. Evidence: People live in a well managed home run by someone that is experienced and qualified. A sample of peoples records show the care management systems are good and make sure peoples care needs are met. Other peoples records show that their nursing needs are met by qualified Nurses who also have special training. People are protected by the way staff are recruited and selected and the staff management systems are good. The daily records and the homes returned satisfaction surveys show people living in the home have a say in the running of the home and the opportunity to comment on the quality of the services provided. The annual quality assurance report shows the information gathered through quality assurance surveys is collated and a report is provided. However, this report is not very detailed and does not reflect everything people said about the home or any changes that was made to the way the home runs as a result of their comments. Peoples financial interests are protected as three Care Homes for Older People Page 19 of 24 Evidence: peoples finances were checked and found to be properly recorded, correct and safe. Peoples health, safety and wellbeing is promoted and protected as staff training records show they have Health and Safety training. The maintenance records also show that the emergency equipment is checked regularly to keep people safe. Care Homes for Older People Page 20 of 24 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 21 of 24 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 1 9 As a matter of good practice the home my also consider having the medicine administration systems audited by a Pharmacist annually. As a matter of good practice the activities coordinator may consider identifying people who participate in activities and those who are asked but dont want to join in. As a matter of good practice the home should consider including the Wakefield Local Authority Protocol as part of its Safeguarding Policy and Procedure. As a matter of good practice Safeguarding update training should be provided as soon as is practicable for those who require it. For the comfort of people living in the home the corridor floor covering and kitchen floor covering should be replaced as soon as is practicable. As a matter of good practice more detail should be added to the Annual Quality Assurance report to reflect what people said about the quality of services provided and what changes were made to the way the home runs as a result of their comments. Page 22 of 24 2 12 3 18 4 18 5 19 6 33 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 Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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 © (2009) Care Quality Commission (CQC). 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