Care Home: Rowandale

Similar services:

• Clover House
• Parkside
• Park Lodge
• Mere Hall View
• St Bonaventures
• Hudson Road
• Whitewalls
• Home Farm

What the care home does well Useful information is supplied to people who are considering a move to the home, to help them make a decision. The manager has spent time and effort to ensure that this information is provided in a helpful and meaningful way and for example, has made the Service User Guide available in DVD format. A significant amount of time is taken to ensure that the admission process for any new resident is carried out in a sensitive and thorough manner, so that people are assured that carers have a good understanding of their needs by the time they move into the home. People are encouraged to visit the home with their families throughout the admission process so that they can get to know other residents and staff and get a feel for the home.The home has an excellent approach to planning residents` care. Care planning is very much based on residents` individual needs and their preferences are taken into account to as great an extent as is possible. The residents` preferred daily routines are rightly seen as very important and clearly stated in their individual plans. The home understands the importance of enabling younger adults to achieve their goals, follow their interests and be integrated into community life and leisure activities. Residents are able to enjoy a full and stimulating lifestyle with a variety of options to choose from. People are encouraged to express their views and opinions about their own care and the general running of the home. There are a number of ways that the manager tries to enable this, for instance by encouraging people to use the services of independent advocates. In addition, there is a Service User Council which meets on a regular basis to discuss ideas about the service. Pictorial menus have been developed to assist residents in making and expressing choices about the meals and snacks they would like. Residents and their representatives are enabled to raise concerns, and any concerns that are raised are dealt with quickly and effectively. Guidance on how to raise concerns is made available to residents in written, pictorial and DVD format. The home is well maintained, and furnished and decorated to a good standard. There are a variety of communal areas for residents to access including a sensory room and safe outdoor space. Residents all have their own bedrooms and these are nicely furnished and decorated in styles chosen by the individual residents. The manager ensures that staffing levels at the home are adequate to meet the needs of people living there. We were also able to confirm that additional staff are available to support people to take part in activities of their own choosing on a regular basis. The home has a good approach to training with a core training programme in place for all staff members. The programme includes all the mandatory training areas such as moving and handling and first aid, as well as additional courses relevant to carers` roles such as safeguarding adults and person centred planning.RowandaleDS0000045627.V351714.R01.S.docVersion 5.2Page 8 What has improved since the last inspection? A number of requirements and recommendations were made following the last inspection of the home and during this visit, we were able to confirm that these had been addressed. The home`s Statement of Purpose and Service User Guide have been amended to provide more accurate and up to date information. The Service User Guide has now been produced in a DVD format, which will be of great benefit to people who are considering a move to the home. All residents and their representatives have been provided with a copy of the home`s complaints policy. In addition, the complaints procedure is now supplied on a DVD as well as in a written and pictorial format. The provision of activities has been enhanced and efforts made to provide a more structured, person centred programme for each resident. In addition, residents are now provided with more opportunities to take part in community based activities. The staff training programme has been reviewed and improved. A more structured induction programme is now provided to all new starters which is in line with Skills for Care standards. Carers` and senior carers` core training has been reviewed and enhanced. As well as training in the key health and safety areas, staff are provided with courses in additional areas such as person centred approaches and safeguarding adults. The home`s recruitment policy and procedures have been reviewed and updated to further safeguard the wellbeing of residents and reflect current good practice. A number of environmental improvements have been made and several areas within the home have been redecorated. The manager has converted some office space into an additional sensory room that residents can use throughout the day and evening. CARE HOME ADULTS 18-65 Rowandale Back Lane Clayton le Woods Chorley Lancashire PR6 7EU Lead Inspector Mrs Marie Cordingley Unannounced Inspection 5th December 2007 10:00 Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 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 Rowandale DS0000045627.V351714.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 Adults 18-65. 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. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rowandale Address Back Lane Clayton le Woods Chorley Lancashire PR6 7EU 01772 620739 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) rowendale@tiscali.co.uk Dalesview Partnership Mrs Tina Diane Roberts Care Home 10 Category(ies) of Learning disability (9), Learning disability over registration, with number 65 years of age (1) of places Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 10 service users to include: Up to 9 service users in the category of LD (Learning Disability not falling within any other category) needing personal care only. 1 Male service user in the category LD(E) (Learning Disability over the age of 65) needing personal care only. The registered provider should, at all times, employ a suitably qualified and experienced manager who is registered with the National Care Standards Commission. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the National Care Standards Commission regarding staffing levels in care homes. 27th June 2006 2. 3. Date of last inspection Brief Description of the Service: Rowandale stands in its own grounds and has open views to two sides. The building is a single storey purpose built establishment, with wide doorways and easy access throughout. The premises incorporate two homes, Rowandale and Hollydale, which share a common entrance, laundry and gardens. Rowandale accommodates ten service users with a Learning Disability. The home provides ten single bedrooms, two of which have en-suite facilities. The rooms have been decorated and furnished with specific service users in mind and are all individually furnished. The bathroom and shower room have been specifically designed to provide a suitable environment for assisting clients with physical disabilities. There is a large spacious lounge/dining room and kitchen that clients may access with appropriate supervision. In addition, there is a laundry and office. The gardens have been landscaped to the front and side and offer a sensory area. There is also a large patio to the rear. The home is situated in Clayton-le-Woods on the perimeter of a housing estate. There is a range of facilities including a supermarket, library, leisure centre, public houses and park. These are within walking distance and service users from the home regularly access them. Clayton-le-Woods is situated on the A6 which is the main road linking the city of Preston and the market town of Chorley. This means the service users also have access to the facilities offered in these towns. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 5 At the time of this inspection the Commission were advised that the weekly fees for care and accommodation at the home vary from £600 to £1300, depending on the assessed needs of the individual service user. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of this home included an unannounced site visit. As the visit was unannounced, the manager, staff and residents didn’t know it would be taking place until we arrived. During the visit we spent time with residents, some visiting relatives, staff and the manager. We also examined a selection of documents including people’s individual care plans and staff personnel files. In addition, we carried out a tour of the home looking at people’s communal living areas and private bedrooms. As part of the inspection, we carried out a case tracking exercise, which involved us looking very closely at the care provided to selected people from the point that they moved to the home. Prior to our visit, we asked the acting manager of the home to complete a comprehensive questionnaire, which provided us with a lot of information about how the home is managed. The questionnaire also gave us information such as staff qualifications and some details about the needs of people living there. We also sent some written questionnaires to people who live at the home and their families to ask them about their opinions of the service. Several completed questionnaires were returned to us. What the service does well: Useful information is supplied to people who are considering a move to the home, to help them make a decision. The manager has spent time and effort to ensure that this information is provided in a helpful and meaningful way and for example, has made the Service User Guide available in DVD format. A significant amount of time is taken to ensure that the admission process for any new resident is carried out in a sensitive and thorough manner, so that people are assured that carers have a good understanding of their needs by the time they move into the home. People are encouraged to visit the home with their families throughout the admission process so that they can get to know other residents and staff and get a feel for the home. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 7 The home has an excellent approach to planning residents’ care. Care planning is very much based on residents’ individual needs and their preferences are taken into account to as great an extent as is possible. The residents’ preferred daily routines are rightly seen as very important and clearly stated in their individual plans. The home understands the importance of enabling younger adults to achieve their goals, follow their interests and be integrated into community life and leisure activities. Residents are able to enjoy a full and stimulating lifestyle with a variety of options to choose from. People are encouraged to express their views and opinions about their own care and the general running of the home. There are a number of ways that the manager tries to enable this, for instance by encouraging people to use the services of independent advocates. In addition, there is a Service User Council which meets on a regular basis to discuss ideas about the service. Pictorial menus have been developed to assist residents in making and expressing choices about the meals and snacks they would like. Residents and their representatives are enabled to raise concerns, and any concerns that are raised are dealt with quickly and effectively. Guidance on how to raise concerns is made available to residents in written, pictorial and DVD format. The home is well maintained, and furnished and decorated to a good standard. There are a variety of communal areas for residents to access including a sensory room and safe outdoor space. Residents all have their own bedrooms and these are nicely furnished and decorated in styles chosen by the individual residents. The manager ensures that staffing levels at the home are adequate to meet the needs of people living there. We were also able to confirm that additional staff are available to support people to take part in activities of their own choosing on a regular basis. The home has a good approach to training with a core training programme in place for all staff members. The programme includes all the mandatory training areas such as moving and handling and first aid, as well as additional courses relevant to carers’ roles such as safeguarding adults and person centred planning. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 8 What has improved since the last inspection? A number of requirements and recommendations were made following the last inspection of the home and during this visit, we were able to confirm that these had been addressed. The home’s Statement of Purpose and Service User Guide have been amended to provide more accurate and up to date information. The Service User Guide has now been produced in a DVD format, which will be of great benefit to people who are considering a move to the home. All residents and their representatives have been provided with a copy of the home’s complaints policy. In addition, the complaints procedure is now supplied on a DVD as well as in a written and pictorial format. The provision of activities has been enhanced and efforts made to provide a more structured, person centred programme for each resident. In addition, residents are now provided with more opportunities to take part in community based activities. The staff training programme has been reviewed and improved. A more structured induction programme is now provided to all new starters which is in line with Skills for Care standards. Carers’ and senior carers’ core training has been reviewed and enhanced. As well as training in the key health and safety areas, staff are provided with courses in additional areas such as person centred approaches and safeguarding adults. The home’s recruitment policy and procedures have been reviewed and updated to further safeguard the wellbeing of residents and reflect current good practice. A number of environmental improvements have been made and several areas within the home have been redecorated. The manager has converted some office space into an additional sensory room that residents can use throughout the day and evening. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 9 What they could do better: It was found during this visit that carers sometimes carry out certain health care tasks for some people who live at the home. We also found that there was very detailed guidance in place for carers in relation to these tasks and that all carers had carried out relevant training. However, in these circumstances it is necessary for an agreement to be in place with the relevant NHS body in respect of each individual task. This arrangement is known as ‘clinical delegation.’ At the time of our visit the manager was unable to confirm that there was such an agreement in place. This matter needs to be addressed as soon as possible. Currently, 8 out of 21 staff members hold National Vocational Qualifications in care at level 2 or above. This means that the home are falling short of the national minimum standard of 50 . However, measures are being taken to address this shortfall and several carers at the home are enrolled on the course. When viewing records of staff training we noted that some of the carers’ key health and safety courses had expired. This was discussed at the time of the visit and we advised the manager to ensure that training records were regularly updated to assist in monitoring staff training. Records of charges made to residents in respect of activities and transport need to be more detailed so that residents and their representatives know exactly what they are paying for these services, and how these charges are being assessed. This was discussed with the acting manager at the time of the inspection. During our site visit we became aware of an incident that should have been reported to us under Regulation 37 of the Care Homes Regulations 2001, but had not been. This was discussed with the acting manager who advised us that she would review procedures to ensure that all future notifiable incidents are reported to us without delay. At the present time, this home is without a registered manager but there is an acting manager in place who is registered with the Commission in respect of another service. Throughout our inspection the acting manager demonstrated a very good understanding of her role and the key principles and focus of the service. However, it is important that a manager be proposed for registration as soon as possible to provide stability and consistency for residents and staff. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 10 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. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 11 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 12 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People considering a move to this home are provided with helpful and meaningful information to help them make their decision. The home’s thorough assessment process means that people can be assured they will receive the help they need from the point of their admission. EVIDENCE: The home provides a Service User Guide to people who are interested in moving there. The guide contains very useful information about daily life at Rowandale, for instance about activities and meal times. In addition, information about staffing levels and qualifications of the manager and staff is included. The acting manager has made efforts to make the information supplied to prospective residents meaningful and interesting. For example, the Service User Guide is available in a pictorial and DVD format. The DVD guide includes a tour of the home, introduces the manager and staff members and also gives some information about community facilities that are available. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 13 A very thorough pre-admission assessment is carried out with any person who expresses an interest in moving to the home. This involves the manager and the lifestyle coordinator from the Dalesview Group, meeting the prospective resident and getting to know them. They spend time assessing the person’s care needs in a variety of different settings such as in their current home and at any day services they attend. This process assists the manager in ensuring that the home would be appropriate for the prospective resident. We tracked the care of the most recently admitted resident and were able to confirm that the home had spent several months gathering information about this person’s care needs. We also noted that the home had worked very closely with the resident’s parents and other professionals, to ensure they had a good understanding of the support she needed. In addition, this resident had been encouraged to make visits to the home prior to her admission. These visits had started as short informal visits, and progressed to mealtime visits and overnight stays. The resident had also been able to choose all the decor, bedding and curtains for her bedroom before she moved in. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 14 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There is a person centred approach to care planning which means that care is provided in line with people’s individual needs and preferences. Residents are encouraged and supported to make decisions about their lives. EVIDENCE: As part of the case tracking exercise we examined a number of residents’ individual plans. We found these to be of an excellent standard, very comprehensive and based on an up to date, holistic assessment. The plans we viewed focused on people’s individual strengths and personal preferences and described what is important to them personally. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 15 Individual plans are developed in a person centred manner and include very detailed guidance to staff in how to support residents. For example, one person’s plan described how she became very anxious when being moved and guided carers to sing certain songs to her during this process, which had been found to allay her anxiety. We found that the manager and staff are fully committed in supporting individuals to lead purposeful and fulfilling lives as independently as possible and as such, constantly encourage and support residents to make decisions. Great emphasis is placed on assisting residents to communicate and each person’s plans contains a communication passport. Various methods of communication are used with different residents to help them express choices in their daily lives, and people’s individual plans include details of choices they have made and how they have expressed them. There are a number of measures in place to involve residents in the daily running of the home. These include the newly appointed ‘Service User Council’. This council is made up of a number of residents from all the homes within the Dalesview Group who meet regularly to discuss issues such as activities and menus. In addition, residents at the home are included in the process of recruiting new staff members and take part in interviews. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 16 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to enjoy a full and stimulating lifestyle. EVIDENCE: Many of the people we consulted both during our visit and in writing, told us that the provision of activities at the home was excellent. One relative said ‘’Activities are so well organised and it seems that real care and thought is put into them.’’ Another visitor told us that her relative really enjoyed taking part in the activities at the home and that when she visited, there was ‘’always something going on for everyone.’’ There were a number of activities going on at the time of our visit including a music session and a baking session. Residents who were taking part appeared to be enjoying themselves and clearly enjoyed spending time with carers. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 17 We viewed individual records for residents which confirmed that people are able to take part in a variety of activities such as music, drama, aerobics and arts and crafts. In addition, residents take part in community activities, such as swimming, bowling and pub visits. Each resident’s individual plan contains information about the support they need to enjoy a full and stimulating lifestyle. Activities are person centred, individualised and reflect people’s diverse needs. For example, imaginative and varied opportunities are provided for people who respond to a more sensory experience due to their level of disability. Residents are supported to maintain contact with their families and friends and people’s individual plans contain details of their needs in this area. We spoke to one relative who told us that the manager of the home helped her with transport to visit her loved one on a regular basis. She also said ‘’On the days I don’t manage to come, the staff always phone me to let me know how things are.’’ Residents’ individual plans contain good details about their dietary needs and preferences, and any additional needs they have in this area. One person’s plan we viewed contained very comprehensive information and detailed guidance to staff about difficulties she experienced with swallowing. Menus confirm that residents are provided with a varied and nutritious diet and that choices are available every day. Residents are assisted to make their choices by the newly developed pictorial menus that are now available. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 18 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s health and well being is closely monitored by staff and there are procedures in place to ensure that medication is handled safely. Any clinical procedures which are carried out by care staff must be done so with the agreement of the relevant NHS body to ensure people’s safety and well-being is protected. EVIDENCE: Residents’ preferences about the way in which they are supported are detailed in their individual plans. In addition, residents’ plans contain information about their preferences in relation to clothing, hairstyle and make up. There is a detailed health action plan in place for every resident which describes any specific health care needs they have and provides evidence that people are supported to access community health care such as dental and optical care, when they require it. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 19 It was found during this visit that carers sometimes carry out certain health care tasks for some people who live at the home. We found that there was very detailed guidance in place for staff in relation to these tasks and that all carers had carried out relevant training. However, in these circumstances it is necessary for an agreement to be in place with the relevant NHS body in respect of each individual task. This is known as ‘clinical delegation.’ At the time of our visit the manager was unable to confirm such an agreement. This matter needs to be addressed as soon as possible. We viewed the home’s medication store and examined a number of medication administration records. These were all found to be in good order and medicines were stored safely and securely. All carers who handle medication have now been provided with training in the safe handling of medication. During our case tracking exercise we were able to confirm that residents’ medication is regularly reviewed by community health care professionals. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 20 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are enabled and encouraged to express any concerns they have. There are procedures in place to protect people from all forms of abuse. EVIDENCE: The home provides guidance to all residents and their representatives in how to go about raising any concerns they have. This guidance is provided in a number or formats including a written, pictorial and DVD guide. All the people who responded to our written survey told us that they were aware of the complaints procedure and a number of people told us they were confident any issues they raised would be dealt with effectively. There are procedures in place to protect people from abuse (safeguarding procedures) and all the staff we consulted were aware of these procedures. The majority of staff at the home have attended a training course on safeguarding and the remaining staff will be completing the course in the near future. The manager told us that this course had been made mandatory to ensure all carers receive this training. Some residents need help in managing their money and we were able to confirm that careful records are made of any assistance residents have received in this area. However we viewed records of charges made to residents in respect of the activities and transport they had been provided and found Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 21 that these were not detailed enough. We advised the manager that these records should be improved to provide more detail for residents on what they have been charged and how these charges have been assessed. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 22 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents at Rowandale are provided with safe, comfortable and homely accommodation. EVIDENCE: We carried out a tour of the home and found all areas to be clean, warm and comfortable. In addition, all areas of the home were well maintained and nicely decorated. There is a programme of routine maintenance in place which includes all residents’ bedrooms to ensure that good standards are maintained within the home. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 23 All the residents have their own bedroom some of which are en suite. We noted that residents’ bedrooms are very nicely decorated and personalised with ornaments and pictures. One resident who has recently moved to the home was enabled to choose all her own bedding, curtains and decor prior to her arrival. There are a number of communal areas for people to access including a quiet sensory room and safe, accessible outdoor space. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 24 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a thorough recruitment procedure in place to ensure that only suitable people are recruited to work with residents. EVIDENCE: We viewed a selection of staff files which contained all the necessary information such as original application forms and full employment histories. We also noted that the necessary background checks had been carried out for all new staff members including references and Criminal Record Bureau checks. There is a good approach to training at the home with staff being provided with a standard induction, which is in line with Skills for Care standards. Ongoing training includes all the mandatory areas such as moving and handling and first aid as well as additional courses including person centred planning and safeguarding adults. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 25 Currently there are 8 staff members (out of 21) who hold National Vocational Qualifications in care at level 2 or above. The home are currently falling slightly short of the recommended 50 , however a number of carers are currently working towards this qualification. We talked with the manager about the training provided to senior carers and were advised that senior’s core training had recently been reviewed to provide additional courses to assist them in carrying out the supervisory aspects of their role. We viewed records within the home that confirmed that all staff members are provided with one to one supervision on a regular basis. This is an important aspect of staff support and gives carers and their line manager the opportunity to discuss any concerns they may have, as well as other issues such as personal development and work performance. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 26 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is currently managed well and in the best interest of residents. However, a manager should be proposed for registration with the Commission to provide more stability for residents and staff. EVIDENCE: At the present time, the home is without a registered manager but there is an acting manager in place who is registered with the Commission in respect of another service. Throughout our inspection the acting manager demonstrated a very good understanding of her role and the key principles and focus of the service. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 27 Prior to our visit, the acting manager completed a very detailed self assessment questionnaire providing details of how the service is currently managed and ideas about areas for improvement. This document was completed to a very good standard and contained clear, relevant information supported by a wide range of evidence. There is a good approach to quality assurance with a number of measures in place to assist the acting manager in monitoring all areas of the service. Such measures include regular audits, self assessments and resident satisfaction surveys. We saw a number of examples of how the manager had responded positively to feedback she had received through consultation with residents and their relatives. For example, relatives had expressed a desire to be updated about any staff changes within the home and the manager had actioned this straight away, by ensuring that any staff changes were included in the home’s monthly newsletter. An unannounced visit is made to the home by one of the owners on a monthly basis. The Commission for Social Care Inspection regularly receives reports of these visits which include evidence that residents and staff are consulted throughout them. During our site visit we became aware of an incident that should have been reported to us under Regulation 37 of the Care Homes Regulations 2001, but had not been. This was discussed with the acting manager who advised us that she would review procedures to ensure that all future notifiable incidents are reported to us without delay. We viewed a selection of health and safety records including records of safety checks on equipment within the home. We were also able to confirm that all staff had been provided with appropriate health and safety training in areas such as moving and handling and food hygiene. However records viewed indicated that some staff members were in need of refresher training in some health and safety areas. This was discussed with the manager during out visit. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 28 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 4 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 3 3 x LIFESTYLES Standard No Score 11 x 12 4 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 x 3 x x 3 x Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 29 no Are there any outstanding requirements from the last inspection? 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 YA19 Regulation 13 Requirement Timescale for action 31/01/08 2. 3. YA37 YA38 8 37 Any clinical task carried out by carers within the home must be agreed by the relevant NHS body. A manager must be proposed for 31/03/08 registration with the Commission for Social Care Inspection. The Commission must be notified 12/12/07 without delay of any incident as listed under Regulation 37 that occurs within the home. 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. 3. Refer to Standard YA23 YA32 YA32 Good Practice Recommendations Charges made to residents in respect of activities and transport should include more detail so that residents know how their charges are being assessed. At least 50 of carers should hold National Vocational Qualifications in care at level 2 or above. Training should be carefully monitored to ensure that all staff are up to date with their mandatory training. DS0000045627.V351714.R01.S.doc Version 5.2 Page 30 Rowandale 4. YA42 Night time protocols for residents who have bed rails should include instructions to staff to carry out nightly safety checks. Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Rowandale DS0000045627.V351714.R01.S.doc Version 5.2 Page 32 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!