Latest Inspection
This is the latest available inspection report for this service, carried out on 17th June 2009. CQC found this care home to be providing an Good service.
The inspector made no statutory requirements on the home as a result of this inspection
and there were no outstanding actions from the previous inspection report.
For extracts, read the latest CQC inspection for Roxholm Hall.
What the care home does well The home is in a rural part of the countryside and provides care in a quiet and peaceful setting. A visitor commented upon this as one reason for choosing the home. People are cared for in a clean and comfortable environment and the home is decorated to a good standard. All people spoken with made positive comments about the care they received; one said I cant fault it and another said The staff are what keep me going, they`re always cheerful. The staff group is well trained and knowledgeable about the people living at the home and how they prefer to be cared for. The manager has made many positive changes since she was apopinted two years ago and both staff and visitors praised her approach. There is a very stable staff group who know the needs of the peoplethey care for well and encourage confidence in them. People are encouraged to make choices about their daily lifestyles and individual likes and dislikes are catered for. Quality assurance is very thorough and ensures that the views of people are heard. What has improved since the last inspection? Care plans are now in more detail and contain more information to enable staff to meet the needs of people. The home has an extensive training record and plan. Bathrooms have been completely refurbished, windows have been replaced and there are new carpets and furniture in many rooms. What the care home could do better: The building suffers from an ongoing problem with flies in the summer, due to its situation. The manager already has plans to provide fly screens to all opening windows shortly. Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Roxholm Hall Roxholm Hall Roxholm Sleaford Lincolnshire NG34 8ND The quality rating for this care home is:
two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Julie Western
Date: 1 7 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 25 Information about the care home
Name of care home: Address: Roxholm Hall Roxholm Hall Roxholm Sleaford Lincolnshire NG34 8ND 01526832128 01526834107 roxholm@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Guardian Care Homes (UK) Limited care home 39 Number of places (if applicable): Under 65 Over 65 20 0 18 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 1 0 Roxholm Hall is a large Victorian detached property set within 7 acres of its own private grounds in a remote rural area approximately 3 miles from the market town of Sleaford and near to the village of Cranwell. The service is registered to provide personal care for 39 residents in the categories of Dementia, Mental Disorder and Old age. Accommodation is provided on two floors in 36 single and 1 double bedrooms all with en-suite facilities. Stairs and a shaft lift serves accommodation on the first floor. There are both lounge and dining rooms on each floor. Care Homes for Older People
Page 4 of 25 Brief description of the care home On the day of the inspection visit there were 33 people living in the home. Local facilities can be reached by car and in addition, staff and a local council transport service provide transport for residents into Sleaford and to attend other appointments. The grounds are well maintained with parking for staff and visitors. The gardens include a water feature and a large brick dovecote, which is a listed building. The homes stated aims and objectives are that they believe in independence, selfimportance and dignity and provide the care and attention each resident deserves. Fees currently range from £351 to £621 each week. Extras are for hairdressing, chiropody, toiletries, personal newspapers and magazines. Information about the home together with the statement of purpose and service users guide is available in the reception area of the home. Care Homes for Older People Page 5 of 25 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: This was an unannounced visit and it formed part of a key inspection, focusing on key standards, which have the potential to affect the health, safety and welfare of people who use the service. Throughout this report the terms we and us refer to The Care Quality Commission (CQC). The visit lasted approximately three hours and we took into account previous information held by us including the previous inspection report, their service history and records of any incidents that we had been notified of since the last inspection. Before we made our visit the provider had returned the Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are meeting standards and their plans to improve aspects of the service. We sent Care Homes for Older People
Page 6 of 25 out surveys to people before we visited the service. The main method used to carry out the inspection is called case tracking, which includes following the care of a sample of four people through their records and assessing their care. We spoke to two people who use the service and saw rooms of those people who said we could and to one staff member. The manager and deputy manager were present throughout the visit and the general outcomes of the visit were discussed with them. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 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 8 of 25 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 9 of 25 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. People who use this service have good information about the home in order to make an informed decision about whether the service is right for them. The home does not provide intermediate care. Evidence: The manager confirmed that she or the deputy manager always visited prospective residents at home or in a care setting such as a hospital to undertake a thorough assessment of all their care needs. Records we saw confirmed this. We saw written admission documentation that was comprehensive and clear, giving staff the information they needed to meet the needs of people. The statement of purpose we saw was very comprehensive and contained the service user guide, terms and conditions and contracts. It was in large print for people with poor eyesight to read easily. The manager said it was sent to all people making
Care Homes for Older People Page 10 of 25 Evidence: enquiries. A resident we spoke with described how he had visited for the day before he was sure she wanted to move in permanently. A relative told us that this home had been chosen because her relative had been in two other local homes and this was the best. A staff member described the admission process and the importance of making new residents and their families welcomed. Care Homes for Older People Page 11 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are in enough detail to ensure that the health care needs of people can be met. There are safe medicine practices in the home. Evidence: Care plans we saw contained information about the health and personal care needs of people. They were reviewed regularly and signed where possible by people or their relatives or advocates. We saw a medication policy that was clear and comprehensive. The pharmacist visited regularly, the last visit being on 14th May 2009 and no issues were identified. One person took their own medication and this was well recorded, with letters from the person and the GP confirming ability to do this. People received regular visits from district nurses, Macmillan nurses, CPNs and other agencies involved with their care. A visiting chiropodist said that the service offered a high standard of health care. We saw staff carrying out their duties with kindness and sensitivity towards people, especially when attending to their personal needs.
Care Homes for Older People Page 12 of 25 Care Homes for Older People Page 13 of 25 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. Social activities are regular and are tailored to suit the individual needs of residents. People have a choice of meals from a balanced and varied menu. Evidence: We found that the home has two activities coordinators, who provide a variety of activities from Monday to Friday for residents including entertainers, indoor games such as board and card games and trips to local pubs and shops. On the day of the inspection people were making scones with the activities co-ordinator and having memory activity in one of the two activities rooms, one upstairs and one down. People we spoke with all said they had a choice of whether or not to take part. Some told us they preferred to sit in a quiet lounge instead and one said she went on regular outings with the local transport services. The activities programme is on the notice board and various places around the building, to ensure that all residents are kept informed. People we spoke with all said they enjoyed the meals served; one said the mid-day meal was marvellous and another that there was good food, variety and plenty of it. The menu for the week was displayed in the dining room and offered alternative choices of meals. The home employs a cook and two kitchen assistants. All have
Care Homes for Older People Page 14 of 25 Evidence: advanced food hygiene qualifications and the National Vocational Qualification in nutrition and food hygiene at Level 2. Care Homes for Older People Page 15 of 25 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. The procedures for addressing complaints and for protection from abuse are clear. People and their families are confident that their comments and concerns will be listened to. Evidence: People spoken with said they did not wish to complain but knew how to make a complaint. The home had an up to date copy of the Local Authority adult protection procedures; staff members said they had read it. The training programme showed that there was a rolling training course for staff on POVA and safeguarding adults. Staff members spoken with knew what to do in the event of a serious concern.The manager said that residents and their families were regularly asked for their views regarding the running of the home. A resident said I am sure that if I had a complaint the manager would see to it and visitors spoken with said that they were given information on how to make complaints. Since the last inspection there had been one complaint which was unsubstantiated. The manager said that complaints were audited by head office and we saw a suggestions and comments box in the reception area for visitors to use. Staff spoken with confirmed that they had received training in safeguarding adults. Care Homes for Older People Page 16 of 25 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 comfortable and pleasant environment with both private and communal space that is generally suitable for their needs. Evidence: Overall, the standard of decoration internal was high and afforded residents a good degree of comfort. The gardens were well maintained and offered pleasant places for people to sit out in good weather. Staff described how any maintenance issues were addressed quickly by the maintenance personnel. There were a large number of flies in the building; this is because there is a chicken farm nearby. The manager has made all attempts to keep flies from entering the building, including insectocutors, sticky tape strips and fly screens in the kitchen. In the next few weeks fly screens are to be put up at all opening windows in the building. Work has commenced on replacing the windows with double glazed units. The boiler has been replaced and staff said control of heating in the building was much better. The bathrooms on the ground floor as also due to be completely refurbished to bring them up to standard with those on the first floor, which are newly refurbished and decorated with seaside themes. There were safety notices around the building to prevent the spread of infection and
Care Homes for Older People Page 17 of 25 Evidence: COSHH regulations were observed throughout. Although the building has different levels and steps throughout there is a lift and a stair lift to enable people to access the whole building. The most recent visit from the Environmental Health Officer found no issues of concern and the service had been awarded four stars in their award scheme. The building smelled clean and on the whole fresh throughout. Care Homes for Older People Page 18 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff numbers are in sufficient quantity for them to be able to care for people. Staff members are suitably trained, qualified and competent. Evidence: There was a minimum of 5 staff for 36 people. In addition the manager and deputy manager could assist during busy periods, although they said that at present this was not necessary. The home also employed a cook and domestic staff. There were no vacancies at present. The manager said that by October 2008, 100 of staff members would have a National Vocational Qualification [a nationally recognised qualification]. Six members of staff have recently achieved NVQ at Level 2, and three staff members had achieved Level 3. The most recent staff member to be employed described how she had an interview, gave three references and underwent CRB/POVA checks. She was still undertaking the induction course. Staff records confirmed this. Staff training records demonstrated that statutory training has been undertaken and we saw a training programme thatincluded external and in-house training. Records showed that staff received regular supervision and were minutes of regular staff meetings.
Care Homes for Older People Page 19 of 25 Evidence: We saw records that showed very little staff turnover and staff spoken with confirmed this. Care Homes for Older People Page 20 of 25 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. The home is very managed and the health, safety and welfare of people are promoted. The views of people are listened to and they are involved in decisions affecting them. Evidence: The manager has been in post for almost 3 years and is a trained nurse. She and the deputy manager are currently working towards a diploma in leadership and management. The manager runs a monthly surgery for people and families/advocates which is advertised in the reception area and she is also available one weekend every month. One resident liked the surgery and found it very useful for discussing all kinds of issues. People we spoke with all made positive comments about the way the manager ran the home, finding her approachable and and very supportive; one visitor said I couldnt speak highly enough of her. There is a sound quality assurance procedure, with separate questionnaires for people,
Care Homes for Older People Page 21 of 25 Evidence: their relatives/visitors, staff and visiting professionals. The findings are discussed and acted upon with the area manager, who visits monthly. The latest results are also displayed in the reception area for visitors to see. Health and safety policies were well documented and showed a clear commitment to ensuring the wellbeing of people. Records were very well maintained. We saw minutes of the last residents meeting and this showed that residents have a voice and feel free to express opinions. There is an active committee to raise money for events and activities. There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. The homes pre-inspection questionnaire evidenced that fire alarm, fire drills and emergency lighting checks have been undertaken. We saw records to show that maintenance and service histories of all aids and adaptations had been carried out. Care Homes for Older People Page 22 of 25 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 23 of 25 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 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 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. 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!
