CARE HOMES FOR OLDER PEOPLE
Rosalyn House King Street Houghton Regis Dunstable Bedfordshire LU5 5TT Lead Inspector
Katrina Derbyshire Unannounced Inspection 18th October 2005 12:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rosalyn House DS0000017690.V259355.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rosalyn House DS0000017690.V259355.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Rosalyn House Address King Street Houghton Regis Dunstable Bedfordshire LU5 5TT 01582 896600 01582 896601 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) SAH Nursing Homes Limited Ms Deborah Porter Care Home 46 Category(ies) of Dementia (16), Dementia - over 65 years of age registration, with number (46), Learning disability over 65 years of age of places (46), Mental Disorder, excluding learning disability or dementia - over 65 years of age (46), Physical disability over 65 years of age (46) Rosalyn House DS0000017690.V259355.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Mental nursing care for Elderly people (over 65 years) Up to 16 Adults (40-64 years) Date of last inspection 12th May 2005 Brief Description of the Service: Rosalyn House is a purpose built Care Home (with nursing) specialising in caring for both younger and older adults with mental health care needs. The home is in Houghton Regis very close to the town centre and in walking distance of local amenities and public transport routes. The home can accommodate up to 46 individuals in single rooms with en-suite facilities arranged over three floors. There is passenger lift access to all areas of the home. The home has a secure courtyard area at the rear and a designated parking area. Rosalyn House DS0000017690.V259355.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 18th October 2005. The Acting manager Mr Jim Hamilton was present for part of the visit. During the inspection several areas of the home were visited and the inspector spent time with many of the residents in one of the lounge areas of the home. The care of three residents was examined in depth by looking at their records and interviewing the residents and staff who look after them. What the service does well: What has improved since the last inspection?
The home has made many changes since its last inspection. The way they write about the care residents need has improved, these care plans are now very clear so staff know the care they should be providing and this helps continuity of care. They have also trained all their staff in how to protect vulnerable people and this means that the home is a safer place to stay in. Staff have been trained in how residents should be treated, and they know that if a colleague or other person didn’t treat all the residents in a respectful manner how to report it. Also the records that they keep to make sure that residents receive the necessary medical support have improved. These are all up-to-date and show that residents receive medical tests when they need one. Rosalyn House DS0000017690.V259355.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rosalyn House DS0000017690.V259355.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rosalyn House DS0000017690.V259355.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 EVIDENCE: Standard six was noted to not be applicable, as intermediate care is not offered at the home. Rosalyn House DS0000017690.V259355.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 9 Since the last inspection the standard of care planning has improved and is now of a good standard, care plans are adequate in providing staff with information they need to satisfactorily meet resident’s needs. EVIDENCE: The home has introduced a new system for care planning; each residents care record contains clear guidance to staff on how they should write care plans. Those plans seen were comprehensive and there was a plan in place for each assessed need. Staff when questioned were able to accurately describe the information contained within the plans and they were clear on following the guidance within them so each resident received individual care. Healthcare records were also viewed and showed entries for example that residents had their blood sugar levels checked daily when required. In addition several residents confirmed that they attended hospital appointments and a General Practitioner was seen visiting several residents on the day of inspection.
Rosalyn House DS0000017690.V259355.R01.S.doc Version 5.0 Page 10 Medication stocks and administration sheets were noted to be in order, staff had received updates in their training profiles and all medication was kept in a secure place. However the home did not have a record of all the prescriptions and medication ordered from a General Practitioner and the Chemist and this they need to do to ensure that they have a clear audit trail from the ordering of the prescription to the administration of the medication. Rosalyn House DS0000017690.V259355.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 14 The provision for the resident’s social, cultural and recreational activities is good. EVIDENCE: All residents spoke of the activities available to them both inside and outside the home these included board games, social events and external outings. Photographs were on display in the reception area to show the day trips residents had been on during the summer, and a notice board was in place within each area of the home advertising daily activities. A designated area is also available for residents to participate in-group and one-to-one sessions. Many of the residents had literature within their care records to evidence that they had advocates working on their behalf. One resident with the support of their advocate was moving back to their own home within a few days, the management and staff had supported and assisted in this so that the resident was able to maintain choice and control over his life. The home also enabled residents to continue to make daily choices in their lives through support and encouragement from the staff, these included clothes to wear, choice of meals and daily activities.
Rosalyn House DS0000017690.V259355.R01.S.doc Version 5.0 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. The complaints procedure is sufficient for residents to feel that their views and concerns will be listened to and acted upon. EVIDENCE: The homes complaints procedure is clearly displayed and detailed within the homes statement of purpose. All residents spoken with knew of their right to complain and to whom they could speak to if they ever had any concerns. Records of any complaints received are kept within the home and the action taken by the home in response. Since the previous inspection in May 2005 staff had now been trained in the protection of vulnerable adults, this had occurred in response to a requirement made at that time. Documentary evidence of this training was seen in the training records of staff therefore this standard has now been met. Rosalyn House DS0000017690.V259355.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 The standard of décor and furnishings in the home is good and provides a warm and homely environment for the residents to live in. EVIDENCE: All areas of the home that were seen were clean and free of odours. The accommodation is provided across three floors, each floor providing lounge/dinning room facilities alongside the individual rooms of the residents. Access to each floor can be through the use of a passenger lift or stairs. Several residents made comments on how they were satisfied with their living space and that they found that the home met their individual needs in this area. Televisions and music centres were also seen to be in use in the communal areas for the entertainment of the residents. Rosalyn House DS0000017690.V259355.R01.S.doc Version 5.0 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 The training arrangements for staff is acceptable with staff demonstrating a clear understanding of their role. EVIDENCE: The induction and training of staff was recorded in the individual records of all employees. Staff through interviewing confirmed that they had undertaken a variety of courses these included health and safety, moving and handling and national vocational qualifications in care. Several of the residents made positive comments on the skills of the staff team, one resident said “they always seem to know what they are doing and they are always training”. It was however noted that not all staff spoke to the residents in an appropriate way. One staff member was noted to call residents “good lad”, this the residents found irritating and training in how residents must be addressed needs to take place. Rosalyn House DS0000017690.V259355.R01.S.doc Version 5.0 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 The systems in place for safeguarding residents financial interests are very good and mean residents have a trustworthy system to use if needed for small amounts of personal allowance. EVIDENCE: A number of residents choose to use the homes financial system for managing small amounts of personal allowance. This system was examined and three residents accounts were checked. The system gave a clear audit trail and all expenditure was receipted. The balances checked were all correct and all monies are kept in a secure area, with a limited amount of staff having access. Rosalyn House DS0000017690.V259355.R01.S.doc Version 5.0 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X X Rosalyn House DS0000017690.V259355.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13(2) Requirement There must be a system in place to ensure that a record is kept of all medication that is ordered. Timescale for action 15/12/05 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 Refer to Standard OP30 Good Practice Recommendations Staff should be trained in the appropriate way to address residents. Rosalyn House DS0000017690.V259355.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: 0845 015 0120 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 Rosalyn House DS0000017690.V259355.R01.S.doc Version 5.0 Page 19 - 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!
