Inspection on 24/09/08 for Rose Cottage

This inspection was carried out on 24th September 2008.

CSCI found this care home to be providing an Excellent 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.

Other inspections for this house

Rose Cottage 28/09/07

Rose Cottage 09/11/06

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The Grove Waltham

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Carentan House

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Rose Cottage 14 Kipping Lane Thornton Bradford West Yorkshire BD13 3EL     The quality rating for this care home is:   three star excellent 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: Stephen Marsh     Date: 2 4 0 9 2 0 0 8 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. the things that people have said are important to them: They reflect 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 26 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Rose Cottage 14 Kipping Lane Thornton Bradford West Yorkshire BD13 3EL 01274833641 01274833641 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Rajal Karavdra,Rajesh Karavdra Type of registration: Number of places registered: care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Rose Cottage Care Home is located in the centre of Thornton village, which is about four miles from Bradford City Centre. The home is on a main bus route and there are a variety of shops and other amenities close by. Bedrooms are located on both the ground and first floor of the home and there is a stair lift available to assist people with mobility problems reach the accommodation on the first floor. There are three communal rooms comprising of separate dining room, lounge and conservatory. There is a large well kept garden to the rear of the property, which is accessible by a ramp and provides a very pleasant area for people to sit and enjoy the good weather. The Care Homes for Older People Page 4 of 26 Over 65 2 12 2 0 0 0 Brief description of the care home majority of people living at the home are elderly although a small number have physical or mental health needs. Care Homes for Older People Page 5 of 26 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: three star excellent 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: The quality rating for this service is three star (3). This means that people that use the service experience excellent quality outcomes. The inspection process included looking at information we have received about the service since the last key inspection, as well as this unannounced visit to the home, which was carried out between 09:30 and 16:30 hrs. The methods we used included looking at records, observing staff at work, talking to people living at the home, talking to staff and looking around the property. Before the visit we had provided some people living at the home, their relatives and other healthcare professionals with survey questionnaires so that they could share their Care Homes for Older People Page 6 of 26 views of the service with us. We received five questionnaires back from people living at the home and/or their relatives. The information they provided has been used as evidence in the body of the report. The home had also completed and returned their Annual Quality Assurance Assessment form and the information provided as also been used has evidence in the body of the report. The purpose of the visit was to assess what progress the home had made in meeting the requirements made in the last inspection report and the impact of any changes in the quality of life experienced by people living at the home. We have recently improved our practice when making requirements to improve national consistency. Some requirements from previous inspections may have been deleted or carried forward as recommendations, but only when it is considered that people that use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. No requirements or recommendations have been made as a result of this inspection. The registered manager retired in June 2008 and Mrs Agnes Rowlings was recently appointed to the post. Mrs Rowlings was available throughout the day of the visit and proved to have a very positive attitude to the inspection process. Feedback was given to the manager at the end of the visit. The fees for the service currently range from 410:00 to 420:00 pounds per week. Details of the exact charges can be obtained by contacting the manager. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Care Homes for Older People Page 9 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 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. Peoples needs are assessed before they are admitted and they can visit or stay for a trial period to make sure the home is right for them. Evidence: The information about the service is good and gives people the opportunity to decide whether or not the home can meet their needs. Records show that peoples needs are assessed before they move in to Rose Cottage either in their own home or temporary place of residence. We looked at the preadmission assessment information for three people and found that in some instances it only provided very basic information and did not always give a clear indication about the level of care or support required. However, the manager is aware of this and is currently introducing a new format, which will provide more detailed information. People are always invited to visit the home before admission and are also able to move in for a trial period if they are still undecided about accepting a permanent place. The Care Homes for Older People Page 11 of 26 Evidence: trial period gives people the opportunity to experience at first hand the standard of care and facilities provided and enables staff to make a more thorough assessment of their needs. People considering moving in to the home are always supported through the admission process and once admitted care is taken to make sure that they happy and content in their new environment. Care Homes for Older People Page 12 of 26 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. Peoples health care and personal needs are met in a way that maintains their dignity and independence. Evidence: Care plans are in place and are initially generated from the information provided by the Social Services Care Management Team or the assessment of needs completed by the manager. There was some evidence to show that wherever possible people are involved in the care planning process, which means that they are consulted about how they want their care and support to be provided. The care plans we reviewed were completed to a satisfactory standard although in some instances they did not always provide staff with clear guidance on how peoples needs were to be met. However, since the visit the manager has introduced a more comprehensive care planning system, which covers all aspects of peoples social and health care needs. The new format is good and gives staff the information they need to provide people with quality care. Care Homes for Older People Page 13 of 26 Evidence: Everyone living at the home is registered with a General Practitioner and are supported in having access to the full range of NHS services. The input of other healthcare professionals is clearly recorded in the documentation available, which shows that staff are seeking advice if they have concerns about an individuals health. People confirmed that they were happy with the care and support they received and said that staff always treated them with kindness and respect. Comments included you could not wish for kinder staff and we are very lucky to live at Rose Cottage the staff are great. We reviewed the medication system in place and found that overall medicines are managed safely. Minor discrepancies in the way medication was being recorded and stored were discussed with the manager and immediate action was taken to resolve the matter. People living at the home can therefore be confident that medication is being administered as prescribed. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home responds to individual needs and choices and encourages people to exercise control over their daily lives. Evidence: On the day of the visit the atmosphere within the home was very calm and relaxed and staff were observed to interact well with the people in their care. The manager confirmed that the daily routines of the home are flexible and people are encouraged to be as independent as possible and consulted about how they want to spend their time. The home offers people the opportunity to join in a range of social and leisure activities including trips out to restaurants of their choice and other places of interest. Both the registered provider and manager are committed to extending the range of activities and outings currently provided and enabling people to lead a full and active life. For people that dont like to join in group activities time is made to engage with them on a one-to one basis. Care Homes for Older People Page 15 of 26 Evidence: The home is very much part of the local community and has established good links with the local churches and schools. People said that they enjoyed the activities arranged for them and confirmed that special occasions throughout the year including birthdays and anniversaries are always celebrated with a party tea or entertainment. The home publishes a newsletter, which highlights forthcoming events and a weekly list of planned activities is on display. Feedback from people shows that they are able to see visitors in their own room if they wish to do so and family and friends are always made to feel welcome and offered refreshments. During the visit we observed the lunchtime meal being served in the dining room. The tables were nicely set and people were given the time they required to eat their meal in comfort without being hurried. As the home is only registered to care for sixteen people the cook is well aware of their preferences and takes this in to account when menu planning. People also have input in to menu planning through the residents meetings , which are held at regular intervals throughout the year. Care Homes for Older People Page 16 of 26 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. There are suitable systems in place to make sure that complaints are dealt with appropriately and people are protected from abuse. Evidence: There is a clear complaints procedure in place and information provided in the self assessment form shows that the home operates a zero tolerance approach when dealing with complaints and adult protection (safeguarding) issues. People living at the home said that they were aware of the complaints procedure and would have no problem at all in approaching the manager or registered provider if they had any concerns about the standard of care being provided. Adult protection policies and procedures are in place and training records provided by the manager show that all staff have received training in the recognition and reporting of allegations of abuse. Feedback from staff indicates that they are aware of the homes policy on whistle blowing and knew what to do if they suspected that people were being abused or working practices at the home were not in the best interest of the people living there. Care Homes for Older People Page 17 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home continues to provide people with a pleasant, safe and comfortable environment in which to live. Evidence: The home is situated in a main road position in the centre of Thornton village. There is a large garden to the rear of the property with a pleasant patio area, which is accessible by a ramp leading from the conservatory. There is an ongoing programme of refurbishment and renewal at the home and since the last inspection the providers have made a substantial financial investment in improving the standard of accommodation. This has included decorating and refurbishing many of the bedrooms and providing new privacy screens and two wash hand basins in all shared bedrooms. The communal areas have also been decorated and new furniture purchased and the stair lift has been extended to reach the first floor of the home so that people can reach their bedrooms without having to climb any steps. Feedback from people living at the home and their relatives shows that they are very pleased with the standard of accommodation. Comments included the home is always kept spotlessly clean and tidy and both the bedrooms and communal rooms are Care Homes for Older People Page 18 of 26 Evidence: nicely decorated and the home is bright and airy. It is apparent when talking to the registered providers that they take pride in providing people with a high standard of accommodation and have further plans to improve the environment and facilities within the next year. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient staff employed to make sure peoples needs are met and staff are supported in developing the skills and knowledge they need to care for people properly. Evidence: The home has a thorough staff recruitment and selection procedure, which includes obtaining at least two written references and a Criminal Record Bureau (CRB) before new staff start work. This makes sure only people suitable to work in the caring profession are employed. All staff are provided with written job descriptions, which outlines their roles and responsibilities and a copy of the staff handbook. We reviewed the recruitment files and found that generally the recruitment policy was being followed although in one instance the procedure had not been as thorough as it should have been. The manager is aware of this and since taking up post has introduced a new system for recording employment information and is currently reviewing the recruitment and selection procedure. The staff rota showed that sufficient staff are employed on day and night duty to meet Care Homes for Older People Page 20 of 26 Evidence: peoples needs and the home has a stable staff team and a low staff turnover, which helps to make sure people receive continuity of care. However, surveys returned by three people living at the home and/or their relatives indicate that at times the home appeared short staffed although no further information was provided. This matter was discussed with the manager who agreed to review the staffing levels at peak periods of the day to see if improvements were necessary. Information provided in the self assessment form also shows that the home is looking to recruit more part time staff to complement the existing staff team. The manager confirmed that all new staff receive induction training in line with the Skills for Care Common Induction Standards. These are nationally agreed induction standards designed to help new staff get the skills and knowledge they need to care for people. Following induction there is an expectation that staff will study for a National Vocational Qualification (NVQ) at level two or above depending on the post they hold. Currently 77 of the care staff have achieved a NVQ at level two and three staff are studying for a NVQ at level three. Feedback from staff indicates that they are generally pleased with the level and standard of training provided and are encouraged to take up training opportunities. Care Homes for Older People Page 21 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management structure in place makes sure that the home is well managed and run in the best interest of the people living there. Evidence: Mrs Agnes Rowlings was recently appointed manager of the home. Mrs Rowlings has many years experience in the caring profession and is to commence studying for the Registered Managers Award (RMA) in the near future. Both the registered providers and manager have a positive attitude to the inspection process and have shown a willingness to work with us to maintain and improve standards at the home. The manager confirmed that she is well supported by the providers and there are clear lines of accountability, which makes sure the home is managed affectively and in the best interest of the people living there. To make sure that there are clear lines of communication within the home regular staff Care Homes for Older People Page 22 of 26 Evidence: meetings are held and the manager operates an open door policy so that people are able to approach her at any time if they have a problem or concerns. Formal one-toone staff supervision also takes place, which gives staff the opportunity to discuss their training and personal development needs. There are quality assurance monitoring systems in place, which the manager is currently reviewing to make sure they cover all aspects of service provision. As part of the quality assurance process survey questionnaires are sent to people living at the home, their relatives and other healthcare professionals on a six monthly basis to assess how well the home is meeting stated aims and objectives. The providers also visit Rose Cottage at least monthly and provide us with a written report on the conduct of the home. The home holds money in safekeeping for a number of people and new transaction sheets have recently been introduced. Only senior staff deal with peoples personal finances and receipts are obtained for any items purchased on their behalf. We checked a number of transaction sheets and no concerns were raised. This means that people can be confident that the system is safe and well managed. Policies and procedures are in place to ensure the health and safety of people living at the home, visitors and staff, which are audited on a regular basis to make sure that they comply with changes in legislation and good practice guideline. Information provided in the self assessment form shows that all equipment in use at the home including the stair lift and hoists are serviced in line with the manufacturers guidelines, which means that people can be sure they are in good working order. Care Homes for Older People Page 23 of 26 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 24 of 26 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 25 of 26 Helpline: 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 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 26 of 26 - 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!