Inspection on 20/01/06 for Rose Cottage Nursing Home

This inspection was carried out on 20th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Rose Cottage Nursing Home 18/11/08

Rose Cottage Nursing Home 29/12/06

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Rose Cottage Nursing Home 47 High Street Haydon Wick Swindon Wiltshire SN25 1HU Lead Inspector Steve Cousins Unannounced Inspection 09:30 20 January 2006 th 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 Rose Cottage Nursing Home DS0000063107.V269747.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. Rose Cottage Nursing Home DS0000063107.V269747.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Rose Cottage Nursing Home Address 47 High Street Haydon Wick Swindon Wiltshire SN25 1HU 01793 706876 01793 706876 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) Hemingway Management Services Ltd Mrs Katharine Elizabeth Ann Pearson Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Rose Cottage Nursing Home DS0000063107.V269747.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th July 2005 Brief Description of the Service: Rose Cottage is a care home for older people that is registered to accommodate up to eighteen service users requiring nursing care. A registered nurse is on duty at all times supported by care assistants. Laundry, housekeeping and catering services are also provided. Rose Cottage is located in Haydon Wick, Swindon, and situated about a quarter of a mile away from local amenities. The home is a two-storey building and has sixteen single bedrooms and one double. A passenger lift is provided to access rooms on the first floor. Although no bedrooms have en suite facilities, each room does have a wash hand basin. The home has a ‘domestic–style’ lounge near the front entrance and another lounge with an integrated dining area at the rear of the building. Patio doors from the rear lounge lead to a level garden area. The home is owned by Hemmingway Management Services Ltd and the registered manager is Mrs Kate Pearson, a registered nurse. Rose Cottage Nursing Home DS0000063107.V269747.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Service users are known as residents in this home and will be referred to as such throughout this report. This unannounced inspection took place between 9.30 am and 4.00pm. There were 18 residents in the home. The findings from this inspection are based on a tour of the premises, speaking to residents, visitors and staff, and visiting frail residents. A number of records were inspected, including care plans and staff files. There were a high number of frail residents in the home, many of who found it difficult to communicate. The findings were discussed with Mrs Pearson, the registered manager, at the end of the inspection. What the service does well: What has improved since the last inspection? What they could do better: Although staffing levels are normally satisfactory, care needs to be taken to ensure that they do not drop below minimum levels, particularly during weekends. Recruitment procedures were generally satisfactory however, when a staff member has previously worked in a care home or agency, then references should be sought for that employment. The sliding door in the sitting room needs to be repaired and a sluice needs to be refurbished or replaced. Rose Cottage Nursing Home DS0000063107.V269747.R01.S.doc Version 5.0 Page 6 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. Rose Cottage Nursing Home DS0000063107.V269747.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 Rose Cottage Nursing Home DS0000063107.V269747.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): 3 and 4. Standard 6 does not apply to this home. Residents’ needs are assessed prior to admission and the home has the capacity to meet those needs. EVIDENCE: Care plans reviewed contained pre admission assessments that had been completed by the manager. Other supporting pre admission documentation was available, such as social services assessments and hospital discharge summaries and these had been used in the assessment process. Rose Cottage is registered to provide nursing care for up to 18 elderly people. The environment is suitable and the adaptations and equipment appropriate. The positive comments of the residents and the inspectors observations indicate that the home has the capacity to meet the needs of the client group. The manager is aware that, where the home is not able to meet a resident’s changing needs (such as increasing dementia) then appropriate action needs to be taken to find a more suitable placement for them. Rose Cottage Nursing Home DS0000063107.V269747.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 and 10 The standard of personal and health care delivered meets the assessed needs of residents and they have care plans in place that reflect their needs. Residents are treated with respect and their right to privacy upheld. EVIDENCE: The care plans seen were based on residents assessed needs, were regularly reviewed and appeared to direct care. Visits to residents indicated that appropriate interventions were in place to meet assessed needs, although some fluid charts appeared incomplete making it difficult to assess if the person was receiving enough to drink. Clearer information needs to be recorded with regard to ‘end of life’ decisions to avoid any confusion. Nutritional assessments are undertaken and residents were weighed regularly to ensure that they are receiving adequate nutrition. All residents are registered with the same GP who visits the home weekly and there was evidence in care records to indicate prompt responses to illness and health care needs. Standard 9 was not fully assessed however since the last inspection, there had been an improvement in the recording of medications received by the home. Rose Cottage Nursing Home DS0000063107.V269747.R01.S.doc Version 5.0 Page 10 Staff were seen to respect residents wishes and maintain their privacy. Residents were positive about the care and support given to them, one saying ‘you can’t fault it’. One particularly frail resident who had recently returned from a spell in hospital said that they were ‘glad to be home’ and praised the care given by the staff. Rose Cottage Nursing Home DS0000063107.V269747.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, 13 and 14. There is a commitment to meet the residents’ social, recreational and religious needs and residents are supported in maintaining control and choice in their lives, including keeping contact with family, friends and the community. EVIDENCE: An activity person is employed and there was evidence to suggest a good range of in house and external activity was available to residents. One to one activity is provided where required and activity records are kept. It was reported that there are no restrictions on visiting unless at the residents request. Visitors were in the home during the inspection and some residents confirmed that they had contact with friends and relatives. Visitors could be received in residents’ rooms or in the communal areas. It was reported that links with the local community were mainly via external activities and that representatives the local Parish Council had visited the home. It was observed that, where possible, residents were able to exercise choice and control over their lives. Some residents had chosen to remain in bed on the morning of the inspection and rise later; some liked to spend their time in specific communal areas and others were supported to attend or receive religious services in the home. One resident chooses to attend a local Luncheon Club and is supported in doing so. Rose Cottage Nursing Home DS0000063107.V269747.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. There are systems in place to ensure complaints are listened to and acted upon. EVIDENCE: A complaint book was placed in the foyer for use by relatives, or, Mrs Pearson stated, complaints could be made to the manager or staff directly. The complaints record indicated that no complaints had been received since the previous inspection. The complaints procedure is on display in the home and is contained in the service users guide. One resident stated that they would approach the manager if they needed to complain, although they had not felt the need to do so. Rose Cottage Nursing Home DS0000063107.V269747.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): 19,21,22 and 26 The home is clean and odour free, there are enough bathing and toilet facilities and specialist equipment is available to support residents assessed needs. Improvements are being made to the home, which should further enhance the environment for the residents. EVIDENCE: A maintenance person has been recently employed and had commenced some redecoration work. The manager reported that new adjustable beds had been ordered along with furniture for the communal areas, but had not been delivered. Since this inspection, Mrs Pearson has confirmed that the beds and furniture had now been supplied. The carpet on the first floor corridor has been replaced and a new dishwasher purchased following the previous inspection, however the sliding door in the sitting room has yet to be repaired. There are five toilets and three bathrooms available. Although there are no en-suite facilities, all of the bedrooms have a wash hand basin. Hot water supplies are temperature controlled to avoid risk of scalding. Rose Cottage Nursing Home DS0000063107.V269747.R01.S.doc Version 5.0 Page 14 To help meet residents assessed needs, the home has equipment such as portable hoists, seat raisers, handrails, wheelchairs, bed safety rails and pressure relief equipment and a call bell system is installed and working. The home was clean and free from unpleasant odours. Improvements have been made to the laundry, new equipment has been purchased and more space is available. Infection control procedures are in place. The sluice on the first floor is in poor condition requires refurbishment or replacement. Rose Cottage Nursing Home DS0000063107.V269747.R01.S.doc Version 5.0 Page 15 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): 27, 28, 29 and 30 On occasions, care staff levels may compromise their ability to meet residents’ needs. Staff are trained and competent and recruitment practices are generally safe but require some improvement regarding staff references and mandatory training. EVIDENCE: Duty rotas indicated times when the minimum staffing levels for care staff, as set in the Notice of Decision dated 11 Feb 2003, were not being met. This related to three occasions over three weekends when the staffing levels dropped between the hours of 2 – 5 pm. To one nurse and one care assistant. This was discussed with Mrs Pearson for immediate action. The majority of the time the staffing notice was either met or exceeded. The manager stated that six of the eleven care assistants had and NVQ and one other was currently undertaking NVQ2. Induction training and mandatory training records were available, although these indicated that some staff required updating with regard to health and safety and first aid. Further training is planned on dementia care. A selection of staff recruitment documents were reviewed and found to be generally satisfactory. CRB and POVA checks had been obtained along with two references, however in two cases, a reference had not been obtained from a previous healthcare employer and the need for this was discussed with Mrs. Pearson. Rose Cottage Nursing Home DS0000063107.V269747.R01.S.doc Version 5.0 Page 16 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): 31 and 36. The manager is experienced and competent and staff are receiving regular, appropriate supervision. EVIDENCE: Mrs Pearson is a nurse who has obtained the Registered Managers Award. She is an NVQ assessor and has a degree in social sciences and a City and Guilds 7307 teaching qualification. She has been in post since November 2001. There were positive comments about the manager from residents and relatives. Mrs Pearson stated that both she and her assistant had been trained in supervision and that formal structure was now in place to ensure that all staff receive regular supervision and annual appraisal. Although standard 38 was not fully assessed, fire safety arrangements were satisfactory and records indicated staff were receiving fire safety training at the Rose Cottage Nursing Home DS0000063107.V269747.R01.S.doc Version 5.0 Page 17 required intervals. A tour of the home indicated that it was free from hazards to safety. Rose Cottage Nursing Home DS0000063107.V269747.R01.S.doc Version 5.0 Page 18 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 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 2 X 3 3 X X X 2 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X 3 X X Rose Cottage Nursing Home DS0000063107.V269747.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 OP8 Regulation 12(1,a,b) Requirement Timescale for action 20/01/06 2 OP19 3 OP26 4 OP27 5 OP29 6 OP30 The registered manager is required to ensure that, in order to evidence practice, intervention charts are fully completed. 23 (2,b) The registered person is required to ensure that the sliding door leading from the rear sitting room to the garden be repaired. Unmet requirement from inspection held 13/07/05. 13(3) 16 The registered person is required (2,j) to ensure that the sluice facility on the first floor be replaced or refurbished. 18 (1,a) The registered manager is required to ensure that care staff levels are enough to meet the needs of the residents at all times. 19(1a,b,c) The registered manager is Sch required to ensure that where a 2(3,4) person has previously worked in a position involving contact with vulnerable adults, then a reference is obtained along with written verification of why they ceased to work in that position. 18 (1,a) The registered manager is DS0000063107.V269747.R01.S.doc 01/03/06 01/06/06 20/01/06 20/01/06 20/04/06 Page 20 Rose Cottage Nursing Home Version 5.0 required to ensure that those staff indicated in the training records receive update training for health and safety and first aid. 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 OP8 Good Practice Recommendations It is recommended that clearer information be recorded with regard to ‘end of life’ decisions. Rose Cottage Nursing Home DS0000063107.V269747.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Rose Cottage Nursing Home DS0000063107.V269747.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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