Inspection on 17/02/06 for Rose Cottage Residential Home

This inspection was carried out on 17th February 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 Residential Home 18/12/07

Rose Cottage Residential Home 28/09/06

Rose Cottage Residential Home 05/10/05

Rose Cottage Residential Home 24/08/04

Rose Cottage Residential Home 06/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Rose Cottage Residential Home School Road Broughton Cambridgeshire PE28 3AT Lead Inspector Janie Buchanan Unannounced Inspection 17 February 2006 09:00 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 Rose Cottage Residential Home DS0000015105.V277285.R01.S.doc Version 5.1 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 Residential Home DS0000015105.V277285.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Rose Cottage Residential Home Address School Road Broughton Cambridgeshire PE28 3AT 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) 01487 822550 01487 824783 www.rosecottagecare.com John Tillisch Limited Josephine Mary Brown Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places Rose Cottage Residential Home DS0000015105.V277285.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th October 2005 Brief Description of the Service: Rose Cottage offers accommodation, care, and support to up to 37 older people. All rooms are for single occupancy and are on the ground floor; 24 of the rooms have en-suite facilities, one is used for respite or short-term care. Residents have access to a range of communal areas including four lounges and a small kitchenette, which has been equipped for residents and relatives to make drinks and snacks. The home is located in the middle of the village of Broughton, which has a church and popular public house. The village is situated about four miles from Huntingdon, and a two-minute drive from the small town of Warboys. The home is also within easy reach of the facilities offered by Peterborough, Cambridge, and St. Ives. The building surrounds an attractive courtyard; to the front, a patio area has been built around a mature pond and there is a level path around the perimeter of the building. The home has a parking area to the front with wellmaintained borders, trees and shrubs. The building backs onto open countryside and many of the rooms have pleasant views of the surrounding meadows. Rose Cottage Residential Home DS0000015105.V277285.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the home’s second inspection for the year 2005/6 and was unannounced. The inspector spent 3.5 hours at the home and interviewed four residents, three members of staff, the manager and the home’s proprietor. A brief tour of the premises was undertaken and a range of documents viewed. Three requirements and three recommendations have been made as a result of this inspection. What the service does well: What has improved since the last inspection? What they could do better: Information about the home is good, although more could be done to make it available in a format suitable for residents such as large print or audiotape. The home’s complaints procedure should be better advertised so that residents know how complaints may be made and who will deal with them. Care plans need to detail more fully the needs of residents and how those should be met. This was raised at the previous inspection. Rose Cottage Residential Home DS0000015105.V277285.R01.S.doc Version 5.1 Page 6 Residents should be provided with keys to lock their bedroom doors to ensure security, and also their privacy. All staff should receive regular supervision to have the opportunity to discuss their working practices, the home’s policies and procedures, and their career development needs. Water and fridge temperatures must be regularly monitored to ensure residents’ safety. 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 Residential Home DS0000015105.V277285.R01.S.doc Version 5.1 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 Residential Home DS0000015105.V277285.R01.S.doc Version 5.1 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): 1,2,3,5 Good information is available about the home to help prospective residents choose if it is where they want to live. Admission procedures are thorough and ensure that residents’ needs will be met at the home. EVIDENCE: The home has an information pack for prospective residents. This pack is comprehensive and includes the home’s statement of purpose, a sample contract, sample menus, the results of an independent satisfaction survey that was carried out about the home, and information about the fees charged. The inspector suggested that this information be developed into a more suitable format for its readers such as large print or audiotape. Information about the home is also available on its website www.rosecottagecare.com. All residents are assessed prior to their admission to ensure that the home can meet their needs. One recently admitted resident told the inspector that he had stayed for a full weekend to see if he liked the home, and assess its facilities. He also said he was given a copy the most recent CSCI inspection report to read. Rose Cottage Residential Home DS0000015105.V277285.R01.S.doc Version 5.1 Page 9 Each resident is issued with a contract that clearly states the terms and conditions of their stay and signed contracts were viewed on the residents’ files checked by the inspector. Rose Cottage Residential Home DS0000015105.V277285.R01.S.doc Version 5.1 Page 10 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): 7,10,11 Residents’ care plans do not set out in enough detail the action to be taken by staff to ensure that all aspects of their health, personal and social care needs are met. Service users are treated with respect, and their dignity is maintained. EVIDENCE: Three residents’ care plans were viewed. The information they contained was limited , and did not set out clearly the basis of care to be delivered. For example, all that was written on several plans was ‘ needs help with washing and dressing’, with no other instruction or information about what help exactly was required. There was little information in the plan about residents’ likes and dislikes, their daily routines, their social histories, and their hobbies, religious and cultural needs. The inspector was told that this information was available, but was kept in a cupboard in the office. The inspector questions the accessibility of this information for care staff if it is kept there. There was also little evidence that residents had actively been a part of drawing up the plan or of its review, or had agreed its contents. None of the residents interviewed were aware that such a document existed about them. The inspector acknowledges that the manager and her deputy have been working hard to get Rose Cottage Residential Home DS0000015105.V277285.R01.S.doc Version 5.1 Page 11 the care plans ‘right’ but more must be done to ensure that the plans are meaningful documents that give staff the information they need to deliver person centred care. Residents interviewed by the inspector confirmed that staff treat them respectfully and maintain their privacy. Staff also gave the inspector many good practical examples of how they maintain residents’ dignity and privacy when helping them with their personal care. Residents’ deaths are treated respectfully and both staff and residents are given opportunity to acknowledge a death and to grieve. At a recent residents’ meeting a minute’s silence was held for residents recently lost. Rose Cottage Residential Home DS0000015105.V277285.R01.S.doc Version 5.1 Page 12 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 The range of activities available in the home is good, providing residents with variety, social interaction and stimulation. EVIDENCE: The home has a well-organised social events programme and a dedicated staff member who visits 3-4 times a week to deliver it. There is a range of weekly in-house activities such as bingo, knitting, board games, exercise sessions and musical entertainers. There are also frequent trips out to garden and shopping centres and a local leisure centre to bowl. Special dates such as Valentine’s Day and St Patrick’s Day are also celebrated. Several residents told the inspector that they had been bowling the previous day and were also looking forward to a trip to the garden centre later in the week. One resident told the inspector ‘ I wasn’t very good at the bowling but I really enjoyed the ride out there’ another stated ‘the boat trip was marvellous and the Scottish dancers at the garden party were very entertaining’. The home also employs a ‘counsellor’ whose job it is to talk with residents on a one to one basis. This practice is to be commended. Residents are supported to maintain contact with family and friends and residents stated that their visitors are made to feel very welcome by staff. Family members are also encouraged to be part of the daily life of the home Rose Cottage Residential Home DS0000015105.V277285.R01.S.doc Version 5.1 Page 13 and one resident told the inspector that a relative of hers runs the whist drive at the home. Rose Cottage Residential Home DS0000015105.V277285.R01.S.doc Version 5.1 Page 14 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 Residents’ complaints are taken seriously although more could be done to ensure that they know how, and who, to formally complain to. EVIDENCE: The home has a complaints procedure to inform residents how to make a complaint about the service and details of it are contained in their terms and conditions. Despite this none of the residents interviewed were aware of the procedure or knew how to complain formally. However all stated they would raise any concerns that they had, primarily with the manager or owner, and all felt confident that it would be responded to appropriately. One resident commented ‘ if I had a complaint I would simply write a memo to John Tilish (the proprietor)’. Another resident stated that she had complained about getting just one bath a week. This was taken seriously and she now receives two. The inspector discussed with the proprietor several ways of making the complaints procedure more accessible to residents. The Commission for Social Care Inspection has not received any complaints about Rose Cottage in the last year. Staff receive regular training in protecting vulnerable adults and there is a large poster on display in the main office concerning this issue. Rose Cottage Residential Home DS0000015105.V277285.R01.S.doc Version 5.1 Page 15 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): 19,20,22,23,24,25,26 Residents live in a comfortable and well-maintained home with a range of indoor and outdoor space available to them. However residents should be provided with keys to lock their bedroom doors unless a risk assessment suggest otherwise. EVIDENCE: The home is in a small village, which has a church and popular pub; access to the home is via ramps or steps. The home is well maintained and decorated to a very high standard and has a homely and pleasant atmosphere. Residents have access to well-kept and attractive gardens; a range of colourful shrubs and flowers has been planted including scented plants in raised beds for people in wheelchairs or with a visual impairment to enjoy. There is also a large patio area adjacent to an established pond, and a level pathway has been created round the perimeter of the building. A large room in the centre of the building is furnished and laid out to provide a dining area and two lounges, one with a small library. A further lounge area is Rose Cottage Residential Home DS0000015105.V277285.R01.S.doc Version 5.1 Page 16 provided at the front of the home with patio doors onto the front garden, and a fourth lounge is situated at the rear of the building. Lighting in the communal rooms is domestic in character, and furniture is good quality and suitable to the needs of service users; all residents spoken to expressed their satisfaction with the communal facilities provided. Twenty-four of the bedrooms have en-suite facilities; five of these also have their own shower or bath. Residents have access to four shared bathrooms, though the bath in one is not suitable for people who would find it difficult to get in and out. The home has two sluice facilities, both of which are separate from the bathrooms. All rooms are centrally heated and residents are able to control the temperature in their bedrooms; radiators have been fitted with guards to ensure residents’ safety from hot surfaces. However not all residents have been offered a key to lock their bedroom door. Appropriate aids and adaptations have been provided throughout the home, including bath hoists and grab rails in bathrooms and toilets, and around the building. A call system has been installed in every room used by residents so that they can summon assistance if necessary. The home is light and airy and this is something residents clearly appreciated. One commented ‘my room is so lovely and sunny and has such a nice view that I rarely want to leave it’. Rose Cottage Residential Home DS0000015105.V277285.R01.S.doc Version 5.1 Page 17 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): 27,30 The number of staff adequately meets residents’ needs and trained and skilled staff look after them. EVIDENCE: Staffing levels at the home are adequate. Between 8am and 2pm there is a manager and a minimum of five carers on duty. Between 2pm and 10 pm there are 4 carers, and between 10pm and 8am two ‘waking night staff and an additional sleep in member of staff. Scrutiny of the duty rota confirmed that these staffing levels were maintained. The home has a stable staff group, with many having worked there for a number of years. Staff turnover is low and agency staff are only used in an absolute emergency. Residents stated that there were staff around when they needed and felt confident that staff would come quickly if necessary. However, on the day of inspection itself, staff seemed harassed and busy. This was discussed with the manager who stated that this was due to exceptional circumstances. Staff training continues to be excellent with good evidence that staff undertake both mandatory training, and training specific to the needs of older people. The home has already well exceeded the minimum requirements for the standard relating to NVQs, which is commendable. Rose Cottage Residential Home DS0000015105.V277285.R01.S.doc Version 5.1 Page 18 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, 33,34,36,38 Leadership in this home is good and there are effective systems in place to allow residents to air their views about the quality of the service they receive. Records required by regulation for the protection of residents were up to date and accurate. EVIDENCE: The registered manager of the home is Josie Brown. Mrs Brown has worked at the home since 1986; she started as a care assistant but was promoted to deputy manager in 1991, she became manager in November 2002 and was successful in her application to be registered in July 2003. Mrs Brown demonstrates a high level of commitment and care to the people living at Rose Cottage and to the service as a whole. She has undertaken a range of courses relevant to her work and has gained the Registered Managers’ Award. The manager and proprietor both have a high presence in the home and demonstrate an approachable and open style of management. All residents interviewed by the inspector spoke highly of both. Rose Cottage Residential Home DS0000015105.V277285.R01.S.doc Version 5.1 Page 19 Staff do now receive regular supervision, although it was of concern to note that one senior member of staff had not received any in the last year. This was discussed with the manager. Consultation with residents is good and there are well-attended (22 attendees at the meeting of 25 January 06) and regular residents’ and relatives’ meetings. One resident told the inspector that, at a recent meeting, he was asked to vote on the design and lay out of the dining room. A number of records in relation to health and safety were viewed by the inspector and found to be in good order. Staff interviewed by the inspector confirmed that they had received training in fire safety, food hygiene, moving and handling, and first aid. There were no major health and safety hazards seen during the inspection, although the inspector advised that water and fridge temperatures should be regularly recorded. Paperwork in relation to residents’ monies and fee payments were also checked, and satisfactory accounting records and receipts were maintained. Rose Cottage Residential Home DS0000015105.V277285.R01.S.doc Version 5.1 Page 20 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 3 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 2 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 3 3 2 x 3 Rose Cottage Residential Home DS0000015105.V277285.R01.S.doc Version 5.1 Page 21 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 OP7 Regulation 15 & Sch 3(1)(b) Requirement Information held in care plans must give an accurate and detailed account of how service users needs are to be met and how assistance and support should be given. Time scale of 31/12/05 not met. Arrangements must be made to ensure that all staff receive formal supervision at least 6 times a year Water temperatures and fridge temperatures must be regularly monitored. Timescale for action 01/04/06 2. OP36 18(2) 01/04/06 3 OP38 13(4)(c) 01/04/06 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 OP1 Good Practice Recommendations The home’s Statement of Purpose and Service user Guide should be developed in a format suitable for residents such DS0000015105.V277285.R01.S.doc Version 5.1 Page 22 Rose Cottage Residential Home 2 3 OP16 OP24 as large print or audiotape. The home’s complaint’s procedure should be more accessible to residents. Residents should be provided with bedroom keys unless their risk assessment suggests otherwise Rose Cottage Residential Home DS0000015105.V277285.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE 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. 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