Inspection on 17/10/06 for Rose Court

This inspection was carried out on 17th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Court 24/01/08

Rose Court 11/01/06

Rose Court 26/09/05

Rose Court 02/02/05

Rose Court 06/07/04

Rose Court 10/03/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Rose Court Rose Court 253 Lower Road Rotherhithe London SE8 5DN Lead Inspector Pam Cohen Unannounced Inspection 17th October 2006 10:00 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 Court DS0000029619.V316188.R01.S.doc Version 5.2 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 Court DS0000029619.V316188.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rose Court Address Rose Court 253 Lower Road Rotherhithe London SE8 5DN 0207 394 2190 0207 394 0123 lucy.ross@anchor.org.uk sharon.blackwell@anchor.org Anchor Trust 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) Ms Lucy Ross Care Home 64 Category(ies) of Dementia (0), Mental disorder, excluding registration, with number learning disability or dementia (0), Old age, not of places falling within any other category (0) Rose Court DS0000029619.V316188.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11 January 2006 Brief Description of the Service: Rose Court is a purpose built residential care home registered for 64 older people and opened in 2002. It is owned and run by Anchor Trust. Since December 2005 the first floor has provided respite care for people with dementia and also has permanent service users needing dementia care. The accommodation is on four floors, each with a group living unit made up of 16 bedrooms all with en-suite facilities, a kitchen, a dining area and lounge. The kitchens on each floor are no longer used to prepare food and this is now done in a large central kitchen on the ground floor. There is a garden to the rear and off road parking to the side. Rose Court is situated on a bus route in Rotherhithe close to Surrey Quays shopping centre and a range of shopping and leisure facilities. On the day of inspection there were no permanent vacancies. Weekly fees for the home range from £462 to £500.46 pence. Rose Court DS0000029619.V316188.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was during the day of 17th October. The inspector returned two days later to spend more time with the manager who had had to leave on the first day. The inspector was able to speak to service users, relatives, staff and a visiting social worker. What the service does well: What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Rose Court DS0000029619.V316188.R01.S.doc Version 5.2 Page 6 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 Court DS0000029619.V316188.R01.S.doc Version 5.2 Page 7 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2,3,4,5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home gives prospective service users and their family good information and provides a statement of terms and conditions. Assessments and visits are carried out before admission, which together with appropriate staff training, means that on admission the home is able to meet service users’ needs. EVIDENCE: The home has a user-friendly Statement of Purpose and Service User guide. This should have a copy of the most recent CSCI inspection and should also have a section of service users’ views of the home. All care plans seen had a signed and dated copy of terms and conditions included. Before admission the manager obtains a copy of a community care plan for the prospective service user and either she or one of her team leaders goes out to assess the person to see if the home can meet their needs. Where possible relatives and the service user themselves visit the home before they move in. Rose Court DS0000029619.V316188.R01.S.doc Version 5.2 Page 8 The manager described good training in dementia care that has been provided for staff now that the home has a dementia care unit. This and other training help staff to meet the needs of service users. The home does not provide intermediate care. Rose Court DS0000029619.V316188.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users feel they are treated with dignity and respect. However service user’s care plans do not detail all their care needs or health care needs. Administration of medication does not always protect the service user. EVIDENCE: Service users appeared well cared for, they and their relatives said they received good care and a social worker who was visiting the home said that Rose Court provided excellent care. Nevertheless service users’ care plans do not address in detail most aspects of service users’ personal and health care needs, nor do they, for the most part, address their social and emotional needs. Where the service users have dementia many of their care plans do not detail how this affect them and what actions can be taken to help them with activities of daily living. Risk assessments are not always filled in for all necessary areas and sometimes an area of risk was seen to be recorded but was not accompanied by what actions need to be taken to minimise the risk. Service users’ life histories are also often absent. Rose Court DS0000029619.V316188.R01.S.doc Version 5.2 Page 10 On one unit there were not sufficient toiletries in all service users’ rooms to properly carry out personal care. The manager described good procedures for liaison when needed with health professionals and said they had good relationships with them. However issues pertaining to service users’ health are not recorded in their care plan in a way that can be easily monitored to make sure that everything necessary is being done, and that health care professionals’ advice is carried out. Medication administration and recording is on the whole good. However there were two instances where medication had run out, one for 5 days. Prescribed creams are not recorded when applied. There was also evidence that staff were not always knowledgeable as to the reason for the medications they were administering or of what side effects they should look out for. Observation and discussion with service users and their relatives show that service users are treated with dignity and respect. Rose Court DS0000029619.V316188.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users have good contact with visitors and are helped to exercise choice and control over their lives. Food provision is good. Although there are examples of good activities in the home service users cannot yet be sure that they will be offered a programme of activities which satisfies their needs. EVIDENCE: The home does not have an activities organiser at the moment although the manager said she is recruiting to the post and that in the meantime one of the senior staff is taking a lead in dealing with activities. There is an activities programme; however there is no evidence that it corresponds to the wishes of the service users regarding their social interests, as these have not been assessed in most cases. It is also not clear whether service users are taking part in activities as this is not recorded in daily records or elsewhere. There was however, also evidence of good practise; a well attended church service, service users going out individually with staff and a service user attending an Irish Day Centre. Also the service users had more visitors on the two days of inspection than is usual in care homes. The home was alive and bustling and interactions were very positive. Visitors said they were made welcome at all Rose Court DS0000029619.V316188.R01.S.doc Version 5.2 Page 12 times and they were seen taking advantage of the tea and coffee making facilities on the ground floor for themselves and the people they were visiting. All evidence showed that service users are enabled to exercise choice in their activities, and some choose to do tasks around the home. They are also helped to control their own lives as much as they wish and are able. Meals are prepared which looked appetising and service users and relatives praised the food in the home. The dining areas are made attractive and there is a menu on each table. Service users are offered a choice at each meal. Rose Court DS0000029619.V316188.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Rosecourt protects service users by dealing properly with complaints, by correct policies, procedures and training on working with vulnerable adults, and with information on representation. EVIDENCE: The organisation has a complaints policy which is prominently displayed in the entrance hall and which also has contact details for the local CSCI office. There is information on a system called Careline, where service users can talk anonymously on the phone to someone in Anchor Trust. There are also details of an advocacy service. A relative said he was clear how he would complain if he wanted to. Service users are on the electoral roll and vote either by post or in person if they are able. The organisation has policies for protection of vulnerable adults and whistle blowing. These tie in with the local authorities policy. Training has been given to staff on working with vulnerable adults. Rose Court DS0000029619.V316188.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20,21, 22,23, 24,25,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Rosecourt offers modern, safe and well-maintained, personal and communal accommodation to service users. EVIDENCE: Service users benefit from a purpose built, modern home which offers safe, accessible, attractive and properly maintained accommodation. The exception to this is the kitchens on each unit, which are in a state of disrepair with parts of units off or hanging off. The inspector was told that refurbishment was due. There is ample communal space with a lounge and dining room on each floor, together with other sitting areas and a further lounge downstairs for activities for the whole home. These rooms are pleasant, light and homely. The garden is attractive and looked well kept and colourful. All service users have a single room which meets minimum space requirements and which has an en suite toilet, shower and wash hand basin. In addition Rose Court DS0000029619.V316188.R01.S.doc Version 5.2 Page 15 there is a bathroom with a toilet and two other toilets on each floor close to the lounge area. Each of the bathrooms has an assisted bath with lift for easy access. All rooms are wheelchair accessible and the en suite showers are level access with plastic seats fitted. There are handrails on all corridors and toilets are fitted with grab rails. This means that the home is well suited for people with physical disability. There is work however still needed to provide an environment which orientates and stimulates the service users who have dementia on the first floor. Service users’ rooms are well furnished and maintained and some have been personalised by service users and their relatives; they do not however have two comfortable armchairs which are needed so that service users can entertain visitors in their rooms. Service users also need to be able to access a bedside light. Service users have a key to their room if they request one. There is good ventilation, heating and lighting in the rooms and records were seen that showed water supplied to rooms is safe and at the correct temperature. On the day of inspection the home was clean. Service users and relatives commented on the cleanliness of the home and their rooms. Hygiene is ensured by separate sluices on each floor, a well-equipped laundry and proper procedures for dealing with soiled laundry or clinical waste. Rose Court DS0000029619.V316188.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28,29, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ needs are met by sufficient numbers of well-trained, properly recruited staff. EVIDENCE: The rota showed that each unit has a team leader or care co-ordinator plus three staff in the morning and two in the afternoon. This level of staff is appropriate for the 16 service users in each unit. At night there is at the moment a senior carer plus three carers. This is a low level of night staffing and in discussion the manager confirmed that a new night staff member was being appointed. The files were seen for three recently appointed staff members. They showed that there is a good interview process. However when checking, the manager must ensure that a complete work history is completed so that it is clear if there are any gaps in employment that need to be explored. The manager confirmed that 35 of care staff have an NVQ qualification and a further 25 have nearly finished their studies. There is a good induction programme for staff of BTEC standard and which covers in the first 6 weeks all necessary areas. Staffs’ further training needs are discussed in supervision and a training programme is drawn up from these. Rose Court DS0000029619.V316188.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33,35,36,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well-managed and good communication and quality assurance systems mean that service users and their families voices are heard. Staff benefit from regular supervision. Good procedures protect service users finances and the health and safety of service users and staff. EVIDENCE: The manager has extensive experience of management in residential homes. She is a trained nurse and has completed the Registered Managers Award. In order to keep up to date with the changes that have happened in the home she also undertook training in dementia care. She was not available on the first day of inspection because she was receiving the organisation’s award for Manager of the Year. Rose Court DS0000029619.V316188.R01.S.doc Version 5.2 Page 18 Observation of her interaction with staff and service users showed that she is accessible and open. A senior member of staff talked of the way she guides people towards good practise and described her as “the backbone of the home.” Staff meetings and residents’ meetings encourage good communication throughout the home. The organisation sends out annual surveys and publishes the results that are included with the service user guide. The home also does its own survey the results of which are used as the basis of any action needed, and which is sent out to relatives. The home has a business plan and an annual development plan. There are proper procedures for dealing with service users’ finances and these were checked and seen to provide a good audit trail. However there needs to be a procedure on admission to ensure that service users’ wishes and capabilities in terms of handling their own cash, is assessed and recorded. The manager described good procedures for staff supervision. The organisation had just started a system of annual staff appraisal. The manager has been appraised and she will “cascade “ this down through the staff group. The home has good procedures for moving and handling assessments and training, with two team leaders trained to provide this. Good systems were seen for monitoring other areas of health and safety for service users and staff. An Environmental Health Inspector had inspected the kitchen the week before the inspection. The report was good but there were some requirements made and these must be carried out. Rose Court DS0000029619.V316188.R01.S.doc Version 5.2 Page 19 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 2 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 2 3 2 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 2 3 X 2 Rose Court DS0000029619.V316188.R01.S.doc Version 5.2 Page 20 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 OP1 Regulation 5(1)(d) Timescale for action The registered person must 31/12/06 ensure that the Service User Guide includes a copy of the most recent inspection by the CSCI together with a sample of service users’ views of the home. The registered person must 31/01/07 ensure that all service users have in place care plans or activity programmes addressing social or leisure interests and activities. Previous target dates of 31/12/05 and 31/03/06 not met. The registered person must 31/01/07 ensure that a full and meaningful audit is undertaken of all individual service users’ preferences, needs and aims with regard to any social, religious and cultural activities. (This audit must form the basis of the individual care plans identified in Requirement 2 of this report) Previous target dates of 30/11/05 and 31/03/06 not met. DS0000029619.V316188.R01.S.doc Version 5.2 Page 21 Requirement 2. OP7 OP12 16(2)(m) & (n) 3. OP7 16(2)(m) (n) Rose Court 4. OP7 15(1) 5. OP7 13(4)(c) 6. OP8 12(1)(a) (b) 13(2) 7. OP9 8. OP9 13(2) 9. OP9 13(2) 10. OP22 23(2)(n) 11. OP24 16(2)(c) 12. OP29 19(1)(a) 13. OP35 12(2)(3) (4)(a) The registered person must ensure that there is a detailed care plan which addresses all aspects of service users’ personal, health and emotional care needs. This should include a life history. The registered person must ensure that all areas of risk for service users are identified and recorded together with actions needed to minimise this risk. The registered person must ensure that service users’ health care is recorded, so that it can be easily monitored. The registered person must ensure that medication is administered by staff who have knowledge of what it is for and what are the possible side effects. The registered person must ensure that creams that are prescribed are recorded when applied. The registered person must ensure that there are systems to ensure that there is an adequate stock of medication prescribed for each service user The Registered person must ensure that there are suitable environmental adaptations, to stimulate and orientate people with dementia, provided on the first floor unit. The Registered person must ensure that all rooms have two comfortable chairs and that service users are able to access a bedside light. The registered person must ensure that satisfactory checks are made on any gaps in employment. The registered person must ensure that service users’ wishes DS0000029619.V316188.R01.S.doc 31/01/07 31/01/07 31/12/06 31/12/06 31/12/06 31/12/06 28/02/07 31/01/07 30/11/06 28/02/07 Page 22 Rose Court Version 5.2 14. OP38 12(1)(a) and capabilities to handle their own monies are assessed and recorded on admission to the home. The registered person must 31/01/07 ensure that the requirements in the EHO’s report are carried out. 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. 2. 3. Refer to Standard OP12 OP20 OP24 Good Practice Recommendations It is recommended that staff record when a service user takes part in an activity. It is recommended that the refurbishment of the unit kitchens is expedited. It is recommended that all service users should be offered a key on admission subject to a satisfactory risk assessment Rose Court DS0000029619.V316188.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH National Enquiry Line: 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 © 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 Court DS0000029619.V316188.R01.S.doc Version 5.2 Page 24 - 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. 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