Inspection on 26/09/05 for Rose Court

This inspection was carried out on 26th September 2005.

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 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 Court 24/01/08

Rose Court 17/10/06

Rose Court 11/01/06

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 Lisa Wilde Unannounced Inspection 26th September 2005 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.V252800.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 Court DS0000029619.V252800.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Rose Court Address Rose Court 253 Lower Road Rotherhithe London SE8 5DN 0207 394 2190 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) Anchor Trust 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.V252800.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd February 2005 Brief Description of the Service: Rose Court is a residential care home registered for 64 older people. It is owned and run by Anchor Trust. The home is purpose built and was opened in March 2002 to replace two ex-local authority homes. The accommodation is on four floors, each with a group living unit comprising 16 bedrooms all with en-suite facilities, a kitchen, a dining area and lounge. Since the last inspection in July 2004 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. The home has been decorated to a high standard and is homely and comfortable. There is a garden to the rear with garden furniture and which service users said is well used in the warm weather. Rose Court is situated on a bus route in Rotherhithe close to Surrey Quays shopping centre and a range of leisure facilities. Rose Court DS0000029619.V252800.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day in September 2005. The inspector met with the Registered Manager, staff, service users and some of their relatives. The previous inspector had been conducted over two days and had assessed the majority of the national minimum standards and found of them apart from one, to be met. This inspection therefore only focussed on the few standards not assessed last time. Feedback from relatives was generally positive with staff being described as “nice people” and stating that their relative “loved living here”. However some concerns were expressed that when their relative moved to the home the care plans weren’t drawn up quickly enough in order to let staff know what to do. At the end of October this home will be taking on the respite provision previously provided by social services within the borough. The organisation has been effectively liaising with the Commission regarding this issue and the Registered Manager stated that they do not envisage there will be any change to the service as they currently provide a respite service anyway. The impact of this change, if any, will be further assessed at the next inspection. What the service does well: What has improved since the last inspection? Rose Court DS0000029619.V252800.R01.S.doc Version 5.0 Page 6 This was the first inspection of this home by this inspector so it is harder to say what has improved. The requirement and recommendations met from the last report show that the home has got better at sending through the monthly report to the Commission, recording more details is service users’ files and recording particular wishes around death and dieing. 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. Rose Court DS0000029619.V252800.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 Court DS0000029619.V252800.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): 1 (Standard 6 does not apply) Potential service users are provided with all the information they need to decide whether to live at the home. Current service users are provided with information about what they can expect from the service and what is expected of them. EVIDENCE: The Statement of Purpose and Service User Guide have previously met the standards but will be revised in about six months to incorporate the changes that are taking place in terms of the dementia care. Rose Court DS0000029619.V252800.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&9 Service users’ health and personal care needs are fully addressed in their Lifestyle Agreements and care plans. Service users social care needs are not fully addressed in these plans. Lifestyle plans and care plans are not always dated and signed by the service user or their representative, which means that the home is not showing that the plans have been drawn up with the full agreement of the service user. The home’s medication administration and stock checking procedures are not effective which means that the home is not keeping an accurate record of all medication it holds on behalf of the service user. EVIDENCE: There was a previous recommendation that the Registered Manager should ensure that full information is recorded about service users that was met by this inspection. The files showed that where Lifestyle Agreements and care plans are in place they now include full details of service users’ needs although there are no care plans in place that assess and address service users social or leisure requirements. Some care plans were not signed by the service user or their representative and some had not initial date and no review date, Rose Court DS0000029619.V252800.R01.S.doc Version 5.0 Page 10 although most care plans were reviewed monthly as required. (See Requirements 1 & 2) The inspector spoke with staff about the new service users and their lifestyle agreements. These lifestyle agreements had not been completed as the member of staff said that these were not drawn up until six weeks into someone stay. In the interim there were no care plans in place to identify how to meet initial needs. (See Requirement 3) There was a previous recommendation that the Registered Manager should ensure that service users’ wishes concerning arrangements after death are discussed and recorded, that was met by this inspection in that there was evidence that some service users had their wishes recorded. Staff said that some service users and their families did not wish to discuss these issues and in those instances a note should be made on file (See Recommendation 1) The inspector examined the medication records and the medication stocks held on both floors. There were some gaps in administration recording and some signatures were not clear or the same as their sample signatures on the list maintained in the file. All the stock of medications checked did not tally with the records of the amounts held. (See Requirements 4 & 5) Rose Court DS0000029619.V252800.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 The home does not currently fully record service users social and cultural needs in their care plans so it was not possible to full assess if those needs are being met or goals being worked towards. EVIDENCE: As mentioned previously the care plans do not address service users leisure, social or cultural needs. Service users were in the house watching television on the day of the inspection. Some staff were engaging with service users and talking with them over drinks other staff were sitting in the kitchen away from the service users talking to each other. Staff commented that it was sometimes difficult to get all staff to engage with service users when they were in the home and undertake activities. Service users said they didn’t go out much but that that didn’t particularly bother them. Given the lack of care plans or activities programmes it was not possible to assess if needs were being fully met in this area. (See Requirement 6) The inspector sat in on the daytime handover and found that it was brief with most service users’ being described as fine or all right. There was some discussion of health care needs arising on the day. There was no forward planning for the forthcoming shift or reference to any other care planning issues. One service user came into the lounge where the handover was being given and approached staff and then sat nearby while handover carried on. Rose Court DS0000029619.V252800.R01.S.doc Version 5.0 Page 12 Staff confirmed that this happens regularly with this particular service user. (See Requirements 7 & 8) Rose Court DS0000029619.V252800.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 17 The current policy and procedures around complaints is not ensuring that service users are aware of everyone they can complain to or making sure that their complaints within the home are being monitored and acted upon. EVIDENCE: There is a complaints procedure that is displayed prominently in the entrance hall with leaflets for service user to complete if they wish. There is an additional system called Careline where service users can talk anonymously to a number within the Anchor Trust. The complaints procedure mentions that service users can complain to the Commission but does not give the address and telephone number and does not explain what the Commission is or that service users can complain to the Commission at any time, outside of the organisation’s procedure (See Requirement 9). The borough’s advocates are available for people who do not have family and the Registered Manager described how one woman is currently going through the Power of Attorney process with her niece. Social services are involved with the finances of people who have no family. Service users are supported to vote by post if they choose to. Rose Court DS0000029619.V252800.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 This home is safe, well maintained and comfortable. There are enough bathrooms that are decorated in a non-institutional manner. Bedrooms are large enough and all have en-suite bathrooms. Service users have personalised their rooms to their own tastes and can bring in some of their own furniture if they choose. The communal areas are bright and airy and the whole home is clean and free from unpleasant smells. EVIDENCE: The evidence found at the last inspection was found to be the same at this inspection. Rose Court is a purpose built building and was opened in 2002. The service user’s accommodation is on four floors and there are two shaft lifts of differing sizes to provide access to all levels. There is a reception and large sitting room on the ground floor. There are bedrooms, a lounge/dining area and a kitchen for the group of people living on each of the floors. There is a large, central kitchen on the ground floor where all meals are prepared. There are kitchenettes on each floor, which the Registered Manager said are due to be refurbished. There is an accessible garden with garden tables and chairs. At Rose Court DS0000029619.V252800.R01.S.doc Version 5.0 Page 15 the side of the building there was a car park for staff and visitors. There is a communal lounge the ground floor, which looks out onto the garden. Each floor is colour co-ordinated and the units on each floor had been given names that reflect in some way the homes from which service users had moved when Rose Court was built. The lounges and dining areas are pleasant, light and airy. There is a range of different types of seating available in the lounges. The dining areas provided tables and chairs for individuals to eat their meals in groups of four. The furnishings are of good quality and overall the communal areas are pleasant places to sit. Each service user’s room had an en suite toilet, level access shower and wash hand basin. In addition there was a bathroom with a toilet and two other toilets on each floor close to the lounge area. Each of the bathrooms had assisted baths with lifts for easy access. All service users’ rooms are wheelchair accessible. The bedroom doors have magnetic closures and close when the fire alarm is activated. There are handrails on all corridors. Toilets are fitted with grab rails. In service users’ rooms the showers are level access with plastic seats fitted. A call bell system is provided. All the bedrooms meet the minimum space requirements and had at least 12 sq m, which also ensured that there was adequate space for those using wheelchairs. There are no shared rooms. The Inspector looked at a range of bedrooms. Each was furnished and carpeted to a good standard. Service users have personalised them and they contain photographs, pictures and ornaments. The standard items of furniture are provided. The home met health and safety requirements. The windows have and the radiators and pipe work are guarded and there are temperature control valves to allow service users to control the heat in their rooms. The water temperatures are appropriately controlled to prevent risks from legionella and regular checks are kept on water temperatures. On the day of this inspection the standard of cleanliness within the home was high. The Inspector toured the building and it was clean and free from offensive odours. The laundry facilities are satisfactory. Rose Court DS0000029619.V252800.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 & 30 Generally the recruitment policy and procedure is operated effectively ensuring that appropriate staff are brought into the home and service users are protected. The home is not operating the criminal record checking procedure properly which means that staff are starting work without the full criminal checks being in place. The staff team is comprehensively trained in both the core statutory areas and the specialist needs of the service user group, which means that service users are being offered care and support from knowledgeable and effective staff. EVIDENCE: The inspector sampled some recruitment files and found the recruitment procedure to be robust and effective. The required identity documents and references are gained before someone starts employment. Currently however the POVAFirst check is being used for all staff and they are starting employment without receiving enhanced CRB checks. This system is only supposed to be used in emergency situations. (See Requirement 10) Staff training records showed that the focus currently is around dementia because of the home taking on the provision for respite care previously offered by social services within the borough. The Registered Manager stated the positive impact of this training on care for service users had been significant. Training records showed that core statutory training is offered on a rolling basis. Induction training takes place for new staff. 10 staff hold the NVQ Level 2/3 in Care with 9 currently undertaking it meaning that the home is achieving Rose Court DS0000029619.V252800.R01.S.doc Version 5.0 Page 17 the target of at least 50 of care being offered by staff who hold the NVQ. (30 care staff in all). Staff said they felt well trained and able to undertake all aspects of the work. Rose Court DS0000029619.V252800.R01.S.doc Version 5.0 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, 35 & 38 The Registered Manager is experienced, qualified and skilled and has the necessary awareness that ensures she is fit to be in charge and the home is well run. The financial procedures and checking mechanisms for service users’ money are robust, open and effective which means that service users’ money and financial interest are protected. The health and safety policies and procedures are comprehensively operated by staff, which means that the environment is safe and service users’ health and welfare is promoted and protected. EVIDENCE: The Registered Manager has nine years experience as a manager of residential care homes for older people and a further two years as a deputy manager. She Rose Court DS0000029619.V252800.R01.S.doc Version 5.0 Page 19 is a trained nurse and also has a Diploma in Health Care. She has almost completed the Registered Manager’s Award. There was a previous requirement that the Registered Provider must ensure that a copy of the report required to be made after each monthly visit is supplied to the CSCI. This is now being done. The financial records of service users’ money are computerised and the inspector went through samples of these records with the administrative assistant. Receipts are given for all money issued and for all money received on behalf of service users from family or social services. The cash held in the building was checked and it tallied with the records. The checking systems of these accounts are robust and open. From discussion with the manager and staff and on examination of records it was evident that safe working practices are generally well promoted. A fire risk assessment has been conducted and regular fire drills and checks are organised. The required equipment checks have taken place. There were no health and safety issues noted on the tour of the building. Rose Court DS0000029619.V252800.R01.S.doc Version 5.0 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 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 X 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 X 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X 3 Rose Court DS0000029619.V252800.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 (1) Requirement The Registered Manager must ensure that all service users’ Lifestyle Agreements and care plans are dated and signed by the service user or their representative (or include a note stating if there is no one available to sign). The Registered Manager must ensure that all service users have in place care plans or activity programmes addressing social or leisure interests and activites. The Registered Manager must ensure that if a service user’s Lifestyle Agreement is not due to be completed until after the initial six week trial stay, that there are in place initial care plans that describe the care to be provided in the interim. Any service user referred for respite must also have in place these care plans even if their initial stay is shorter than six weeks. The Registered Manager must ensure that all medication is signed for at the point of DS0000029619.V252800.R01.S.doc Timescale for action 14/12/05 2 OP7 16(2)(m) & (n) 31/12/05 3 OP7 12(1)(a) & (b) 15(1) 30/11/05 4 OP9 13 (2) 22/10/05 Rose Court Version 5.0 Page 22 5 OP9 13 (2) 6 OP12 16(2)(m) & (n) 7 OP12 12(1)(a) & (b) 8 OP12 OP10 12(4)(a) 9 OP16 22 10 OP29 19(1)(b) Schedule 2 adminstration and that the staff member’s signature is clear and the same as the sample signature held on file. The Registered Manager must ensure that the medication stock checking system is effective and accurate records are maintained at all times, of the medication held in the home. The Registered Manager must 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) The Registered Manager must ensure that handover time is used more usefully to give a full handover of issues and also include care or action planning issues for the forthcoming shifts. The Registered Manager must ensure that service users confidentiality is respected by the staff handover being conducted in private with no service users present. The Registered Manager must ensure that the Complaints Procedure and leaflets include the contact details of the local Commission office along with a brief explanation of who the Commission is and why service users may want to complain to them. The Registered Individuals must ensure that the POVAFirst check is only used for new staff in emergency situations. In normal circumstances staff must not commence employment at the DS0000029619.V252800.R01.S.doc 22/10/05 30/11/05 30/11/05 22/10/05 30/11/05 22/10/05 Rose Court Version 5.0 Page 23 home until a current enhanced CRB check has been received by the organisation. 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 OP11OP7 Good Practice Recommendations The Registered Manager should ensure that a note is made on service users’ file if they or their family do not wish to discuss issues of death or dieing. Rose Court DS0000029619.V252800.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH 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 Court DS0000029619.V252800.R01.S.doc Version 5.0 Page 25 - 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!