CARE HOMES FOR OLDER PEOPLE
Rose Lodge/ Rose Court 3 Sutton Road Mansfield Nottingham NG18 5ET Lead Inspector
Steve Benson Unannounced 20 June 2005 9.30 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 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 Lodge/ Rose Court C53 C03 S63714 Rose Lodge V234318 200605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Rose Lodge/Rose Court Address 3 Sutton Road Mansfield Nottinghamshire NG18 5ET 01623 471300 01623 461558 rleuropeancare@aol.com or rceuropean@aol.com European Care Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mavis McLaughlin CRH 110 Category(ies) of OP 110 registration, with number of places Rose Lodge/ Rose Court C53 C03 S63714 Rose Lodge V234318 200605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 16/12/04 Brief Description of the Service: Rose Lodge is the registered name for 2 units on the same site, Rose Lodge and Rose Court, each providing personal care and accommodation for 55 older people. The home can provide short and long term care.The home is owned by Eurpoean Healthcare. The home is located near Mansfield town centre and is close to shops, pubs, the post office and other amenities. The home was opened in June 1998 and consists of two identical purpose built buildings. Eachy unit has fifty three single bedrooms and all of the bedrooms have ensuite facilities. Bedrooms are located on 2 floors and each unit has a passenger lift. The home has well appointed garden and patio areas that are well maintained and easily accessible. There is ample car parking available Rose Lodge/ Rose Court C53 C03 S63714 Rose Lodge V234318 200605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was the first of two unannounced inspections to be carried out between April 2005 and March 2006. The inspection lasted for 7 hours and the main method of inspection used was called case tracking which involved selecting 6 residents and tracking the care they receive through the checking of their records and discussing this with them. Other residents were spoken with and additional records were seen. A discussion was had with the manager, care staff on duty and care practices were observed. Other residents and relatives were spoken with as well as a visiting doctor and district nurse. The premises were not inspected in detail but various areas of the home were visited as part of the inspection What the service does well:
New residents are assessed before they are admitted to the home to en sure that their needs can be met. A resident said he was visited whilst in hospital. Residents are able to receive the healthcare they need and staff work well with other professionals. Residents commented positively on the support they receive. There are good arrangements for the storage and administration of medicines and residents are able to self medicate if they want to and are assessed as being able to do so. Staff are made aware of the importance of respecting residents privacy and dignity and good examples of doing this were given and residents felt that this was done. Residents have good opportunities to take part in activities and kept informed of what’s on through a newsletter. Visitors are made welcome when visiting. Residents are able to choose how and where they spend their time and one resident said he had made changes to his room to suit his needs. Meals are well praised by residents an d the menu shows that a good diet is provided and there is a choice of meals. Residents know how to raise concerns with staff but said there has not been the need. The accommodation is spacious and well suited as a home for older people. It is maintained and cleaned to a high standard and has just been awarded a 3 star healthy living award.
Rose Lodge/ Rose Court C53 C03 S63714 Rose Lodge V234318 200605 Stage 4.doc Version 1.30 Page 6 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. Rose Lodge/ Rose Court C53 C03 S63714 Rose Lodge V234318 200605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Rose Lodge/ Rose Court C53 C03 S63714 Rose Lodge V234318 200605 Stage 4.doc Version 1.30 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 standard(s) 3 New residents are assessed prior to admission. EVIDENCE: Two newly admitted residents were case tracked and a member of staff from the home had assessed both prior to admission. There was also an extended community care assessment provided buy Social Services. Information contained in the assessment had been used to prepare the care plans. A resident said that a member of staff had visited him in hospital and told him about the home and asked him questions. He said that he had already seen the home’s Statement of Purpose and Service User Guide. Rose Lodge/ Rose Court C53 C03 S63714 Rose Lodge V234318 200605 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9 and 10 Risk assessments and care plans must be reviewed in light of any changes identified. Good practices are in place to enable healthcare needs to be met and attention is paid to maintaining the privacy and dignity of residents. EVIDENCE: The care planning system within the home has developed over a number of years and staff are trained on how to complete and use these plans. Although plans seen were on the whole well completed there was a lack of consistency seen as to where some information was recorded. One plan examined included a risk assessment for falling due to a previous history of falls by the resident. Entries in the evaluation section showed that the resident had fallen on a number of occasions recently but the risk assessment or care plan had not been reviewed in light of these falls. Entries in the accident book did not fully correspond with the record made in the care plan. Staff discuss care plans with residents who sign to confirm this has happened. It would be further good practice to include comments from residents on the content of their plans. Residents said that they have seen their care plans. Care plans include a record of all healthcare appointments ands these showed that residents have access to a range of services. A visiting district nurse said that she found staff helpful and would vary their routines to assist the visiting
Rose Lodge/ Rose Court C53 C03 S63714 Rose Lodge V234318 200605 Stage 4.doc Version 1.30 Page 10 nurses. The nurse also said that staff handover any information needed and will carry out any treatment or monitoring they are asked to. Assessments are carried out identify any resident at risk of a pressure sore and there are activities provided to promote movement. A resident and relative praised staff saying they are helping the resident to walk and another resident said that staff have been very helpful when he has had to go to hospital. Each building has a well equipped treatment room where all medicines are stored and staff were seen taking trolleys out to give out medication. One resident did self medicate, however due to a change in the medication he now takes he has chosen not to do so, other than an inhaler. A newly appointed member of staff said that ways of promoting residents privacy and dignity were included in her induction. Residents said that staff were very good in the way they helped them. A description of duties that can be carried out by students on a work experience placement included the observation of some personal care tasks with residents’ permission. These duties should not compromise the residents’ privacy and dignity. Rose Lodge/ Rose Court C53 C03 S63714 Rose Lodge V234318 200605 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14 and 15 Residents are able to spend their days how and where they choose, they have opportunities to take part in a variety of activities and maintain contact with families and friends. Residents have a well balance diet and have a choice as to what they eat. Arrangements for providing assistance with feeding could be improved. EVIDENCE: Residents were seen making use of various areas of the home and grounds. Each unit has an activities lounge with photographs of recent activities displayed in the corridor outside. Bingo was being played during this inspection. A resident said he had not wanted to take part but there was always plenty to do if he wanted. There were notices referring to each units summer fayre and residents said they had enjoyed a recent boat trip. A monthly church service has just been introduced and details of all activities are included in the newsletter. Visitors were seen coming throughout the day to the home and talking at ease with staff. One relative told the manager she was taking her relative to the local pub for a drink. Both residents and relatives said that visitors are made welcome and one resident said that his family bring his dog into see him. Rose Lodge/ Rose Court C53 C03 S63714 Rose Lodge V234318 200605 Stage 4.doc Version 1.30 Page 12 Entries seen in care plans highlighted areas where residents are able to choose and residents were seen exercising a number of choices over where they went and what they did. One resident said he had changed the television provided in his room as he wanted a bigger screen. The kitchens on both units are well equipped and the same menu is used in both units. A varied and balanced diet is provided and residents can choose an alternative if they wish. Staff were seen asking residents what they would like for tea. Residents said that they thought the food was excellent and they had enough to eat. Extra drinks and ice creams were provided during the recent hot weather. Home made cakes and biscuits were also available. Residents were seen being assisted with eating, although one person doing this was a student on their first day of work experience and another was stood rather than seated. Rose Lodge/ Rose Court C53 C03 S63714 Rose Lodge V234318 200605 Stage 4.doc Version 1.30 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 standard(s) 16 Residents are able to raise any concerns or complaints, which are then appropriately dealt with. EVIDENCE: The complaints procedure is displayed in the entrance area of both units and there is a book for recording any complaints in. There was one recent entry over the menu, which was not upheld and the reason for this was clearly explained. A recent complaint has been received by The Commission for Social Care Inspection regarding practices at night time which proved to be not upheld when investigated by the manager. Residents said they would bring anything they were not happy to the notice of staff, but had not felt the need to do so. Rose Lodge/ Rose Court C53 C03 S63714 Rose Lodge V234318 200605 Stage 4.doc Version 1.30 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 standard(s) 19 and 26 The décor, maintenance and cleanliness of the home are kept to a high standard providing an extremely pleasant environment. EVIDENCE: Both units are well laid out and have excellent facilities, The home provides a good range of communal areas including a well furnished dining room and has a number of small seating areas in addition to a large lounge, broken into smaller seating areas, an activities lounge with drink making facilities and a smoking lounge. Separate facilities are provided for medical treatment and hairdressing. All areas of the home are accessible to wheelchair users and there is a large paved area with seating outside for use in good weather. The home is decorated and furnished to a high standard and well maintained. There is a decorator and handyman employed. Staff were seen recording a broken door handle for repair in the maintenance book. A recent Environmental Health Officer visit awarded the home a 3 star healthy living award and the report said that management and staff deserve credit for the standards of the areas inspected. Everywhere seen was clean, tidy and fresh to a high standard and residents and relatives said how lovely the home
Rose Lodge/ Rose Court C53 C03 S63714 Rose Lodge V234318 200605 Stage 4.doc Version 1.30 Page 15 is kept. The laundry in each unit is well organised and there are procedures in place to prevent the spread of infection. Rose Lodge/ Rose Court C53 C03 S63714 Rose Lodge V234318 200605 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 There are appropriate and sufficient staff employed to ensure key areas of the home run effectively. Correct recruitment procedures are used for new staff and the required training is provided. EVIDENCE: There is a rota for each unit showing the staff on duty and efforts were seen being made to cover the absence of an absent member of staff from the laundry. A new post of team leader has been introduced into each unit. There is good ancillary staff support employed in addition to care staff, including administration, catering, housekeeping, maintenance and decorating. Residents said that there were always enough staff on duty to help them. A new system for recruitment has been bought into the home as a result of the change in ownership. The procedure for this showed that the correct procedures are followed. The manager was seen given out an application form to a potential applicant referred by the job centre. Staff training records showed that all the required mandatory training is provided, including refresher courses and staff said that they have regular opportunities to take part in training. Rose Lodge/ Rose Court C53 C03 S63714 Rose Lodge V234318 200605 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 There are systems in place for seeking the views of residents, which are not used to their full potential. EVIDENCE: There are questionnaires displayed in the entrance of each unit about the care, activities, housekeeping, catering and management in the home. There have been some completed on both units but the number that have been is a low percentage of residents within each unit. Additionally the forms have not been reviewed since they were introduced. Copies of the most recent Commission for Social Care Inspection report were displayed in the entrance of the home and the manager has recently introduced a survey for any resident who come into the home for respite care. Rose Lodge/ Rose Court C53 C03 S63714 Rose Lodge V234318 200605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 2
COMPLAINTS AND PROTECTION 4 x x x x x x 4 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x 3 x x x x x Rose Lodge/ Rose Court C53 C03 S63714 Rose Lodge V234318 200605 Stage 4.doc Version 1.30 Page 19 No Are there any outstanding requirements from the last inspection? 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 7 Regulation 13 Requirement Ensure risk asessments and care plans are kept under review and updated in light of any changes noted Ensure that entries made in all records are accurate The duties that can be carried out by work experience students should not compromise residents privacy and dignity Ensure that asssitance with feeding is provided by a competent persion Timescale for action 1st August 2005 1st August 2005 1st August 2005 1st August 2005 2. 3. 7 10 12 12 4. 15 12 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 7 7 33 Good Practice Recommendations Provide guidance to staff as to what information should be recorded where in care plans Include comments from residents about their care plans Review current questionaires used and involve more residents and relatives in completing them Rose Lodge/ Rose Court C53 C03 S63714 Rose Lodge V234318 200605 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Edgeley House Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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