Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 07/06/05 for Rose Hill Nursing Home

Also see our care home review for Rose Hill Nursing Home for more information

This inspection was carried out on 7th June 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides a comfortable homely atmosphere. Service users stated that they felt safe in the home, and that staff were kind and considerate. Activities were provided which were appropriate for the service users. There are good training opportunities for staff in the home.

What has improved since the last inspection?

The new manager is providing good leadership to the home. The number of complaints and incidents has decreased. The home is staffed with permanent staff, and agency staff are not currently needed.

What the care home could do better:

Information about terms and conditions must be available in the service user guide, and the contracts between the home and the service user require updating. The care plans require further development to reduce duplication, and to ensure that up to date information is available, which is regularly reviewed. The Manager must have access to staff files and all information about service users, and be fully involved in all aspects of running the home, including complaints management and recruitment of staff.

CARE HOMES FOR OLDER PEOPLE Rose Hill Nursing Home 9 Rose Hill Dorking Surrey RH4 2EG Lead Inspector Janet Daulton UnAnnounced 7 June 2005 10:00am 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 Hill Nursing Home H58 H09 s13349 Rose Hill v232650 070605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Rose Hill Nursing Home Address 9 Rose Hill Dorking Surrey RH4 2EG 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) 01306 882622 01306 741450 Rose Hill (UK) Limited To be confirmed CRH Care Home 35 Category(ies) of DE(E) Dementia - Over 65 - 3 registration, with number OP Old Age - 35 of places PD(E) Physical Disability - 2 Rose Hill Nursing Home H58 H09 s13349 Rose Hill v232650 070605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Of the 35 residents accommodated, up to 3 may fall within the category DE(E) Date Implemented 1 April 2002 Of the 35 residents accommodated, up to 2 may fall within the category PD(E) Date Implemented 19 November 2002 The age range for residents is: 65 YEARS AND OVER Date Implemented 1 April 2002 Up to 3 beds may be used for the provision of respite care Date Implemented 16 May 2002 Up to 2 persons may be cared for on a day care basis between 08.30-18.30 Date Implented 19 November 2002 Date of last inspection 20th January 2005 Brief Description of the Service: Rose Hill Nursing Home is situated in a quiet residential area of Dorking in Surrey.The building appears to be Victorian in origin and is surrounded by a pleasant garden area. Accomodatiion is arranged on three floors, accessed by a passenger lift. The accomodation consists of single and double bedrooms, some of which have ensuite facilities. There is a communal lounge and dining room. There is a small car parking area to the front of the property, and also on road parking nearby. The facilities of Dorking are within close proximity. Rose Hill Nursing Home H58 H09 s13349 Rose Hill v232650 070605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, and the first in the inspection programme for 2005-2006. The inspection took place over 6 hours, and was undertaken by Janet Daulton, lead inspector for the service. The Manager Ms. J. Abiona was present for most of the inspection, and the Registered provider Mr. Chahal was also present during the inspection. A tour of the premises took place. The inspector spoke with ten service users during the inspection, and written feedback was obtained from eight service users. Feedback was also obtained from staff working in the home. Observation of care practice was carried out This was generally a positive inspection. Overall, the service users were very satisfied with the care being provided by the home. The inspector wishes to thank the staff and service users for their time, assistance and hospitality during this inspection. What the service does well: What has improved since the last inspection? The new manager is providing good leadership to the home. The number of complaints and incidents has decreased. The home is staffed with permanent staff, and agency staff are not currently needed. Rose Hill Nursing Home H58 H09 s13349 Rose Hill v232650 070605 Stage 4.doc Version 1.30 Page 6 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 Hill Nursing Home H58 H09 s13349 Rose Hill v232650 070605 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 Hill Nursing Home H58 H09 s13349 Rose Hill v232650 070605 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) 1,2,3,4,5,6 Information about the terms and conditions of residency must be available in the Statement of purpose/Service user guide. The systems in place in the home ensured that all service users were assessed before admission to make certain that the home could meet the needs identified at that assessment. EVIDENCE: The Service User Guide was incorporated in the Statement of Purpose. There was also a brochure which was given to prospective service users. The Statement of purpose stated that service users were welcome to visit the home before they came in, and a trial stay of a month was in place. The fees were stated in the brochure. There were no details of the terms and conditions of residency in either the Statement of Purpose or the brochure. Service users contracts were sampled. The contracts need updating as they state the Health Authority and Nursing Homes Regulations. Service users were assessed by the manager of the home prior to admission to ensure that the home can meet the needs. Rose Hill Nursing Home H58 H09 s13349 Rose Hill v232650 070605 Stage 4.doc Version 1.30 Page 9 The Manager was committed to staff training and there was evidence that staff had received training to enable them to have the skills to deliver the care required. Intermediate care was not provided at the home. Rose Hill Nursing Home H58 H09 s13349 Rose Hill v232650 070605 Stage 4.doc Version 1.30 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 standard(s) 7,8,10 Care needs identified in the care plans were being met. Care was provided in a dignified, respectful manner. EVIDENCE: A new system of care plans was being introduced to reduce the amount of duplication of information. There was a lot of out of date information in the current care plans. Four care plans were randomly selected for inspection. Overall the care plans set out in detail the action which needed to be taken to meet the assessed needs. One of the care plans had not been regularly reviewed, and they were not always signed by the service user. The home had received an inspection from the pharmacist inspector since the last inspection. Requirements from that inspection had been met. There were two service users suffering from pressure sores at the time of the inspection. The home had suitable equipment to prevent and treat pressure sores , and for assisting in moving and handling service users. All service users were registered with a local GP, and had access to visits from other health professionals such as the chiropodist and optician. Rose Hill Nursing Home H58 H09 s13349 Rose Hill v232650 070605 Stage 4.doc Version 1.30 Page 11 Staff were observed to carry out their care duties in an appropriate manner. Service users spoken with said that their privacy and dignity were always maintained. Screens were available in the double rooms and these were seen to be used by staff when caring for the service users. Rose Hill Nursing Home H58 H09 s13349 Rose Hill v232650 070605 Stage 4.doc Version 1.30 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 standard(s) 12,13,14,15 The service users were enabled to maintain their independence as much as possible. Activity provision was varied and stimulating. EVIDENCE: The full time chef oversees the catering arrangements. The choice of food offered was varied and appeared nutritious. A menu was displayed. Feedback from service users was generally complimentary about the variety and standard of food served. Visitors were able to call on the service users at any reasonable time. Several of the service users had regular visitors. An activities organiser produced a programme of varied actvities. This programme was displayed in each room. Service users stated that they enjoyed the activities provided, and that they had the choice whether to participate or not. Rose Hill Nursing Home H58 H09 s13349 Rose Hill v232650 070605 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) 16,18 Service users stated that they were satisfied with the homes complaints process. Care workers demonstrated that they had awareness of vulnerable adults abuse procedures. EVIDENCE: Several service users spoken to during the inspection were aware of the complaints procedure and felt confident about using it. There had been two complaints since the last inspection. From evidence in the complaints file. these appeared to have been appropriately dealt with. The provider dealt with complaints, and the Manager did not have access to all information about the complaint and the action taken. It was therefore recommended that the Manager should be fully informed and involved in a complaint investigation. The home follows Surreys multi-agency procedures for the protection of vulnerable adults. Twenty staff had received vulnerable adults training in October last year. Rose Hill Nursing Home H58 H09 s13349 Rose Hill v232650 070605 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, 26 The location and layout of the home was suitable for its stated purpose. The home presented as a homely comfortable environment for the service users. EVIDENCE: The Service users rooms appeared homely and were comfortable and decorated and furnished to a satisfactory standard. Service users were satisfied with the facilities provided. Rooms were seen to be personalised with service users own pictures and ornaments. The gardens were well maintained. The home provided comfortable communal areas. Several service users were sitting in the large lounge on the day of the inspection. A maintenance man provided routine maintenance, and there was a planned record of maintenance. This should be initialled when actioned. The home appeared clean on the day of the inspection with no malodours present. Training records evidenced that staff had received infection control training in March 2005. Rose Hill Nursing Home H58 H09 s13349 Rose Hill v232650 070605 Stage 4.doc Version 1.30 Page 15 Rose Hill Nursing Home H58 H09 s13349 Rose Hill v232650 070605 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) 27,28,29,30 The number of staff on duty during the inspection was sufficient to meet the physical needs of the service users. The recruitment procedure in the home met the National Minimum Standard. EVIDENCE: The home provided adequate staff to meet the care needs of the service users. A registered nurse was on duty at all times. A record was maintained of staff on duty. Domestic staff were employed. The home has a commitment to NVQ training for care staff. From information seen at inspection, the National Minimum Standard of 50 of staff having level 2 NVQ was met. Staff recruitment files were examined. All necessary checks had been carried out prior to employment. From discussion with the Manager about the recruitment process it was evident that currently the Manager does not have full access to the staff recruitment files. The home had good staff training records, with a variety of training sessions arranged by an outside training agency. All staff received more that 3 paid days training a year Rose Hill Nursing Home H58 H09 s13349 Rose Hill v232650 070605 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) 31,33,34,35,38 The management of the home has improved with the new Manager in post. There are systems in place to safeguard the service users health and safety. EVIDENCE: The Manager is currently applying for Registration with the Commission for Social Care Inspection. The Manager demonstrated at inspection good leadership qualities. It is the expectation of the Commission that a Registered Manager has access to all information relating to the registered establishment, including staff files, and service users contracts. Service users meetings were held every three months, and a separate meeting for relatives was also regularly held, the last one being !st June. Minutes were seen of these meetings. A full service user survey was completed in May/ June 2004, and the Manager informed the inspector that another one would be completed this year. It is recommended that the views of stakeholders in the community, such as Rose Hill Nursing Home H58 H09 s13349 Rose Hill v232650 070605 Stage 4.doc Version 1.30 Page 18 GPs,chiropody, and social services are sought on how the home is achieving its goals for the service users. Records were seen at inspection of financial transactions and receipts for charges to service users. These were appropriately maintained. Insurance cover was in place for the home. Records relating to safe working practices and Health and Safety were sampled at inspection. These included fire drill log, risk assessments, and maintenance certificates. These were seen to be in order. Rose Hill Nursing Home H58 H09 s13349 Rose Hill v232650 070605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 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 3 2 x 3 3 x x x 3 Rose Hill Nursing Home H58 H09 s13349 Rose Hill v232650 070605 Stage 4.doc Version 1.30 Page 20 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 1 Regulation 5(1) Requirement Information about the terms and conditions of residency must be available in the Statement of Purpose/Service User Guide. The contract between the home and the service users must be updated The service users care plans must be regularly reviewed The care plans must be drawn up with the involvement of the service user or their representative wherever possible. Timescale for action September 30th 2005 Sept. 30th 2005 July 31st 2005 July 31st 2005 2. 3. 4. 1 7.4 7.6 5(1) 15(2) 15(1) 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. 4. Refer to Standard 16 19 29 33 Good Practice Recommendations The manager be fully involved in the complaints process. the maintenance record is initialled when actioned. The Manager should be fully involved in the recruitment process and have access to staff files. The views of stakeholders in the community, such as GPs chiropodist, and social servics are sought on how the home is achieving its goals for the service users. H58 H09 s13349 Rose Hill v232650 070605 Stage 4.doc Version 1.30 Page 21 Rose Hill Nursing Home Rose Hill Nursing Home H58 H09 s13349 Rose Hill v232650 070605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Hill Nursing Home H58 H09 s13349 Rose Hill v232650 070605 Stage 4.doc Version 1.30 Page 23 - 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!