Inspection on 01/03/06 for Rose House

This inspection was carried out on 1st March 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 House 15/06/07

Rose House 20/10/05

Rose House 07/12/04

Rose House 12/08/04

Rose House 27/11/03

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Rose House Rose Grove, Church Street Armthorpe Doncaster South Yorkshire DN3 3AJ Lead Inspector Ramchand Samachetty Unannounced Inspection 1st March 2006 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rose House DS0000031969.V273314.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rose House DS0000031969.V273314.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Rose House Address Rose Grove, Church Street Armthorpe Doncaster South Yorkshire DN3 3AJ 01302 831450 01302 834275 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) Doncaster Metropolitan Borough Council Pamela Beverley Castle Care Home 36 Category(ies) of Dementia - over 65 years of age (12), Old age, registration, with number not falling within any other category (24) of places Rose House DS0000031969.V273314.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th October 2005 Brief Description of the Service: Rose House is a Care Home providing accommodation and care for up to thirtysix service users in the category of older people. The Home is divided in two units. Twelve of the 36 places are registered for ‘ Elderly Mentally Infirmed’. The other 24 places are for older adults- (over 65 years old). Rose House is owned by the Doncaster Metropolitan Borough Council and managed by its Social services Department. There is a registered manager who is responsible for the day- to- day running of the Home. Rose House is a two-storey building, situated in the Armthorpe area of Doncaster. It is close to local amenities and is accessible by public transport. Accommodation for service users, are provided on both floors, and there is a passenger lift to facilitate access between the floors. All bedrooms are single. The Home also provides day care for up to six clients a day. The communal areas comprise of two dining areas and four smaller television lounges. The kitchen and laundry facilities are located on the ground floor. There is a secure internal garden for use by clients who suffer from dementia. Rose House DS0000031969.V273314.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 1st March 2006, starting at 14.00 hours and finished at 18.00 hours. Unfortunately, on the day of this inspection, there was an episode of viral infection, which affected residents and staff at the Home, leading to diarrhoea and vomiting. Staff had taken prompt action, in line with guidance from the local health protection service, to control the spread of infection within the Home. This inspection was therefore, largely a desk exercise. The inspector was able to review progress achieved since the last inspection, check the handling and administration of medicines and examine care documents and other records. What the service does well: What has improved since the last inspection? Structural alterations and decoration to one part of the building are now complete. A number of bedrooms have been refurbished and are waiting for new furniture. Assessment of needs and care planning has improved. Rose House DS0000031969.V273314.R01.S.doc Version 5.1 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 House DS0000031969.V273314.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rose House DS0000031969.V273314.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 The Home provides information to its client group, to enable them to choose where to live. However, further improvement is required to its statement of purpose and service user guide. The residents’ needs are assessed before their admission to the Home. EVIDENCE: Residents and their relatives were satisfied with the information that they were given about the Home. They stated that it was adequate and did help them in choosing a Care Home. However, the Home’s statement of purpose and service user guide was still waiting to be amended, to bring them in line with the Regulations. A sample of residents’ care files was checked. They included copies of full assessments and of the Home’s own assessments of care needs. These assessments were in turn used to draw up individual care plans. Rose House DS0000031969.V273314.R01.S.doc Version 5.1 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 Residents were provided with individual plans of care, to guide care staff, in meeting their health, personal and social care needs. The management of medicines at the Home is inadequate and the shortfalls could potentially put the health of residents at risk. Remedial action is required. EVIDENCE: A sample of care plans was checked. Actions to be taken in order to meet the needs of individual service users were outlined. There were daily entries about the care provided to individual residents, and these were related to action laid out in the care plan. Care plans checked showed that they were evaluated and reviewed. The receipt, storage, handling and administration of medicines were checked. There appeared to be an overstocking of some items of medicines, in particular, topical creams. Medicines for internal and external use were not kept separate. Rose House DS0000031969.V273314.R01.S.doc Version 5.1 Page 10 One item of topical application, prescribed for one resident was being used for another resident. Medicines administration records (MAR Sheets) were checked. Medicines were administered but not signed for and no explanation was given for these omissions. In some instances, medicines had been omitted on a few occasions, because the residents in question were asleep. No efforts were made to administer the medicines at different times or the issue referred to their GPs for a review. There were hand written entries and amendments on the MAR sheets and these were not signed and dated. It was not possible, therefore, to track authorisation for these changes. Some items of medicines (Steroid based topical creams) were selfadministered by residents, but no risk assessments had been undertaken to establish that they were safe to do so. Rose House DS0000031969.V273314.R01.S.doc Version 5.1 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): These standards were checked at the previous inspection and were not met. The inspector was unable to check them at this visit, because of the incidence of diarrhoea and vomiting at the Home. Appropriate infection control measures were put in place to stop the spread of infection at the Home. Visitors were also appropriately advised. Staff worked effectively as a team to ensure that residents received all the care they needed. EVIDENCE: Rose House DS0000031969.V273314.R01.S.doc Version 5.1 Page 12 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): 18 The Home has procedures in place to adequately protect its residents fro abuse, but it continues to fail to provide training to its staff on issues of adult protection. EVIDENCE: The Home has use of the Doncaster Council’s policy and procedures on adult protection and whistle blowing. However, staff at the Home, have not yet been provided with training on adult protection. This was a requirement at the previous inspection. This requirement is repeated and must now be met. Rose House DS0000031969.V273314.R01.S.doc Version 5.1 Page 13 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 The key standards were checked at the previous inspection. Standard 19 was not fully met. It was not possible to check this standard fully because of the incidence of diarrhoea and vomiting that was affecting residents at the Home at the time of this visit. However, some information was provided by staff to allow a review of progress of the work being done on the physical environment. EVIDENCE: In discussion, staff stated that repair to the building is usually carried out as necessary by the Works Department of the Council. The building works to the Unit for Elderly Mentally Infirm are now complete. A shower is being installed. The bedrooms in that unit have been decorated and new furniture was awaited. No progress is reported on the provision of access to a public telephone for residents. Rose House DS0000031969.V273314.R01.S.doc Version 5.1 Page 14 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): 28, 30 Rose House has a good and committed staff team that is able to provide a high standard of care to the resident group. However, there are shortfalls in the provision of training and this does not allow care staff to keep abreast with best and safe practice. The training of care staff in both the mandatory and specialist care issues must be prioritised. EVIDENCE: During the inspection, the inspector was able to witness a shift hand over. The senior care staff from the morning shift gave a summary of the state of health and care needed by residents. Information about the health care and nutritional requirements of individual residents was appropriately communicated. There was evidence of good team working. In discussion, staff confirmed that little training has been provided since the last inspection. Three kitchen staff had started food hygiene and advance cooking courses. Three care staff have started their accredited training in medicines administration. On a total of 24 care staff, only 7 are qualified to NVQ level 2 in Direct Care. Training on adult protection issues has not yet been provided. Rose House DS0000031969.V273314.R01.S.doc Version 5.1 Page 15 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): 33, 35 The interests of residents are generally safeguarded, but there is an absence of quality monitoring to ensure that the service provided meets the satisfaction of the client group. EVIDENCE: In discussion with care staff, it was noted that apart from care evaluation and review, they were unaware of other tools or methods that were in place, to monitor the overall quality of the service. Staff stated that they usually get feedback from residents on an on-going basis and that they would therefore have an indication of their satisfaction or their concern. It was noted that no residents meeting had yet taken place, this year. Rose House DS0000031969.V273314.R01.S.doc Version 5.1 Page 16 The Home was responsible for managing the personal allowances of seven residents. Relatives of eight others usually leave small amount of money for safekeeping at the Home for their loved ones to spend as necessary. Separate accounts were kept for each of the residents. It was noted that six residents had individual saving accounts. Income and expenditure were recorded. Two of the accounts were checked. In one instance, the reason for a money withdrawal, on behalf of a resident, was not given. There was only one signatory to witness the withdrawal of the money. In another instance, money was withdrawn for shopping. Some items were purchased but the rest of the money had not been returned almost four weeks after the transaction. The carer involved was contacted and she explained that she still had some other items to purchase for the resident in question. However, the accounts were found to be in balance. Rose House DS0000031969.V273314.R01.S.doc Version 5.1 Page 17 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 3 X X X X X X X STAFFING Standard No Score 27 X 28 3 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 2 X X X Rose House DS0000031969.V273314.R01.S.doc Version 5.1 Page 18 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 4, 5 Requirement Timescale for action 26/05/06 2. OP9 12, 13 3. OP10 12, 16 4. OP18 12, 13 5. OP30 12, 13, The statement of purpose and service user guide must be improved in line with the regulations. (Previous timescale of 30/01/06 not met) Action must be taken to ensure that staff adhere correctly to the policies and procedures relating to the management of medicines at the Home. This must also include the appropriate risk assessment of residents who undertake self -medication. Access to a public telephone must be provided at the Home, for use by residents. (Previous timescale of 27/02/06 not met) Training on adult protection issues must be provided to all staff. (Previous timescale of 13/02/06 not met.) 18 Staff training and development must be appropriately identified and provided. A plan of action to show when and how 50 of care staff will be qualified to NVQ level 2 in Direct Care. DS0000031969.V273314.R01.S.doc 26/05/06 26/05/06 26/05/06 26/05/06 Rose House Version 5.1 Page 19 6. OP33 12, 24 7. OP35 12, 17 Quality assurance and quality monitoring systems must be put in place to assist in service improvement. Appropriate procedures must be put in place for the management of residents’ personal allowances. 30/06/06 26/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Rose House DS0000031969.V273314.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Doncaster Area Office 1st Floor, Barclay Court Heavens Walk Doncaster Carr Doncaster DN4 5HZ 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 House DS0000031969.V273314.R01.S.doc Version 5.1 Page 21 - 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. 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