Inspection on 15/06/07 for Rose House

This inspection was carried out on 15th June 2007.

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.

Other inspections for this house

Rose House 01/03/06

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 Ian Hall Key Unannounced Inspection 15th June 2007 07:45 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 DS0000031969.V331083.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000031969.V331083.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rose House Address Rose Grove, Church Street Armthorpe Doncaster South Yorkshire DN3 3AJ 01302 831450 01302 834275 NONE 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 30 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (10) of places DS0000031969.V331083.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st March 2006 Brief Description of the Service: Rose House is a Care Home providing accommodation and care for up to thirty people in the category of older people. The Home is divided in two units. Twenty of the thirty places are registered for Dementia. The other ten places are for older adults- (over sixty five 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 residents is 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 people 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 people with dementia. Information gained on the 15th June 2007 indicates the current fees are from £340.00 to £490.00 per week with additional charges being made for newspapers, hairdressing and toiletries. These fee charges only applied at the time of inspection, more up to date information may be obtained from the home. DS0000031969.V331083.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 1 day with a total of 7.0 hours being spent at the home. As part of the inspection the inspector spoke to people who live at the home, their relatives, staff, and the home’s manager. Three care files and the associated records were checked. The inspector toured the home with the senior officer in charge. All people spoken with were open and happy to provide comment to assist with the inspection process. Comments received were very positive describing the motivation, care and commitment of the staff team. The service provided was described as very good overall. Feedback of the findings was given to the homes manager before the inspector left the home. What the service does well: What has improved since the last inspection? The system of care management continued to develop and evolve. The home’s manager continued to demonstrate her commitment and positive attitude to staff training induction and development of the care team. DS0000031969.V331083.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. DS0000031969.V331083.R01.S.doc Version 5.2 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 DS0000031969.V331083.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Pre admission assessments demonstrated that individual needs had been planned for before the people moved into the home. No one had moved into the home without having their needs assessed, this ensures that care needs can be met. People were given all the information they required to be able to decide whether they wanted to live at Rose House. Individual written contracts detailing terms and conditions of residence provided clear information for people who use the service. DS0000031969.V331083.R01.S.doc Version 5.2 Page 9 EVIDENCE: People who lived at the home and their relatives confirmed that they’d been invited to visit and discuss the care and service provided before choosing Rose House as a home. Care records contained copies of assessments by social workers and the homes staff identifying care needs of people prior to their admission to the home. This ensured that the home and care staff were prepared and able to meet peoples individual care needs. Staff confirmed that any specialised equipment that may be required is obtained before anyone is admitted to ensure that resident’s health and wellbeing was maintained. Intermediate care was not available at the home. DS0000031969.V331083.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Case files contained detailed assessments that had formed the basis for care plans to enable staff to meet the identified social and care needs. People who lived at the home and their relatives were involved in care planning and setting measurable targets for care. Care staff had acted in a timely manner to ensure that health care needs were addressed. Staff were working to the home’s policies for the administration of medication, this promoted the wellbeing of people who lived at the home. Staff interactions and approach demonstrated their respect for each person, this helped to safeguard and promote the rights and dignity of individual people. DS0000031969.V331083.R01.S.doc Version 5.2 Page 11 EVIDENCE: Three care plans were checked. Each set out individual needs and the staff action required to meet them. Discussion with three staff and a visiting nurse confirmed that a range of health professionals visited the home to meet residents’ health care needs. Weights were being checked each month. A range of aids to assist service users with mobility problems was provided; these included lifting hoists, assisted baths, walking frames and wheelchairs. The care plans were well compiled and complete they promoted dignity, privacy and encouraged independence. Risk areas had been identified and planned for such as: poor appetite, risk of falls, episodes of confusion and disruptive behaviours, all had plans for staff to follow. The risk assessments had been reviewed regularly to promote the safety of people who used the service. Care plans stated the gender of staff preferred to support them with their personal care; they also contained details of religious and cultural needs. People living at the home and relatives had assisted key workers to draw up care plans and joined the regular review of care provided. Systems were in place to ensure the safe storage, administration and disposal of medication. Records were kept of medication received, and disposed of. Staff were observed administering and assisting people to take their prescribed medication. Staff had received accredited training for safe administration of medicines. Systems to enable people to safely store and take their own medicines were in place although no one were doing so on the day of inspection. Relatives were observed to visit freely and continue to assist with care of their loved ones as they wished. They said they could have access to care plans whenever they wanted. People who lived at the home and relatives spoken with confirmed that staff did provide privacy and dignity. The inspector observed staff knocking on bedroom doors and waiting to be invited before entering. Staff were observed to interact with residents appropriately and with obvious empathy for their needs. Staff were praised for “going the extra mile”, “having endless patience”, “they give me peace of mind, I can go home and know they are giving the care I would be giving myself if I still could”. DS0000031969.V331083.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. A range of social and leisure activities were organised and provided that met individual residents choice and needs. Activities of daily living were flexible and suited their individual residents preferences. A good choice of food was offered to meet peoples’ nutritional needs. People who lived at the home were encouraged to eat a healthy and varied diet; this promoted their health and wellbeing. People were supported with maintaining and developing contact with their family, friends, and relatives who were made welcome at the home. EVIDENCE: All said that staff were extremely supportive and always encouraged them to keep their links with the local community. Staff confirmed that they were encouraged to support residents with social situations and activities. DS0000031969.V331083.R01.S.doc Version 5.2 Page 13 People said that they were satisfied with the social and recreational activities that take place at the Home. Some people also spoke of the choice they had in how they spend their time, several chose to spend their days in their bedrooms. Care plans included social care needs of each individual. These included cultural and faith issues. All were encouraged to choose their own clothes to wear each day, decide when to bathe, where to sit and select their own meals. Care plans checked showed that nutritional needs and food preferences of individual had been assessed and catered for. Care staff also helped to choose the meal they enjoyed best, and those who had difficulty with eating were offered appropriate assistance. The meals provided appeared well cooked and presented. Mealtimes were unhurried with extra portions available as required. Portions were adjusted to each persons likes and calorie needs. People living at the home were encouraged to eat healthily. Plentiful supplies of food and fresh fruit were available. Specialist diets were available for those requiring this service. There was a four weekly menu with records kept of each persons food consumption. Alternative meals were available if they did not like the planned meal. People who used the service and relatives expressed their satisfaction with the meals provided at the home. They confirmed that drinks and snacks were readily available throughout the day. DS0000031969.V331083.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Rose House operated an effective complaints policy to protect people at the home. The policy and procedures for adult protection was in line with the local multi-agency approach. The complaints procedure was clear, accessible and contained the necessary information and was highly visible within the home. This gives all a clear understanding of how to make a complaint. People living at the home were protected from abuse by the awareness of staff through training and the homes procedures. This protected the well being of residents. EVIDENCE: The complaints procedure was available for residents, visitors, relatives and staff. The manager confirmed that this would be available in alternative formats and languages should this be requested. The people, a nurse and the relatives said that they knew how they could complain if they were not happy about anything. They said that staff were always available and that they were encouraged to talk about anything that troubled them or caused them anxiety. DS0000031969.V331083.R01.S.doc Version 5.2 Page 15 The home ensured through training, supervision, reviews and quality monitoring that the care staff fully complied with the policies and procedures provided to protect and safeguard the rights of residents. Staff had been made aware of the action to take in dealing with third party information. No complaints had been made to The Commission for Social Care Inspection since the last inspection. DS0000031969.V331083.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was clean and smelled fresh. Bedrooms were clean, comfortable, and overall well decorated. They were furnished to meet residents’ needs. The bedroom doors were fitted with locks; this promoted the privacy of people who lived at the home. Good hygiene standards were maintained throughout the home, this helped with the control of infection and made the home more pleasant for people who lived there. DS0000031969.V331083.R01.S.doc Version 5.2 Page 17 EVIDENCE: All commented that they were pleased that staff kept the home clean. Toilets were close to lounge and dining areas. They were easily accessible as they had been adapted for people with physical disabilities. Each floor had assisted baths and showers provided for those people with mobility problems. The manager had continued her programme to redecorate and refurbish the home. A range of colours and homely features had been used to individualise and improve the appearance of the bedrooms. A number of families had assisted with personalisation of bedrooms with favourite items and memorabilia. Bedroom doors were fitted with suitable door locks and lockable facilities were provided in all the bedrooms. Lighting should be replaced to provide a domestic atmosphere in the identified corridor areas. The maintenance record book identified that any repairs needed had been dealt with promptly. The gardens were accessible to people who live at the home whenever the weather was suitable. Several people who lived at the home had been helped by staff to plant and maintain a number of containers for their own enjoyment. The grassy areas of the gardens were overgrown and in need of attention. The building and its surroundings were generally well maintained, thereby enhancing its appearance and facilities. The home offers a comfortable standard of accommodation. DS0000031969.V331083.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including interviewing and observing staff as they worked. The numbers and skill mix of staff were sufficient to meet residents’ needs. Staff files included the required information. The home operated a recruitment policy that protected people who lived at the home. There was a training and development plan and all staff had completed a range of training relevant to their role. This allowed staff to meet the assessed needs of people who lived at the home. EVIDENCE: All said that there was always enough staff on duty and that they worked hard, describing them as “very caring, kind and understanding”. Staff were approachable and sensitive to the needs of service users and were able to communicate effectively with each person. Three staff files were checked; the DMBC policy and procedure had been followed with proper checks made to ensure people were protected. Staff had an understanding of the home’s fire procedures; they had received training on moving and handling, fire, food safety and infection control. DS0000031969.V331083.R01.S.doc Version 5.2 Page 19 Staff files checked and discussions with three staff and the manager confirmed that all staff had completed detailed induction training. There was clear evidence of ongoing training and development of staff with training topics including dementia care and prevention of abuse, 50 of the staff team were qualified to NVQ level 2. This promoted good practice and protects people who use the service. Staff were being formally supervised at the frequency required to fully ensure individual staff development and the monitoring of care practices DS0000031969.V331083.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including interviewing the registered manager and observing staff as they work. The home was well organised and managed; the manager supported her staff and was perceived as approachable and very professional by people who used the service. Service users and relatives surveys were completed six monthly, ensuring that the home was run in the best interest of people who lived at the home. Relatives oversee financial matters thereby protecting people’s interests. Records were in the main up to date and well ordered to ensure the best interests of residents. A safe environment was provided in all parts of the home. This protected the health, confidentiality and welfare of people who used the service. DS0000031969.V331083.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager had a job description that defined her roles and responsibilities; staff were aware of her role. Staff stated there was always a senior member of staff on duty at the home with advice and support readily available. Responsibilities were shared between senior members of the team. Visitors to the home stated that they had ready and easy access to the homes management and that they felt confident in them. The manager completed regular internal audits on all aspects of the service provided by the home. There was a quality assurance system, which sought the views of all. Results were used to influence care and practise at Rose House. The responsible individual visited the home on a regular basis, a report was written following their visit with a copy being sent to the local office of the Commission for Social Care Inspection. The staff handled money on behalf of some people, account sheets were kept, receipts were available for all transactions and a second individual witnessed all transactions. The accounts are audited annually. All records were available for inspection and were up to date and securely stored. The homes policies and procedures met the required standards. Case files were securely stored. The manager monitored case files and the personnel files to ensure policies and procedures were adhered to and enabled her to identify where improvements were needed. Staff files contained evidence of completed statutory checks protecting vulnerable adults. Staff had an understanding of the home’s fire procedures; they had received training on moving and handling, fire, food safety and infection control. The manager maintained a system to ensure staff training needs had been met. This enabled her to ensure staff had the necessary skills to provide the care and service that the residents required. The home assisted some people to manage their personal monies. The monies held and records maintained were correct. Health & Safety at Work risk assessments had been reviewed to maintain continued safety for all. Statutory checks and servicing of equipment were undertaken and records maintained. No fire exits were blocked and hazardous substances were securely stored. The Environmental Health and Fire Prevention Services inspection reports were positive confirming that the home met all requirements to provide a safe environment for people who lived at the home. DS0000031969.V331083.R01.S.doc Version 5.2 Page 22 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 X X 3 x X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 DS0000031969.V331083.R01.S.doc Version 5.2 Page 23 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 OP19 Regulation 23(p) Requirement Fluorescent lighting in service user areas needs review to ensure lighting is domestic and homely in appearance. Timescale for action 31/12/07 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 OP19 Good Practice Recommendations Grassy areas of the gardens were overgrown and require regular maintenance. 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