Inspection on 26/06/07 for Rose Lodge Care Home

This inspection was carried out on 26th June 2007.

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 Lodge Care Home 01/04/08

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Rose Lodge Care Home Walton Road Wisbech Cambridgeshire PE13 3EP Lead Inspector Elaine Boismier Unannounced Inspection 26th June 2007 10:10 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 Lodge Care Home DS0000069320.V344499.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. Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rose Lodge Care Home Address Walton Road Wisbech Cambridgeshire PE13 3EP 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) 01945 474449 01945 474735 Barchester Healthcare Homes Ltd Mrs Janet Olwyn Rippengill Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (58), Physical disability (2), Physical disability of places over 65 years of age (58), Terminally ill over 65 years of age (58) Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 2 named individuals under 65 years with Physical disbailities (PD) for the duration of their residency only. 58 older people over 65 years of age, not falling into any other category (OP) for the duration of condition 1. 58 older people with physical disabilities PD(E) for the duration of condition 1. 58 terminally ill people over 65 years of age TI(E) for the duration of condition 1 The maximum number of places not to exceed 60 at any one time Date of last inspection 11th July 2006 Brief Description of the Service: Rose Lodge provides care for people over 65 years of age assessed to need both personal and nursing care. At the moment there are 2 people under 65 years of age that are able to live in the home, after agreements had been made between the home and the Commission. The home has 49 bedrooms that have ensuite facilities; 3 single bedrooms that have hand washing facilities and all four shared bedrooms have ensuite facilities. There is a medium sized car park at the front of the home and large gardens that surround the building. The home is close to the centre of the market town of Wisbech that offers a range of leisure and shopping facilities. Current fees range between £343 and £711.46. Additional costs include those for chiropody, hairdressing, confectionary and toiletries. Since the inspection in July 2006 Barchester Healthcare Homes Ltd has now become the registered owner of the home. A copy of the inspection report is available on request at the home or via the CSCI website. Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is a key inspection of Rose Lodge. The inspection was unannounced and was carried out between 10:10 and 15:40 and took 5.5 hours to complete. Before the inspection 60 residents’ surveys were sent out and 19 of these were returned. We also sent out 30 relatives’/visitors’ comment cards and we received 18 of these back. A pre-inspection questionnaire was sent to the Manager to complete although we have no record of receiving this. At the time of the inspection there were 56 people living at the home and 5 of these were spoken to. A tour of the premises was made, documentation was examined and staff were spoken to. Staff were observed also during their work. As the Manager was not in the home at the time of the inspection we contacted her the following day for further information. We would like to take this opportunity to express our gratitude for the helpfulness of staff in assisting with the inspection process. For the purpose of this inspection report those living at the home are referred to as residents and as people. Rose Lodge has been assessed to provide an adequate quality service. What the service does well: We received written comments about the food that included, “Very good food and choice” and “If I don’t like what is on the menu that day I can choose something else I do like”. During the inspection people said that Rose Lodge was an “Excellent home” and a “Homely place”. Gardens are very well maintained and presented. Written comments received from the residents’ surveys included, “ The staff are very friendly and helpful”. During the inspection people said, “Staff are very good” and “No crossness. Nurses are nice people.” Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: A requirement has been made for the home not to admit people that the home is not registered for. A recommendation has been made for care plans to provide clearer guidance with regards to how things are worded. A requirement has been made for people to be consulted about their care plans. A requirement has been made for people to be provided with the care as documented in the care plan. A requirement has been made for people to have access to specialist healthcare professionals. Two requirements were made following the inspection in July 2006. These were related to medication records and the safety of medication. Neither of these requirements have been met: a) An immediate requirement was made at this inspection as medication was left unattended on top of a medicine trolley. b) The controlled medication register did not contain the name and address of the dispensing pharmacy. This requirement was therefore not met and has been carried forward with a new timescale for action. This requirement is to include all the elements of this regulation to improve existing current methods of storage and disposal of medication. Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 7 A requirement has been made for suitable activities to be provided for all residents. A recommendation was made for information of how to make a complaint to be made more readily available. This recommendation remains. A recommendation was made for people to be able to call for assistance at any time. This recommendation has not been considered. A requirement has been made for people to be cared for by sufficient numbers of staff. A requirement was made for all satisfactory information to be obtained before staff work at the home. This requirement has not been met and has been carried forward with a new timescale for action. A requirement has been made for staff to attend training in infection control. A requirement has been made for staff to attend training in how to care for someone with dementia. A recommendation was made for the Registered Manager to have the RMA qualification. This recommendation remains. A requirement was made for staff to attend training in moving and handling. This requirement has not been met and has been carried forward with a new timescale for action. A requirement has been made for all staff to attend fire training according to Company policy. An immediate requirement was made for substances that are hazardous to be locked away when left unattended. 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. Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 8 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 Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 9 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 &4 Quality in this outcome area is adequate. Prospective residents have a good standard of information about the home to assist them in their decision where to live. The home is not compliant with its categories of registration. This judgement has been made using available evidence including a visit to this service. EVIDENCE: 100 of completed residents’ comment cards said that the person had received enough information about the home before moving in. People said that they knew about the home before they moved in. Examination of people’s care records indicated that home receives information about the prospective person’s needs from external agencies before deciding if the home can meet the needs of the person. Examination of a person’s care records indicated that the home manager had also carried out her own assessment of the person before they moved into the home. Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 10 Observation of a resident and examination of the person’s care records indicated that the person has a formal diagnosis of dementia before moving into the home. The home does not have a category of registration to care for people with a formal diagnosis of dementia. A requirement has been made about this. (See also Standards 8, 27 and 30 of this report.) Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 11 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 &10 Quality in this outcome area is adequate. People receive an appropriate standard of care that must be improved upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During this inspection care records of 5 people were examined and these were generally well detailed to give staff information about the person’s needs. Some care plans however were rather ambiguous and not person centred. For example a care plan for communication, for a person who was confused, said that the aim of the care provided was,” To maintain balance of thought.” For another person the care plan for nutrition said that the goal was, “To maintain well-balanced diet and maintain weight to an acceptable level.” For another person the care plan for breathing said that the goal was “To maintain normal exchange of gases.” Such ambiguity could pose some risk to the health of residents unless the outcome is made clearer. We have taken a reasonable Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 12 view and made a recommendation for the goals for the care to be person centred and clearer. Speaking to people and noting the contents of the care plans, as described above, there was insufficient evidence to suggest that people are consulted about their care plans. A requirement has been made about this. A person’s care plan was examined that recorded the person, who had a pressure sore, to have 2-4 hourly change of position. Her repositioning charts demonstrated that her position was changed but not always according to her care plan. For example: a) On 20.06.07 the records note that at 5am the person was repositioned on their right side and then at 11:15, i.e. 6.25 hours later before they were repositioned on their right side. At 12:45 the person was assisted by staff to be sat up for lunch until, according to the records, the person was repositioned on their right side at 21:00, i.e.8.75 hours later. b) There was no record for 21.06.07, the repositioning chart, in how this person was being cared for with regards to pressure relief. A requirement has been made for staff to provide appropriate care for people in accordance with the care plan. 47 of the residents’ surveys said that the person always received the care and support that the person needed; 53 of the residents’ surveys said that the person usually received the care and support that the person needed. 68 of residents’ surveys said that the person always received the medical attention that they needed; 26 of residents’ surveys said that the person usually received the medical attention that they needed; 6 of residents’ surveys said that the person had not received the medical attention that they needed but made it clear that this was not the fault of the home. Examination of care records and discussion with staff indicated that residents have access to chiropody services, speech and language therapists, dieticians, GPs and physiotherapy services. On the day of the inspection a rehabilitation team visited a resident. Examination of care records of people with mental health needs (See Standard 4 of this report) indicated that community psychiatric services are not consulted in how to manage people’s challenging behaviours. The home is currently providing care for a number of residents with an infection caused by MRSA. Discussion with the Manager, the day after the inspection, indicated that infection control agencies had not been consulted to Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 13 provide specialist guidance in how to care for these people. A requirement has been made about these findings. (See also Standard 30 of this report). A requirement was made for medication to be kept safe at all times. On arrival to the home it was noted that a medication trolley was left unattended that had blister packs of medication on top of the trolley. This requirement had not been met and an immediate requirement was made. A requirement was made for medication records to be accurate. Examination of the controlled drug registers on both floors was carried out. Records of amounts of the medication were accurate with the amount of the medication that was available. However there was no name and address of the dispensing pharmacy. As a result of this finding, this requirement has not been met and has been carried forward with a new timescale for action. The requirement will also include action that must be taken in response to the following findings: a) The records for the temperatures of the rooms and fridges where medication is kept were examined on both floors. On the ground floor the records were found to be satisfactory. On the first floor of the home the air temperatures of the room where medication was stored were also satisfactory. However the temperatures of the fridge, on the first floor, had been recorded on 14.06.07 to be 1.7 degrees centigrade. Between 18.06.07 and 23.06.07 the temperatures of the fridge were recorded between 1.0 and 1.7 degrees centigrade before action was taken to defrost the fridge. A requirement has been made for medication to be stored safely (according to the manufacturer’s instructions). b) On the first floor there was controlled medication, no longer in use since 18.05.07 and was waiting to be disposed of. Staff reported that they had received training in medication and a certificate of confirmation that one of the members of staff had attended this training was seen on their personal file. Written comments received from the residents’ surveys included, “ The staff are very friendly and helpful”. During the inspection people said positive things about the staff including, ““Staff are very good” and “No crossness. Nurses are nice people.” Staff were seen to be treating people in a respectful way. Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 14 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 &15 Quality in this outcome area is adequate. People are provided with opportunities to live an adequate quality of life that could be improved upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: 10.5 of the residents’ surveys said that the home provides suitable activities that the person can always take part in; 52 of the residents’ surveys said that the home provides suitable activities that the person can usually take part in: 21.5 of the residents’ surveys said that the home provides suitable activities that the person can sometimes take part in. Written comments in the surveys included, “I feel there is not enough activities and not enough to keep my mind active” and “ There are activities arranged but …. is bed bound and can’t take part in”. Staff reported that there are limited activities occurring in the home following a vacancy for an activities co-ordinator. Staff considered that there was not Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 15 enough staff to take people out into the garden or sit and read to them. (See Standard 27 of this report). During the inspection it was noted that no activities were available. One person said, “Time tends to drag.” A requirement has been made about this. 100 of relatives’/visitors’ comment cards said that the home welcomes the person in the home at any time and 100 of these comment cards said that they could visit their relative/friend in private. During the inspection it was noted residents were receiving guests. People said that they were provided with opportunities to choose when to go to bed and what to wear although the choice of when to get out of bed was not always considered. However during the inspection it was noted that some people were allowed to stay in bed and eat their meals where they preferred. The opportunity of choice might be limited due to the insufficient numbers of staff as reported in Standard 27 of this report. 31.5 of the residents’ surveys said that the person always liked the meals at the home; 47 of the residents’ surveys said that the person usually liked the meals at the home; 10.5 of the residents’ surveys said that the person sometimes liked the meals at the home; 11 of the residents’ surveys said that they were given food by artificial methods, that is by tubes. Written comments received ranged from “The meals are ok but I wish I could get through to the kitchen staff that there are certain dislikes that my relative has…but they still keep turning up” to “ “Very good food and choice” and “If I don’t like what is on the menu that day I can choose something else I do like”. Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 16 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 &18 Quality in this outcome area is adequate. People are sometimes listened to and are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Those people spoken to said that they knew what to do if they were unhappy about something. A recommendation was made for information about how to make a complaint to be made more readily available. 66.6 of relatives’/visitors’ comment cards said that the person was aware of the home’s complaint procedure whereas 33.4 of relatives’/visitors’ comment cards said that the person was not aware of the home’s complaint procedure. A recommendation made following the inspection in July 2006, regarding providing information of how to make a complaint, appears that it may not have been considered. This recommendation will not appear in the recommendation table of this report. 33 of relatives’/visitors’ comment cards said that the person had made a complaint although 67 of relatives’/visitors’ comment cards said that the person had never made a complaint. Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 17 A written comment in a relatives’/visitors’ comment card said, “ I have had occasion to bring certain things to light and they have been put right!” The complaints record was examined and it was difficult to assess if the home was adhering to the complaints procedure due to lack of information in the record that was seen. It is expected that the home manages this issue rather than by reliance on regulation. 89 of the residents’ surveys said that staff listened to the person and acted on what was said to them whereas 11 of the residents’ surveys said that staff did not always listen to the person and acted on what was said to them. A requirement was made for the home to follow correct reporting procedures should allegations of abuse be made. We have received information from the local authority following a meeting, held during April 2007 under Cambridgeshire Vulnerable Adult Protection procedures, that the home has taken appropriate action and as a result of this, this requirement is considered as met. Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 18 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): 19,22 & 26 Quality in this outcome area is adequate. People live in a comfortable home that is generally clean and safely maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is surrounded by well maintained and well presented gardens. During a tour of the premises it was noted that the home was comfortably furnished and generally well-maintained. The majority of bedroom carpets were clean and of a good standard. It was noted that carpets in two of the bedrooms were clean but ad become discoloured. It is our expectation that the home will manage this issue without reliance on regulation. A recommendation was made for people to be able to call for assistance at any time. During this inspection it was noted that residents, sitting in lounges, Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 19 were calling out for assistance. When one person, who was unable to get out of their chair without assistance, was asked how they called for help, the person answered, “I haven’t a clue.” Although this recommendation will not appear in the recommendation table of this inspection report this recommendation remains to be considered. 63 of residents’ surveys said that the home was always clean and fresh; 27 of residents’ surveys said that the home was usually clean and fresh. Written comments we received included, “Have seen quite a bit of dust round the bed frame from time to time” and “Cleaning could be done more thoroughly e.g. skirting boards as I have done this myself” and “Sometimes (the bedroom) smells very strong of urine”. At the time of the inspection the home was clean and no stale odours were noted. A requirement was made to ensure that care practices did not pose a risk of spreading any infection. This was related to bed linen being transferred to laundry facilities in an open way. During this inspection it was noted that staff were using appropriate bags to transport used/dirty linen. As a result of this finding, this requirement is considered as met. (See also Standards 8 & 30 of this inspection report with regards to MRSA and infection control training for staff.) Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 20 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 &30 Quality in this outcome area is poor. People receive care from adequately trained, but insufficient numbers of staff and people are at risk of abuse due to poor recruitment practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: 68.7 of residents’/visitors’ comment cards said that in the person’s opinion there was always sufficient numbers of staff on duty; 29 of residents’/visitors’ comment cards said that in the person’s opinion there was not sufficient numbers of staff on duty. Examination of the duty roster was carried out and it was noted that on the night of 25.06.07 there were 4 staff working that night. The rostered for the following nights indicated that there were 6 to 7 staff rostered to work. People spoken to indicated that there was not enough staff on duty. Comments made included, “Not enough staff” and “I have had to wait for half an hour (before staff came)”. Staff said that they were able to provide personal care but did not have time to take people out into the garden or read to them (See also Standard 12 of this report). A member of staff reported that a person who had a tendency to shout Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 21 became quiet and calmer when receiving 1:1 attention but the staff considered that they were unable to provide this care for the person (See Standards 4 & 14 of this report) 15 of the residents’ surveys said that staff were always available when the person needed them; 73 of the residents’ surveys said that staff were usually available when the person needed them and 22 of the residents’ surveys said that staff were sometimes available when the person needed them. A range of written comments were received from both residents and relatives’/visitors’ surveys including “ More carers would be helpful” and “More staff to take residents out in the garden”. Other written comments that we have received in the surveys include, “There are times when I ring the bell that I have to wait for help longer than I would like. I think this might be due to staff shortages” and “Staff don’t always answer the call bell”. A requirement has been made based on this evidence. A recommendation was made for 50 of care staff to have NVQ level 2 in care. Information provided by staff at the time of the inspection indicated that he home employs 28 care staff. The home currently has 14 care staff with NVQ level 2 and 6 care staff with NVQ level 3. This recommendation has been considered. A requirement was made for all satisfactory information to be obtained before staff are allowed to work at the home. During this inspection 3 staff files were examined. Required information was available with the exception of the following: a) For the first staff member there was no documentation available with regards to the person’s nursing qualification. b) For the second staff member there were no dates of employment history on her application form or documented elsewhere; there was one written reference only. c) For last staff member there was a gap in the person’s employment history between May 2005 and October 2006. There was no written record to explain this gap in employment history. This requirement has not been met and has been carried forward with a new timescale for action. Staff reported that they had attended training in a range of topics that included male and suprapubic catheterisation, palliative care, falls and osteoporosis and assessing people with continence difficulties and Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 22 certificates of attendance to this training was seen on a member of staff’s personal file Staff however reported that they had not attended infection control training and there was no evidence found from records seen or from staff that staff had attended training in how to care for someone with dementia (See Standards 4 & 8 of this report). A requirement has been made about this. Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 23 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 & 38 Quality in this outcome area is adequate. People benefit from a home that is adequately managed but must be improved upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A recommendation was made for the Registered Manager to have the Registered Manager’s Award. The Manager, reported on the day following the inspection, that she is hopeful in completing this award before September 2007. This recommendation remains although will not appear in the recommendation table of this report. Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 24 The current standard of management of the home is considered to be adequate due to the number of requirements made as a result of this inspection and of those requirements that have not been met and have been carried forward. The Company sends to us copies of monthly reports. These reports, of visits made by a person from the Company, includes their assessments of the home environment, people’s views about the home and the standard of documentation. Staff were unable to confirm if, since the change of registered ownership of the home, surveys had been carried out to seek the views of people about Rose Lodge. Since the change of registered ownership of the home, there has been a change in how people’s monies are handled. According to staff the home no longer has the responsibility of safe-keeping people’s personal monies. This standard is therefore not applicable. A requirement was made for fire drills to be carried out in line with the Company’s procedures. Since the last inspection records for fire drills indicated that three of these had been carried out and the names of people attending had been included in the records. A requirement was made for staff to attend training in moving and handling. Staff spoken said that they had not attended this training since 2006. One member of staff reported that they had not received this training since starting working at the home in March 2007 and had no updated training for three years. This requirement has not been met and has been carried forward with a new timescale for action. Staff said that they had last attended fire training in 2006. A member of staff reported that they had not attended fire training since starting working at the home in March 2007. A requirement has been made about this. During the tour of the premises it was noted that a bottle of liquid that had a hazard warning on the label, was in an unlocked room and the room was left unattended. An immediate requirement was made about this. Records for checks on the lift, hoists, fire alarms and emergency lighting were seen and these were satisfactory. Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 25 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 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 3 3 x x 2 x x x 3 STAFFING Standard No Score 27 2 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x N/A x x 2 Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 26 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. 2. Standard OP4 OP7 Regulation Requirement Timescale for action 28/06/07 30/09/07 3. 4. OP8 OP8 5. OP9 6. OP9 Section 24 Service users must not be CSA 2000 admitted to the home that the home is not registered for. 15(c) Service users must be consulted, where possible, about their plan of care to ensure that care is given with consent. 12 Service users must receive appropriate care to protect them from the risk of harm. 13(b) Service users must have access to health care and specialist advice to ensure that their specialist needs are met. 13(2) Medication must be kept in a safe manner to safeguard service users from the risk of harm. Requirement not met by timescale of 17/07/06. Immediate requirement made. 13(2) Medication records must be accurate (requirement not met by timescale of 17/07/06) and medication must be stored and disposed of safely to safeguard service users from the risk of harm. Requirement carried forward with new DS0000069320.V344499.R01.S.doc 10/07/07 31/08/07 26/06/07 11/07/07 Rose Lodge Care Home Version 5.2 Page 27 7. 8. OP12 OP27 16(2)(n) 18(1)(a) 9. OP29 19 10. OP30 18(1)(c) 11. OP30 18(1)(c) 12. OP38 13(5) 13. OP38 23(4)(d) 14. OP38 13(4)(a) timescale for action. Service users must be provided with suitable activities to prevent boredom and depression. Staff must be sufficient in numbers to ensure that service users needs are met in a timely manner. To protect service users from abuse from unsuitable staff, full and satisfactory information about staff must be obtained before they start to work at the home. Staff must be trained in dementia care to ensure that service users’ specialist needs are met. Staff must be trained in infection control to ensure that service users’ are protected from the risk of spread of infection. All staff must have up to date moving and handling training to protect service users from the risk of harm. Requirement not met by timescale of 01/10/06. Requirement carried forward with new timescale for action. All staff must have up to date training in fire safety to protect service users from the risk of harm. When left unattended all hazardous substances must be stored safely to protect service users from the risk of harm. 15/08/07 15/08/07 24/07/07 30/11/07 30/09/07 15/08/07 15/08/07 26/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 28 No. 1. Refer to Standard OP7 Good Practice Recommendations The current wording used in care plans should be less ambiguous and more person centred. Rose Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Lodge Care Home DS0000069320.V344499.R01.S.doc Version 5.2 Page 30 - 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. 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