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Inspection on 30/07/05 for Rose Lodge Care Home

Also see our care home review for Rose Lodge Care Home for more information

This inspection was carried out on 30th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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.

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

What the care home does well

The home provides a pleasant, well-maintained environment where residents are free to move about as they wish. It is a well-established staff group who appear to work well together. Residents are provided with activities that are flexible and varied to meet their preferences and capacities. Meals are served in a pleasant dining area and nutritious meals are provided which meet the assessed needs of residents. Care plans are detailed and clear, providing staff with the information they need to ensure residents` care needs are met.

What has improved since the last inspection?

The acting manager has ensured that appropriate risk assessments have been done and recorded on residents care plans. The downstairs toilet has been repaired and communal areas are well maintained.

What the care home could do better:

The registered person must ensure that the acting manager is registered with the Commission. Training plans need to be evidenced to ensure that this outstanding requirement is met and care plans need to provide more information regarding residents` wishes if their health deteriorates. Adult Abuse Awareness Training must take place for all staff to minimise any risk residents may be placed at by staff lack of knowledge.

CARE HOMES FOR OLDER PEOPLE Rose Lodge Care Home 88-90 Musters Road West Bridgeford Nottingham NG2 7PS Lead Inspector Susan Lewis Unannounced 30th July 2005 at 9:50 am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rose Lodge Care Home C53 C03 S8797 Rose Lodge V241804 300705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Rose Lodge Care Home Address 88-90 Musters Road West Bridgeford Nottingham NG2 7PS 0115 9455575 0115 9455575 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Old Brompton Court Limited, C/O Mr David Wheatcroft (Shrubs) Limited Vacant Care home 17 Category(ies) of OP Old age, x 17 registration, with number of places Rose Lodge Care Home C53 C03 S8797 Rose Lodge V241804 300705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 resident shall be aged 55 or over - 27 December 2002 Date of last inspection 8 March 2005 Brief Description of the Service: Rose Lodge Care Home is located close to West Bridgford town centre and the main local amenities. The home offers care for up to fifteen older people in single bedrooms. All rooms have a call alarm. Communal space includes two lounges and two dining areas. There is a stair lift to the first floor and the home is well maintained throughout in terms of decoration and furnishings. There is a pleasant enclosed garden to the rear of the property with seating and shade for communal use. Rose Lodge Care Home C53 C03 S8797 Rose Lodge V241804 300705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over 4 hours one Saturday in July 2005. It was conducted by one inspector as part of the annual inspection process. A partial tour of the building took place and a selection of residents’ bedrooms were inspected. Residents’ records were inspected and seven residents, two visitors and both staff on duty were spoken with. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rose Lodge Care Home C53 C03 S8797 Rose Lodge V241804 300705 Stage 4.doc Version 1.40 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Rose Lodge Care Home C53 C03 S8797 Rose Lodge V241804 300705 Stage 4.doc Version 1.40 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 4 Prospective residents needs are met within the home. EVIDENCE: Three care plans were looked at for the purpose of this inspection and were found to have assessments that covered all activities of daily life. They provided care staff with sufficient information to ensure care was carried out to meet the needs of the resident. Residents spoken with on the day of the inspection could not recall being involved in creating their care plans. Staff spoken with were aware of the care plans and one member of staff said that she found them useful. Rose Lodge Care Home C53 C03 S8797 Rose Lodge V241804 300705 Stage 4.doc Version 1.40 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 and 11 Individual plans meet residents’ risks but do not fully ensure residents’ wishes regarding their care and comfort should their health deteriorate EVIDENCE: At the last inspection a requirement had been made regarding the risk assessment of residents regarding mobility needs. All plans viewed had risk assessments for this need. This requirement is considered met. Care plans were well structured and provided clear information on how needs are to be met. Although medication was not fully inspected staff spoken with said that only staff who received training administered medication and the Medication Administration Sheets were seen and were well ordered and there were no gaps in recording. A requirement was also made regarding the need to document residents’ funeral arrangements, wishes and preferences. All three care plans stated ‘family to make arrangements’. Although this is acceptable at the minimal level, the standard does expect more from the home regarding residents’ wishes should their health deteriorate. The registered person must ensure that this standard is fully met. Rose Lodge Care Home C53 C03 S8797 Rose Lodge V241804 300705 Stage 4.doc Version 1.40 Page 9 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15 Residents are able to spend their time as they choose and are provided with nutritious appetising meals. EVIDENCE: Residents spoken with said that they were happy with the routine of the home, they could have visitors when they wanted, and some residents attend church when they want to. Residents’ interests are recorded and some residents spoken with confirmed that they were involved in various activities during the week, such as dominoes or scrabble. It was noted that around the home there were a variety of books, jigsaws and board games. Residents were seen reading newspapers, and staff spoken with said that they often sat with residents and discussed the newspaper with them. This had been observed during the course of the inspection. Staff spoken with confirmed that they did different activities with residents, dependent on their abilities and short-term memory levels. Although the meal was not sampled, residents spoken with were positive about the meals saying they had choice and the meals were of a good standard. Residents ate in a pleasant dining area and were given appropriate support if they needed this. Information regarding residents’ dietary needs appears both on care plans as well as in the kitchen. Although there was a menu it did not identify what each individual resident ate on a specific day. This is recommended as good practice in the event there was an outbreak of food poisoning or some other illness. Rose Lodge Care Home C53 C03 S8797 Rose Lodge V241804 300705 Stage 4.doc Version 1.40 Page 10 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Residents and visitors are assured that their concerns are listened to but residents are placed at potential risk by staff not having adult abuse awareness training. EVIDENCE: Residents and visitors spoken with all knew who to complain to if they had any concerns, and felt confident that they would be dealt with. A requirement had been made at the last inspection regarding staff receiving training for Adult Abuse Awareness. Staff spoken with said they had not received any training in this area. This is now an immediate requirement. Rose Lodge Care Home C53 C03 S8797 Rose Lodge V241804 300705 Stage 4.doc Version 1.40 Page 11 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 21 and 26 Residents live in a mostly clean, homely and well-maintained environment, which meets their needs. The kitchen needs some refurbishment. EVIDENCE: The kitchen was inspected and although clean, the work surfaces were heavily worn and there were a number of cracked wall tiles. The registered person must ensure these areas do not compromise the cleanliness of the home. It was noted that the hand wash basin in the kitchen had cigarette ash in it, when staff were questioned regarding this staff spoken with said that usually this sink was not used and alternative sinks were used. The registered person must ensure that all staff follow good practice in hygiene, washing their hands in the most appropriate area at the time. A requirement had been made at the last inspection regarding the wedging open of doors, the registered person was asked to establish with fire officer that this practice was acceptable this has now been done. Overall the home was well maintained and clean, residents confirmed that their rooms were clean and they were happy with their personal space. A requirement was made at the last inspection to repair the downstairs toilet and that was seen to have been completed. Residents were happy with the way clothes were Rose Lodge Care Home C53 C03 S8797 Rose Lodge V241804 300705 Stage 4.doc Version 1.40 Page 12 laundered and the laundry itself was a spacious environment and a system was in place to ensure residents received their clothes back. Rose Lodge Care Home C53 C03 S8797 Rose Lodge V241804 300705 Stage 4.doc Version 1.40 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 Although there appears to be sufficient staff to meet the needs of residents this may be compromised by in-house rules. Staff training must meet standards to minimise risk of residents and staff being placed at risk. EVIDENCE: On the day of the inspection there were two care staff on duty. Residents spoken with said that mostly they found there were enough staff around, however staff spoken with found that if one was upstairs working with a resident and another was working with a resident downstairs, they could not always answer the phone or the door as quickly as they had been instructed by management. If the management create rules for staff they must ensure that there are enough staff available to operate them. Staff spoken with said that training was not always available, although three staff were undertaking their NVQ level 2. A requirement was set at the last inspection regarding training. As the manager was not available during this inspection, this standard was not fully inspected and this requirement will be carried over to the next inspection where it will be inspected in more detail. Rose Lodge Care Home C53 C03 S8797 Rose Lodge V241804 300705 Stage 4.doc Version 1.40 Page 14 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 The residents are placed at potential risk by a lack of registered manager. EVIDENCE: The acting manager has yet to register with the Commission, as this is an outstanding requirement from the last inspection this is now an immediate requirement. The registered person must ensure that there is a manager in post Rose Lodge Care Home C53 C03 S8797 Rose Lodge V241804 300705 Stage 4.doc Version 1.40 Page 15 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 x 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x 3 x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 1 1 x x x x x x x Rose Lodge Care Home C53 C03 S8797 Rose Lodge V241804 300705 Stage 4.doc Version 1.40 Page 16 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 11 Regulation 12 Requirement The registered person must ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of residents. Care plans must include more information regarding residents wishes should health deteriorate. Arrangements must be made to train all staff in preventing service users being harmed or suffering abuse, following the introduction of the home’s own procedures for the protection of vulnerable adults. This is an outstanding requirement from the previous inspection. Timescale for action 31/012/05 2. 18 12, 13 Immediate 3. 30 12,18 The registered person must 1/09/05 ensure all staff receive updated training to fulfil the aims of the home and to meet the changing needs of service users. A training plan is required to address this for all staff a copy of which must be sent to the Commission as part of the action plan. Version 1.40 Page 17 Rose Lodge Care Home C53 C03 S8797 Rose Lodge V241804 300705 Stage 4.doc 4. 31 9 The Registered Person must appoint a registered manager and inform the Commission for Social Care Inspection. This is an outstanding requirement from the previous inspection. Immediate RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard 15 19 26 27 Good Practice Recommendations The registered person should record all meals consumed by each resident. The registered person should ensure that the hygiene in the kitchen is not compromised by the cracked tiles and worn work surfaces. The registered person should ensure that staff are following good hygiene practices if not using the hand wash sink in the kitchen. The registered person should ensure that there are sufficient staff on duty to meet both the residents needs and any in-house rules that are established regarding time allowed to open the door to visitors. Rose Lodge Care Home C53 C03 S8797 Rose Lodge V241804 300705 Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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. 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