Inspection on 25/07/05 for Rose Meadow

This inspection was carried out on 25th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 Meadow 03/07/07

Rose Meadow 02/08/06

Rose Meadow 23/02/06

Rose Meadow 11/03/05

Rose Meadow 05/10/04

Rose Meadow 02/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE ROSE MEADOW Yarmouth Road North Walsham Norfolk NR28 9AU Lead Inspector Ginette Amis Unannounced 25 July 2005 10.05 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 MEADOW I55 S34927 Rose Meadow (un) V240005 250705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Rose Meadow Address Yarmouth Road, North Walsham, Norfolk, NR28 9AU 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) 01692 402345 01692 5000157 Norfolk County Council Community Care Mrs Elizabeth Ann Lockwood Care Home 30 Category(ies) of OP Old Age (30) registration, with number of places ROSE MEADOW I55 S34927 Rose Meadow (un) V240005 250705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. From time to time the home may accommdoate one service user over the age of 65 years who has dementia and is named in the Commissions records. Total number not to exceed thirty (30). 2. People who need wheelchairs to assist with independent mobility at the point of admission cay only be accomodated in rooms numbered 34, 41, 66 and 68. Date of last inspection 11 March 2005 Brief Description of the Service: Rose Meadow is a care home providing personal care and accommodation for up to 30 older people. The home has 26 permanent placements and 4 respite care placements. Two of the respite placements are GP beds. There is a day centre attached to and managed by the care home and this offers up to 12 day care places on Wednesdays, Thursdays and Fridays. The home is owned by Norfolk County Council and is located on the outskirts of North Walsham, being quite close to shops, pubs and other local amenities. The home was purpose built and accommodates service users on two floors. Norfolk County Council have completed some refurbishment and redecoration but further work remains outstanding. All service users have their own bedroom but several of these are rather small. The communal areas are plentiful and offer a variety of seating areas including a smoking area, quiet room and large dining room. There is a shaft lift that offers access to the first floor. The lift is very small and does not comfortably accommodate a wheelchair. There is a large garden that service users benefit from in the summer months. ROSE MEADOW I55 S34927 Rose Meadow (un) V240005 250705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 10.05 am and 2.20 pm on Monday 25th July 2005. The manager and a senior carer assisted with the provision of information and 7 residents offered their views of the care home and have been quoted in this report. In addition interactions between residents and other members of staff were observed. Many of the residents were in the process of keeping appointments with the visiting hairdresser. Rose Meadow was found to have a happy and cheerful atmosphere. Residents spoken with were particularly keen to relate how comfortable they were there and how well they got along with each other and especially with the staff group as a whole. Care needs were well documented and records gave indication these were being met. The files of 4 of the residents spoken with were examined in the course of the inspection. A tour was made of the premises although only a sample of residents’ rooms were entered. The premises were found to be clean, for the most part reasonably well decorated and well maintained. Procedures were in place to help minimise risks to health and safety. The care home had inadequate bathing and toilet facilities. While it was evident from residents’ comments that staff are conscientious and effective in performing their duties, a shortage of staff hours was identified. Some recommendations were brought forward from the previous inspection and it can be seen how these relate to the 2 requirements made. What the service does well: The manager and staff at Rose Meadow have created a caring, homely environment in which residents feel appreciated and content. ROSE MEADOW I55 S34927 Rose Meadow (un) V240005 250705 Stage 4.doc Version 1.40 Page 6 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 MEADOW I55 S34927 Rose Meadow (un) V240005 250705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection ROSE MEADOW I55 S34927 Rose Meadow (un) V240005 250705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3 and 6 Information offered in the Service User Guide would assist prospective residents to make a decision over admission to the care home. Residents needs are assessed to ensure they can be met prior to their admission to the care home. Short term residents and their regular carers’ also benefited from staying at Rose Meadow. ROSE MEADOW I55 S34927 Rose Meadow (un) V240005 250705 Stage 4.doc Version 1.40 Page 9 EVIDENCE: A comprehensive statement of purpose and service user guide together with copies of the last inspection report were prominently made available in the main foyer of Rose Meadow. The manager confirmed how the needs of all residents were assessed prior to their admission to the care home and copies of assessments were contained within the 4 residents’ personal files examined during this inspection. The assessment process was explained in the Service User Guide. Rose Meadow offers 4 dedicated short-term placements, all subject to assessment of individual needs and the ability of the care home to meet those needs. One temporary resident spoken with related how greatly she benefited from and enjoyed her regular short stays, saying “After my first visit here I told my daughter (main carer at home) that you can send me there as often as you like its’ so good.” ROSE MEADOW I55 S34927 Rose Meadow (un) V240005 250705 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 Residents’ needs were detailed in their personal files and with their participation regularly reviewed to help ensure the availability of appropriate care. Residents’ health care needs were being met by 2 supportive GP practices. Medication was appropriately stored and administered. Residents were confident that staff respected their rights and individuality ROSE MEADOW I55 S34927 Rose Meadow (un) V240005 250705 Stage 4.doc Version 1.40 Page 11 EVIDENCE: The files of 4 residents were examined and found to contain useful information as to their personal care needs, health care and social needs. Care needs had been reviewed at regular intervals and the records of these reviews had been signed by the resident involved. A senior carer described the wide range of health care support services available to residents. One resident related how staff acted promptly when ever medical help was needed. Medication was seen to be appropriately and securely stored. A member of the staff team related that only staff trained to do so were authorised to administer medication and gave account of the practises followed. Policies and helpful information was available in the medical room. Residents were unanimous in their view that care staff were respectful. When asked if this was always so one resident said, “The staff are always the same, always helpful and kind, they never make a big thing of anything, even in the middle of the night it you need something.” ROSE MEADOW I55 S34927 Rose Meadow (un) V240005 250705 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 Residents met with appeared to be at ease, comfortable with staff and one another, were complementary of available services and gave every indication they were content with life at Rose Meadow. EVIDENCE: Each of the 6 permanent residents together with one short stay resident expressed satisfaction with life at Rose Meadow and said they would recommend the care home to others. It was confirmed by residents that relatives and friends could visit when-ever they wished, as was outlined in the service user guide. After some discussion a group of residents were able to give account of a number of social activities that had taken place recently. An activities log listed some of these, including, in July alone, a bowls match, walks in the garden, musical entertainment and bingo. The group of residents then offered a rendition of one of their favourite songs. The daily menu was on display in the foyer, indicating how choice was always available. Residents confirmed this saying the food was always good and very plentiful. Two residents said they thought they had put on weight since admission because they enjoyed their food so much. ROSE MEADOW I55 S34927 Rose Meadow (un) V240005 250705 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Residents and their relatives or representatives can be confident that any issues they raise will be dealt with in a serious and sympathetic manner and a remedy sought. Members of staff have been made aware of the need to always protect residents from any potential abuse. EVIDENCE: Records contained in the complaints log-book indicated that issues raised are always taken seriously and appropriately dealt with in a timely manner. It was noted there had been no complaints raised since before the time of the previous inspection. Complaints procedures are contained within the service user guide. Staff training records contained certificates relating to training courses attended to raise awareness of the vulnerability of older people to abuse and guide staff in how to deal with such issues. A member of staff was able to confirm that the need to protect residents from any form of abuse from whatever source is made clear to the staff team. ROSE MEADOW I55 S34927 Rose Meadow (un) V240005 250705 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,21 and 26 Rose Meadow was for the most part clean, tidy, safe and generally well maintained. Areas that failed to meet acceptable standards were the up stairs bathroom and toilet facilities. The shaft lift was considered only just acceptable. ROSE MEADOW I55 S34927 Rose Meadow (un) V240005 250705 Stage 4.doc Version 1.40 Page 15 EVIDENCE: Apart from certain areas requiring renovation or redecoration, Rose Meadow is on the whole safe and well maintained. Risk assessments have been completed for the premises and considerable input has been made to ensure safety in the event of fire. There are handrails fixed to aid passage along lengthy corridors. Most of the communal areas are in a reasonably good state of decoration and efforts have been made to create a comfortable, homely atmosphere. Access to the front of the building was good and exits into the garden where there are steps had handrails put in place. The grounds appeared well maintained and offered level walkways through a shrubbery together with areas of lawn, a summerhouse and out-door seating. The care home has a shaft lift to give access to the first floor. The manager explained that for several weeks the lift had remained out of order and as an interim measure a stair lift had been installed on the front staircase. The lift had ultimately been repaired and it was expected the stair-lift would soon be removed. However, it was noted the recommendation made at the previous inspection, for a larger capacity lift to be installed, had been ignored by the provider. As the lift in place is very small, and only just able to accommodate a carer with a resident in a wheelchair, it was regrettable that the opportunity to improve the situation had been missed. The recommendation has as a result been repeated here. Residents’ rooms at Rose Meadow, though described as comfortable and acceptable by residents, were for the most part rather small and none had en suite facilities. This drawback was compounded by a lack in bathroom facilities generally. There was one well-equipped bathroom on the ground floor but the 2 bathrooms on the first floor left a lot to be desired and as a result were seldom made use of by residents. These bathrooms, one of which included shower facilities were shabby, institutional in design and poorly equipped. It was noted how some of the communal toilets were also institutional and lacked proper privacy. As a result a requirement was made for action to be taken to remedy these failings. On the day of this unannounced inspection all areas seen at Rose Meadow were found to be clean and tidy. The recommendation of the previous inspector for awareness to be raised of the need to wear protective clothing when entering the kitchen had been acted upon. ROSE MEADOW I55 S34927 Rose Meadow (un) V240005 250705 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 Rose Meadow’s residents benefited from the attention of a well trained and managed staff team who went about their duties in a caring and pleasant manner. Staff shortages were an ongoing problem and required further review and resolution. EVIDENCE: On the day of this unannounced inspection Rose Meadow was reasonably well staffed with the manager, a senior carer and 3 carers on duty. In addition 2 domestic assistants were working in the home. (Catering was by outside contractor). It was however noted that one member of the team was an agency worker and another a relief. The manager explained that the care home had experienced difficulties recruiting staff and currently had 4 care staff vacancies. The requirement made at the previous inspection for the provider to cease in stipulating the manager work part of her hours on the care rota has been met but unfortunately this had been achieved by effecting a loss of approximately 12 hours per week from the care rota. The care home offers 4 respite care beds, and these are generally always occupied. This operation was considered to have particular implications by way of a draw on the time of the manager and staff at Rose Meadow. In addition, the manager takes responsibility for the day centre attached to the care home and the proximity of this operation could also in an emergency ROSE MEADOW I55 S34927 Rose Meadow (un) V240005 250705 Stage 4.doc Version 1.40 Page 17 situation or time of staff shortages have implications for the staff levels at the care home. Taken together, the high number of vacancies, drop in hours from the care rota, additional demands of the short term care and day care services associated with the care home, staffing was considered in need of urgent further review. Despite these problems, records revealed that staff were well trained to do their work and the caring and cheerful disposition of team members was evident. Residents confirmed this view, applauding staff kindnesses and the conscientious way in which they undertook their duties, saying “Nothing is ever too much trouble” “They are always there with a smile” “I can’t think of anything about them to complain of” ROSE MEADOW I55 S34927 Rose Meadow (un) V240005 250705 Stage 4.doc Version 1.40 Page 18 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) 33, 35 and 38 The manager and staff were mindful of the views and preferences of the residents. Any residents’ money held at the care home was carefully handled with good records maintained. Efforts had been made to ensure safety for everyone at all times. ROSE MEADOW I55 S34927 Rose Meadow (un) V240005 250705 Stage 4.doc Version 1.40 Page 19 EVIDENCE: Evidence of residents being involved in the decision making processes at Rose Meadow could be gathered from the publication of feedback from questionnaires in the current service user guide. The open and cheery interactions between residents, the manager and staff indicated how residents felt comfortable and at home. Residents unanimously related how they would have no hesitation in discussing any issue of concern to them with the manager or members of her team. One resident said of the manager “She always listens to you and sorts things out for you and she’s a really good manager” “Every one of them (Care staff) are the same, it doesn’t matter what shift it is, they’re all there to help you.” Some residents had their cash held for them in safe keeping by the care home. Clear records are kept in relation to deposits and withdrawals. A variety of risk assessments have been completed with a view to ensuring safety at the care home. A call system operates throughout the care home with a monitor in the main office. The fire action pack was clearly located in the foyer and all staff had received regular training in how to act in the event of a fire. Fire safety systems were regularly checked and serviced. The fire officer last inspected the premises on 24/4/04 and recommendations have all been acted upon. Ski sheets had been installed on all residents’ beds and there were evacuation chairs on the upper floors. There were 2 external fire escapes to the building. Members of staff were trained in food hygiene and other infection control issues. The Environmental Health officer last inspected the premises 22/12/04 and issues raised have been addressed. Contracts were in place for the safe disposal of waste and to service all equipment held in the care home. ROSE MEADOW I55 S34927 Rose Meadow (un) V240005 250705 Stage 4.doc Version 1.40 Page 20 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 3 x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 x 1 x x x x 3 STAFFING Standard No Score 27 2 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 3 x 3 x x 3 ROSE MEADOW I55 S34927 Rose Meadow (un) V240005 250705 Stage 4.doc Version 1.40 Page 21 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 21 Regulation 23(2)d j Requirement The provider must ensure that adequate bathing and toilet facilities are available and that these are suitable, in sound order, comfortable and provide privacy The provider must review staffing levels and address the need for a sufficiently large staff complement and adequate care hours to meet the needs of all the residents Timescale for action 31/3/06 2. 27 18(1)a 31/10/05 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 19 23 27 27 Good Practice Recommendations The provider should consider replacing the existing lift with one of larger capacity. Recommendation brought forward from the last inspection. The provider should have TV ariel sockets fitted in every service users room Recommendation brought forward from the last inspection The care home should have a bank of relief staff. Recommendation brought forward from the last inspection One member of staff should be able to oversee the I55 S34927 Rose Meadow (un) V240005 250705 Stage 4.doc Version 1.40 Page 22 ROSE MEADOW organisation of activities for the residents. Recommendation brought forward from the last inspection ROSE MEADOW I55 S34927 Rose Meadow (un) V240005 250705 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 3rd Floor Cavell House St Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI ROSE MEADOW I55 S34927 Rose Meadow (un) V240005 250705 Stage 4.doc Version 1.40 Page 24 - 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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