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Inspection on 31/07/06 for Rose Villa Nursing Home

Also see our care home review for Rose Villa Nursing Home for more information

This inspection was carried out on 31st July 2006.

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.

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 offers 24hr Nursing care to Service Users who require assistance with daily life tasks and medical intervention. The environment is homely and comfortable, with most Service Users having their own bedroom with toilet and basin ensuite. Attractive home cooked meals are served daily including a hot breakfast and tea. Alternative meals are offered at each mealtime. Relative and staff meetings are held and minutes kept.

What has improved since the last inspection?

Some redecoration has commenced but must continue. The Laundry floor has been tiled and sealed.The involvement of Service Users relatives in the Care Records ahs improved slightly but this must continue to be completed.

What the care home could do better:

CARE HOMES FOR OLDER PEOPLE Rose Villa Nursing Home 148/150 Eccleshall Road Stafford Staffordshire ST17 9AA Lead Inspector Mrs Joanna Wooller Key Unannounced Inspection 31 July 2006 07:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rose Villa Nursing Home DS0000061869.V306469.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 Villa Nursing Home DS0000061869.V306469.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rose Villa Nursing Home Address 148/150 Eccleshall Road Stafford Staffordshire ST17 9AA 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) 01785 254760 F/P 01785 214263 Mr Jayantical James Bhikhashai Patel Mrs Jennifer Lyn Davies Care Home 35 Category(ies) of Physical disability (35), Physical disability over registration, with number 65 years of age (35), Terminally ill (3) of places Rose Villa Nursing Home DS0000061869.V306469.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. PD Minimum age 60 yrs Date of last inspection 8th December 2005 Brief Description of the Service: Rosevilla is situated on the Eccleshall road leading to the M6 (junction 14), in a residential area about one mile from Stafford town centre. Rosevilla is a registered care home offering 24 hour nursing care, which aim to offer a high standard of care and accommodation for thirty-five service users. The home has mostly single bedrooms, all with en-suite facilities. There are 3 double rooms for those who prefer to share, but these may be used as larger singles. The home started life as two large properties that have been extensively extended to provide the facilities it offers. Rosevilla consists of two floors, serviced by a lift in the original building, and a purpose built ground floor unit of single rooms with ensuite facilities. The service users have a choice of several lounges to choose from, one with views to the back of the property and two with views to the front. The opportunity to become involved with activities is also available with the homes activity organiser. Good home cooking is provided and special dietary needs are catered for. The service users have access to all areas of the home including the gardens. There is ample parking space for visitors. Rose Villa Nursing Home DS0000061869.V306469.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Lead Inspector carried out this unannounced Key Inspection. The Registered Manager was on duty in the home and available to assist the Inspector. Also on duty were one other trained nurse and five Carers. There were 30 Service Users in the home; enquiries were being made with regard to the vacant beds. The Inspector evidenced care records, all necessary documentation and inspected the entire environment, including the kitchen, laundry and the Service Users bedrooms and bathrooms. Staff were approachable and friendly in their manner, they were observed offering sympathetic support to those Service Users who required it. The home was clean and tidy and some redecoration had taken place. Some Service Users were served breakfast in the dining room or in their rooms as desired. Plenty of drinks were evidenced as being served throughout the Inspectors time at the home. Only a few CSCI feedback cards were returned with few comments on them. The home had recently sent out their own questionnaires and the response to this was good. The Inspector evidenced these. Fees … Highest £505. Lowest £327 £35 Top Up What the service does well: What has improved since the last inspection? Some redecoration has commenced but must continue. The Laundry floor has been tiled and sealed. Rose Villa Nursing Home DS0000061869.V306469.R01.S.doc Version 5.2 Page 6 The involvement of Service Users relatives in the Care Records ahs improved slightly but this must continue to be completed. 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 Villa Nursing Home DS0000061869.V306469.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rose Villa Nursing Home DS0000061869.V306469.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 This quality outcome is good. This judgement has been made using available evidence including a visit to this service. All Service Users have their individual needs assessed prior to admission to ensure their needs can be met. This is discussed with the family and any representatives prior to admission and confirmed in writing. EVIDENCE: The Statement of Purpose and Service User Guide had been rewritten to reflect the new provider and new managers’ ethos. This is presently being amended. The information will need to be reorganised and then redistributed to the Service Users and relatives. The Service Users spoken to felt that they had all the information they needed and asked staff if they were unsure. They had been issued with a letter to demonstrate that the home could meet the individual needs whilst at the home. Rose Villa Nursing Home DS0000061869.V306469.R01.S.doc Version 5.2 Page 9 Each Service User is issued with a contract that is signed on admission by the resident, this document includes all relevant information required by them to be aware of their rights. Personal care, mobility and medication were documented within the care records. There was again little evidence of relatives/representatives being included in this procedure. All necessary specialists needs were arranged as required. The care staff are trained and updated by the Nursing Staff in the home to ensure that they are skilled and experienced to care for the service users, and identify and meet their daily needs. Staff spoken to was knowledgeable about the Service Users. In house and external training is arranged to take place. Rose Villa Nursing Home DS0000061869.V306469.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 - 11 This quality outcome is good. This judgement has been made using available evidence including a visit to this service. Care documentation is in place and individual needs are identified through the admission process. Policies and procedures are followed with regard to medication administration. Respect and dignity are evidenced as being promoted. EVIDENCE: Each service user had an individual plan of care, which includes health, personal, and some social care needs. The care plans seen at the visit reflected the care that the tracked service users were receiving and these are updated at least monthly. Named nurses and key workers were identified on the records. There was again little evidence that the service users were involved in the plan of care and this is to be developed as far as is possible. Relatives must be shown the individual plan of care and asked to sign the relevant risk assessments if Service Users are unable to do so. Rose Villa Nursing Home DS0000061869.V306469.R01.S.doc Version 5.2 Page 11 Carers assist where necessary with personal care needs; key workers ensured that service users toiletries were available. Service Users spoken to say that they continued to feel that they were treated with dignity and respect. They said the carers encourage them to be as independent as possible. New care records are being introduced at the home and these must continue. It was noted that Communication and Social care plans must be extended. Rose Villa Nursing Home DS0000061869.V306469.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 - 15 This quality outcome is good. This judgement has been made using available evidence including a visit to this service. Individual Service Users likes, dislikes are hobbies are identified on admission. Service Users are assisted to exercise choice and they receive a wholesome, well balanced diet. EVIDENCE: The home had an activity programme, arranged over the week to attempt to meet the needs and capabilities of the residents. This was distributed in the individual bedrooms for service users. The activity organiser involves and encourages less able individuals. The numerous photographs displayed in the Hall again confirmed evidence of the activities arranged. It was identified at the last visit that some more one-to-one sessions would benefit certain Service Users and also trips out in the community. Trips out had been arranged including pub lunches and trips to the garden centre. Visitors were welcomed at any time. There were no visitors in the home throughout the visit by the Inspector. Each individual Service User was encouraged to exercise ‘daily control’ in respect of his or her life style. Rose Villa Nursing Home DS0000061869.V306469.R01.S.doc Version 5.2 Page 13 One relative commented on the Feedback card that they were very pleased with the care and attention that their relative received. The menus for the week were displayed for all to observe. The records offered choice, variety and a well balanced diet. The meal for the day was observed being prepared in a well-maintained kitchen. • It was noted that the kitchen window grills needed to be deep cleaned. Rose Villa Nursing Home DS0000061869.V306469.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 This quality outcome is good. This judgement has been made using available evidence including a visit to this service. A complaints policy and procedure is in place and followed as necessary. Service Users are protected from abuse through staff training and supervision. EVIDENCE: The inspector observed the complaints process and procedure displayed. Each of the Service Users had been provided with a copy of the homes procedure in the event of having a complaint. Staff training and supervision covers issues of abuse, its identification ad types of abuse. The Whistle Blowing policy is also in place to support staff in reporting of any untoward incidents. No complaints had been received by the CSCSI. Rose Villa Nursing Home DS0000061869.V306469.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 This quality outcome is good. This judgement has been made using available evidence including a visit to this service. The Service Users live in a wellmaintained, clean, safe environment. EVIDENCE: Rosevilla Care Home continues to provide a clean, well-maintained environment for Service Users throughout the home. Accommodation is personalised to suit individuals. Lounges are located on the ground and first floor. Bathrooms and toilets are sited around the home. The need for a shower room and one bathroom was identified as being suitable and the provider agreed this alteration during the previous visit but this has not been attended to as yet. Service Users live in a safe environment where all the necessary checks and risk assessments are in place. Rose Villa Nursing Home DS0000061869.V306469.R01.S.doc Version 5.2 Page 16 Equipment and adaptations were provided as necessary to maximise service users independence. Cot side bumpers ensure that all cot sides at the home are protected. The laundry operated over seven days and clean laundry was delivered to the Service Users room by the staff. The staff responsible for the hygiene of the home worked extremely hard to maintain the high standard. Emergency lighting was tested and recorded. Water storage was monitored and the temperature of bath water was tested prior to use. One issue raised on the day was that carpet identified as frayed and a risk to Service Users and staff had been since taped. This now needs to be replaced. Rose Villa Nursing Home DS0000061869.V306469.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 - 30 This quality outcome is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are appropriate to meet the needs of the Service Users. Staff training is offered to ensure all the staff are competent to do their jobs. EVIDENCE: To ensure appropriate skill mix and qualifications of staff on the rota the Manager assess the Service Users dependencies. Staffing rotas were evidenced and found to be in order. Service Users dependencies are monitored to ensure the correct amount of staff are on duty to meet their individual needs. Additional staff are employed as the Service Users needs increase. One vacancy has been recently filled for a trained nurse and the recruitment process is being followed, the CRB is awaited. Ancillary staff are employed on a rota system to cover their duties and maintain the homes hygienic state. Rose Villa Nursing Home DS0000061869.V306469.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 This quality outcome is good. This judgement has been made using available evidence including a visit to this service. The home is run in the best interest of the residents. Finances are safeguarded by the systems in place. The health, safety and welfare of residents and staff is promoted and protected. EVIDENCE: The manager is now registered with the Commission for Social Care Inspection. Mrs Davies has day-to-day control over the home and her deputy manager supports her. Both managers are due to complete the Managers Award in the autumn. Rose Villa Nursing Home DS0000061869.V306469.R01.S.doc Version 5.2 Page 19 The manager continues to demonstrate an open and inclusive style of management and this is now being communicated throughout the home and the documentation. Risk assessments were in place and signed appropriately. Quality audits have continued to be carried out; the maintenance man performs room audits weekly and records the action taken. A new quality audit system is being organised to reflect that the National Minimum Standards, once the policies and procedures have been rewritten. Financial procedures were robust and no issues were raised. Accidents and incidents were documented. The manager was fully aware of the need to ensure the health, safety and welfare of service users and staff. There was evidence that the manager monitored safe working practices and health and safety issues within the home. One issue was raised relating to record keeping checked on the day as the fire alarms had not been tested weekly and recorded. Rose Villa Nursing Home DS0000061869.V306469.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Rose Villa Nursing Home DS0000061869.V306469.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 (3) Requirement Communication and Social Care Plans must be in place to address individual needs. Residents or representatives must be involved with the plan of care and this must be evident within the documentation. Signatures must be gained. Corridor carpets must be replaced. GP Visits must be clearly evidenced in the notes and Service Users must be reviewed at least annually. The kitchen window mesh requires a deep clean and regular cleaning within the kitchen cleaning programme. Timescale for action 31/08/06 2. OP7 15 (2c) 31/08/06 3 4 OP19 OP8 23 15 (3) (1) 30/09/06 31/08/06 5 OP15 16 (2) (g) 14/08/06 Rose Villa Nursing Home DS0000061869.V306469.R01.S.doc Version 5.2 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP22 Good Practice Recommendations Consideration should be made to replace one of the less used baths with a walk in shower facility. Rose Villa Nursing Home DS0000061869.V306469.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Villa Nursing Home DS0000061869.V306469.R01.S.doc Version 5.2 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!