Inspection on 03/10/06 for Rosebank Care Home

This inspection was carried out on 3rd October 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Rosebank Care Home 01/12/05

Rosebank Care Home 30/08/05

Rosebank Care Home 03/12/04

Rosebank Care Home 24/08/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Rosebank Care Home High Street Bampton Oxfordshire OX18 2JR Lead Inspector Philippa MacMahon Unannounced Inspection 3rd October 2006 09:10 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 Rosebank Care Home DS0000013137.V314369.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. Rosebank Care Home DS0000013137.V314369.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosebank Care Home Address High Street Bampton Oxfordshire OX18 2JR 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) 01993 850308 haslampenny@hotmail.com Rosebank Nursing Homes Limited Mrs Penny Haslam Care Home 28 Category(ies) of Dementia (13), Old age, not falling within any registration, with number other category (28) of places Rosebank Care Home DS0000013137.V314369.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The total number of persons that may be accommodated at any one time must not exceed 28 Admittance of one named under age resident effective from 27th March 2006 1st December 2005 Date of last inspection Brief Description of the Service: Rosebank is a care home registered for 28 older people, of whom 13 may have dementia. It is situated on the high street of the attractive village of Bampton and is very much a part of the village. Accommodation is provided on two floors and the first floor can be accessed by a passenger lift. There are both single and shared rooms provided and many have en-suite facilities. There are three large, comfortable lounge areas and two dining areas. The home has large attractive and well-maintained gardens, which are accessible to the service users. There is a wide range of activities available and service users are actively encouraged to maintain their independence for as long as possible. The fees for this service range from £382.12 to £570 per week. Rosebank Care Home DS0000013137.V314369.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 09:10 hours and was in the service for 5.hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the services and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. A very warm welcome was given to the inspector by the staff, and all cooperation given throughout this inspeciton. Care plans were examined and this was followed by meeting with the individual resident to see if the care plan was meeting their needs. Discussion took place with the registered manager and the senior staff about all aspects of the care delivery. The medication system was examined, and the policies and procedures supporting this. Time was spent with the activities co-ordinator, and the administrator, the cook and other staff members. Residents were spoken to and given the opportunity for questions. A tour of the environment was made including the garden. What the service does well: The standard of care provided to the residents is excellent. The home is well managed and there are clear lines of accountability in the staff team. The registered manager is proactive in keeping up to date with new initiatives and implementing them as appropriate. Rosebank Care Home DS0000013137.V314369.R01.S.doc Version 5.2 Page 6 Staff are valued and offered every support from the registered manager. Rosebank offers a homely and happy place for the residents to live. The activities programme is excellent and tailored to the individual needs of the residents. 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. Rosebank Care Home DS0000013137.V314369.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 Rosebank Care Home DS0000013137.V314369.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. Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection that included a visit to the service and takes into account the views and experiences of people using the service. The registered manager carries out comprehensive pre-admission assessments. The home does not provide an intermediate care service. EVIDENCE: The inspector examined the care plans and found that the registered manager carries out comprehensive pre-admission assessments. Two of the latest assessments had been countersigned by the relatives to say that they agreed with the assessment. In the “Have your say about Rosebank” questionnaire all of the responses said that they had enough information to make a decision as to which home to choose. Rosebank Care Home DS0000013137.V314369.R01.S.doc Version 5.2 Page 9 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): 7,8,9,10.11. Quality in this outcome area is excellent. This judgement has been made from evidence gathered during the inspection that included a visit to the service and takes into account the views and experiences of people using the service. The care provision at the home is consistently of a high standard and the registered manager is proactive in keeping up to date with new initiatives to support the care provided. EVIDENCE: A sample of care plans was examined and this was followed by meeting the individual resident, and talking to staff. On each occasion the care plans reflected an accurate picture of the resident, their care needs and how these will be met. The care plans are reviewed on a regular basis and changes are made as the resident’s care needs alter. There was evidence of good collaborative work between the staff in the home, the GP, District Nurses, and Pharmacist. There are also good working relationships with the local hospice, and the registered manager has developed End of Life Plans to ensure that the residents are able to choose where they would like to spend their last days, and to make sure that the appropriate resources are available to them to provide the best care possible. Rosebank Care Home DS0000013137.V314369.R01.S.doc Version 5.2 Page 10 The medication system was examined and a new system has been implemented to assist the staff in the safe administration of medicine. The system was found to be in good order. The homely remedies procedure is in need of updating and it is recommended that the policy and procedure for giving “homely remedies” should be reviewed and updated. The medication refrigerator was found to be in need of defrosting and the Senior Carer was addressing this at the time of the inspection. The home keeps a register of staff signatures and the inspector noted that none of the night staff were included in this. It is recommended that a list of signatures and initials of all staff who make entries in any records should be maintained. There were many positive responses to the commission’s comment cards and questionnaires saying how good the care provision is and saying that the staff really understand the needs of all their residents. The inspector observed staff assisting the residents in a kindly and appropriate manner, and always knocked on doors prior to entering a resident’s private room, toilet or bathroom. Rosebank Care Home DS0000013137.V314369.R01.S.doc Version 5.2 Page 11 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): 12,13,14,15. Quality in this outcome area is excellent.. This judgement has been made from evidence gathered during the inspection that included a visit to the service and takes into account the views and experiences of people using the service. The residents all have the opportunity to engage in activities suited to their personal needs. Meals and mealtimes are an important part of the residents’ life and much appreciated. From the evidence seen by the inspector and comments received, the inspector considers that this home would be able to provide a service to meet the needs of individuals of various religions, race or culture. EVIDENCE: The inspector met with the activities co-ordinator and discussed the programme of activities available to the residents. The programme is very varied and flexible to take into account the individual needs of the residents. The programme includes “theme days”, games, physical activity, and music appreciation. Time is also given to spending time on a 1 to 1 basis with residents. A record is kept on individual files of the resident’s response to activities, to enable the programme to be developed. Relatives are encouraged to assist with a history of the resident’s life, to help with Rosebank Care Home DS0000013137.V314369.R01.S.doc Version 5.2 Page 12 identifying the needs of the residents. Residents spoken to said how much they enjoyed the activities provided and that there was always plenty to do. The home is situated in the heart of the village and is very much a part of village life. Residents are able to join in events locally as well as hosting events in the home. Comments in the commission’s relatives comment card include comments such as “My mother now cannot join in all the activities (of which there are a good variety) but she can manage a little keep fit sometimes. The Activities co-ordinator has been a good addition to Rosebank.” Meals and mealtimes are very important and the inspector examined the menus and found that a wholesome and nutritious diet is provided for the residents. Flexible mealtimes were also observed to suit the needs of the residents. Special diets and assistance are given when required. Rosebank Care Home DS0000013137.V314369.R01.S.doc Version 5.2 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 the following standard(s): 16,18. Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection that included a visit to the service and takes into account the views and experiences of people using the service. The home has in place an accessible complaints system. Residents are protected from abuse. EVIDENCE: There is an appropriate complaints system in place, and the registered manager has an open door style of management so that she is always available to residents, relatives, and staff. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. All staff receive training in relation to Safeguarding Adults. Rosebank Care Home DS0000013137.V314369.R01.S.doc Version 5.2 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 the following standard(s): 19,21,26. Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection that included a visit to the service and takes into account the views and experiences of people using the service. Overall the home is well maintained and fit for the purpose of being a care home. However there are a few areas that require some attention. EVIDENCE: The inspector toured the building and overall found all areas to be cleaned to a high standard. The furnishings and décor are of a good standard throughout, and well maintained. A resident’s room was being redecorated at the time of this inspection. Staff spoken to say that the redecoration programme is almost constant and not just when the room is vacated. Hot water temperatures were recorded by the inspector and found to be within acceptable norms. The registered manager records all hot water temperatures on a regular basis. The residents’ private rooms are all very individual as residents are able to personalise them with their own possessions. Three of the rooms visited had a Rosebank Care Home DS0000013137.V314369.R01.S.doc Version 5.2 Page 15 malodour probably from the carpets. This was pointed out and the Inspector was told that they were due to be cleaned that afternoon. The downstairs bathroom flooring is damaged and in need of heat sealing to ensure it can be cleaned appropriately. The specialist bath in this bathroom is also in need of cleaning around the trim area of the bath and the base. It is recommended that the flooring in the downstairs bathroom is made good, and that the trim to the bath should be cleaned. The laundry was found to be in good order and the care assistants are responsible for the care of the residents’ clothing. Part of the flooring in the laundry is not impermeable and could be a risk to health and welfare as it is not easy to clean. It is recommended that consideration should be made to covering the entire floor in the laundry with impermeable covering. The communal areas are well planned and much enjoyed by those residents spoken to. The grounds and garden are most attractive and one resident said how good it was to be able to go into the garden on a nice day. Rosebank Care Home DS0000013137.V314369.R01.S.doc Version 5.2 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 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): 27,28,29,30. Quality in this outcome area is excellent. This judgement has been made from evidence gathered during the inspection that included a visit to the service and takes into account the views and experiences of people using the service. The home is well staffed by an experienced and well motivated team. EVIDENCE: The inspector examined the staff rosters and found that there are sufficient numbers and skill mix of staff on duty at all times. The registered manager considers it important to have sufficient staff on duty at all times to ensure the high standard of care is sustained. Many of the staff have worked at the home for a long time and there is little “staff turnover” ensuring continuity of care at all times. Staff files were examined and this showed that correct recruitment procedures are in place. Training and development of staff is of high importance in the home and there is evidence of appropriate training being undertaken for all staff. A system of staff supervision is in place and staff spoken to really appreciate this and feel that they are valued. Rosebank Care Home DS0000013137.V314369.R01.S.doc Version 5.2 Page 17 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. Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection that included a visit to the service and takes into account the views and experiences of people using the service. The home is very well managed by an experienced manager who has strong leadership skills. EVIDENCE: The home is well managed by a very experienced Manager/Provider whose focus on running the home is very much about providing the best possible care for all the residents. She values her staff and this is shown by the training and support that is offered. There is evidence of good teamwork being in place and a “happy crew”. Residents spoken to said that the registered manager and her team are wonderful. Quality systems have been implemented including a residents’ satisfaction survey that is carried out annually. This is due to be carried out again shortly. Rosebank Care Home DS0000013137.V314369.R01.S.doc Version 5.2 Page 18 The inspector met with the home’s administrator and discussed how the financial matters are dealt with. The home does not deal with any resident’s financial matters; relatives or representatives of the residents deal with this. Small amounts of cash and the custody of any valuables are kept on the residents’ behalf and records are kept of any transactions undertaken. The inspector examined the system and found it to be clear and auditable. Records required by regulation were examined and found to be in good order. Issues of health and safety were discussed with the manager. Fire training is provided by an external consultant twice a year and documented accordingly. The visiting hairdresser works in the corridor that is a fire exit, therefore blocking the exit. The registered manager said that there was nowhere else for her to work and all the staff are aware. It is a requirement that the registered manager must undertake a risk assessment concerning the hairdresser working in a fire exit, and to look into the possibility of her working in another area of the home. The inspector met with the cook and toured the kitchen area. Two sacks of potatoes were found on the floor that could give rise to ineffectual cleaning of the floor, and the risk of vermin being attracted to the area. Opened packets of dry foods were also seen in the dry store. It is a recommendation that potatoes should be stored above the ground, and any packets of dry ingredients must be placed in a container with a lid once they have been opened. Rosebank Care Home DS0000013137.V314369.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X 2 X X X X 2 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 3 3 X X 2 Rosebank Care Home DS0000013137.V314369.R01.S.doc Version 5.2 Page 20 No 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 OP38 Regulation 23(4)(c) (iv) Requirement It is a requirement that the registered manager must undertake a risk assessment concerning the hairdresser working in a fire exit, and to look into the possibility of her working in another area of the home. Timescale for action 23/10/06 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 OP9 Good Practice Recommendations It is recommended that the policy and procedure for giving “homely remedies” should be reviewed and updated. • It is further recommended that a list of signatures and initials of all staff who make entries in any records should be maintained. It is recommended that the flooring in the downstairs bathroom is made good, and that the trim to the bath should be cleaned. DS0000013137.V314369.R01.S.doc Version 5.2 Page 21 • 2 OP21 Rosebank Care Home 3 OP38 It is recommended that potatoes should be stored above the ground, and any packets of dry ingredients must be placed in a container with a lid once they have been opened. Rosebank Care Home DS0000013137.V314369.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South, Cowley Oxford OX4 2SU 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 Rosebank Care Home DS0000013137.V314369.R01.S.doc Version 5.2 Page 23 - 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. 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