Inspection on 21/09/06 for Rosebank Residential Home Limited

This inspection was carried out on 21st September 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Rosebank Residential Home Limited 11/11/05

Rosebank Residential Home Limited 14/07/05

Similar services:

Springfield House

The Shelley

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Rosebank Residential Home Limited Rosebank 56 Pelham Road Gravesend Kent DA11 0HZ Lead Inspector Graham Cummings Unannounced Inspection 21st September 2006 10:00 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 Residential Home Limited DS0000063433.V311785.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 Residential Home Limited DS0000063433.V311785.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosebank Residential Home Limited Address Rosebank 56 Pelham Road Gravesend Kent DA11 0HZ 01474 537428 01474 823930 RosebankRH@aol.com 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) Rosebank Residential Home Limited Mrs Aujla Care Home 12 Category(ies) of Old age, not falling within any other category registration, with number (12) of places Rosebank Residential Home Limited DS0000063433.V311785.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Mrs Aujla completes the Registered Managers Award within two years from September 2005. Up to date fire safety audit and water installations reports to be obtained. 11th November 2005 Date of last inspection Brief Description of the Service: Rosebank is a care home providing personal care and accommodation for twelve older people. Mrs. Aujla owns the home, which is located close to the town centre, with the usual town amenities. Bus and train services are nearby. All residents have single en-suite bedrooms, which are located on the ground and first floors. There is a parking facility for a few cars to the front of the premises. The garden to the rear of the home has a ramp to enable access for residents using wheelchairs. Rosebank employs care staff, working a roster, which gives 24-hour cover. Currently no staff are employed for catering and domestic duties. The fees range from £300 to £375 per person per week. Rosebank Residential Home Limited DS0000063433.V311785.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit was the final part of the Key Inspection and was carried out by Graham Cummings on the 21st September 2006. The site visit lasted for six and a half hours. The Inspector met with the Provider/Manager, staff and 5 Service users, looked at documentation and toured the home. The home is registered for 12 but currently has 10 placements. The home was clean, tidy well decorated and free from any offensive odours. There was evidence that staff knew the needs of the Service users but this was not always in writing. The Inspector observed staff and Service user interaction and noted that it was positive. At the last inspection the home had 16 Requirements, although 10 of these were the same issue, care plans, record keeping and availability, put under different Standards. The Manager has completed 9 care plans with the outstanding 1 being that of a Service user who arrived in July and is the process of being written. Records now in place include, fire risk assessment, fire safety report and staff training. The Manager still needs to continue working to improve the paperwork, evaluation and recording of information. The medication cabinet is still stored in the kitchen and consideration is being given to moving it to the small recess at the rear of the lounge by the small seating area. The staff signature list has been updated with new staff who are trained to give medication but it still contains signatures of staff who have left. The Inspector suggested that a new list be made. The Service user who had mobility problems and whose bedroom was on the first floor has now moved to the ground floor. A discussion took place with the Manager regarding having a stair lift it was agreed that there was not enough space for this to happen and it would mean that any future placements made would need to be fully mobile and be able to use stairs. A new fridge freezer is in place and work has commenced on the shower downstairs. A staff rota was in place and working well, however it may be that in the near future the rota will be changed to make 3 working teams on a rolling rota that worked 6 days on and 3 days off. Rosebank Residential Home Limited DS0000063433.V311785.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The home needs to continue improving the recording of what goes on in the home as it does not presently do justice to the care being carried out. The Manager must complete her RMA by September 2007 as this was a condition of Registration. The staffing structure at present is the Manager and then care staff, this means that the Manager has no management support in the home and when not on the premises there is no one in a Senior or lead role. The Manager is looking to address this in the near future. The number of staff with an NVQ needs to be addressed as only 3 of the employed 9 staff have gained this qualification. The Inspector looked at 6 staff files and found that all of them were lacking in the required information set out in Schedule 2 of the Care Home Regulations 2001. The Manager needs to ensure that records and paperwork are dated and signed by the person writing it and where appropriate themselves. The Manager needs to ensure that any incident set out under Regulation 37 of the Care Home Regulations 2001 are completed and sent to the Commission. Rosebank Residential Home Limited DS0000063433.V311785.R01.S.doc Version 5.2 Page 7 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 Residential Home Limited DS0000063433.V311785.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rosebank Residential Home Limited DS0000063433.V311785.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5,6 The quality of the service provided is good. Prospective Service users have the information required to make an informed choice about where they live. Service users have written contracts and have their individual needs assessed prior to a placement being made. Prospective Service users and their relatives have an opportunity to visit the home prior to a placement being made. The home does not cater for intermediate care. EVIDENCE: The Manager has updated the home’s Statement of Purpose and is looking to complete the Service user Guide in the near future. These documents are given to all prospective service users, their family and Care Manager at the initial stages of the referral process. Rosebank Residential Home Limited DS0000063433.V311785.R01.S.doc Version 5.2 Page 10 The Manager carries out a Pre Placement Assessment of Needs to ensure that the home can meet the needs of the individual. This assessment is carried out at the prospective Service users accommodation or at Rosebank during a visit to the home. If a placement is agreed then a Statement of Terms and Conditions are drawn up and given to the Service user on the day of admission. The family, friends and Care Manager are all invited to look around the home prior to a placement commencing. The home does not cater for intermediate care. Rosebank Residential Home Limited DS0000063433.V311785.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 The quality of the service provided is adequate. Service users have a care plan. Service users health care needs are met. No Service users currently self medicate. Service users are treated with respect and dignity and their wishes regarding illness and death are noted. EVIDENCE: Since the last inspection the home has implemented a new system where each Service user has 2 working files, 1 is for the care plan and daily notes, the 2nd is for Key worker reports, care reviews, and medical issues. Currently the home has 10 placements, the Inspector was informed that there were 9 completed care plans but the 10th was in the process of completion. The service user who had moved into the recently and the care plan had not been completed yet. The home did have the pre placement assessment and Social Services assessment for guidance. The Inspector advised the Manager Rosebank Residential Home Limited DS0000063433.V311785.R01.S.doc Version 5.2 Page 12 that a care plan should be in place with the information available, this can be reviewed, updated and evaluated at any time following the Service users arrival. The Inspector looked at 2 care plans and found that the information contained was clear and written in plain English, however, little of the documentation was dated and signed, this made it difficult for the Inspector to evidence if evaluations had taken place to ensure the changing needs of the Service users were being recorded. The Inspector informed the Manager of the need to have documentation signed and dated. From discussions with service users, and observations made during the inspection, the Inspector was satisfied that service users needs were being fully met by the staff and home. All of the Service users were registered with a Doctor, Dentist and Optician of their choice. A chiropodist visited the home every 2 months. None of the Service users presently living at the home self medicate, a policy is in place should this ever change. The Inspector spoke to 5 service users, all of them were able to confirm that they were treated with dignity and respect and were able to make decisions for themselves. The issue of heating was raised with the outcome that it was difficult for staff to meet everyone’s needs as some felt the cold and others didn’t like it hot, one service user said ‘you’ve always got the choice to go to your own room if you don’t like it’. A form is available to record the wishes of Service users regarding illness and death. Rosebank Residential Home Limited DS0000063433.V311785.R01.S.doc Version 5.2 Page 13 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 The quality of the service provided is good. Services Users’ lifestyles matches their expectations. Service users maintain contact with their families. Service user exercise choice and control over their lives. Service users receive a wholesome and nutritious diet. EVIDENCE: The Inspector spoke to 5 Service users and all were positive in their comments about their lifestyle in the home. One Service user said ‘friends and relatives just drop in for a cup of tea’ ‘we are able to choose what we want to do’ ‘the food is good’ ‘staff are helpful and treat us well’. The menu was seen and was nutritional and healthy. The food is prepared and cooked by staff on duty with the main meal at lunchtime. The dining area is in a conservatory that since the last inspection have purchased hot and cold air conditioning. Rosebank Residential Home Limited DS0000063433.V311785.R01.S.doc Version 5.2 Page 14 The home has an Activities Co-ordinator 4 days a week who organise daily activities with the Service users such as, quizzes, puzzles, bingo, floor basketball, reminiscing sessions, singing, visits from the local choir and card games. Rosebank Residential Home Limited DS0000063433.V311785.R01.S.doc Version 5.2 Page 15 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 The quality of the service provided is good. Service users are confident their complaints will be listened to. Service users are protected from abuse. EVIDENCE: Service users spoken to said they had no need to complain, but if they had to they would go to the Provider/Manager. The service users said that the Manager was approachable and listened to them. The home and CSCI have received no complaints since the last inspection. Adult Protection training has been booked for later this year and 4 staff have already attended. Rosebank Residential Home Limited DS0000063433.V311785.R01.S.doc Version 5.2 Page 16 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): 19,20,21,23,24,25,26 The quality of the service provided is good. Service users live in a comfortable, safe and well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient lavatories and washing facilities. Service users’ bedrooms suit their needs and are safe, comfortable and furnished with personal possessions. Service users benefit from living in a clean and hygienic home. EVIDENCE: The home is registered for 12 Service users and all rooms are en-suite with 4 of the rooms also having showers. Rosebank Residential Home Limited DS0000063433.V311785.R01.S.doc Version 5.2 Page 17 There is also a communal bathroom and separate shower room plus a downstairs W.C. and a staff toilet. Staff sleep-in accommodation consists of bathroom, kitchen and bedroom. The home was well decorated throughout and is clean, hygienic and free from offensive odours. The Inspector viewed some Service user bedrooms and they were furnished in part with personal belongings. The rooms were of ample space and the communal areas complemented the space available for Service users. Service users told the Inspector that the home was always clean and tidy and had been recently redecorated. At the last inspection it was noted that a Service user with mobility difficulties had a bedroom on the 1st floor, they have been moved downstairs in line with the Requirement made. Rosebank Residential Home Limited DS0000063433.V311785.R01.S.doc Version 5.2 Page 18 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 The quality of the service provided is adequate The number of staff on duty meets Service users’ needs. Service users appear to be in safe hands Service users are not protected by the home’s recruitment practices. Service users benefit from staff who are becoming trained and increasing in competency. EVIDENCE: The home currently has 10 Service users and there are 2 staff on shift during the day and at night 1 wake night plus a sleep-in staff. The Manager is supernumerary and usually at the home Monday to Friday between 9 and 5. The Manager is on call at all times as the staffing structure has no Deputy, Team leader or Senior staff, the next level of staff are the care workers. Service users told the Inspector that the staff were kind, friendly and helpful. The Inspector observed positive interaction between staff and Service users. The Inspector spoke to the Manager about the home’s recruitment process. The Manager was aware of the Requirements under Schedule 2. Rosebank Residential Home Limited DS0000063433.V311785.R01.S.doc Version 5.2 Page 19 The home employs 9 care staff and the Inspector looked at 6 staff files. There was a substantial shortfall of information contained on files ranging from no application form and no references, the Inspector was assured that the information was in the office somewhere but it could not be found. The home has not employed a cook or cleaner Training is improving and a matrix was available showing completed and planned training for the future. Of the 9 staff employed only 3 have an NVQ level 2, this issue needs to be addressed in order to meet the Regulations. Rosebank Residential Home Limited DS0000063433.V311785.R01.S.doc Version 5.2 Page 20 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): 31,33,34,35,36,37,38 The quality of the service provided is adequate. The Manager is fit to be in charge and of good character but has difficulty in discharging their responsibility fully. The home is run in the best interests of the Service users. Service users are protected by the home’s finance procedures of the home. The care of service users may be compromised because staff do not receive supervision. The home’s record keeping needs to be improved. Service users and staff’s health, safety and welfare is promoted and protected. Rosebank Residential Home Limited DS0000063433.V311785.R01.S.doc Version 5.2 Page 21 EVIDENCE: The Manager is looking to change the staffing structure and appoint 2 Team Leaders when they have completed their NVQ level 3. Due to the staffing structure within the home, where the Manager has no support from a Deputy, Team Leader or Senior Support worker this leaves the Manager isolated in having to be involved in the day to day running and decision making of the home and not enabling them to concentrate on putting the changes required from the last inspection in place. Service users spoken to confirmed that they are consulted about the way they are cared for and make daily choices in the care offered. The Manager is the only person with access to the finances and Service users sign for any transactions made along with the Manager Staff supervisions are informal ‘chats’ whilst staff are working, these are not being recorded. The Manager was informed that formal individual staff supervisions should be carried out at least 6 times a year. The home’s record keeping is in need of improving and documentation set out in Schedule 3 and 4 must be in place. The Inspector found that a lot of the paperwork in use was not signed or dated and it was difficult for the Inspector to see if evaluations were taking place. The home has a set of Policies and Procedures that are general and have been purchased from a care management company. The spaces for information to be completed have not been filled in. The Manager is currently working on personalising the Policies and Procedures but this is taking some time due to no management structure to delegate other tasks. Rosebank Residential Home Limited DS0000063433.V311785.R01.S.doc Version 5.2 Page 22 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 3 3 3 X 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 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 X 18 3 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 3 3 1 2 3 Rosebank Residential Home Limited DS0000063433.V311785.R01.S.doc Version 5.2 Page 23 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 Home’s Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15(1) Schedule 3 Requirement Timescale for action Unless it is impracticable to carry out such consultation, the 31/12/06 Registered person shall, after consultation with the service user, or a representative prepare a written plan (the service user plan) as to how the service user’s needs in respect of his health and welfare are to be met. To be completed by: 2. OP28 OP30 18(1)(a) Schedule 2 The Registered person shall, having regard to the size of the care home and the Statement of Purpose and number and needs of the service users – (c) ensure that the persons employed by the Registered person to work at the care home receive (i) training appropriate to the work they are to perform i.e NVQ level 2 training in care. That all persons employed are done so in line with Schedule 2 of the Care Home’s Regulations 2001. To be completed by: The Registered person must DS0000063433.V311785.R01.S.doc 31/12/06 3. OP29 19(1) Rosebank Residential Home Limited Version 5.2 Page 24 ensure that all staff are employed in line with Schedule 2 of the Care Home’s Regulations 2001. 4. OP36 18(2) To be completed by: The Registered person shall ensure that persons working in the care home are appropriately supervised – in that formal individual supervision should be carried out a minimum of 6 times per year with records kept that are signed and dated by both parties. To be in place by: 31/12/06 31/12/06 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. 2. 3. Refer to Standard OP7 OP31 Good Practice Recommendations That the manager has care plans in place for all Service users. That the manager considers changing the staffing structure to strengthen the management team, this will allow them to discharge their responsibilities fully. That the home updates their Policies and Procedures and personalise them to the home. OP37 Rosebank Residential Home Limited DS0000063433.V311785.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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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