Inspection on 14/12/05 for Rosebery House

This inspection was carried out on 14th December 2005.

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

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

Other inspections for this house

Rosebery House 27/10/08

Rosebery House 01/05/08

Rosebery House 03/05/07

Rosebery House 10/04/06

Rosebery House 20/02/06

Rosebery House 21/06/05

Rosebery House 30/11/04

Rosebery House 18/05/04

Rosebery House 02/12/03

Rosebery House 10/06/03

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

CARE HOMES FOR OLDER PEOPLE Rosebery House Residential Home 2 Rosebery Avenue Eastbourne East Sussex BN22 9QA Lead Inspector Lucy Green Unannounced Inspection 14th December 2005 07:30 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 Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 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. Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Rosebery House Residential Home Address 2 Rosebery Avenue Eastbourne East Sussex BN22 9QA 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) 01323 501026 01323 511124 hilenshah@aol.com/ kellym32@hotmail.com Spemple Limited Vacant Care Home 26 Category(ies) of Dementia - over 65 years of age (26) registration, with number of places Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The maximum number of service users to be accommodated is twenty-six (26). Service users must be aged sixty-five (65) years or over on admission. Service users to be diagnosed with a dementia type illness. One named service user under the age of sixty-five (65) may be accommodated. 21st June 2005 Date of last inspection Brief Description of the Service: Rosebery House is a large, detached property situated in a residential area, adjacent to Hampden Park, Eastbourne. Local shops and amenities are a short, level walk away. The home is registered to accommodate twenty-six older people with dementia. Single bedroom accommodation is provided on two floors. All rooms are equipped with a call bell and a passenger lift provides easy access to the first floor. Assisted bathrooms and toilets are located on both floors of the home. Meals are usually served in the dining room, but can be taken in the residents own room, if preferred. Communal areas consist of a large lounge, dining room and quiet seating area. A large, rear garden provides a safe and pleasant area for residents to walk in and relax. Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at Rosebery House have are referred to as ‘residents’. This unannounced inspection took place over six and a half hours on 14 December 2005. Due to recent concerns raised about the home, two Inspectors undertook this inspection. This is the second inspection of the year and the original purpose of this inspection was to assess compliance with the requirements of the previous inspection and to generally monitor care practices at the home. At the time of the inspection however, the Inspectors were so concerned about the health and safety of residents at Rosebery House, that the planned inspection was suspended and the Inspectors targeted only a few key areas. The Inspectors undertook a tour of the premises and examined medication, care and recruitment records. The preparation and serving of the lunchtime meal was observed. The Inspectors met with most of the residents during the inspection and spoke with staff on duty. Lengthy discussion was held with the Registered Provider and a consultant who works on behalf of the home. Following the inspection, a letter of Serious Concern was issued to the Provider outlining a number of requirements which needed immediate attention. The CSCI will be monitoring the service closely and at the time of this report two additional monitoring inspections have been carried out. The second statutory inspection has been rescheduled and will occur before April 2006. It should be stated that, the Provider has co-operated fully with the CSCI both during and following the inspection. The Provider acknowledges the issues raised by the Inspectors and has provided written responses to all letters sent to him. The Provider has voluntarily agreed not to take any further admissions at this time and to concentrate on securing a management team who have the necessary skills and experience to take Rosebery House forward. The Provider has also requested that a consultant for the home undertake weekly monitoring of the service and provide written reports to the CSCI. What the service does well: As previously stated, this inspection raised serious concerns about the health and safety of residents at Rosebery House. The Inspectors therefore did not assess many of the National Minimum Standards. Therefore, it was not Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 Page 6 possible to evidence the areas that Rosebery House may be doing well, as the inspection process concentrated on the areas where failings were identified. 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. Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 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 Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 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&4 The pre-admission process does not protect residents. Assessments are inadequate and do not demonstrate that needs have been identified. The home is unable to evidence how needs are being met. Observations made throughout the inspection, highlighted that the home cannot meet the complex needs of some of the residents living at Rosebery House. EVIDENCE: The assessment information for three five residents was viewed. The preadmission documentation was found to be wholly insufficient and did not contain a thorough assessment of needs. At the current time, the home does not have a person who is competent to conduct assessments in place and therefore the Provider has agreed not to accept further admissions at this time. At the time of the inspection, the Provider was unable to demonstrate the home’s capacity to meet the needs of the people living in the home. The documentation fails to identify needs and provide a plan as to how they will be met. Observations on the day of the inspection highlighted that staff do not Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 Page 9 have the skills and experience necessary to meet the needs of some of the residents. One resident in particular, presented with behaviour that challenged the service. Staff were unable to manage this behaviour which consequently led to the comfort and safety of other residents being impinged upon. The strong smell of urine throughout the home and the poor state that some residents’ bedrooms were found in indicated that the home was not effectively managing the incontinence needs of residents. One resident was unwell at the time of the inspection and yet they had still been supported to get up and dressed. This person had subsequently fallen asleep at the dining room table. At lunchtime, this person was served a liquidised meal, rather than be offered a lighter alternative. This highlights the lack of understanding about the type of care needed in this situation. The Provider is therefore required, to conduct a review of all residents’ placements, involving relatives and professionals to ensure that the home is able to meet the needs of the people accommodated at Rosebery House. Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 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&9 The care plans in place to not provide detailed guidance to staff about how to provide appropriate support to residents. Residents would be better protected if staff followed the medication policies in place. EVIDENCE: Five care plans were inspected and information included was found to be inadequate. It was a requirement of the last inspection that care plans and associated risk assessments be addressed to provide a system that effectively monitors residents’ health, welfare and social needs and it was disappointing that this had not been complied with. Care plans still do not provide staff with support guidelines about how care should be given and behaviours managed. The care plans viewed had not been regularly reviewed and indeed the last entry on some was made by the previous Registered Manager in August 2005. Where significant information had been received by the home, this had not been transferred into the care plan. For example, a Social Worker had reviewed their client and noted “(resident name) does appear to have lost some weight and her health appears to have deteriorated rapidly over the past Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 Page 11 two or three months”. Despite this information on the review notes, no care plan had been formulated around weight monitoring, mealtimes or healthcare. Risk assessments need to be developed. It is required that where risks are identified, they are followed through with an assessment of the controls in place to minimise those risks. Risk assessments should be linked in with the support plans to ensure a member of staff can support residents in the safest and most appropriate way. The requirements made at the last inspection around improving the home’s approach to care planning and risk assessing are therefore reaffirmed at this inspection. Medication systems were not wholly inspected, but the Medication Administration Record (MAR sheets) were examined a number of signature gaps were noted. If staff do not sign for medication they administer, there is no record to state whether it has been given correctly. A number of labelled medication pots were also found on the medication trolley. This would indicate that staff are ‘potting up’ medication and therefore dispensing more than one residents’ medication at a time. This practice is unacceptable, as it greatly increases the chance of an error in administration from occurring. Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 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): 14 & 15 The observations on the day of inspection, suggests that residents cannot exercise choice and control over their lives. Residents’ diets are poor due to the lack of fresh fruit and vegetables in the home. Meals are unimaginative, insufficient and poorly presented and consequently are unappealing to residents. EVIDENCE: The inspection commenced at 7:30am and at this time seven residents were up, dressed and sitting in the dining room. Several of these residents were clearly tired and two had their heads resting on the dining room table. One resident said that he had been up for hours. None of these residents had been offered anything to eat or drink. A tour of the building, revealed that despite being fast asleep, one resident had his light switched on and door propped open. Another resident requested bacon and eggs for breakfast and was informed by a member of staff that “bacon and eggs are only available on a Tuesday and Saturday.” The evidence gathered at the time of inspection, therefore suggested that residents have limited flexibility about the times they get up or have drink or meal. Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 Page 13 The kitchen was inspected and it was identified that there was a lack of fresh fruit and vegetables. A conversation with the Cook confirmed that fresh vegetables are only available at the weekends. Throughout the week, vegetables are of the frozen variety. The Cook also implied that fruit is only available for those residents with diabetes, as an alternative to dessert. The dry food store was unclean and some frozen items were found not to be wrapped or sealed. It was evident that the home serves a lot of convenience foods, rather than freshly prepared and homemade meals. The Inspectors observed the serving of breakfast and lunchtime meals – both of which were inadequate. The choice of meal at breakfast was not reflective of the residents’ needs or wishes and for some, their toast and porridge was found to be served cold. At lunchtime, residents were served either fisherman’s pie or omelette with mashed potato and green beans. The portions were small and offered only one vegetable portion. Many meals were again found to be cold and several residents refused to eat their meals. One resident who was unwell, was given a liquidised meal as opposed to another more suitable option. Another service user was given a liquidised meal where the food groups had been mixed together. As previously stated, some care plans highlighted that residents had lost a significant amount of weight. A complaint made to the CSCI from one relative, claimed that a resident had left Rosebery House severely dehydrated. It is not possible to evidence the accuracy of this, but certainly throughout the inspection, residents were offered insufficient fluids and there was no record maintained of what residents had actually drunk each day. An immediate requirement was made in respect of the meals available at Rosebery House. Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 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 Complaints need to be more carefully investigated to ensure residents are protected. Despite recent adult protection training for staff, residents are not protected by the systems in place to prevent and manage abuse. EVIDENCE: A series of complaints have been received in respect of Rosebery House since the last inspection. The Provider was requested to investigate concerns raised by two people who reported issues to the CSCI. The issues were wide-ranging and included allegations about; insufficient night staff, residents being got up very early, poor quality of food, inaccessibility of call bells, staff speaking inappropriately to residents. The Provider conducted an investigation and provided a written response to the CSCI, concluding that the allegations were largely unsubstantiated. It was therefore disappointing to discover at the time of this inspection that; the food was of poor quality, some call bells were indeed inaccessible, residents had been got up very early and that there were insufficient staff on duty between the hours of 6am and 8am. A further complaint had been received by the CSCI the day prior to the inspection. This complaint raised concerns about the cleanliness of the home, the lack of food and drink and inadequate staffing levels. The inspection highlighted that most parts of this complaint were substantiated. Since the last inspection, the home have reported a number of incidents where some residents have hit other residents. These were addressed within the Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 Page 15 adult protection arena and consequently two residents were transferred to other homes. There was also an incident where a staff member spoke inappropriately to a resident and this too was substantiated. During the inspection, care plans, daily report records and accident sheets were viewed. It was identified that there were a number of incidents whereby one resident had verbally and/or physically abused other residents at Rosebery House. These incidents had not been addressed in respect of raising adult protection alerts to Social Services nor had the CSCI been informed. Similarly, there was no available evidence that follow-up action had been taken to support this service user effectively and protect other residents from harm. During the inspection, this resident struck another resident around the face – it was evident that staff were unclear how to manage, record and report this incident. Despite recent adult protection training for some staff, correct protocols had not been followed. This incident also highlighted the need for staff to undertake training in the managing of challenging behaviour. Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 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 & 26 Residents are at risk from the unclean and unhygienic environment in which they live. EVIDENCE: During the inspection, it was found that appropriate action had not been taken to ensure residents were safe whilst a number of building works were carried out. It was also identified that various tools and other potentially hazardous items were left unattended in areas accessed by residents. Other parts of homes were found with floorboards exposed and surfaces uneven, presenting trip hazards to residents. Electrical problems prevented the lighting in parts of home from working and some water temperatures were too hot, whilst others barely lukewarm. The leads to call bells in parts of the home were found wound round the system to prevent them from being used. The home was found to be malodorous throughout, with a strong smell of urine in a number of identified bedrooms. The smell was so unpleasant in some Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 Page 17 rooms, that it was unbearable to stay in these rooms. A number of areas, including the upstairs shower room and one bedroom were found to have faeces smeared on the floor, walls and washbasins. Staff were also noted throughout the inspection to move from one task to another without changing aprons or gloves. The laundry floor and several doors are yet to be sealed and therefore pose a real risk in the spreads of infection. Many bins were without lids and contained items of clinical waste. This level of poor hygiene is unacceptable and poses a danger to residents, staff and visitors to the home. It was therefore required that a system of continence management, cleaning and managing infection control be implemented to appropriately addresses these issues. Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 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 & 29 There are insufficient staff on duty between 6am and 8am to meet the needs of the residents. Residents are not fully protected by the recruitment practices adopted by the home. EVIDENCE: At the start of the inspection it was identified that there were insufficient staff to meet the needs of the residents. The inspection commenced at 7:30am and at this time, seven residents were dressed and sitting in the dining room. The two night carers were located upstairs assisting residents to get up and dressed, leaving the downstairs area entirely unsupervised. During this period, an altercation between two residents occurred which had to be diffused by the Inspectors. Consequently, it was made an immediate requirement that an additional staff member be brought in between the hours of 6am and 8am, to support night staff with this busy early morning period. Staffing rotas for other parts of the day were examined and it appeared that levels were adequate for the number of residents in the home. It was identified that staff are not always deploying themselves appropriately thoroughout the home and therefore residents are left unsupervised in some parts of the home. Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 Page 19 On inspection of staff recruitment files it was apparent that the required level of documentation was not in place for the staff that had been recently recruited. For two staff members, there was no evidence of valid work permits, there were gaps in employment histories, not all staff had a recent photograph on file, not all staff had provided proof of qualifications and for two staff an appropriate second reference had not been obtained. An immediate requirement was issued to ensure all recruitment files are checked and the required information obtained. Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 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 & 38 Residents are at risk from the lack of effective management and leadership within the home. The identified matters of health and safety present real hazards for people, who live, work and visit Rosebery House. EVIDENCE: Rosebery House is currently without a Registered Manager in post and it was identified throughout the inspection, that the home had not been appropriately managed. It was evident from a number of records, that information had not been updated since the Registered Manager left the home in August 2005. It is accepted that the Provider is in the process of advertising for a new Manager, but in the interim period the home must also be effectively managed. An immediate requirement was made for the rota to be reviewed and a Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 Page 21 responsible person for every shift who can manage the home appropriately to be identified. In addition to the poor risk management of the ongoing building works and the identified lack of infection control, serious concerns were also raised about the disregard to fire safety in the home. During the inspection a number of fire doors were found to be propped open with various items, including; tables, boxes and fire extinguishers. In addition, parts of the home were poorly lit. On arrival at the premises, the Inspectors identified that lights in the lounge and part of the top corridor had tripped and residents were found sitting or wandering in the dark. Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 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 X X 1 1 X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 1 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 1 1 X X X X X 2 1 STAFFING Standard No Score 27 2 28 X 29 1 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X X X X X X 1 Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 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 Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14(1) Requirement All new admissions are assessed in accordance with requirements prior to admission and information available for inspection. All documentation should be signed and dated. (Previous timescale of 01 August 2005 not met) A review of all service users’ needs to ensure the suitability of the placement is undertaken, involving all relevant parties. That the homes care planning system to effectively monitor residents health, welfare and social needs. Care plans should provide support guidelines which outline how care should be given. Care plans to be regularly updated. (Previous timescale of 01 September 2005 not met). Comprehensive risk assessments are to be carried out in respect of all areas of residents lives and the controls in place evaluated. (Previous timescale of 01 September 2005 not met). Medication to be dispensed, administered and where DS0000021246.V255957.R01.S.doc Timescale for action 14/12/05 2. OP4 14(1) 01/04/06 3. OP7 15 01/03/06 4. OP7 13(4) 01/03/06 5. OP9 13(2) 14/12/05 Rosebery House Residential Home Version 5.1 Page 24 6. OP14 13(2) & (3) 16(2) 7. OP15 8. 9. OP16 OP19 22(3) 13 (6) 10. 11. OP18 OP19 18(1)(c) 23(2)(c) 12. OP25 13(4) 13. OP26 16(2)(j) & (k) 14. 15. OP27 OP27 18(1)(a) 18(1)(a) 16. OP18 37(e) necessary discarded, appropriately. The Provider to ensure that service users have the opportunity to exercise choice and control over their lives. Ensure service users are provided with sufficient quantities of nutritious and wholesome meals that meet their needs and expectations The Provider to ensure that any complaints received are fully investigated Staff undertake training in the prevention of abuse and protection of vulnerable adults (Previous timescale of 01 October 2005 not met). Staff receive training in managing challenging behaviour Ensure that all calls bells are accessible to residents and that staff respond to their use appropriately The Provider to ensure that the ventilation, heating and lighting is suitable and provided in all parts of the care home which are used by service users. A system of continence management, cleaning and managing infection control that ensures the home is hygienic and free from odour. (Previous timescale of 01 August 2005 not met). An additional staff member is brought in to work between the hours of 6am and 8am. To ensure that staff working in the home ensure that all areas of the home are appropriately supervised at all times. The home to report any event which adversely affects the wellbeing or safety of any service DS0000021246.V255957.R01.S.doc 20/01/06 14/12/05 01/04/06 01/04/06 01/04/06 06/01/06 20/01/06 14/12/05 14/12/05 14/12/05 14/12/05 Rosebery House Residential Home Version 5.1 Page 25 17. OP29 18. OP31 19. 20. 21. OP38 OP38 OP38 user to the CSCI and other relevant agencies 19&Sch2 The home follow correct (as recruitment procedures to amended) ensure the safety and protection of residents. 8(1) A responsible person to be identified for every shift who can manage the home appropriately, whilst a new Manager is being recruited. 13(4) Ensure that all parts of the home are kept safe, secure and free from hazard at all times. 23(4)(a) Ensure that all fire doors are kept closed in accordance with fire safety guidance. 23(4)(c)(ii Ensure that fire exits are kept i) clear at all times. 06/01/06 14/12/05 14/12/05 14/12/05 16/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Rosebery House Residential Home DS0000021246.V255957.R01.S.doc Version 5.1 Page 27 - 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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