Inspection on 26/06/07 for Rosebery House

This inspection was carried out on 26th June 2007.

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 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

Rosebery House 25/06/08

Rosebery House 14/06/06

Rosebery House 16/12/05

Rosebery House 03/08/05

Rosebery House 11/10/04

Rosebery House 17/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Rosebery House 1 Rosebery Avenue Harpenden Hertfordshire AL5 2QT Lead Inspector Julia Bradshaw Key Unannounced Inspection 26th June 2007 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 Rosebery House DS0000019514.V345553.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. Rosebery House DS0000019514.V345553.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosebery House Address 1 Rosebery Avenue Harpenden Hertfordshire AL5 2QT 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) 01582 715600 01582 765555 Fairheart Limited Mrs Anne Knight Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places Rosebery House DS0000019514.V345553.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The manager must complete NVQ Level 4 in Management and Care within three years of the registration date. 14th June 2006 Date of last inspection Brief Description of the Service: Rosebery House is registered to accommodate 14 elderly people. The building is a converted three-storey detached house located in a quiet residential area in Harpenden. The shops and local amenities are a short distance away. There are parking areas on the road in front of the building. The ground floor consists of a spacious lounge, an administrative office, a dining room, a kitchen and a laundry room. The first and second floors are connected by a passenger lift and the bedrooms are all located on these floors. Bedrooms are all offered as single occupancy. Bathing and toilet facilities are nearby and these are wheelchair accessible. There is a conservatory at the rear of the premises and this leads on to a patio area. The conservatory is comfortably furnished and serves as an additional lounge for service users. The back garden consists of a lawn area bordered by mature plants and a flowerbed. The garden and patio areas are also accessible to wheelchair users. The home has a service user’s guide and statement of purpose that are provided to prospective service users. Copies of the latest report on the home from the Commission for Social Care Inspection (CSCI) are available in the home. The manager stated that there is a range of fee’s starting from £550 per week to £597. Rosebery House DS0000019514.V345553.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report draws on information obtained during this unannounced site visit carried out on the 26th June. The inspection process included an opportunity to speak to people living in the home, to staff and to inspect some key records, including those for medication, staff recruitment and care planning. This report also draws on any information received by the CSCI about Rosebery House since the last inspection report in 14th June 2006. The manager was present throughout the inspection and the proprietor was available for consultation via the telephone. Staff and service user surveys should be part of the ongoing inspection of this service and any issues arising from these will be assessed and will then inform further regulatory activity by the CSCI in respect of Rosebery House. The atmosphere throughout the inspection was calm and friendly, promoting a good relationship between staff and service users. The ethos of working openly, honestly and with a transparent approach appears to be effective. The home has a stable staff team to promote continuity for the service users. There are six requirements made as a result of this unannounced inspection. What the service does well: What has improved since the last inspection? The proprietor and manager are working hard to implement the new care planning system into the home and the manager stated that this will be fully operational by the end of July. The general standard of hygiene throughout the home had improved, especially within the kitchen area, which had been identified as a requirement in the previous inspection. Several areas of the home have been decorated since the last inspection including, re-painting the Rosebery House DS0000019514.V345553.R01.S.doc Version 5.2 Page 6 kitchen and new carpets in five of the bedrooms. The home has purchased a new hoist to assist with transferring less mobile service users. 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. The summary of this inspection report can be made available in other formats on request. Rosebery House DS0000019514.V345553.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 Rosebery House DS0000019514.V345553.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 –5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessment and admission process is satisfactory in order to ensure that the resident’s identified needs could be met on admission. Information is available for people to make an informed choice regarding this service. EVIDENCE: The Statement of Purpose and Service User Guide were seen on the day of the inspection. The Statement of Purpose contains information for the service user to make an informed choice about where to live. The content is suitable to meet individual needs. Rosebery House DS0000019514.V345553.R01.S.doc Version 5.2 Page 9 A total of four service users files were reviewed and evidence gained regarding the initial assessments that are carried out to assess if the home can meet the needs of the service users. Detailed information is held regarding the service users history and current needs. Assessments of each service users needs and aspiration are made before the service user moves into the home. The admissions procedure to the home includes trial visits for the service users to make an informed choice about where to live. The assessment process includes the gathering of information from other professionals. Rosebery House has its own internal assessment forms and reflected fully the current service provided. Rosebery House DS0000019514.V345553.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 –11. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Care plans are currently inadequate. Some individual risk assessments for service users are incomplete and could place service users at risk. Service users healthcare needs are being met. Medication procedures are being adhered to. Service users are treated with dignity and respect. EVIDENCE: The proprietor has recently implemented a new care planning system into the home and the manager is currently transferring the existing information into this new format. Once complete these care plans should give a more comprehensive record of the individual service users needs. The current care plans are adequate but lack detail and some risk assessments require updating, reviewing and signing. Service users are weighed regularly. Rosebery House DS0000019514.V345553.R01.S.doc Version 5.2 Page 11 Documentary evidence is available to show that health assessments are undertaken with respect to individual service user. Visits from GPs and other health professionals are documented. Identified health care needs are addressed and observations are maintained, in order to respond quickly to any change, as noted from the daily record of relevant occurrences. At the time of the inspection, there were no residents self-medicating, although the home would support anyone who wishes to and is able to do so. In the main, the home operates a safe and satisfactory medication system that is understood by staff members. Consistent with previous inspection reports, detailed evidence is available to demonstrate that service users are treated with dignity and respect, and their privacy upheld. Staff members spoken to, cited many examples of how residents’ privacy and dignity are respected and promoted at all times. Service users spoken with echoed a high level of satisfaction regarding the manner staff members treat and respect them. Rosebery House DS0000019514.V345553.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 –15. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The range and frequency of activities currently available in the home is adequate but could be expanded to ensure that everyone’s expectations and preferences are met. EVIDENCE: On entering the home it was apparent that the manager and staff have created a very welcoming and friendly environment for its service users. There is a person who provides regular activities as well as helping maintaining the garden areas. The range of activities include ‘sherry and shop’, exercise classes, manicures, flower arranging and music sessions. Various fundraising events are also arranged to help fund the activities programme. The manager was in the process of arranging a birthday party for someone who was celebrating their 100 birthday. The local clergy also visit for people who wish to take communion. Rosebery House DS0000019514.V345553.R01.S.doc Version 5.2 Page 13 Several service users stated that they are very happy to “voice their opinions” to the manager if and when necessary. Some service users expressed a wish to have more opportunities to go out of the home, on social outings and perhaps have more musical events provided. The activities record is not kept updated. Service user meetings are not held regularly and minutes taken in order to ensure all service users have the opportunity to have a degree of involvement in the running of the home. Service users and relatives are given information about the home’s procedures on visiting and maintaining contact with family and friends. Service users and staff members confirmed that visiting times are flexible and visitors are “very welcome” at any reasonable time. All residents maintain very good contact with family and friends. The cook on duty on the day of the inspection stated that the home operates a four weekly menu and this is representative of the likes and dislikes of each service user. The menu seen during this inspection included a good variety and nutritionally balanced. Care staff serve the supper, which has usually been prepared by the cook prior to going off duty. The inspector joined the service users for lunch which was proved to be both flavoursome and plentiful and thoroughly enjoyed by all. Service users stated “ you can always have something else if you don’t like the meal served”. “the food is just like I used to cook at home”. Rosebery House DS0000019514.V345553.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16-18. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Procedures are in place to safeguard service users. There is a complaints protocol in place which service users and staff appear comfortable about using. EVIDENCE: There is an appropriate written complaints policy in place. One complaint has been received since the last inspection took place. However this has been resolved to a satisfactory conclusion for both parties. There are written procedures in place for Safeguarding Adults and a Whistle blowing Policy, which staff were aware of. There are also policies for handling service users’ monies. A random check was carried out on three service users personal monies and found to be accurate. Rosebery House DS0000019514.V345553.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 –26. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Service users live in a comfortable and clean environment. However service users safety is currently compromised due to inadequate fire safety and hot water temperatures being inadequate. EVIDENCE: Rosebery House is a beautiful three storey Edwardian house that due to its age requires constant attention and maintenance. The premises appeared tidy and generally well maintained. The bedrooms inspected appeared comfortable, neat and clean. The service users spoken to said that they are very pleased with their bedrooms and the facilities provided. The items displayed reflected their individual lifestyles. Rosebery House DS0000019514.V345553.R01.S.doc Version 5.2 Page 16 There is annual re-decoration programme in the home, which on the day of the inspection looked bright and clean except for one bedroom that was identified to the manager as having a strong smell of urine. The manager agreed to discuss this with the proprietor. The kitchen had been decorated since the last inspection was carried out as well as five bedrooms receiving new carpets. A new hoist has been recently purchased. There were three areas of concern identified during this inspection. One of the fire doors on the first floor did not close properly and the water temperatures were recorded outside of safe limits. The flooring in the laundry room has a large burn mark on it and does not appear to be impervious, which contravenes infection control and environmental health standards. Fire records were inspected and all documentation was up to date. The last fire drill was carried out on the 22/06/07.The last weekly checks were carried out on the 14/06/07 and 20/06/07. Rosebery House DS0000019514.V345553.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 –30. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The numbers and quality of staff are such as to provide a good level of care and to adequately meet service user’s needs. Training records are currently inadequate. Records to protect service users are incomplete. EVIDENCE: All the staff demonstrated their dedication to their work in caring for the service users in the home. This was further evident by the complimentary remarks received from the service users interviewed during the inspection. They are all so kind and caring”. The members of staff present confirmed that they are given opportunities to attend training. However on the day of the inspection there was inadequate evidence to confirm that all staff have received the necessary mandatory training to carry out their role effectively. The manager confirmed the staffing levels as two careworkers plus herself, throughout the daytime hours and two waking night care staff per night. The home currently has a deputy post vacant. The manager works the majority of hours on shift, which provides the third member of staff on duty. Rosebery House DS0000019514.V345553.R01.S.doc Version 5.2 Page 18 The proprietors carry out all staff recruitment and selection within the home. The condition of registration states “ The manager must complete NVQ level 4 in management and care within three years of the registration date.” The manager has completed eighteen months of this three-year degree in “care management” at New Barnfield. However during a discussion with the manager, it appears that she is unable to complete this course as it requires her to achieve and pass units in “budgeting and recruitment and selection” within her workplace and unfortunately the current arrangements within Rosebery house do not allow her to be involved in either of these tasks. It would be helpful and positive for the service as a whole, if the proprietors could enable the manager to carry out these tasks in order for her to complete these outstanding units and obtain this valuable qualification. The recruitment records of 3 staff including the latest recruit were viewed; evidence demonstrates that there are adequate recruitment practices in the home, which means that service users are protected. Records relating to staff supervision and staff meetings were inconsistent. Rosebery House DS0000019514.V345553.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a well managed home but some improvements are needed in health and safety and record keeping in order to ensure service users health and safety is protected and maintained. EVIDENCE: Then current manager has been in post for a period of three year and generally the home is well managed. Unfortunately the home has been without a deputy manager since 2006. The manager is hopeful that this post will be filled soon in order to assist with the management responsibilities of the home, and to provide management cover in her absence. The management approach creates Rosebery House DS0000019514.V345553.R01.S.doc Version 5.2 Page 20 an open, positive and inclusive atmosphere. This is further evidenced from the complimentary feedback that the manager works as part of a team with the those spoken to said that the staff team group works effectively and well. Staff and service users said that they were clear about procedures in the home and that the manager was approachable and supportive. The manager carries out supervisions to all staff. However on the day of the inspection there was inadequate evidence to confirm these and staff meetings were held regularly. A current fire risk assessment was not in place and individual risk assessments were not all reviewed and signed. Staff were aware that service users and families could access their records, subject to individual permission and the Data Protection Act. The accident records were well kept, with an overview maintained so that trends could be monitored, and the system complies with the Data Protection Act. CSCI is provided with details of all significant events. Rosebery House DS0000019514.V345553.R01.S.doc Version 5.2 Page 21 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 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 x 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 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 3 3 3 3 2 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 2 2 2 Rosebery House DS0000019514.V345553.R01.S.doc Version 5.2 Page 22 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 OP7 Regulation 15(2) Requirement Timescale for action 31/07/07 2. OP30 18(1)(c) (i) 3. OP33 24(1) & (5) So that service users can be assured that their needs will be meet appropriately all the required information must be contained in the service users care plan, including any current risk assessments. These care plans must be reviewed on a regular basis. All mandatory training must be 31/08/07 provided to all staff working at the home to ensure that they are competent and able to meet the service users needs. The manager must devise a 31/08/07 quality monitoring system in order to ensure all areas of the service are monitored, reviewed and improved where necessary. This must include obtaining the views of the service users and others interested in the service so to improve the service and meet their expectations. Rosebery House DS0000019514.V345553.R01.S.doc Version 5.2 Page 23 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 OP14 OP36 OP31 Good Practice Recommendations The manager should maintain an up to date record of daily activities. Activities provided need to meet service users expectations. Supervisions should be carried out at least six times per year and documented. The proprietor and manager should endeavour to reach an arrangement, which enables the current manager to complete her current management training course. Rosebery House DS0000019514.V345553.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000019514.V345553.R01.S.doc Version 5.2 Page 25 - 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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