Inspection on 03/05/07 for Rosebery House

This inspection was carried out on 3rd May 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Rosebery House 27/10/08

Rosebery House 01/05/08

Rosebery House 10/04/06

Rosebery House 20/02/06

Rosebery House 14/12/05

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 2 Rosebery Avenue Eastbourne East Sussex BN22 9QA Lead Inspector Lucy Green Key Unannounced Inspection 03 May 2007 08:30 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 DS0000021246.V337793.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 DS0000021246.V337793.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosebery House 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 Penelope Wickens Care Home 30 Category(ies) of Dementia - over 65 years of age (30) registration, with number of places Rosebery House DS0000021246.V337793.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - (OP) 2. Dementia (DE)(E) maximum number of places 30. The maximum number of service users to be accommodated is 30. Date of last inspection 26th October 2006 (Random) Brief Description of the Service: Rosebery House is a large, detached property situated in a quiet residential area of Hampden Park in Eastbourne. Local shops and amenities are a short walk away. The home is registered to provide residential care to thirty older people with dementia. Single bedroom accommodation is provided on two floors. Level access is provided by way of a passenger lift. All bedrooms are equipped with a call bell and four have ensuite facilities. 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. Assisted bathrooms and toilets are located on both floors of the home. The fees at Rosebery House currently range from £404.87 to £650 per week depending upon the level of assessed needs. More detailed information about the services provided at Rosebery House can be found in the home’s Statement of Purpose and Service User Guide - copies of these documents can be obtained directly from the Provider. Latest CSCI inspection reports are on display in the reception area of the home. Rosebery House DS0000021246.V337793.R01.S.doc Version 5.2 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 are referred to as ‘residents’. This report reflects a key inspection based on the collation of information received since the last inspection, feedback from representatives and an unannounced site visit which lasted for eight and three-quarter hours on Thursday 04 May 2007 between the hours of 8:30am and 5:15pm. The site visit included a discussion with the people living and working in the home, a tour of the premises and an examination of medication, care and staffing records. There were twenty-five residents living at Rosebery House at the time of this inspection visit. During the visit, the Inspector met with all of the residents and spoke individually with twelve of them. The breakfast and lunchtime meals were observed in the dining room. The Inspector spoke individually with the Provider, Manager, Cook, Cleaner and three carers, two of which were in a senior role. During the inspection, the Inspector also met with a relative and an NVQ Assessor who were visiting the home. Following the inspection the Inspector made telephone contact with a Care Manager, a Solicitor who represents one resident and the district nurse team. Comment cards were also sent to the home to give to relatives and visitors, although none of these had been returned at the time of this report. What the service does well: The home is situated in an attractive location and offers a homely environment for residents to live in. The Registered Provider has a rolling programme of maintenance and is striving to give residents a choice of comfortable communal and private spaces to spend their time. Rosebery House has become a relaxed and friendly home where residents benefit from the provision of care in a respectful and dignified manner. Positive comments from residents were expressed throughout the inspection, including “I am content with my life” and “I feel settled here”. The Manager is a skilled and experienced practitioner who is dedicated to ensuring residents receive a high standard of care. She makes it her priority to know each of the residents and their needs personally. Rosebery House DS0000021246.V337793.R01.S.doc Version 5.2 Page 6 The home has an experienced team of staff who are committed to their work and have a good understanding of the needs of the people living at the home. Residents spoke highly of the support received by staff and positive relationships between residents and staff were observed. What has improved since the last inspection? What they could do better: The home has developed a number of systems to self-audit and the effectiveness of these systems is reflected in the fact that only one requirement and two recommendations have been made as a result of this inspection. In order to continue improving, the home is requested to review staffing levels, both in respect of care and domestic staff. The issue of food has again raised discussion and the Registered Manager has agreed to work with the Cook to ensure that all meals are prepared according to a nutritionally balanced menu. Rosebery House DS0000021246.V337793.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. The summary of this inspection report can be made available in other formats on request. Rosebery House DS0000021246.V337793.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 Rosebery House DS0000021246.V337793.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents benefit from an assessment process that ensures their needs are identified and confirmed that they can be met before moving into the home. Rosebery House does not provide intermediate care. EVIDENCE: The Inspector viewed the pre-admission assessments for three residents who have moved to Rosebery House in the last twelve months. For all three residents, there was evidence that the Manager had conducted a thorough assessment on each individual prior to the resident moving into the home. Information from other relevant parties had also been obtained, including where appropriate the latest social care assessment and for those being admitted from hospital, a link letter or discharge form. Rosebery House DS0000021246.V337793.R01.S.doc Version 5.2 Page 10 A review of the subsequent care plans in place for these three individuals provided evidence that the information gathered at the assessment stage is then subsequently used to develop a plan of care. The Statement of Purpose and Service User Guide state that prospective residents and/or their representatives are encouraged to visit the home prior to admission. Conversation with a relative who was visiting the home at the time of the inspection, evidenced that both she and her family had visited the home prior to their mother moving in. Feedback gathered from the Registered Manager, staff, relatives and other professionals indicates that those residents who have moved to Rosebery House in the last twelve months have settled in well and are having their needs are met by the home. The Registered Manager confirmed that Rosebery House still does not provide intermediate care. Rosebery House DS0000021246.V337793.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health and personal care needs are fully met in a respectful and private way. Residents are further protected by the way medication is managed. EVIDENCE: Staff practices observed throughout the inspection demonstrated a significant improvement in the way residents at Rosebery House are being supported. Discussion with three care staff, including two senior carers produced evidence that they have a much better knowledge and understanding of the needs of people with dementia than has been the case at previous inspections. It was clear from observation, talking to residents, visitors and staff and from the written material in place, that care and support is now being provided in a sensitive, dignified and respectful way. During the inspection, staff were observed to be knocking on bedroom doors and talking appropriately to Rosebery House DS0000021246.V337793.R01.S.doc Version 5.2 Page 12 residents. The Inspector observed one carer supporting a resident who was upset and the professional and kind way in which this provided is of credit to the home. Feedback from two representatives also reflected this level of support, with both commenting that staff spend “quality time with residents”. Another visitor to the home commented “staff treat residents as individuals and provide dignified support”. A sample of four care plans were viewed and it was pleasing to note that significant improvements have been made in this area. The plans focus on the strengths of the individual and provide holistic information about the person. There was evidence that each resident has a plan of care that provides detailed information about their health and welfare needs. Care plans are now well maintained and regularly updated. The inclusion of a life history evidenced that consultation had taken place with the resident and/or their representatives. Documentation confirmed that wherever possible, the resident and relatives/representatives have been involved in compiling the care plan. Discussion with one resident identified that they enjoyed playing cards and this interest was found documented in the care plan alongside evidence that the individual continues to attend a bridge club. Care plans contain risk assessments for each of the areas identified in the plans of care and it is now possible to track the level of risk and the controls in place to minimise any risk. It is also pleasing to report that dependency level charts and cognitive assessments have been introduced and these too are updated and reflect changing needs. Residents are fully supported with their health care needs and care plans contain a record of any visits or contact with professionals external to the home. There was evidence of a multi-disciplinary approach to care where required and the home has current involvement from General Practitioners, District Nurses, Dentists and Chiropodist. Records demonstrated that residents are weighed on a monthly basis and specialist dietary monitoring, including nutritional screening assessments are undertaken where necessary. Conversation with three staff members highlighted that the improvements to paperwork is reflected in the way staff work. One staff member commented “care plans are of a high standard now that people understand the importance of paperwork”. Another carer who has recently started working at Rosebery House stated that they had found “the information in care plans very useful”. An assessment of medication systems was conducted as part of the inspection, although the medication policy was not inspected. The Annual Quality Assessment submitted by the Registered Provider prior to the inspection Rosebery House DS0000021246.V337793.R01.S.doc Version 5.2 Page 13 confirmed that a medication policy was in place and had been reviewed in March 2007. The home has continued to improve the way medication is managed in the home, including the way medicines are stored. The administration of medication was observed to be person centred and thought was given to ensuring residents received their tablets at appropriate times without being rushed. A review of the Medication Administration Record (MAR sheets) reflected that staff are now ensuring they maintain a clear audit trail for when medication is administered which includes the appropriate handling of controlled medication. Rosebery House DS0000021246.V337793.R01.S.doc Version 5.2 Page 14 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, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from the greater opportunities to exercise choice over their lives and to participate in fulfilling activities. The quality and quantity of food has improved, but menus must be followed to ensure that diets are sufficiently varied and nutritious. EVIDENCE: The daily running of the home was observed to allow residents more freedom of choice about when they get up, where they spend their time and what activities to participate in. Conversations with residents, relatives and staff highlighted that wherever possible, staff facilitate individual routines and interests. On arriving at the home at 8:30am, it was pleasing to observe that breakfast is now served over a wider span of time and that residents can eat either in their bedrooms or the dining room. Residents were also observed to have a choice of food including a range of cereals and toast. Staff stated that cooked breakfasts are routinely offered on a Tuesday and a Saturday, but that Rosebery House DS0000021246.V337793.R01.S.doc Version 5.2 Page 15 requests at other times would be accommodated. Staff were noticed to be available in the dining room to support residents as required and the food was freshly served, with residents being offered second helpings. For those people who needed help to eat, this support was provided in a sensitive and dignified way. Conversation with residents and visitors about the food produced a range of comments such as; “I like the food”, “the food is beautiful”, “the food is adequate” and “the food is quite good”. The menu for the lunchtime meal was on display in the hallway outside the dining room. The main meal was recorded as chicken apricot with vegetables and potatoes. An alternative of beef filled yorkshire pudding was also listed. Dessert was fruit cocktail. During staff interviews, it was highlighted that people believed improvements to food could still be made. All parties spoken with confirmed that the quality and choice of meals had improved, but that extra efforts would be of beneficial. The issues raised included; improving the variety of meals, offering two freshly prepared meals, rather than one fresh and one convenience food, more fresh vegetables and offering a non-meat option. These issues were presented to the Registered Manager along with information that at the last three inspections the main lunchtime meal had been chicken apricot. A subsequent review of the menus identified that the Cook is not always preparing meals according to the food listed on the menus. It was highlighted to the Registered Manager that whilst it is evident that the home has improved menus and developed a four-weekly rotating menu that the Registered Manager believes is nutritionally balanced – this is not being entirely adhered to. The Registered Provider and the Registered Manager have agreed to address this issue as a matter of priority and therefore this issue is only reflected as a recommendation in this report. The Statement of Purpose states that visitors are welcome throughout the waking day at Rosebery House. This was seen to be the case at the time of the inspection, with visitors arriving at different times to see their relatives. One visitor confirmed that they visit every day and are always made to feel welcome. Since the last inspection the home have recruited an Activities Co-ordinator who works at the home five days each week. The Inspector met with this individual and spent some time observing the activity session in the morning. Feedback from residents, staff and visitors confirmed that this appointment had been a huge success. From observation, it was pleasing to see so many residents engaged in the session. For those residents who chose not to participate in the formal activity, they were noted to be gaining pleasure from a more relaxed atmosphere in the home. Rosebery House DS0000021246.V337793.R01.S.doc Version 5.2 Page 16 A review of the activities book provided evidence of a range of activities taking place including; sing-alongs, quizzes, exercises, art sessions and word association. A conversation with one resident highlighted that a number of residents had recently been to see a production at a local theatre. Discussion with staff and the Activities Co-ordinator identified that the home are trying to create more opportunities for people to go out. One resident confirmed that she now sometimes goes shopping for her own personal items. Rosebery House DS0000021246.V337793.R01.S.doc Version 5.2 Page 17 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. Residents benefit from a more open culture where they are able to express their views and feel valued and protected from harm. EVIDENCE: Rosebery House has a complaints policy which is reported by staff to be available to both residents and visitors to the home. Records in the home identify that the home has received one complaint in the last twelve months which was satisfactorily resolved. The CSCI have not received any formal complaints about the provision of service at Rosebery House in the last twelve months. Discussion with relatives and other residents confirmed that people now felt confident to raise any issues with a member of the management team. The staff spoken with were knowledgeable about the vulnerability of residents and the systems in place to protect them. Staff have received training in the protection of vulnerable adults and prevention of abuse. Care plans also provide detailed guidance as to how to support residents in an appropriate way that reflects choice and preserves dignity. Similarly, the work undertaken to assess compatibility of residents with each other has significantly reduced the risk of residents abusing each other. Rosebery House DS0000021246.V337793.R01.S.doc Version 5.2 Page 18 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 good. This judgement has been made using available evidence including a visit to this service. Residents benefit from an environment that is now homely, clean and more accessible. EVIDENCE: Rosebery House is a detached property situated in a quiet residential area of Hampden Park, Eastbourne. Resident accommodation is provided on two floors, to which level access is provided by way of a passenger lift. Since the last inspection, four new rooms with ensuite facilities have been registered for use. Communal facilities include a large lounge, a quiet lounge area and a separate dining room. A garden with grass and paving area is situated to the rear and side of the home. Parking is available at the front of the home. Rosebery House DS0000021246.V337793.R01.S.doc Version 5.2 Page 19 The Inspector toured the home at various intervals throughout the day and it was pleasing to note that the improvements to the environment reported on at the last inspection have been maintained. A positive impact continues to be the introduction of the odour-control system. Whilst the overall cleanliness of the home was found to be satisfactory, this report re-iterates the need to recruit a second cleaner. Rosebery House is a large building, especially with the recent extension and therefore produces a lot of work for one person. Discussion with the Registered Manager confirmed that this post is being advertised and therefore this is not reflected as a requirement. It was a requirement of the last inspection that the environment continues to be upgraded and as areas are re-decorated to seek professional advice about how to make the environment as suitable as possible for people with a dementia type illness. It is of positive note that a number of environmental changes have been made including the colour coding of doors for easy recognition. Efforts have also been made to make bedrooms more homely and include more furniture than on previous visits. Rosebery House DS0000021246.V337793.R01.S.doc Version 5.2 Page 20 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, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are benefiting from the support of a more experienced and committed team of staff and are protected by the improved recruitment systems in place. EVIDENCE: Rotas indicated that staffing levels provide four care staff during the waking day, including one senior carer. Five days each week an additional staff member works in the morning to provide cover for the serving of breakfast. On the day of the inspection, this individual was on a day off and it was observed that the morning routine was a little slow without this extra support. Discussion with staff identified that now they are spending more time supporting residents with their morning and evening routines, then an additional staff member would be useful at these core times. This was raised with the Registered Manager who acknowledged that it would be beneficial to have five carers on duty for a few hours in the morning and again when people are getting ready for bed. In addition to care staff the home employs cooking and domestic staff and again whether the number of these is sufficient would benefit from being reviewed. The need to review staffing levels is reflected as Rosebery House DS0000021246.V337793.R01.S.doc Version 5.2 Page 21 a recommendation only as the Registered Manager has already started to identify potential shortfalls. All of the residents spoken with commented on how nice staff were. One resident expressed: “the staff are marvellous” and another resident said “staff are nice and I get on well with all of them”. Similarly, a visitor told the Inspector “the staff are amazing – they spend quality time with the residents”. The interaction between residents and staff was observed to be positive at the time of the inspection. Staff training has further developed since the last inspection and the Annual Quality Assurance Assessment completed by the Registered Provider indicates that 44 of staff have now completed National Vocational Qualifications (NVQ) to at least Level 2 and a further seven staff are currently working towards this qualification. The Registered Manager reported that all new staff complete an induction and that the new programme is in line with Skills for Care. In addition to other mandatory training, it is pleasing to report that a number of staff are undertaking a distance learning course in dementia over a twenty-two week period. Conversation with the NVQ Assessor identified that staff knowledge has noticeably improved with the additional investment in training and that “staff now really treat residents as individuals”. The recruitment files for three new care staff were inspected and the required information was in place for each individual, including satisfactory checks with the Criminal Records Bureau, two written references, completed application form and full employment history. Rosebery House DS0000021246.V337793.R01.S.doc Version 5.2 Page 22 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 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from the commitment of a skilled and experienced Manager who ensures that the home is well managed and run in the interests of the people who live there. Systems are now in place to self-audit and this is leading to noticeable improvements. EVIDENCE: Since the last key inspection, the home has recruited a new Manager who has now been registered with the CSCI. The appointment of this individual, along with support from a consultant has led to a significant improvement in the management of Rosebery House. Throughout the inspection it was observed Rosebery House DS0000021246.V337793.R01.S.doc Version 5.2 Page 23 that the Manager has a good relationship with the residents and knows and understands each of their needs. Similarly, discussion with staff provided positive feedback about the Manager. One staff member commented: “the Manager is good and gets things done”. Another staff member commented: “the Manager is doing a really good job”. The home has a number of systems in place to audit and review the services provided. Since the last inspection, the home has introduced resident and relatives meetings, along with annual satisfaction questionnaires. Minutes from the last staff meeting were seen and it was evident that the meetings are professional and well structured. A consultant undertakes regular unannounced visits in accordance with Regulation 26 on behalf of the Registered Provider. The home only handles money where there is no alternative and the Registered Manager reported that where the home makes purchases on behalf of residents, receipts are always in place with a clear audit trail as to how much money has been spent. The information submitted to the Commission prior to the inspection indicates that the home has a number of systems in place to ensure the health and safety of the home is monitored and maintained and therefore health and safety records were not inspected on this occasion. It was however identified that the home must compile a risk assessment in respect of the part of the home that is currently subject to maintenance work, illustrating the measures taken to keep residents safe in this area. Rosebery House DS0000021246.V337793.R01.S.doc Version 5.2 Page 24 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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 3 2 Rosebery House DS0000021246.V337793.R01.S.doc Version 5.2 Page 25 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP38 Regulation 13(4) Requirement The Registered Person must compile a risk assessment in respect of resident access to the area of the home currently undergoing maintenance work. Timescale for action 01/06/07 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. Refer to Standard OP15 OP27 Good Practice Recommendations The Registered Person to work with the Cook to ensure that meals are being prepared according to a nutritionally balanced menu. The Registered Manager to review the current staffing levels (both care and domestic) to ensure that they continue to meet the needs of the residents living at Rosebery House. Rosebery House DS0000021246.V337793.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 DS0000021246.V337793.R01.S.doc Version 5.2 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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