Inspection on 27/11/06 for Rosecroft

This inspection was carried out on 27th November 2006.

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

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

Other inspections for this house

Rosecroft 12/08/08

Rosecroft 01/08/07

Rosecroft 25/04/06

Rosecroft 06/09/05

Rosecroft 20/05/05

Rosecroft 25/11/04

Rosecroft 01/07/04

Similar services:

Springfield House

The Shelley

Thorndene

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Rosecroft 8 Cross Road Southwick West Sussex BN42 4HE Lead Inspector Mrs K Allen Key Unannounced Inspection 27th November 2006 09:45 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 Rosecroft DS0000014687.V314734.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. Rosecroft DS0000014687.V314734.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosecroft Address 8 Cross Road Southwick West Sussex BN42 4HE 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) 01273 597326 Mr D R Clark Mr D R Clark Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19), Physical disability (1) of places Rosecroft DS0000014687.V314734.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Total of 19 persons at any one time, one of whom is in the category of Physical Disability, aged 60-65 years. 25th April 2006 Date of last inspection Brief Description of the Service: Rosecroft is a care home registered to provide care and accommodation for up to 19 older people over the age of sixty-five, one of whom may have a physical disability. The premises overlook the green at Southwick, and are close to local shops and bus and train services. The accommodation for residents is located on ground floor and first floor levels, both of which are served by a passenger lift. The fees for the home range from £325-£400 per week. Rosecroft DS0000014687.V314734.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the inspection a review was made of the contact between the home and the Commission for Social Care Inspection (CSCI) since the last inspection. This included an analysis of incident reports and those of other statutory bodies such as the fire service. The manager was sent a pre-inspection questionnaire and Comment Cards for distribution to residents, relatives and visitors. Unfortunately no completed documents were returned to the inspectors prior to the visit. The inspection was conducted by Mrs Kathy Allen, Regulatory Inspector and Mrs Carolyn Adcock, Business Relationship Manager. It took place from 9.45am over six hours. During the inspection sixteen residents were spoken to either in the lounge or privately, in their rooms. A discussion was held with the manager and three staff were interviewed. In addition a number of records were seen. Residents said the home was “friendly”, “staff were kind” and that they liked the “atmosphere”. Others said the food was “good” and “I have no complaints”. A number of requirements and recommendations remain outstanding from the pervious inspection. The requirements are that the environment must be improved, radiators must be guarded or evidence of risk assessments provided and individual care plans need to include action to be taken by staff to meet residents needs. The recommendations are that unused equipment and appliances should be suitably stored and that an annual development plan should be provided. What the service does well: What has improved since the last inspection? The Statement of Purpose and Service Users Guide have been updated so that residents have the information they need. There is a clear policy and procedure for the safe administration of medication, which is followed in practice and therefore protects residents. Rosecroft DS0000014687.V314734.R01.S.doc Version 5.2 Page 6 The menu has been developed and shows that alternatives are provided. Medical treatment is provided when needed and residents have access to this. A washing machine with a sluice cycle has been provided to reduce infection risk. The environmental health department have recently inspected the kitchen and confirmed that the standard was good. A new call bell system has been installed which is more accessible for residents. There is a clear adult protection policy which is understood by staff and supports the protection of residents. Staff are suitably trained to do their job. A quality assurance system has been started. Risk assessments are in place for individual residents. 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. Rosecroft DS0000014687.V314734.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 Rosecroft DS0000014687.V314734.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 6 The outcome for residents is good. Prospective service users have the information they need to make an informed choice about where to live. They have a contract with the home and their needs are assessed prior to moving in. Intermediate care is not provided. EVIDENCE: There is a Statement of Purpose which has recently been updated and typed to make it more readable. Each resident has a copy of the Service User Guide, which is also typed up. Both documents contain the necessary information. Whilst no residents were able to recall having a contract with the home the deputy manager confirmed that they were in place. If the resident was not able to sign these themselves then this was done for them by a relative. Assessments are carried out on new residents. The home had obtained assessment details from the social services department for the person who had moved in most recently. There was not, however a written assessment by the home. No one was at the home for intermediate care. Rosecroft DS0000014687.V314734.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 The outcome for residents was good. Residents personal, health and social needs are set out in an individual plan of care. Their health care needs are met and they are protected by the homes procedure for the administration of medication. Residents’ privacy and dignity are respected including at the time prior to and after death. EVIDENCE: All residents have an individual care plan which is drawn up when they first come to live at the home. It is reviewed and updated each month. The plan does not, however give details of action to be taken by staff to meet service users needs. Staff support the majority of residents with their personal hygiene. It was reported that no one had pressure areas and special equipment is provided to prevent this. There is no organised exercise for residents but it is part of their daily activity as staff encourage them to walk around the home as much as possible. One person attends a local stroke club. Residents said that they could see a doctor when they requested it. One person had recently been to the optician and had a new pair of glasses. She Rosecroft DS0000014687.V314734.R01.S.doc Version 5.2 Page 10 did not wear them however, nor did she choose to wear her hearing aid which was provided. The staff look after the medication for all residents apart from painkillers for one person. Supplies are safely stored and good records are kept of its receipt, administration and disposal. Staff who administer medication receive training. Residents described staff as kind and caring. They used their preferred form of address as well as “dear” and “love”. When entering rooms staff knocked. The home endeavours to allow a resident to remain at the home until the end of their lives. Staff support this and are clear about the need for them to pass away in their own surroundings if possible. They were able to describe the manner in which they treated a person after death which showed that they maintained their dignity throughout. The services of a community nurse are engaged as necessary and staff are enabled to attend funerals as appropriate. Family and friends are also involved and supported throughout. Rosecroft DS0000014687.V314734.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 The outcome for residents is good. Their lifestyles match their expectations and they are able to maintain contact with family and friends. They are helped to exercise choice and control over their lives. Residents receive a wholesome and appealing diet. EVIDENCE: Routines for residents are flexible. They are able to take their time getting up and go to bed when they wish. Meals could be taken in their room or in the dining room with others. One person chose to spend all of their time in their room and this was respected. Another enjoyed a small snack late in the evening and this was provided. Communion is conducted in the home once a month for one resident, although others are welcome to participate if they wish. The majority of residents have visits from relatives and friends. One person said her son visits everyday and another sees their niece at least once a month. All residents have access to a telephone to help them keep in touch. The home is near to shops and other facilities and this is appreciated by residents, some of whom can go out independently. Everyone at the home manages their own finances usually with help from a relative or solicitor. They are able to bring their own possessions into the home and one person said how much this had helped to make her “feel at home and settle in”. Rosecroft DS0000014687.V314734.R01.S.doc Version 5.2 Page 12 The menu is set each week so that residents know what is provided. However, nobody said this was a problem and they could have an alternative if they wished. They were consulted prior to each meal and given options. Records showed that these were varied and provided a balanced and appealing diet. Hot and cold drinks are regularly available and residents confirmed that they were happy to ask for something if they wanted a snack or extra drink. One person was diabetic and her diet adjusted accordingly. Rosecroft DS0000014687.V314734.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The outcome for residents is good. They are confident that their complaint will be listened to and acted upon. They are protected from abuse. EVIDENCE: There is a clearly written complaints procedure which is included in the Service Users Guide given to residents. The manager confirmed that he dealt with any complaints through talking with the person concerned and agreeing a resolution as soon as possible. Residents knew who was responsible for the home and said that they could raise any concerns as they often saw the owner. One person felt that he was not always listened to but said that he had no complaints. A log is available for recording complaints and advice was given to the owner about the type of concerns that should be recorded. The home has a copy of West Sussex Multi-Agency Adult Protection procedures as well as its own policy and procedure which is in line with this. Staff were able to describe the actions they would take should they receive any allegation of abuse as well as the signs and symptoms which may indicate this. The majority of staff have obtained National Vocational Qualifications (NVQ) and therefore received training in this matter. One person has requested a further update and this is being considered. There have been no adult protection referrals since the last inspection. Rosecroft DS0000014687.V314734.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 The outcome for residents is adequate. They do not always live in a well maintained environment. The home is clean and hygienic. EVIDENCE: There is no programme of routine maintenance however rooms are decorated when they become vacant if this is deemed to be necessary. There remain a number of communal areas that need improving mainly due to lack of attention to detail. For example, old sockets and wiring remain in situ although not live, dead light bulbs are not routinely replaced, some lampshades are missing, skirting boards are chipped and doors worn due to frames and wheelchair use. The garden contains a broken ladder and lounge chair, which make it look unkempt. Rooms have stored items which compromise the homely feel and lead to some areas of the home being unappealing to residents. The owner has been required to submit an improvement plan and this remains outstanding. He accepts that work is necessary however he does not consider it urgent. Rosecroft DS0000014687.V314734.R01.S.doc Version 5.2 Page 15 The building complies with the requirements of the local fire service and was recently inspected by the Environmental Health Department, the outcome of which was satisfactory. The home was free of significant offensive odours. The laundry is situated away from food preparation areas and a washing machine with a sluice cycle is provided. Hand washing facilities are suitably sited to prevent cross infection. There are steps up to the front door and the owner was required to improve disabled access following the last inspection. This remains outstanding. Rosecroft DS0000014687.V314734.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 The outcome for residents is good. Their needs are met by the numbers and skills of the staff, who are trained to do their job. Residents are protected by the home’s recruitment procedure EVIDENCE: There is a recorded rota showing which staff are on duty at any time. Staff confirmed that there were enough of them to carry out all of their duties which varied according to the needs of the home. For example, some care staff did day and night duties, others mainly carried out the cooking but also some care duties when required and another did the cleaning as well as care. Duties were confirmed at the beginning of each shift and all staff were clear about their different roles. Those who did domestic duties took steps to ensure they did not cause cross infection. The majority of staff have an NVQ level 2 in care. In addition, there is an ongoing training programme which covers such matters as first aid, lifting, medication, infection control and food hygiene. A number of staff have been at the home for some time and their original documents show that two references were not always taken out prior to their appointment. In addition, one person had a standard police check as opposed to an enhanced one. The owner, stated, however that should any new staff be recruited then all necessary checks would be carried out. Rosecroft DS0000014687.V314734.R01.S.doc Version 5.2 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 The outcome for residents is adequate. They live in a home which is run satisfactorily and generally in their best interests. Residents’ financial interests are protected. Their health and safety is not always safeguarded. EVIDENCE: The owner/manager is suitably experienced and qualified with NVQ level 4 in management and care. A quality assurance system is being established. It currently consists of recording the direct care given to residents with the owner and his deputy monitoring this. The owner agreed that the system needs to be developed to take account of residents’ views and those of others involved in the home such as visiting professionals. This will ensure that the home continues to operate in residents’ best interests. Action is not always progressed within agreed timescales following requirements made at CSCI inspections. Rosecroft DS0000014687.V314734.R01.S.doc Version 5.2 Page 18 The home does not manage any residents’ money. The health and safety of staff and residents is addressed through the staff training programme which includes lifting and handling, fire safety, food hygiene and infection control. Medication and hazardous chemicals are safely stored and regular checks made on fire safety equipment. A record is kept of all accidents and risk assessments carried out in such areas as steps around the house, wet floors, poor lighting, lifting and in one case the use of a rug by a resident in their room. A number of radiators are covered for residents’ safety however some remain uncovered and are hot to the touch including in one bathroom. The owner agreed that risk assessments must be carried out to ensure that all residents are safe from injury from hot radiators. In addition, the temperature of water delivered for use by residents is not regulated and again this must be subject to risk assessment and action taken accordingly. There are steps throughout the home which could be a hazard. Interior steps on the ground floor have been fitted with tape to alert people to the hazard although this is not a permanent or attractive solution. It has therefore been recommended that hard warning strips should be put in place. Rosecroft DS0000014687.V314734.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Rosecroft DS0000014687.V314734.R01.S.doc Version 5.2 Page 20 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 OP7 Regulation 15 Requirement Individual care plans need to include the action to be taken by staff to meet a resident’s care needs (Previous timescale of 30/06/06 not met) The environment must be improved to make sure that residents live in a safe and well maintained home (a schedule of works must be provided by the timescale given). (Previous timescales of 1.11.05 & 30/06/06 not met). Radiators must be guarded and hot water regulated or evidence of documented risk assessment be provided to minimise risks. (Previous timescales of 1.11.05 & 30/06/06 not met). A formal quality assurance system must be established. (Previous timescale of 1/11/05 & 30/06/06 not met). Better disabled access to and from the premises needs to be provided. (Previous timescale of DS0000014687.V314734.R01.S.doc Timescale for action 28/02/07 2 OP19 23 28/02/07 3 OP38 13 28/02/07 4 OP33 24 28/02/07 5 OP19 23 28/02/07 Rosecroft Version 5.2 Page 21 30/06/06 not met) 7 OP19 23 Garden areas need to be appropriately maintained. (Previous timescale of 30/07/06 not met) 28/02/07 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 3 4 Refer to Standard OP3 OP26 OP33 OP38 Good Practice Recommendations The home should complete a written assessment for each resident prior to them entering the home. Unused equipment and appliances being stored in communal areas should be removed. An annual development plan for the service should be provided. Hard warning strips should be put in place to alert people to steps in the hallway and kitchen. Rosecroft DS0000014687.V314734.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Rosecroft DS0000014687.V314734.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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