Inspection on 17/07/08 for Rosedale

This inspection was carried out on 17th July 2008.

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

Rosedale 18/07/07

Rosedale 14/09/06

Rosedale 24/11/05

Rosedale 25/04/05

Rosedale 07/10/04

Rosedale 04/05/04

Rosedale 28/11/03

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Rosedale 1 Wide Way Mitcham Surrey CR4 1BP Lead Inspector Liz O`Reilly Key Unannounced Inspection 17th July 2008 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 Rosedale DS0000027228.V367796.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. Rosedale DS0000027228.V367796.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosedale Address 1 Wide Way Mitcham Surrey CR4 1BP 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) 0208 679 0752 Mr Kanagasabai Wignarajah Kailasananthan Mr Kanagasabai Wignarajah Kailasananthan Care Home 12 Category(ies) of Dementia - over 65 years of age (3), Mental registration, with number disorder, excluding learning disability or of places dementia (3), Mental Disorder, excluding learning disability or dementia - over 65 years of age (3), Old age, not falling within any other category (12) Rosedale DS0000027228.V367796.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th July 2007 Brief Description of the Service: Rosedale is an extended domestic property which provides accommodation and care for up to twelve older people three of whom may have dementia or suffer from mental illness. The home is owned and managed by Mr Kailasananthan. The property is in keeping with neighbouring houses and is not identifiable as a care home. The home is close to public transport, leisure facilities, a group of local shops and places of worship. Accommodation is provided on two floors. The shared areas of the home are on the ground floor. A garden is available to the rear of the building. The home is staffed twenty four hours a day. Fees for this service are £425 to £445 per week. Rosedale DS0000027228.V367796.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two stars. This means people who use this service experience good quality outcomes. This unannounced inspection was carried out by one regulation inspector over one day. We had the opportunity to speak with four of the nine people using the service one member of staff and the service owner/manager. Completed surveys were returned by five people who use the service and two members of staff. Information from all of the above sources, along with our observations have been used to reach the judgements in this report. What the service does well: People who use the service told us they were happy with the support they receive. Comments received included, “they look after us well here”, “the care is very good”, “they do their very best”, “I’m very comfortable here”, “I am happy here” and “it’s the next best thing to my own home”. The manager and staff have developed very good relationships with people who use the service. People told us “staff are very good”, “staff are 1st Class”, “staff are very good” and “the manager is a good fellah”, “you can always talk to him”. We found staff have a very good understanding of the needs and preferences of the individuals they support. We observed staff working with people who use the service in a sensitive and caring manner. The service supports people to maintain their independence and encourages individuals to take part in activities in the community. Staff told us they feel well supported by their colleagues and the manager. Records showed regular staff meetings and individual supervision. Rosedale DS0000027228.V367796.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: To make sure that people are supported to take informed risks, risk assessments need to be up to date and reviewed on a regular basis. Staff should continue to work towards more person centred care planning by including information on how the social, emotional and cultural needs of individuals will be met. To make sure that people receive the support they need in the way they want evidence of consultation with individuals on their care plans needs to be in place. Staff should make sure that daily recording covers more than the physical support provided. The record of medication should be expanded to include a medication profile for each person. Any worn chairs must be replaced or repaired to ensure that people who use the service are provided with a well maintained and comfortable environment. The manager should carry out an audit to make sure that staff are provided with up to date training. The quality assurance and monitoring systems should be completed and include the views of people who use the service. Please contact the provider for advice of actions taken in response to this Rosedale DS0000027228.V367796.R01.S.doc Version 5.2 Page 7 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. Rosedale DS0000027228.V367796.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 Rosedale DS0000027228.V367796.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): 3&6 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. A full needs assessment is carried out before anyone is admitted to the service. Admissions only take place if the service is confident staff have the skills and abilities to meet the assessed needs of the individual. EVIDENCE: We looked at a sample of records and found pre admission assessments had been carried out for each person. Staff are provided with a copy of the Care Management assessment carried out by staff from the local authority. Senior staff from the service will also visit people before they move in to carry out their own assessment if the stay is not to be funded by a local authority. Rosedale DS0000027228.V367796.R01.S.doc Version 5.2 Page 10 These assessments make sure that the service can meet the needs of the individual and provide information which can be used to set up an initial care plan. This will ensure that staff have some information on the needs of each individual from day one. This service does not provide intermediate care. Rosedale DS0000027228.V367796.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 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Progress has been made in keeping care plans up to date and moving towards a more person centred plan. The work on making plans more person centred needs to continue. Risk assessments are in place but need to be reviewed. The health care needs of individuals are met and medication is well managed. EVIDENCE: We looked at a sample of care plans. We found staff are now keeping these up to date with regular reviews which note any changes in individual needs. Plans set out the needs of the person using the service, the aims and actions to be taken. Staff are still focusing on the physical and mental health needs of individuals. Although staff are including some information on individual interests and preferences in the persons file there is little information on the Rosedale DS0000027228.V367796.R01.S.doc Version 5.2 Page 12 care planning on how the social and cultural needs and wishes of individuals will be supported. To ensure that the full needs and wishes of individuals are met the social, emotional and cultural needs and wishes of people who use the service need to be included in the care planning. As noted in previous inspection reports consideration should be given to providing opportunities for people who use the service to share information on their life history with staff. We found daily recording also focused on the physical care provided. Staff should be including information on how people are spending the rest of their time and whether their full needs are being met. Daily recording should relate to the individual care plan. We found little evidence that care plans were compiled in consultation with people who use the service. Systems must be put in place to ensure this is recorded. This will ensure that the person using the service has agreed the support they need is provided in the way they want. We found the health care needs of people who use the service are met. The service has good relationships with local mental health care professionals who visit the service if needed. Each person is registered with a local GP practice who will visit if needed. However people are supported and encouraged to attend the local surgery. Arrangements are in place for people who use the service to receive regular dental, optical and chiropody services. Staff have been provided with training on cutting nails. Medication is well managed. We found records were up to date and accurate. A record of all medication given, received into the home and returned to the pharmacy was in place. The service is not keeping a medication profile for each individual. It is recommended that this is introduced to provide information on all medication prescribed for the individual, the date commenced and discontinued. We saw staff were monitoring individuals who they felt might be in pain and taking action to ensure they receive pain relief. We saw staff are now keeping a monthly record of each persons weight which assists in monitoring general health. We observed staff offer support in a sensitive and caring manner. Staff respected the privacy of people who use the service in the way they offered assistance and advice. Individuals are supported to maintain their independence. Rosedale DS0000027228.V367796.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use the service felt they were give choices about how they live their lives. Staff support people to maintain links in the community and continue with individual interests within and outside the service. The social and cultural needs and wishes of individuals should be included more in care planning. EVIDENCE: We found staff supporting people to take part in activities in the service and in the wider community. On the day we visited a group of people were engaged in, a quiz with staff, one person was listening to music and singing in a separate sitting room, three people were spending time in their room person and one person was going out to a local church. We observed individuals engaged in reading newspapers and magazines through the day. One person continues to go on regular coach trips with staff supporting them to make bookings. Rosedale DS0000027228.V367796.R01.S.doc Version 5.2 Page 14 Individuals told us they enjoy going out to local shops and for walks in the areas. People can receive visitors at any time and can meet with them in communal areas or in the privacy of their own room. People who use the service told us that they were asked if they would like to join in activities and what they would like to do. The record of meetings with people who use the service showed that activities and meals were often discussed, with people asked their opinion on what they would prefer. The service provides a four week menu which showed a good variety of food on offer. People who use the service told us that they enjoy the meals. Comments received included “the food is good, I can’t think what anyone would have to complain about”, “there is plenty to eat, I never feel hungry” and “they are good cooks here”. People who use the service come from diverse cultural backgrounds and the service is able to provide a varied menu. However people who use the service at the moment have chosen to take their meals from the present menu. There is flexibility in the menu and staff will provide alternative meals when requested. Staff should make sure that cultural needs and wishes of people who use the service are recorded on care planning to ensure that these are met. Rosedale DS0000027228.V367796.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use the service have confidence that any complaint they may have will be taken seriously by the management. Systems are in place for recording any complaint. Staff have been provided with training on safeguarding vulnerable people. EVIDENCE: The complaints procedure is on display in the service. People who use the service told us that they knew how to make a complaint and who to speak to if they were unhappy. No one we spoke to had any complaint about the service. Systems are in place for recording any complaint along with actions taken and outcomes. Training has been provided for staff on safeguarding people. This ensures that staff have an understanding of their responsibilities to report any allegation or suspicion of abuse. A copy of the local authority procedure for dealing with allegations of abuse is available to staff. Rosedale DS0000027228.V367796.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use this service experience adequate quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Generally people who use this service enjoy a satisfactory and clean environment. The home owner has a programme to improve the decoration, fixtures and fittings. Maintenance tends to be reactive rather than proactive. EVIDENCE: This is a domestic style service and is not purpose built. Since the last inspection the kitchen has been redecorated and refurbished. The dining area has been extended into the small conservatory which can provide more space for people take their meals there is they wish. Rosedale DS0000027228.V367796.R01.S.doc Version 5.2 Page 17 People who use the service told us they felt the service was “comfortable” and “homely”. As noted in previous inspection a rolling programme to replace worn furnishings needs to be continued. We found a number of chairs in the main lounge in a poor state of repair. These chairs need to be either re upholstered or replaced to ensure that people who use the service are provided with satisfactory furnishings. A well maintained garden is available where individuals enjoy sitting in the sun. Staff keep the service clean and tidy. One person told us “they are always cleaning here”. Rosedale DS0000027228.V367796.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The number of staff on duty are sufficient to meet the needs of people who use the service. Pre employment checks are carried out on staff. Staff have good opportunities for training. EVIDENCE: A minimum of two staff are available at any one time in addition to the owner/manager. At night one member of staff is awake with another member of staff asleep on the premises. Staff keep a record of any instances when the sleeping member of staff is called on to assist to make sure that the staffing levels at night remain appropriate. Staff take up opportunities for training. Four staff are in the process of completing NVQ level 2. Two staff have completed level 2 and 3 NVQ and one member of staff is in the process of completing management training. One member of staff has completed nursing training. All staff have completed training on the management of medication, food hygiene and manual handling. Staff have attended mental health awareness training. Rosedale DS0000027228.V367796.R01.S.doc Version 5.2 Page 19 This training ensures that people who use the service are supported by a well informed and skilful staff group. We noted that the certificate of training in manual handling for one member of staff was dated 2005. The manager should carry out an audit of training to make sure that staff are kept up to date. We looked at a sample of staff files. We found that appropriate checks had been carried out on staff before they commenced work in the service. This assists in ensuring the safety of people who use the service. Staff told us the felt well supported by their colleagues and the manager. Records show regular supervision and staff meetings which ensures that staff are working in line with the aims and objectives of the service and have opportunities to discuss their work. Rosedale DS0000027228.V367796.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The manager has the knowledge and many years of experience to run the service. People who use the service have confidence in the manager to listen to them and work on their behalf. Staff carry out regular checks to ensure the health and safety of people who use the service and visitors. Quality assurance systems are still not fully developed. EVIDENCE: The manager has had some difficulty in completing the Registered Managers Award as the original course enrolled on ceased to operate. The manager Rosedale DS0000027228.V367796.R01.S.doc Version 5.2 Page 21 informed us that he was now planning to complete the course by the end of this year. People who use the service are encouraged to manage their own finances or have someone outside the service act as their agent. Facilities are available for small amounts of cash to be held for safekeeping. At the time of this visit no one had deposited any money. The manager intends to use the assessment required by the Commission to carry out quality monitoring along with feedback from people who use the service, visitors and other professionals. This needs to be carried out each year and the views of people who use the service should be added to the service user guide each year. Staff consult with people who use the service through monthly meetings where day to day issues can be discussed. One person is provided with a one to one meeting as they do not feel comfortable in group meetings. Staff carry out regular checks to ensure the health and safety of people who use the service. We looked at the records for fire alarm tests, fire drills, hot water temperatures and fridge and freezer temperatures. These records were well maintained and up to date. Environmental Health Officers had visited the service in May of this year and had awarded three stars to the kitchen. The manager has started a Safer Food Better Business diary. The manager keeps a record of any accident in the service. This ensures that action is taken to reduce risks. Rosedale DS0000027228.V367796.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X 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 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Rosedale DS0000027228.V367796.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care 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 In order to make sure that people receive the support they need care plans must be compiled in consultation with the individuals concerned and or their representative Be signed and dated Timescale of 15/12/07 not met 2. OP7 13(4) To ensure that people who use 01/11/08 the service are supported to take informed risks staff need to review and up date risk assessments on a regular basis. To make sure that people who 01/01/09 use the service are provided with good quality furnishings any worn chairs must be repaired or replaced. Timescale for action 01/11/08 3. OP19 23(2)(c ) Rosedale DS0000027228.V367796.R01.S.doc Version 5.2 Page 24 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. Refer to Standard OP7 Good Practice Recommendations Consideration should be given to expanding the opportunities for people to share with staff their life history. Work should continue to provide a more person centred care plan with the inclusion of how the social, emotional and cultural needs of individuals will be met. To further protect the health of people who use the service a medication profile should be compiled for each individual. To make sure that people who use the service are supported by a well trained staff group with knowledge of up to date practice the manager should carry out an audit of the training carried out by staff. Refresher training should be provided where necessary. The manager should complete the quality monitoring and audit systems with an annual review of the service taking into account the views of people who use the service. This review should be available for inspection and the results of consultation should be made public. 2. OP7 3. OP9 4. OP30 5. OP33 Rosedale DS0000027228.V367796.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Rosedale DS0000027228.V367796.R01.S.doc Version 5.2 Page 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!