Inspection on 18/07/07 for Rosedale

This inspection was carried out on 18th July 2007.

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

The inspector 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 17/07/08

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Rosedale 1 Wide Way Mitcham Surrey CR4 1BP Lead Inspector Liz O`Reilly Unannounced Inspection 18th July 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rosedale DS0000027228.V347718.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.V347718.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.V347718.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th February 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. Rosedale DS0000027228.V347718.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one regulation inspector. The inspection included discussion with residents, staff and the home owner/manager. Questionnaires were provided for residents and staff. The length of the inspection was extended to allow for questionnaires from relatives or friends to be returned. A number of records were examined. What the service does well: What has improved since the last inspection? What they could do better: Staff need to work on making care plans more person centred. Care plans must be kept up to date, be compiled and reviewed in consultation with the Rosedale DS0000027228.V347718.R01.S.doc Version 5.2 Page 6 individual and or their representatives. Staff must take care to sign and date documentation. As part of the health monitoring staff need to keep a record of the weight of individuals and take action should there be any marked weight loss or gain. To ensure that the rights of individuals are respected agreements must be in place if restrictions are placed on anyone’s freedom of movement. The home manager needs to complete the quality monitoring and assurance process to produce an annual review of the care provided. Improvements could be made in providing key documents in more accessible formats for residents. The manager needs to audit the furnishings in the bedrooms to make sure that they are in good condition and fit for purpose. 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. Rosedale DS0000027228.V347718.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 Rosedale DS0000027228.V347718.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&3 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. Good information is made available about the home. Assessments are completed before people move in which makes sure that their individual needs can be met. EVIDENCE: People living in the home told us that they had been given the opportunity to visit the home before they moved in. The first few weeks are viewed as a trial period after which a review is carried out to make sure that the person is satisfied and the home can meet the needs of the person. A user guide is available which contains information on what people can expect from the service. Staff said that this could be provided in large print if needed. Consideration should be given to providing the guide in other formats such as audio tape or pictures to make the information more accessible. Rosedale DS0000027228.V347718.R01.S.doc Version 5.2 Page 9 Before anyone moves into the home an assessment of their individual needs is carried out to ensure that this is the appropriate place for them. These assessments are used by staff to set up an initial care plan. Rosedale DS0000027228.V347718.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Care plans are not fully person centred and not always kept up to date. There is no evidence that people who live in the home are involved in compiling their care plans. Documents have not been signed and dated. Medication is well managed and the health care needs of individuals are mostly met. EVIDENCE: We looked at a care plans for two people. These covered personal care, mobility, diet, memory and social care. Each care plan gives basic information on the needs of individuals. Some progress has been made in seeking information on the life history of individuals and this should be continued. We found instances where staff have provided good information on personal care but this needs to be expanded. Staff have also sought information on the cultural needs of individuals. Rosedale DS0000027228.V347718.R01.S.doc Version 5.2 Page 11 We noted that changes in the mobility of one person had not been reflected in the care plan. The needs of one person who is partially sighted was not addressed and there was little information on the personal preferences of individuals in relation to the support they receive. In order to ensure that all staff are working to provided the correct support to individuals care plans must be kept up to date. Care plans were not signed by residents or their representatives to show that they have been involved in and agree the plans. Risk assessments had been carried out but not reviewed. The health care needs of individuals are mostly met with staff reporting good relationships with health care professionals. Residents are supported to attend appointments and receive health care within the home. More care needs to be taken to make sure that staff monitor and record the weight of individuals. Medication is well managed. Rosedale DS0000027228.V347718.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use this service receive good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Individuals felt they were offered choices in what they do and were given support to carry on their own interests, in and outside the home. Staff support individuals to keep contact with family or friends. There is scope to improve activities for those people who spend most of their time in the home and to include social activities in care planning. Where there is any restriction on individuals leaving the home a written agreement needs to be in place. EVIDENCE: Staff were seen to be active in encouraging people to take part in activities and continue with their individual interests. One resident arranges and makes regular coach trips throughout the summer. Another person attends a luncheon club. Trips out for shopping take place and a number of people go out with their family. One resident attends church on a regular basis. Staff told us that they support residents to receive visits in the home from religious centres. Rosedale DS0000027228.V347718.R01.S.doc Version 5.2 Page 13 People who live in the home told us they were free to spend their time in the communal areas of the home or their own room as they wished. One person said that they liked to spend time listening to their radio or watching their TV in privacy. Visitors felt they were “made welcome” in the home at any time. Staff were described as “helpful” by visitors. Residents gave us positive comments on the food which included “there is always plenty to eat”, “this is they kind of food I like”, “the staff are very good cooks” and “ I don’t think anyone could complain about the food here”. A four week menu is in place with alternatives available at each meal. People told us that staff will provide snacks outside meal times if they are feeling hungry. The record of food provided has not been maintained. Staff must ensure that the record of food is kept up to date. Individuals felt that they had choice and control over their own lives. However should there be any restrictions on the freedom of movement of any person the manager must ensure that there is a written agreement in place. Rosedale DS0000027228.V347718.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use this service receive good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Individuals are aware of how to make a complaint. Training for staff on Safeguarding Adults ensures that staff are able to recognise abuse and are aware of their responsibilities to report any allegation or concerns they may have. EVIDENCE: There are suitable procedures in place for dealing with complaints. The complaints procedure is on display in the home and residents spoken to knew who to go to if they had a complaint. The manager told us there had been no recent complaints. Consideration should be give to using large print for the procedure on display. All staff have been provided with training on safeguarding adults. A copy of the local authority procedure for dealing with allegations of abuse is available to staff. There have been no allegations of abuse. Rosedale DS0000027228.V347718.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23 & 26 People who use this service receive adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Improvements have been made in the environment since the last inspection. Generally people who live at the home enjoy a satisfactory and clean living environment. The improvements made need to be continued particularly in replacing bedroom furnishings which are showing signs of wear and tear. EVIDENCE: Since the last inspection one of the bathrooms on the first floor has been refurbished with the installation of a walk in bath. This can assist with people retaining independence in their personal care. Rosedale DS0000027228.V347718.R01.S.doc Version 5.2 Page 16 Locks have been fitted to bedroom doors which will allow residents to lock their rooms if they wish. Comments from individuals included “I like my bedroom I have everything to hand”, “my room is very comfortable” and “this is my space”. Residents have been encouraged to personalise their rooms with their own pictures, ornaments and personal items. Bedroom doors have been cleaned and painted. The small patio area on the ground floor had been missing a door for a considerable length of time but this has now been installed. A well maintained garden is available at the back of the house. People told us they enjoyed sitting out in the warmer weather. At the time of this visit one resident was meeting with a visitor in the garden. Work needs to be continued to replace worn bedroom furniture. The manager informed us that the kitchen, which is showing signs of wear and tear, will be refurbished within the next twelve months. Rosedale DS0000027228.V347718.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use this service receive good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The number of staff on duty at any one time are sufficient to meet the needs of the present resident group. The staffing at night must continue to be monitored to make sure that this continues to be appropriate. Individuals feel they are well supported by the staff. Staff have good opportunities for training. There is scope to improve the key working system. EVIDENCE: A minimum of two staff are available at any one time day or night. At night one member of staff sleeps on the premises with another member of staff awake through the night. A record of any instances where the person sleeping in has been called out is be kept in the home. This ensures that the staffing levels are kept under review. Comments from residents on the staff group were all positive. Staff were described as “the best” that they have “lots of patience” that “they treat everyone with respect” and that “nothing is too much trouble for them”, “they are very kind”. A relative said that “carers are always there if residents need someone to talk to”. Rosedale DS0000027228.V347718.R01.S.doc Version 5.2 Page 18 All staff have completed training on medication. Four staff are due to start NVQ level 2 training in the next few months. One member of staff has completed NVQ level 4, two level 3 and one person is a student on a Diploma in Social Work course. The manager told us they were planning on taking part in a two day course on mental health organised by the local authority. Staff records were not examined at this visit as there are no new staff. The manager is aware of the requirements in place to take up specific checks and to obtain information on previous work carried out by staff before they start work in the home. Rosedale DS0000027228.V347718.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People who use this service receive adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The manager has not completed the registered managers award yet. The quality assurance and monitoring systems need further work to make sure that the home is run in the best interests of people living in the home. Generally good arrangements are in place to make sure the health and welfare of residents, staff and visitors is protected. EVIDENCE: The owner/manager holds appropriate qualifications and has significant experience in the care and health sector. However he has yet to complete the Registered Managers Award. Rosedale DS0000027228.V347718.R01.S.doc Version 5.2 Page 20 People can leave small amounts of cash for safekeeping in the office. At the time of this visit only one person had deposited a very small amount of money. Records of all transactions are kept. Regular residents meetings are held which provide some opportunity for people to make their views known on the service. The last meeting was held in June of this year. The minutes showed that residents mainly discussed where they would like to go on outings. Residents had decided that the weather needed to be better before they made any set plans. A quality assurance and monitoring process has been started. Questionnaires have been sent to residents, relatives and other connected professionals. However the process has not been completed. The manager needs to collate the feedback received and use this as part of an annual review of the care provided. Following this review a development plan for the service needs to be completed. A copy of the annual review and development plan must be supplied to the CSCI. Regular health and safety checks are carried out in the home with records kept. The fire alarm system is checked by staff each week along with regular professional maintenance checks. Professional maintenance checks are carried out on the stair lift and assisted bath. Staff check the temperature of hot water weekly. All staff have received up to date training on moving and handling. Rosedale DS0000027228.V347718.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X 2 X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 3 Rosedale DS0000027228.V347718.R01.S.doc Version 5.2 Page 22 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 Timescale for action 15/12/07 2. OP8 12(1)(a) 3. OP14 17(1)(a) Schedule 3 (q) 4. OP33 24(2) In order to make sure that people receive the support they need care plans must be:• Person centred • Kept up to date • Be compiled in consultation with the individuals concerned and or their representative • Be signed and dated In order to ensure the health of 15/10/07 people living at the home staff must where possible keep a record of residents’ weight and take appropriate action should anyone show marked weight loss or gain. In order to ensure that the rights 15/10/07 of people are protected written agreements from the relevant persons must be available should restrictions on the freedom of movement be in place for any resident. 15/12/07 A copy of the report produced following the annual review of the service must be supplied to the CSCI. DS0000027228.V347718.R01.S.doc Version 5.2 Rosedale Page 23 (timescale of 01/02/07 and 17/04/07 not met) 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 OP1 Good Practice Recommendations Consideration should be given to providing key documents including the service user guide and complaints procedure, in a variety of accessible formats. Consideration should be given to expanding the opportunities for people to share with staff their life history. In order to make sure that people who live at the home are provided with a comfortable well maintained environment an audit of bedroom furnishings should be carried out to ensure that replacements are provided for any damaged or worn items. 2. OP7 3. OP19 Rosedale DS0000027228.V347718.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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.V347718.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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