Inspection on 25/04/05 for Rosedale

This inspection was carried out on 25th April 2005.

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

Rosedale 17/07/08

Rosedale 18/07/07

Rosedale 14/09/06

Rosedale 24/11/05

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 OReilly Unannounced 25 April 2005 10:00 am th 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 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 G54-G04 S27228 Rosedale V225866 250405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Rosedale Address 1 Wide Way Mitcham Surrey CR4 1BP 0208 679 0752 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Kanagasabai Wignarajah Kailasananthan Mr Kanagasabai Wignarajah Kailasananthan CRH Care Home 12 Category(ies) of OP Old age (12) registration, with number DE (E) Dementia (3) of places MD (E) Mental Disorder Over 65 (3) Rosedale G54-G04 S27228 Rosedale V225866 250405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th October 2004 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. Accomodation 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 G54-G04 S27228 Rosedale V225866 250405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 25th April 2005 by one regulation inspector. The inspector had the opportunity to speak with four residents, one member of staff and the owner/manager of the home. What the service does well: What has improved since the last inspection? What they could do better: The instructions and record of medication must be checked on a regular basis to make sure they are up to date and accurate. The ground floor bathroom is in need of redecoration. All staff working in the home must be supplied with training on the protection of residents from abuse. Further work should be carried out to expand the activities and outings available to residents, particularly for those residents who do not attend outside activities on a regular basis. Please contact the provider for advice of actions taken in response to this Rosedale G54-G04 S27228 Rosedale V225866 250405 Stage 4.doc Version 1.30 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rosedale G54-G04 S27228 Rosedale V225866 250405 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Rosedale G54-G04 S27228 Rosedale V225866 250405 Stage 4.doc Version 1.30 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 standard(s) 1, 2, 3 and 6. Prospective residents are supplied with information on the care and facilities the home can provide via the Statement of Purpose and Service User Guide. Each individual is provided with a contract. The strengths and needs of each individual are assessed prior to them moving into the home. EVIDENCE: At the time of the last inspection of the home a requirement was made for the Service User Guide to be updated to include the contact details of the Commission, the last inspection report, the complaints procedure and the contract. This work has been carried out. The contract provided to residents was seen to include the room to be occupied, the rights and obligations of residents, the terms and conditions of occupancy, the fees to be paid. All the residents in the home have been placed via social services. Prior to moving into the home an assessment of the individual needs of the person is carried out by Care Managers from social services. The home receives a copy of this document and this is used to compile an initial care plan. This home does not provide intermediate care. Rosedale G54-G04 S27228 Rosedale V225866 250405 Stage 4.doc Version 1.30 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 standard(s) 7, 8 and 9. The care planning has improved since the last inspection of the home. The system could be further developed to provide more individualised care plans. The health needs of residents are met. Improvements must be made in the instructions for staff and the recording of medication. EVIDENCE: Each resident has their own individual care plan. The care plans in use in the home provide information on the needs of individuals along with how staff will support residents. It was noted that a short history is taken for each resident giving information on family, early life, employment, relationships and major life events. Good information was seen to be included in the care plans in relation to encouraging activities, talking about past and present events and monitoring. Care plans should be reviewed on a monthly basis. However this was not seen to be carried out each month. Staff have clearly made efforts to include residents and or their representatives in the care planning. A number of entries in the daily recording carried out by staff were of a very good standard, providing detailed information on events. Rosedale G54-G04 S27228 Rosedale V225866 250405 Stage 4.doc Version 1.30 Page 10 Staff have a good understanding of the individual strengths and needs of residents. The care planning could be improved by including the strengths of individuals, expanding the opportunities for residents to give information on their previous life experiences and developing more individualised plans. As suggested in previous inspection reports consideration should be given to offering residents the opportunity to help maintain their own records. All residents are registered with local GP practices. The home has good links with the community psychiatric team. District nurses visit the home as required and have supplied pressure relieving equipment for particular residents. Arrangements are in place for residents to receive regular dental, optical and chiropody services. Since the last inspection of the home risk assessments relating to the risk of falls have been produced. Where a significant risk of falling has been identified this is also addressed in the individual care plan. Medication is safely stored in the home. The pharmacist for the home has provided training for staff on the management of medication. Staff monitor the condition of residents who are taking medication and contact the GP or consultant should they have any concerns. The recording of medication given includes any allergies. In two instances the record indicated that medication had not been given as prescribed to one resident. The instructions recorded for this medication on the daily recording, the medication record and the bottle from the pharmacy did not match. The record of medication given did not follow the instructions from the consultant. The owner must ensure the medication record is up to date and accurate at all times. The instructions for staff on giving medication “as required” must be clearly recorded. Rosedale G54-G04 S27228 Rosedale V225866 250405 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14 and 15 Residents in this home are encouraged and supported to maintain their independence and to continue with their own individual interests for as long as they wish and are able. Staff have a good knowledge of the strengths and needs of individuals. The home has an open visiting policy. Residents are provided with a balanced diet at flexible times. EVIDENCE: Staff make efforts to ensure that residents are supported to continue with their own interests and activities. Three residents attend day centres twice weekly. One resident continues independently with their own interest outside the home three to four times a week. Residents walk to local shops and one resident attends church on a regular basis. A priest visits one resident in the home. Until very recently one resident was supported to continue looking after his dog in the home. Further work should be considered on expanding the opportunities for activities and outings, particularly for those residents who do not attend outside activities. Resident stated they could see their visitors in their own room or in the lounge according to their own wishes and that their visitors could come to the home at any time. Residents spoken to at the time of this visit stated that their relatives often visited them in the home. Rosedale G54-G04 S27228 Rosedale V225866 250405 Stage 4.doc Version 1.30 Page 12 Young people from a further education college attend the home for work experience providing opportunities for residents to participate in further in house activities. Staff in the home were observed to engage residents in card games and one to one conversations. Staff were found to have a good knowledge of the strengths and needs of individual residents. Residents were seen to join in activities, spend time in their own room or join with others in the lounge according to their own wishes. Residents are free to bring to the home items of their own furniture as well as smaller personal possessions. Residents are encouraged to handle their own financial affairs for as long as they are able and wish to do so. Information on contacting external advocates is available. Residents informed the inspector that they enjoyed the food provided in the home. All the residents who gave an opinion said they had enough to eat and never felt hungry because staff would make them a snack if they wanted. The timing for breakfast is flexible to meet the wishes and individual routines of residents. Staff stated that if a resident is out for the day a meal or snack would be provided for them on their return. The kitchen is open at all times day and night. A menu is produced with alternatives available at each meal time. Staff were seen to ask residents what they would like to eat. None of the residents in the home at the time of this visit required help with eating. Residents can take their meals at the dining tables or on small tables in the lounge area. Rosedale G54-G04 S27228 Rosedale V225866 250405 Stage 4.doc Version 1.30 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 standard(s) 16, 17 and 18. The home has systems in place for the reporting and recording of any complaint. Residents are supported to vote if they wish to do so. Procedures are in place for the protection of residents from abuse. This needs to be backed up with training for all staff in the home on abuse. EVIDENCE: Systems are in place for recording any complaint made. No complaints have been received by the home or the commission since the last inspection of the home. Residents stated that if they had a problem they would talk to the staff first. One resident commented that “the girls are very good here they help you out if you have any worries.” Residents also said they would talk to their family or the manager if they were not happy with anything in the home. The complaints procedure was seen to be available in the home. All residents are registered to vote. Staff provide support for residents who wish to attend the polling station. Those who do not wish to do so are registered for postal voting. The Registered Manager has attended training on the protection residents from abuse. The deputy manager has attended meetings on this subject. The Registered Manager must ensure that all staff in the home are provided with training on the recognition of abuse, their responsibilities in relation to reporting abuse and the procedures to be followed. Rosedale G54-G04 S27228 Rosedale V225866 250405 Stage 4.doc Version 1.30 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 standard(s) 19, 21, 22 and 26 Residents are provided with a comfortable homely environment. Sufficient, accessible lavatories and washing facilities are available. Work is in progress to meet the recommendations made following an assessment of the home by an Occupational Therapist. The home was clean and tidy. One bathroom is in need of redecoration. EVIDENCE: Repairs to be carried out noted at the last inspection of the home have been carried out. The Registered Manager stated that regular checks are carried out within the home to ensure that any repairs are carried out as soon as possible. The furnishings and fittings supplied in the home are as domestic in style as possible whilst meeting the needs of the residents. It was noted that the bathroom on the ground floor was showing signs of wear and tear. This room needs to be redecorated within the next six months. A well maintained garden is available to the rear of the home. This home does not use CCTV. Rosedale G54-G04 S27228 Rosedale V225866 250405 Stage 4.doc Version 1.30 Page 15 A separate laundry area is available. Since the last inspection of the home a new washing machine has been installed. An adequate number of toilets close to the lounge area are provided. Three bedrooms are provided with en suite toilet facilities. An assisted bath and two shower rooms are available. Since the last inspection of the home the owner has arranged for an assessment of the premises to be carried out by an Occupational Therapist. A copy of the report following this assessment has been supplied to the Commission. A number of recommendations were made by the Occupational Therapist and the owner has commenced work to meet these requirements. The home was found to be clean and tidy. Rosedale G54-G04 S27228 Rosedale V225866 250405 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 The number of staff on duty were seen to be adequate to meet the needs of the residents in the home at the time of this visit. Information provided by residents and observations made at the time of this visit indicated that staff were well motivated and caring. The numbers of staff taking part in NVQ training indicate that staff are open to expanding their knowledge and experience. Training on moving and handling needs to be completed for all staff. EVIDENCE: The home is fully staffed with a minimum of two members of staff on duty at all times. At night one member of staff is awake in the home with a second member of staff asleep on the premises who can be called upon for assistance if required. Catering staff are not employed. Meals are prepared by the care staff, all of whom have completed food hygiene training. All staff are over the age of 21. One member of staff is employed on a part time basis to carry out cleaning twice weekly. Day to day cleaning is carried out by care staff. The owner stated that arrangements were being made for all staff to receive up to date moving and handling training in the near future. Training on the management of medication has been provided by a pharmacist. One member of the night staff has completed NVQ level four training. One member of staff is in the process of completing this training. Four members of Rosedale G54-G04 S27228 Rosedale V225866 250405 Stage 4.doc Version 1.30 Page 17 staff are enrolled on NVQ level two training and one on level three. The owner is in the process of NVQ level four training. Rosedale G54-G04 S27228 Rosedale V225866 250405 Stage 4.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33 and 38 The owner is committed to continuing expanding his knowledge and experience through further NVQ training. Comments made by residents regarding the owner indicated that they viewed him as approachable. Regular checks are carried out in relation to the health and safety of residents, staff and visitors to the home. EVIDENCE: The owner is a registered mental health nurse who is also in the process of completing NVQ level four training. Discussions with residents and staff indicated that he is viewed as approachable and reliable. Quality assurance and monitoring systems have yet to be fully developed. Residents have the opportunity to put their opinions and suggestions regarding the home in monthly residents meetings or one to one meetings. A record of these meetings are maintained. Rosedale G54-G04 S27228 Rosedale V225866 250405 Stage 4.doc Version 1.30 Page 19 Staff meetings are also recorded and carried out on a regular basis. Checks were seen to be carried out on the fire alarm system with fire drills taking place on a regular basis. Staff check the temperature of hot water to ensure this poses no danger to residents. A record of any accident with good information on actions taken is kept in the home. The owner must ensure that all portable electrical equipment is tested by a suitably qualified person on an annual basis. Rosedale G54-G04 S27228 Rosedale V225866 250405 Stage 4.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 x COMPLAINTS AND PROTECTION 2 x 3 3 x x x x STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 2 3 x 3 x x x x 3 Rosedale G54-G04 S27228 Rosedale V225866 250405 Stage 4.doc Version 1.30 Page 21 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 9 Regulation 13(2) Requirement The Registered Provider must ensure that acurate records are maintained in reatlion to medication. The instructions for staff on administering medication prescribed as required must be clearly recorded. The Registered Provider must ensure that all staff working in the home are provided with training on the protection of vulnerable adults. The Registered Provder must ensure that the ground floor bathroom is redecorated. Timescale for action 20th June 2005 2. 18 13(6) 18(c) 1st August 2005 3. 19 23(2)(b) 1st November 2005 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 7 Good Practice Recommendations The Registered Provider should consider expanding the care planning documentaiton to include, the strengths of individual residents, opportunities for residents to provide information on their previous life experiences and opprotunities to help maintain their own records. G54-G04 S27228 Rosedale V225866 250405 Stage 4.doc Version 1.30 Page 22 Rosedale 2. 12 The Registered Provider should consider expanding the opprotunities for residents to take part in outings and a more varied selection of activities. Rosedale G54-G04 S27228 Rosedale V225866 250405 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Ground Floor - CSCI 41-47 Hartfield Road Wimbledon SW19 3RG 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 Rosedale G54-G04 S27228 Rosedale V225866 250405 Stage 4.doc Version 1.30 Page 24 - 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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