Inspection on 27/06/06 for Rosedale

This inspection was carried out on 27th June 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rosedale 29/04/08

Rosedale 21/05/07

Rosedale 08/12/05

Rosedale 24/05/05

Rosedale 21/12/04

Rosedale 02/11/04

Rosedale 05/09/02

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

CARE HOME ADULTS 18-65 Rosedale 42a Manchester Road Haslingden Lancashire BB4 5ST Lead Inspector Mrs Lynn Mitton Key Unannounced Inspection 27 & 28th June 2006 09:30 th Rosedale DS0000009612.V291941.R01.S.doc Version 5.1 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 DS0000009612.V291941.R01.S.doc Version 5.1 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 Adults 18-65. 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 DS0000009612.V291941.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Rosedale Address 42a Manchester Road Haslingden Lancashire BB4 5ST 01706 222066 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) Mrs Bridget Mary Healy Mrs Sarah Jane Taylor Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Rosedale DS0000009612.V291941.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th December 2005 Brief Description of the Service: Rosedale is registered to provide accommodation and social care for 6 adults with a mental illness. The house is a Victorian building and offers spacious accommodation with small garden areas to the front and rear of the house. It is situated in the centre of Haslingden town centre, surrounded by all local amenities. Accommodation is provided on two floors in six single bedrooms. There is a lounge and a games and dining room on the ground floor. There are designated smoking areas for service users and support staff. Fees for the cost of a weeks care at Rosedale ranges from £546.50 – £900.00. There was some information available to potential service users advising them of the home and about the type of service they could expect. Rosedale DS0000009612.V291941.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and took place over 2 days. A tour of the communal areas of the premises took place. Two of the care staff on duty were spoken to, the registered manager and three resident’s also contributed to the inspection process. Throughout the report there are various references to the “tracking process”, this is a method whereby the inspector focuses on a small representative group of staff member and service users. Records pertaining to these people were inspected. Policies and practices were also looked at. There were 5 service users living at Rosedale at the time of the inspection. What the service does well: One resident said; “ I am settled down and I am happy with the way things are”. Another resident said; “Staff are good listeners at Rosedale they sort all my problems out”. Another commented “this home has got me better and now I am nearly ready to move on, the support is great, staff are good listeners, good food and staff are good at Rosedale”. Staff spoken to and observed by the inspector on the day demonstrated an understanding of the needs of the residents. An experienced and appropriately trained manager ran the home. The inspector was satisfied that residents were regularly consulted regarding the running of the home. Resident’s privacy was respected and they were valued as individuals. They were each given opportunities to lead fulfilling lives and maintain their independence. Individual dietary needs were catered for. Residents were encouraged to participate in shopping, planning and preparation of meals. There was a clear complaints procedure and evidence that resident’s views were sought and acted upon. Staff spoken to had an understanding of adult protection issues, ensuring that any allegations would be dealt with appropriately. Staff records seen Rosedale DS0000009612.V291941.R01.S.doc Version 5.1 Page 6 demonstrated appropriate checks had been taken to ensure that service users were safeguarded. What has improved since the last inspection? 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. Rosedale DS0000009612.V291941.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rosedale DS0000009612.V291941.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA2 & YA5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Needs assessments identified the care needs of residents so that support staff would have a clear understanding of how they needed to support them. Contracts did not fully explain what residents could expect, and what was expected of them in order for them to live at Rosedale. EVIDENCE: There had been no new admissions to the home since the last inspection. The most recent admission to the home was in March 2005. The updated assessment format complied with this standard and the registered manager advised this would be used for all new referrals. Resident’s contracts were seen. These did not fully explain the terms and conditions of their residence at Rosedale, although there were now costings of the placement written into the contract. The shortfall related to the contract referring to the statement of purpose, the inspector advised that this document was not for service users, but is a document between the Commission and the service provider. The contract should be written in a way that can be understood by service users. Rosedale DS0000009612.V291941.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA6, YA7 & YA9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information on care and health plans enabled support staff to meet residents needs. The risk assessment and management framework did not fully support residents in taking responsible risks. EVIDENCE: One residents care plan was examined in detail. This had been updated and gave clear and detailed information about the level of support needed for each resident for staff to ensure continuity of care. This included reference to the resident’s physical and mental health. The care plan case tracked had residents input and had been recently reviewed. All residents had a next of kin or advocate. Resident’s personal allowances were kept safe in the office and given on request. The registered person is appointee for all the residents. Each resident had their own bank account. The inspector and registered manager discussed how residents could have better access to their own monies. Rosedale DS0000009612.V291941.R01.S.doc Version 5.1 Page 10 There were risk assessments in place, and these had been recently reviewed. The inspector and registered manager discussed at length how the format could be further developed and improved to ensure that once a risk has been identified, appropriate management strategies had been developed and were implemented. Rosedale DS0000009612.V291941.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YP12, YP13, YP15, YP16 & YP17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents had opportunities to maintain to lead fulfilling lives, whilst maintaining their independence. Individual dietary needs were catered for. Residents were encouraged to participate in shopping, planning and preparation of meals to further their independence. EVIDENCE: Two residents were planning to move onto more independent living, they both told the inspector how they were looking forward to this and viewed their move very positively. Residents were able to make day-to-day decisions about their lives, and had opportunities to fulfil their potential. Residents were seen to come and go Rosedale DS0000009612.V291941.R01.S.doc Version 5.1 Page 12 from the house with autonomy, using the phone to make arrangements to meet friends and family etc., Residents were able to maintain family links, and had regular access to their local community. Reference to family support was made in the care plan. One resident told the inspector about her planned activities for the forthcoming week. Until recently she worked 2 days per week at a Café. She also had very regular contact with her family and planned to visit her mum unsupported in a nearby town. She also told the inspector how much she valued going out shopping on her own. One resident told the inspector how he enjoyed going to a Making Space sports group once a week. Another resident works voluntarily at the Salvation Army one day every 2 weeks. The inspector was advised that a house meeting was held each Monday when a plan was made of the forthcoming weekly activities and menus were planned. The inspector was advised that most residents had recently been on holiday to Morecambe for 2/3 nights and another holiday was planned, perhaps to Wales later on in the year. One resident was supported to attend his church. The inspector observed residents being spoken to with respect and being encouraged to take responsibility for their day-to-day living arrangements. Support staff were also observed respecting residents rights and wishes. The inspector saw records of what each resident eats on their daily records. Residents made their own meals with staff support as required, except tea, which was usually a communal meal. Residents were advised individually about nutritionally balanced diets. Menus were discussed and planned during residents meeting. Rosedale DS0000009612.V291941.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA18, YA19 & YA20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal support was offered in accordance with resident’s needs and wishes. There was now sufficient evidence to show that the service users case tracked had all their health needs identified and how they would be met documented. Current poPolicies and practices for managing and administering medication do not fully safeguard residents. EVIDENCE: The inspector was advised that the residents at Rosedale only needed prompting to maintain their own personal care. Since the previous inspection the care plan format had been further developed and this now clearly demonstrated that service users mental health and physical health needs were being given due care and attention. The inspector examined in detail one care plan, and this included a recently developed health check. This had been reviewed in January 2006. All residents were registered with a GP and consultant psychiatrist. Other health professionals such as Community Psychiatric Nurses were also involved with some residents. Rosedale DS0000009612.V291941.R01.S.doc Version 5.1 Page 14 The home used Boots MAR system. Administration records seen by the inspector appeared in good order. The inspector was advised that all staff members had already or were undertaking safe administration of medication training. One resident was partially self-medicating and appropriate safeguards were in place for this. Good practice was in place regarding the dispensation of medication for residents during periods of home leave and taking of over the counter remedies (e.g. cough mixture or painkillers). The policies and procedures for the safe dispensation of medication should be updated to include reference to these and other issues. The inspector and registered manager discussed the security of the drugs given that the drugs cabinet is clearly visible from the ground floor office and the busy location of the home. Rosedale DS0000009612.V291941.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA22 & YA23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was a clear complaints procedure and evidence that resident’s views were sought and acted upon. Staff spoken to had an understanding of adult protection issues, ensuring that any allegations would be dealt with appropriately. EVIDENCE: The Commission had received no formal complaints. Policies and practices regarding concerns complaints and protection were in place. The inspector noted that this issue was raised during residents meeting and those present were asked if they had any concerns or complaints. A copy of the complaints procedure was on display in the homes dining area and each resident had a copy in their room. One staff spoken to by the inspector knew what to do should they have any concerns about resident’s wellbeing. They were also aware of whistle blowing, and said they would have no hesitation in doing so should they need to. The inspector observed that residents at Rosedale were assertive and had no hesitation in voicing their opinions. Staff and residents interaction was observed by the inspector and was respectful and understanding of each residents needs. One resident commented; “If there is anything wrong I would complain to the staff or there is a complaints book”. Rosedale DS0000009612.V291941.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of décor and furnishings was adequate but improvement in some areas would lead to amore comfortable environment. EVIDENCE: The inspector conducted a tour of the communal areas. Magnetic safety fire door devices had now been fitted to all communal thoroughfare fire doors. The carpet in the entrance hall had been lifted revealing original tiles. The office and games room location had been swapped, this meant that the office was now more centralised. The games room had bare plaster and was in need of decoration. Some office property (staff manuals) was still located in the games room and needed transferring to the new office location. The front and side entrance and hallway was in need of redecoration. The front garden area was weeded and cleared of litter during the inspection. The front door and external area was in need of maintenance attention and redecoration. The windows had not been cleaned inside or out for a considerable time. Rosedale DS0000009612.V291941.R01.S.doc Version 5.1 Page 17 Some bedroom curtains did not fit correctly, thus compromising resident’s privacy and dignity. The carpet in room 3 was in need of replacing. The toilet roll holder was missing in room 2. The resident’s payphone was still out of order. Although residents have the opportunity to use the office ‘phone the inspector advised this issue should be resolved as it has now been outstanding since the inspection dated May 2005. A number of comments seen on the completed visitors survey conducted in May 2006 commented on the homes facilities letting down the overall service. Rosedale DS0000009612.V291941.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA32, YA34, & YA 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff spoken to and observed by the inspector on the day demonstrated an understanding of the needs of the residents. At certain times of the day the number of staff on duty were hard pressed to meet the resident’s needs. Staff records showed appropriate checks had been taken to ensure that service users were safeguarded. Although staff had completed their NVQ training, further training would enable them to better meet the needs of the residents. EVIDENCE: There were no staff vacancies at the time of the inspection. According to the rota, there were usually only two staff members on duty from 9am – 5pm and one or two staff members from 5 – 10pm. One staff member slept in overnight. There were still occasions where there was only one staff member on duty during the waking day. The inspector advised that this was not acceptable practice that there should be 2 support staff on duty during the waking day. The inspector and registered manager discussed having a “security net” of bank or agency staff to cover for sickness and leave, especially as the staff team only consisted of 5 people. The inspector case tracked two staff files. These files contained information that demonstrated appropriate checks had been taken to ensure that service users were safeguarded. Rosedale DS0000009612.V291941.R01.S.doc Version 5.1 Page 19 However it was also noted that there was no evidence of induction training on either staff member’s file. All 5 care staff had completed NVQ 2 training. Other training had also been identified; the inspector advised that the training matrix should be updated to contain accurate and relevant information. The inspector was advised that the registered manager did not have access to a training budget. One staff member said “I really like the new care plan’s they are easy to use and read”. Rosedale DS0000009612.V291941.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA37, YA39 & YA42 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. An experienced and appropriately trained manager ran the home. Residents were consulted about the day-to-day running of the home and their views acted upon. The lack of appropriate hot water controls and appliance safety certificates leaves residents and staff at risk. EVIDENCE: The registered manager had completed her NVQ4 training in care and management. Weekly discussions with the registered manager and registered person usually took place. Managers meetings were held three monthly. Residents meeting took place weekly. Residents were observed by the inspectors to be consulted about making day to day decisions about their lives. A residents survey was last conducted in September 2005. Since the previous inspection a survey for family/visitors and staff members had been developed and implemented and completed in April/May 2006. Rosedale DS0000009612.V291941.R01.S.doc Version 5.1 Page 21 The results of these surveys were collated during the inspection. The inspector was advised that the residents survey was due to be repeated in the near future. Metal waste bins had been provided in communal areas where residents smoke. The inspector noted that the hot water temperatures in the shower and bath were now between 50.5 degrees and 57.5 degrees centigrade. The inspector was advised that this thermostatic valves had now been fitted, however these temperatures continued to be excessively hot. This issue has been outstanding since the previous inspection in December 2005 and the inspector advised must be resolved as a matter of urgency. The inspector noted that records were made of the water temps each week. The 5year electrical and PAT certificates were not available to the inspector nor were the gas safety or boiler certificate. The fire book was seen and was up to date; fire-fighting appliances had been serviced in November 2005. Rosedale DS0000009612.V291941.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 2 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 1 X Rosedale DS0000009612.V291941.R01.S.doc Version 5.1 Page 23 Yes 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 YA5 Regulation 5(1b) Requirement All residents must have terms and conditions in respect of accommodation to be provided. This requirement outstanding from 24/05/05 The registered person shall ensure that any activities in which service users participate in are so far as reasonably practicable free from avoidable risks. The registered person must provide appropriate telephone facilities. This requirement outstanding from 24/05/05 The registered person must make suitable arrangements that the home is conducted in a manner which respects the privacy and dignity of the service users. The registered person must ensure at all times suitably qualified competent and experienced persons are working at the home in such numbers as are appropriate for the health and welfare of residents. This requirement outstanding from 24/05/05 DS0000009612.V291941.R01.S.doc Timescale for action 06/10/06 2. YA9 13 (4b) 06/10/06 3. YA24 16(2) 06/10/06 4. YA24 12(4a) 06/10/06 5. YA33 18 (1) 06/10/06 Rosedale Version 5.1 Page 24 6. YA35 12,17,18 &19 7. YA42 12(1a) Persons working in the care 06/10/06 home must receive training appropriate to the work they perform. This requirement outstanding from 24/05/05 The registered person shall make 06/10/06 and promote proper arrangements for the health and welfare of service users. This requirement outstanding from 24/05/05 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 YA20 Good Practice Recommendations The registered manager should ensure that policies and procedures for medicines management be reviewed in line with the current Royal Pharmaceutical Society of Great Britain guidelines Rosedale DS0000009612.V291941.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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 DS0000009612.V291941.R01.S.doc Version 5.1 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. 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