Inspection on 29/04/08 for Rosedale

This inspection was carried out on 29th April 2008.

CSCI found this care home to be providing an Adequate service.

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 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rosedale 21/05/07

Rosedale 27/06/06

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 Marie Dickinson Unannounced Inspection 29th April 2008 10:00 Rosedale DS0000009612.V366359.R01.S.doc Version 5.2 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.V366359.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 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.V366359.R01.S.doc Version 5.2 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.V366359.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st May 2007 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. It is situated in the centre of Haslingden town centre, close to all local amenities. Accommodation is provided on two floors in six single bedrooms. There is a lounge, a games room, and dining room on the ground floor. There are designated smoking areas for residents. Fees at Rosedale range from £550.00 - £1253.50 per week, according to assessed need. 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.V366359.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 1 star. This means the people who use this service experience adequate quality outcomes. A key unannounced inspection was conducted in respect of Rosedale on the 29th April 2008. The inspection involved getting information from an Annual Quality Assurance Assessment completed by the manager, staff records, care records and policies and procedures. It also involved talking to residents, staff on duty, the manager, and an inspection of the premises. Areas that needed to improve from the previous inspection were looked at for progress made. The home was assessed against the National Minimum Standards for Younger Adults. One additional visit had been made to the home since the last inspection. This visit was in relation to compliance of requirements made at the last key inspection in relation to complaint policies and practices; Prevention of Abuse Training for staff; Environmental issues; Recruitment processes; Levels of staffing; relevant training for staff and arrangements in place to make sure residents were safe. What the service does well: Admission to the home was planned giving people enough time to settle in, and know how their support will be provided. Professional people helped arrange the care that was needed. People living in the home had made the decision to live there. They had an assessment of their needs, which provided essential information needed to support them in every day living and used to plan the care they required. People living in the home who completed questionnaires for this inspection indicated that members of staff treated them well and gave them the support they needed. Staff who also gave written comments said ‘The service provides a residential home in a community setting for service users to build on social skills, working in a holistic way to meet individual needs’. Residents living in the home benefited from the support of a named worker referred to as a Key worker who took responsibility for their personal care. Rosedale DS0000009612.V366359.R01.S.doc Version 5.2 Page 6 Resident’s also benefited from additional specialist support where needed, such as health and mental healthcare needs. Activities and daily living was very much residents choice. Residents had opportunities to discuss issues of importance to them and of life at the home at house meetings. These were held weekly enabling residents to voice their opinions and make suggestions, such as menu planning. The atmosphere in Rosedale was relaxed, supportive, and friendly. Written comments from staff included, ‘I think the whole service does well as a team, the whole household works together aiming for goals set by staff and service users’. Residents spoken to had confidence in staff and the manager to help them with any difficulty they may have, or to deal with any concern. The complaints procedure was regularly explained to residents at their meetings, enabling them to have confidence to raise any issue they may have. The deployment of staff meant residents benefited one to one support when needed. The manager was qualified and experienced, and staff expressed confidence in her leadership. ‘‘In this employment I have a monthly supervision with my manager, which I find very helpful and rewarding as Rosedale’s manager is very approachable’. What has improved since the last inspection? The manager said medication policies and procedures had been updated as required. She had developed new policies and procedures regarding dealing with complaints. This meant any concern residents raised would be dealt with properly. Staff had some training in adult protection, to support them in dealing with any allegation or suspicion of abuse. Some improvements had been made to the environment. These included the gable end wall in the front room had been re-plastered and remedial work had been undertaken on the outside wall to prevent further damp. A number of windows had been replaced in bedrooms and the smoking room, and missing staircase spindles fitted. All staff employed in the home had the relevant Criminal Record Bureaux enhanced checks in place. Some health and safety training had been provided and over 50 of staff was trained in National Vocational Qualification in care level two and above. Information received at the commission from staff stated they had supervision. The weekly housekeeping budget had increased to £250 per week. Rosedale DS0000009612.V366359.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Rosedale DS0000009612.V366359.R01.S.doc Version 5.2 Page 8 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.V366359.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2,5 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Admission procedures followed, supported a decision made to offer a placement in the home, and determine if the home could meet people’s needs and expectations. Residents were given individual contracts that informed them what was included for their overall care, and of their legal rights. EVIDENCE: There had been no new admissions to the home since the last inspection and this standard could not be fully assessed. However the manager discussed the admission protocol. This included an assessment of need made by health and social care professionals, an assessment made by the home, and introductory visits arranged for people considering living at Rosedale, to look around and meet the people living and working in the home. Residents had been given a written statement of terms and conditions of residence. Those seen did not include the amount of fee payable for each individual. Rosedale DS0000009612.V366359.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Care plans linked to residents assessed needs, which meant they were involved in decisions about their lives and staff knew how to support them. More information was needed to link risk management into daily living needs and show how people were kept relatively safe with support from staff. EVIDENCE: There was evidence that the service did understand the right of the resident to take control over their own life and make their own decisions and choices. Written information received at the Commission referred to ‘identifying needs and choices’, and residents ‘fully supported in their own choices’. Care planning used, although showed some needs, still required some work to make sure the plan is written in a way to address all areas of need completely. The manager spent time during inspection documenting short- term goal setting. This Rosedale DS0000009612.V366359.R01.S.doc Version 5.2 Page 11 improved the possibility of showing measurable achievements for residents, and the staged support required to enable them to reach their full potential. Individual plans had been reviewed. Staff worked to a key worker system that allowed staff to work on a one to one basis and contribute to individual care plans. Acceptable risk taking had been considered. Each care plan included risk assessments. These were reviewed. However whilst management of risk was recorded, where limitations were in place, and decisions made, this needs to show residents involvement. Risk management needed to be clearer for staff as vague instructions recorded such as ‘encourage’ must be clearer as to what action that involves. Guidance for staff in managing non-compliance of agreed action to minimise risk should also be recorded. This will ensure there is a consistent approach by all staff when dealing with risk. An example of a general risk found during inspection was smoking in bedrooms. The manager said residents handed their cigarettes in at night, although there was no record of this happening. Decision-making was said to be encouraged and residents were given time to consider the individual choices they made. Written information received from residents for this inspection showed they were able to make choices about their lives. They had the benefit of planned one to one discussions with staff, and weekly house meetings. Rosedale DS0000009612.V366359.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents had a degree of independence and opportunity to take part in chosen activities, access community resources and keep in touch with families and friends. The meals were sufficient in providing for residents tastes and choices. EVIDENCE: The manager said since the random inspection conducted in September 2007, staffing levels had improved and there were staff available to give one to one support to people in their personal development needs. Activity programmes completed for residents showed how this was planned. Rosedale DS0000009612.V366359.R01.S.doc Version 5.2 Page 13 Written information to assist with this inspection showed management considered the service did well by: ‘Active lifestyles were promoted that suits all individuals in a positive and constructive way’. Residents were supported to ‘follow religious and educational beliefs, locate places of employment, and take part in community therapeutic activities with full support of the staff, day, and evening’. The location of the home meant residents could shop in town, visit the library, pubs, and clubs. Residents had a weekly planner to show what activity they would be doing on a daily basis. For example in the morning after breakfast, a resident may go to a planned activity or take some responsibility to clean their bedroom, make their own lunch, have a one to one session with staff in the afternoon, and in the evening attend the house meeting. Activities were varied and included voluntary work, planned visits to relatives, and days out. The manager had also made an application for an allottment from the council to give residents an additional interest. As part of the basic contract price, residents had the option of a minimum seven-day holiday outside the home they helped to choose. Plans were being made for a holiday in the Summer, and residents had been consulted where to go. Two destinations had been chosen, Morecambe and Southport. Generally residents in the home did what they wanted to do and what what they were comfortable with. The home was managed in a manner to avoid any institutional routines. Letters were delivered unopened and residents were observed making their own choices such as when to eat lunch, and what to have. Oservations of staff working in the home showed they treated people living there with respect, were polite and considerate. All bedrooms had locks on their doors and people managed their own keys. Relatives and friends were made welcome to the home. Records show residents were encouraged where appropriate to maintain good contact with their relatives and friends. Records showed menus were discussed at house meetings, and residents decided what the menu should consist of every week. The weekly allocation for housekeeping was identified as been increased during the random inspection in september 2007. This meant the manager had more flexibility to provide residents with what they asked for. Rosedale DS0000009612.V366359.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20, 21 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People’s health and general wellbeing was being monitored, with support being provided to access health care services. Medication policies and procedures and staff training promoted best practice. EVIDENCE: Records showed people using the service were registered with a General Practitioner and that appointments had been made and kept. Staff support was observed during inspection. Records also showed appointments had also been kept with care coordinators, consultants, and community psychiatric services. Care planning took into account physical and mental healthcare. A ‘Staying Well’ Plan had been written for residents. It contained essential information and was well written. Changing mental and physical healthcare was responded to. Rosedale DS0000009612.V366359.R01.S.doc Version 5.2 Page 15 Comments from people living in the home indicated staff treated them well. Personal care was given according to needs. Records showed most residents needed to be reminded to maintain their own personal care. Preferences for carers support with personal care such as gender issues was not clear. One resident was female. Those residents who were self caring said they did not need any help as they managed very well. There was no written procedure to support staff in the event of a death of a resident. Records of residents medication was kept that included information about service users medication, and what staff should be aware of if someone was not well. Written information received at the Commission indicated staff responsible for administering medication had been trained. During inspection the manager said the policies and procedures for medication management had been updated as requested during the last inspection. Residents could self medicate following an assessment to make sure this would be safe. Currently two residents are supported to self medicate. Medication storage was kept secure. Records were up to date. Rosedale DS0000009612.V366359.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The complaints procedure provided guidance on raising complaints and residents were able to express their concerns and views. In order to fully protect the residents the adult protection procedures required further consideration, and lack of restraint policy meant staff might not be aware of how to handle difficult situations correctly. EVIDENCE: Both informal and formal arrangements were in place for the manager and staff to listen to and act on the views and concerns of residents. This was achieved during daily conversation, one to one discussion with residents, and their key workers and during residents’ meetings. Since the last key inspection the complaints procedure had been finalised and all residents were given a copy. It was displayed in the home and discussed during residents meetings. Minutes taken at the last residents meeting read, ‘Everyone at the house meeting was aware that there was a complaints folder that was located in the lounge and that at any time this was readily available for anyone to access’, and ‘reassurance given all complaints would be dealt with in a confidential manner’. Rosedale DS0000009612.V366359.R01.S.doc Version 5.2 Page 17 The manager said eight staff had completed adult protection training in September 2007. Policies and procedures were available and included ‘whistle blowing’. Records show staff employed in the home, were issued with a contract of employment, and therefore the registered provider had a formal agreement of protection issues, such as staff not benefiting financially from residents, and formal agreement to abide by the homes code of conduct as set out by General Social Care. Whilst staff interviewed recognised their duty and responsibility to report poor practice, safeguarding protocols require further consideration due to the specific circumstances. Two couples worked in the home. The implication of this was discussed with the manager who gave strong assurances there was ‘no favouritism, and that she was confident it did not affect staff confidence to ‘whistle blow’. Records showed related couples sometimes worked together. There was no indication this situation had been considered regarding what systems were in place to give other staff confidence to ‘speak out’, if the need arose. This potentially impacts in the credibility of Safeguarding Vulnerable Adults and requires further consideration to manage this possible circumstance. The types of restraints used in the home to support residents had not been considered such as cigarette allocation, and money management. These must be documented and their need demonstrated and agreed by all parties concerned. Rosedale DS0000009612.V366359.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,27,30 Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. The accommodation did not provide residents with a safe, homely, and comfortable environment to live in. EVIDENCE: The home is ideally located for all main shopping facilities and recreation. Parking is limited, however free parking is available in the town. As a result of legislative requirements being made during the last key inspection in relation to improvements required to upgrade the home, an additional inspection was carried out in September 2007 to monitor progress made. Where improvements were made, these had been sustained. The outcome was as follows. Rosedale DS0000009612.V366359.R01.S.doc Version 5.2 Page 19 The gable end wall in the front room had been re-plastered and remedial work had been undertaken on the outside wall to prevent further damp. Missing staircase spindles had been replaced. Some bedrooms had a new double glazed window fitted. The smoking lounge had two new double glazed windows fitted. The cleanliness of the home was adequate and there were no offensive odours. However a tour of the premises during this inspection showed; The home was not maintained satisfactorily. The front room had been decorated, and the hallway had the original floor tiling exposed. However some remedial work was required to cement crumbling cracked tiles near the lounge doorways. The joining edges of the lounge carpet and hallway had not been secured together, making the carpet edge unsafe and a potential hazard for a trip or fall. The stairs carpet was dirty and stained. There was a gap in the woodwork at the top of the staircase exposing the cavity between the ceiling and floor. The bathroom on the 1st floor had wallpaper peeling off. The bath panel was broken and needed replacing. The carpet required replacing. Water temperature at source for the bath was very hot to touch and a reading taken by the manager during inspection showed a maximum temperature of 55 degrees Celsius. The shower and toilet facilities used by residents were poor. A shower cubicle glass panels were not flush in the frame, and the grouting around the tiles in showers very black with what looked like ‘mildew’. One toilet door was hanging off its hinges and could not be shut. Residents spoken to were generally satisfied with their bedrooms. However new voiles for bedroom windows reported as being ordered at the random inspection in September 2007, had not been provided and resident’s privacy remained compromised. One curtain track had been fitted at an uneven angle and electrical wiring in this bedroom exposed. Some bedrooms would benefit being redecorated as wallpaper was peeling away, and woodwork needed to be painted. Some bedroom carpets were very worn with the groove of the floorboards visible. The smoking lounge did not adequately keep the room ventilated. This was because residents chose to keep the windows shut; therefore some form of smoke extraction was required for health purposes. Essential maintenance appears to be only done when a problem has already arisen. The manager completes requests for repairs in a maintenance book. A handyman works between all Healey Homes for this purpose. Rosedale DS0000009612.V366359.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Staffing levels were sufficient to meet the needs of residents, however staff training was not entirely satisfactory to ensure residents had an effective, consistent, and person centred approach to their care. EVIDENCE: Rotas seen showed an improvement with the numbers of staff on duty at any given time. No staff worked alone during the day. One carer was on night duty covering waking watch, with a support staff sleeping in. The manager said staffing levels in the home allowed for staff to meet the needs of the residents, and supported a person centred approach to care. Residents benefited from one to one care and a Registered Mental health Nurse was employed. Since last inspection no new staff had been employed. The home operated an equal opportunity policy. ‘Staff will be promoted, employed and treated fairly Rosedale DS0000009612.V366359.R01.S.doc Version 5.2 Page 21 on the basis of their ability and merits, and according to their suitability and no-one will be disadvantaged by a condition or requirement, which is not justified by the genuine needs of the job’. The manager said all staff had signed the employee handbook and safety handbook, and staff were given contracts of employment, and job specification. The home had achieved a high percentage of staff trained in National Vocational Qualification in care level 2 and above. Training for staff however had not included specific mental health training as routine for this specialist service, although the manager said this was being arranged. She said training was given on conflict and resolution, although there was no restraints policy and procedure to follow. Training in basic mandatory training needs to improve, for example food hygiene. The manager was aware that there are some gaps in the training programme and had made plans to deal with this. This is required particularly in relation to mental health issues to enable staff to be proactive rather than be reactive with resident care. Written comments from staff indicated they were satisfied with the level of training they received. The manager said there had been a staff meeting July 2007, and January 2008. She was planning to hold them every two months, and staff were receiving one to one supervision. There was no domestic support provided, although there was evidence this was needed for the communal areas of the home, such as hall and staircase, and bathrooms. Staff spoken to was clear regarding their role and what was expected of them. Written comments from staff included, ‘I have completed short courses in moving & handling, first aid also covering basic food hygiene. At this present time I am on a 16 week course to gain NVQ2 in approaches to mental health of which this course is the most important to me because of my role at Rosedale.’ Rosedale DS0000009612.V366359.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,40,42,43 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The management arrangements were not fully effective and therefore did not allow for the home to develop long-term strategies for best practice issues in day to day running of the home. This meant residents health, welfare, and safety was not altogether considered. EVIDENCE: The manager of Rosedale is qualified and experienced to run the Home. She had completed NVQ4 training in care and management. The manager said she was aware of the need to keep up to date with practice and continuously Rosedale DS0000009612.V366359.R01.S.doc Version 5.2 Page 23 develop her skills. She attends training courses alongside the care staff. Arrangements were in place for emergency management out of hours contact. Managers meetings are held every three months, and the manager had regular contact with Mrs Healey the registered provider. The manager was not involved in business planning, however she had a fair understanding of the need to plan ahead and improve the service. She said she was trying to meet with the National Minimum Standards, but has limitations on her role for example with improvements required. She was given a weekly allowance that was sufficient to purchase food and essentials. Any request for larger items needed would go through Mrs Healey. Evidence shows there is a failure by Mrs Healy the registered provider to comply with legislative requirements made within agreed timescales in providing residents with a good standard of accommodation. Staff who completed questionairres for this inspection considered the home did well by, ‘Promotes independence, promotes personal choice among service users. ‘ Gives good care and support for young vulnerable adults with enduring mental illness’. ‘The service provides a residential home in a community setting for service users to build on social skills, working in a holistic way to meet individual needs’. ‘Promoting independence and individuality with as much support as the service user asks for or needs’. ‘I think the whole service does well as a team, the whole household works together aiming for goals set by staff and service users’. The home sent us their annual quality assurance assessment (AQAA), that gave us information we asked for. Rosedale holds ‘Investors In People award’ as part of the Healey scheme. Residents meetings were held every week enabling residents to discuss living at the home. Formal staff meetings were held in addition to regular informal meetings held to discuss resident care. Written comments from staff indicated confidence in the manager. Comments included, ‘In this employment I have a monthly supervision with my manager, which I find very helpful and rewarding as Rosedale’s manager is very approachable’. And ‘regular supervisions, always ready to give support’. Money is held for residents for safekeeping, and part of supporting people to manage their finances. Financial procedures included records kept of transactions made on behalf of people, to provide a clear audit trail. Secure storage was available for the safekeeping of money. There was evidence the manager is improving and developing systems that monitor practice and compliance with the plans, policies, and procedures of the home. However more work is needed in this area to ensure the health, safety, and welfare of residents and staff must always be considered with the range of policies and procedures, aimed at keeping everyone safe. For example, a restraint policy, procedure, and good practice guide being available for staff to work to. Rosedale DS0000009612.V366359.R01.S.doc Version 5.2 Page 24 Information received at the Commission showed regular maintenance of the homes fixtures, fitting and equipment, however despite a new boiler being fitted, the temperature of the water at source was high and a risk to people using showers and bathing. Staff training records showed essential mandatory training was being given to staff, however there were gaps in training identified by the manager, who was currently arranging for this training. Rosedale DS0000009612.V366359.R01.S.doc Version 5.2 Page 25 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 2 ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 1 28 X 29 X 30 2 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 2 36 3 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 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 2 3 X 3 2 X 1 2 Rosedale DS0000009612.V366359.R01.S.doc Version 5.2 Page 26 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 2 Standard YA5 YA23 Regulation 5(b)(c) 13(6) Requirement People using the service must be informed of the fees they are charged. To make sure residents are not placed at risk of harm or abuse, safeguarding vulnerable adults policy, procedure, and practice must be robust in managing all circumstances. Previous timescale 18/09/07 not met. The home must be maintained to a satisfactory standard. Previous timescales 31/08/07 and 18/09/07 not met. The shower panels and bath panel must be made safe. A more suitable means of extracting cigarette smoke form the smoking room must be provided, as residents do not want the windows left open. Persons working in the care home must receive training appropriate to the work they perform. Previous timescales 24/05/05, 31/08/07, and 18/09/07 not met. DS0000009612.V366359.R01.S.doc Timescale for action 31/05/08 31/05/08 3 YA24 23(2)(b) 30/06/08 4 5 YA27 YA30 13(4) 12(3) 30/06/08 30/06/08 6 YA35 18 30/06/08 Rosedale Version 5.2 Page 27 7 YA40 10,12 8 YA42 12(1a) 13 (4) 9 YA43 26 Regulatory requirements must be addressed within the timescales set by the Commission. There must be proper arrangements in place to ensure residents are not at risk of accidental scalding whilst bathing. Previous timescales of 24/05/05, 29/06/07, and 18/09/07 not met. Mrs Healey Registered Provider must visit the home once a month and make a report of the visit, forwarding a copy of the report made to the Commission. 30/06/08 30/06/08 31/05/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard YA5 YA9 YA21 YA30 YA40 Good Practice Recommendations Residents should be informed of their individual cost for staying at the home. More information is needed to link risk management into daily living needs, and show how people were kept relatively safe with support from staff. A procedure should be available for staff to deal with the event of a death. The stairs carpet should be kept clean. Policies and procedures should be kept up to date with current good practice. Rosedale DS0000009612.V366359.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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. 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