Inspection on 07/06/07 for Rosedale Care Home

This inspection was carried out on 7th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 Care Home 25/07/06

Rosedale Care Home 09/02/06

Rosedale Care Home 10/08/05

Rosedale Care Home 03/03/05

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

CARE HOMES FOR OLDER PEOPLE Rosedale Care Home 36 Lansdowne Road Luton LU3 1EE Lead Inspector Katrina Derbyshire Unannounced Inspection 7th June 2007 12:15 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rosedale Care Home DS0000062137.V334595.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rosedale Care Home DS0000062137.V334595.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosedale Care Home Address 36 Lansdowne Road Luton LU3 1EE 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) 01582 481188 F/P 01582 481188 Mr Cornelius Crowley Mr Stephen Giles Betty Ann Woolford Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (20), Old age, not falling within any other category (20), Physical disability over 65 years of age (20) Rosedale Care Home DS0000062137.V334595.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Numbers of service users 20. Age over 65 years including the two named service users under the age of 65 years who are currently accommodated at Rowles House. Categories: Older people with physical disorders, mental disorders or dementia OP, PD(E), MD(E), DE(E). 25th July 2006 Date of last inspection Brief Description of the Service: Rosedale is a large three-storey home located in a residential suburb of Luton within a mile of the town centre. There are local shops, parks and churches close by. The home is registered to provide care for 20 people over the age of 65. Accommodation is provided on three floors linked by stairs and a passenger lift. All the bedrooms are single rooms. Communal accommodation consists of a lounge/diner on both the ground and first floor and a conservatory off the ground floor lounge. Some off-road car parking is available at the front of the home with time limited road parking available on the street outside the home. The Registered manager provided the following information on charges in June 2007. The fees for this home vary from £420.00 per week, to £480.00 per week, depending on the funding source and assessed need of the person. Additional charges are made for hairdressing, barber services and newspapers. Rosedale Care Home DS0000062137.V334595.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was to undertake a key inspection. This unannounced inspection was carried out on 7th June 2007. During the inspection several areas of the home were visited and the inspector spent time with some of the people who live at the home in the communal areas. The care of three people was examined by looking at their records and interviewing them and staff who look after them, alongside speaking with other people that live at the home and visiting relatives. Information from the home, through written evidence in the form of an Annual Quality Assurance Assessment has also been used to assess the outcomes within each standard. Evidence used and judgements made within the main body of the report include information from this visit. Observations of care practice and communication between the people living at the home and staff was also made at the inspection. The focus of this inspection was to look at the key standards and to follow up on previous requirements. What the service does well: Relatives of people living here feel that they still are involved in their care and support. One person said, “my aunt looked at other homes before deciding on this one, whenever l come staff always chat away and let me know what is going on”. Another relative said, “The staff are very kind and are always pleasant to me when l visit”. So people living at the home and families also feel that staff support them in maintaining relationships that are important to them. Staff at the home are also good at arranging access to health care professionals when people require their support. District Nurses for example visit the home when needed to provide care to people who need their help. They also make sure that if a person needs to attend a hospital appointment, then transport is arranged or other arrangements are made. This means people benefit from access to medical services when they need them. Rosedale Care Home DS0000062137.V334595.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Rosedale Care Home DS0000062137.V334595.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rosedale Care Home DS0000062137.V334595.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Pre admission assessments is now sufficient to ensure people can make an informed choice as to whether to move into the home or not. EVIDENCE: On examination of care records an improvement was noted in the pre admission assessment documentation in place. Assessment documentation was in place for people that had moved into the home recently. This showed that the social, psychological and physical needs of the person had been looked at to ensure staff would know if they had the skills and experience to meet their needs. Management through discussion confirmed that an assessment of someone’s needs was always undertaken prior to their admission. Intermediate care is not provided at the home. Rosedale Care Home DS0000062137.V334595.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Access to heath care is good ensuring people receive specialist care and support although improvements are still needed in the management of medication systems to ensure people living at the home benefit from safe audit systems. EVIDENCE: Care plans were in place for most of the assessed needs of people whose care was tracked and were kept in ring binder folders. Improvements were noted since the previous inspection, however further development is still needed. One example was that a person had been assessed as being at high risk concerning their nutritional needs within their admission paperwork. The guidance was not sufficient to direct staff in how to reduce any risks in this area. No entries had been made to indicate that they should consider supplements for example; or monthly re assessment. Rosedale Care Home DS0000062137.V334595.R01.S.doc Version 5.2 Page 10 People spoken with confirmed that they could see their General Practitioner when needed. Documentary evidence was also seen that people had received treatment from services such as chiropody and opticians. Assessment of risk in relation to skin integrity had been undertaken by staff at the home for the people living there. Equipment was also seen to be in place including pressurerelieving cushions and these were noted to be in place in accordance with the persons needs. However the risk assessment relating to the nutritional needs of people was not clear. One document was in use to assess a variety of needs, where a high risk in nutritional needs was evident guidance was not clear in what action staff should take or linkage to the persons care plan. People spoken with indicated that they felt their privacy had been maintained by staff. All people had individual rooms and staff were seen to knock on these doors prior to entering. The receipt and storage of medication was secure. Records were maintained of medication ordered and individual care records contained listings of the prescribed medication of each person, which matched the entries within the actual medication administration records. A staff member was seen to give out medication around the lunchtime meal, and their practice was noted to follow current best practice guidelines. Staff responsible for the administration of medicines had received training updates, which are certificated. All returns are receipted and records were up to date and accurate. However the balances of medication are not clear so an audit of stock against administration records was not possible in all cases, the need to maintain a running balance is required and was discussed with the manager at the time of the inspection. Rosedale Care Home DS0000062137.V334595.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People at this home feel that arrangements in place for activities are good and meet their social needs. EVIDENCE: Several people spoke of the activities available to them in the home and one person commented “ l enjoy the garden”. Information supplied by the home to the Commission for Social Care Inspection showed that activities arranged in the home included outings, church services and visiting entertainment. The Bedfordshire library service also visits the home. Equipment was seen to be in place that could be used to meet the social needs of the people living at the home. At the time of this inspection some people were engaging in an activity. A relative of one person was seen to be visiting at this inspection. A family member of one person said, “ l find the staff very nice and they make me feel Rosedale Care Home DS0000062137.V334595.R01.S.doc Version 5.2 Page 12 welcome”. People spoken to spoke of being able to receive visitors when they wished and many would chose to see them in the privacy of their own rooms. The manager confirmed that the home continued to invite relatives and friends to certain events that the home organised. Entries were also seen within people’s records that demonstrated that the staff at the home would contact the nominated next of kin if there had been a change in their well being, one example of this was following an accident and the contact details had been recorded by the staff member. Options available to people in maintaining control, independence and choices in their lives included, choice of meals, voting, choice of clothing, access to a complaints procedure and access to community healthcare support. People living at the home and records confirmed that the choices associated with people’s daily lives were available to them whilst living in this home. Menus are available in the home and show that a diet is provided that includes fruit and vegetables. Several of the people when spoken to regarding the meals in the home said that the standard of cooking was satisfactory. However some stated that they felt there was repetition in what was offered especially with the sandwiches offered. They said that on some days the food was tasty and of a very good standard yet on others their meals could on occasion taste bland. This was discussed with the manager on the day of the visit to the home and the quality of the food provided. Rosedale Care Home DS0000062137.V334595.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Systems in place at this home for receiving and investigating complaints is good so people are assured that their concerns will be acted upon. EVIDENCE: Complaints received at this service had been kept alongside documents to show the investigation carried out, response and any recommendations made following the investigation. All comments recieved indicated that they knew who to speak to if they were unhappy. Within the homes statement of purpose there was details on how you could complain and to whom. Staff when interviewed gave satisfactory responses on their responsibilities if they were to receive a complaint and this matched the guidance within the homes own procedure. Records supplied by the home to the Commission for Social Care Inspection show that staff had undertaken training in the protection of vulnerable adults. On interviewing one member of staff they demonstrated a sufficient level of knowledge on the types of abuse including physical and psychological. In Rosedale Care Home DS0000062137.V334595.R01.S.doc Version 5.2 Page 14 addition the homes procedure in this area was examined, it’s reflected the local guidance. The management had sought a copy of the local protocols. The management and staff at the home did demonstrate through discussion an understanding of the need to refer any allegation or suspected abuse. Rosedale Care Home DS0000062137.V334595.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The general maintenance of the environment and furnishings in some areas of the home is good to create a pleasing and pleasant environment for people to live in. EVIDENCE: As previously reported risk assessments in relation to the environment were seen. They had been reviewed yearly. Safety aspects covered included, routine testing of electrical equipment, safe handling and storage of hazardous substances, risks of burns and scalds, infection control, use of equipment and maintenance of the same, flooring doors and smoking. The accommodation was provided over three floors and accessed via a passenger lift. The location and layout of the home was noted to be suitable for Rosedale Care Home DS0000062137.V334595.R01.S.doc Version 5.2 Page 16 its purpose. Furnishings and fittings were domestic. The communal areas in the home were clean and tidy and bedrooms contained personal items, which reflected their individual personalities. The communal areas of the home were clean and free from offensive odours at the time of inspection as were individual rooms seen by the inspector. Policies were in place regarding infection control and staff were seen to be using protective clothing. Hand washing facilities were sited in the areas where waste was being handled. Rosedale Care Home DS0000062137.V334595.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The systems in place for the recruitment of staff and vetting of prospective employees are robust and of a good standard and protect people. EVIDENCE: The induction and training of staff was recorded in the individual records of all employees. Staff through interviewing confirmed that they had undertaken a variety of courses these included health and safety, moving and handling and national vocational qualifications in care. Several of the people living at the home made positive comments on the skills of the staff team, one person said “they always seem to know what to do”. The homes recruitment policy and procedures as previously assessed are clear and comprehensive, documents submitted by the home to the Commission for Social Care Inspection show that no change has taken place to these policies. References are taken prior to staffs’ commencement and the relevant Criminal Records Bureau check is also carried out and evidence of this having been undertaken was seen. Certificates of qualifications are present within staff files. Rosedale Care Home DS0000062137.V334595.R01.S.doc Version 5.2 Page 18 Senior support workers, care assistants, catering and housekeeping staff are employed at the home. The rotas supplied by the home show that there are sufficient numbers of staff on duty throughout the day and night to meet the needs of the residents at this time. People confirmed that staff were available to help and assist them when they need help. Training records examined that were supplied by the home show that staff had undertaken statutory training, including moving and handling, fire safety and food hygiene. In addition staff confirmed that they had attended a variety of courses including dementia awareness. People living at the home who were spoken with felt that the staff had a satisfactory level of knowledge and felt confident in their abilities to meet their needs. Staff were questioned on the individual needs of some of the people who live at the home, through this they demonstrated a good level of understanding of the needs of the person. One staff member had a very good level of knowledge relating to one person, and was able to describe their individual likes, dislikes, family history and the level of care and support needed. Rosedale Care Home DS0000062137.V334595.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Health and safety in the home is managed well and reduces the risk of accidents to people at the home. . EVIDENCE: Documents pertaining to the management of Fire, environmental Health and internal safety checks were seen. All were up-to-date and demonstrated that required safety measures were in place to meet the relevant legislation in this area. Staff and their training records confirmed that they had been trained in a variety of Health and Safety areas including moving and handling, food hygiene and infection control. Rosedale Care Home DS0000062137.V334595.R01.S.doc Version 5.2 Page 20 Monies held on behalf of people by staff at the home were examined. Balances were noted to be correct and documents were in place to ensure an audit trail was in place. People living and visiting the home reported that they found the manager to be a very good listener and all felt that she was very easy to talk to and that they trusted her. Staff said that they found the manager to be very committed to the care of the residents and approachable. Other people living at the home said that the manager was nice and their comments suggested that they felt confident in her abilities. Rosedale Care Home DS0000062137.V334595.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Rosedale Care Home DS0000062137.V334595.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 12(1)(a)1 5 Requirement A care plan must be in place for all assessed needs with sufficient guidance to staff to ensure continuity of care for everyone living at the home. Medication balances must be kept and brought forward to ensure an audit can be undertaken. A varied diet that is of a sufficient standard must be available to meet the individual needs, preferences and nutritional needs of the people living at the home. Timescale for action 31/08/07 2. OP9 13(2) 31/08/07 3. OP15 12(1)(a)1 9 31/08/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000062137.V334595.R01.S.doc Version 5.2 Page 23 Rosedale Care Home Standard Rosedale Care Home DS0000062137.V334595.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rosedale Care Home DS0000062137.V334595.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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