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Inspection on 20/04/05 for Rosedale Court

Also see our care home review for Rosedale Court for more information

This inspection was carried out on 20th April 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Rosedale Court was registered on 31st March 2005, only 20 days before the first inspection. The standard of decoration, furnishings and fitments throughout the home is of a high standard. The home has a good sized garden/patio area for the enjoyment of residents. Staff spoken with were committed to providing a good service and were enjoying the experience of being part of establishing a brand new home. Information gained at the next inspection will be used to develop this part of the inspection report.

What has improved since the last inspection?

This was the first inspection since the home was registered on 31st March 2005.

What the care home could do better:

The shortfalls found on the 20th April were disappointing, as the home had only been registered for 20 days. However, the second visit on 26th April was more positive as the home had addressed many of the shortfalls. The home must establish a more robust local management structure to provide continuity of leadership and direction. At present the home does not have a registered manager or deputy in place. During the absence of a local manager, Runwood plc must ensure that systems and practices are regularly monitored to ensure compliance with regulation and the national minimum standards. The home has all the potentials of providing a high standard of care, but this will only be achieved by the continuity of robust management.

CARE HOMES FOR OLDER PEOPLE Rosedale Court Hockley Road Rayleigh Essex SS6 8EP Lead Inspector Ann Davey Christine Bennett Announced 20 April 2005 & 26 April 2005 09:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rosedale Court 156 S64180 RosedaleCourt 222931 200405 Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Rosedale Court Address Hockley Road Rayleigh Essex SS6 8EP 01268 773180 01268 774025 rosedale.court@runwoodhomes.co.uk Runwood Homes plc Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) N/A Care Home 14 Category(ies) of registration, with number DE(E)) Dementia - over 65 of places Rosedale Court 156 S64180 RosedaleCourt 222931 200405 Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection N/A Brief Description of the Service: Rosedale Court is a large detached building set back from the main road. The home is approxmately 1 mile from Rayleigh town centre. At present the home is registered to provide personal care for 14 service users on the ground floor. All bedrooms have ensuite factilites and there are separate lounge, dining, bathroom areas. The home has good car parking facilities. There is a garden/patio area to the rear of the buiding. This area has yet to be furnished with garden seats and furniture. Rosedale Court 156 S64180 RosedaleCourt 222931 200405 Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Rosedale Court has made application to provide care for 74 residents with dementia and 40 service users requiring nursing care. At this stage, the home has registration to provide personal care for 14 residents only. This was granted on 31st March 2005. The home does not have a registered manager. Runwood plc met with the Commission for Social Care Inspection on 14th April 2005 to discuss increasing the registration numbers to 33 service users with dementia. A visit to the home was arranged to take place on 20th April 2005, to assess the staffing situation. The findings at that visit were not acceptable to the Commission for Social Care Inspection and a further announced visit was arranged for 26th April 2005. The second visit evidenced that the home had addressed many of the shortfalls identified on 20th April 2005. This report contains the findings of the announced visits that were undertaken on 20th April 2005 and 26th April 2005. The Director of Care & Nursing (for Runwood) and the acting manager were present on both occasions. The visit on 20th April 2005 lasted 4 hours and the visit on 26th April 2005 lasted 3.5 hours On both occasions a partial tour of the home was undertaken, staff records were examined and staff were spoken with. In addition, on 26th April residents and members of staff were spoken with and care records/medication examined. What the service does well: Rosedale Court was registered on 31st March 2005, only 20 days before the first inspection. The standard of decoration, furnishings and fitments throughout the home is of a high standard. The home has a good sized garden/patio area for the enjoyment of residents. Staff spoken with were committed to providing a good service and were enjoying the experience of being part of establishing a brand new home. Information gained at the next inspection will be used to develop this part of the inspection report. Rosedale Court 156 S64180 RosedaleCourt 222931 200405 Stage4.doc Version 1.30 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. Rosedale Court 156 S64180 RosedaleCourt 222931 200405 Stage4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Rosedale Court 156 S64180 RosedaleCourt 222931 200405 Stage4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) x EVIDENCE: Rosedale Court 156 S64180 RosedaleCourt 222931 200405 Stage4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 and 9 The home had a good standard of care planning and medication documentation. However, risk assessments must be implemented with no delay to minimise potential harm and risk to residents. EVIDENCE: 26th April 2005, admission assessments, care and medication records of the 3 residents accommodated were examined. These were in good order, but there were no risk assessments in place. It is recommended that staff receive further training on the use of appropriate documentation, as information which should be noted on the daily occurrence sheet(s) was found in the care plan section. Is important that as the home has only been registered for 26 days, that good recording systems are implemented and maintained. It is important that the acting manager takes a more positive role in the leadership of the home at this stage to establish and monitor good recording practices. Although two of the three current residents have only been accommodated for a very short period of time, they were positive about the care received. Rosedale Court 156 S64180 RosedaleCourt 222931 200405 Stage4.doc Version 1.30 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15 The home’s projected menu indicates a balanced varied diet is provided, but limited records were available to support what is actually served and eaten. EVIDENCE: Residents were positive about the quantity and quality of food, but the home does not maintain a record of the foods eaten. Rosedale Court 156 S64180 RosedaleCourt 222931 200405 Stage4.doc Version 1.30 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) x EVIDENCE: Rosedale Court 156 S64180 RosedaleCourt 222931 200405 Stage4.doc Version 1.30 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 26 The standard of decoration, furnishing and maintenance around the home is high. EVIDENCE: The home has been registered for only 26 days and still has the atmosphere of ‘newness’ about it. The environment for residents is homely, attractive, clean and pleasant. Residents were positive about the environment. Rosedale Court 156 S64180 RosedaleCourt 222931 200405 Stage4.doc Version 1.30 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,& 30 Staffing levels on 20th April 2005 were not in sufficent numbers to provide adequate care for 14 residents. Staff records available could not demonstate that the home has robust recruitment, induction and training proedures in place to safeguard and protect residents. On 26th April 2005, staff records for recruitment, induction and training were in place. In addition there were sufficient numbers of staff to provide adequate care for 14 residents. EVIDENCE: Visit on 20th April 2005. The home was unable to demonstrate that there were competent, skilled and experienced staff in sufficient numbers to provide adequate safe care for 14 residents. One member of senior staff had been rostered to work 83 hours in one week. The rota available was incomplete. Not all staff recruitment/training/induction files were available or completed and many were in a state of disorder. The acting manager was unable to justify the findings. Visit on 26th April 2005 Since the last visit it was positive to note that the shortfalls identified at the last inspection had been addressed. It was disappointing to note that the Rosedale Court 156 S64180 RosedaleCourt 222931 200405 Stage4.doc Version 1.30 Page 14 acting manager had not visited the home over the weekend between the two visits as agreed on 20th April. The home is still in the process of consolidating staff training records. The home now has sufficient staff on duty for every shift to provide adequate safe care for 14 residents. The home is undertaking a recruitment drive for more staff in preparation for the home to apply for an increase in the registration numbers. Rosedale Court 156 S64180 RosedaleCourt 222931 200405 Stage4.doc Version 1.30 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38. On 20th April 2005, the absence of appropriate COSHH, safety, hygiene and safe working practice assessments did not promote a safe working environment for staff or a healthy, safe environment for service users. On 26th April 2005, COSHH, hygiene and safe working practice assessments were evident. EVIDENCE: Visit on 20th April 2005. There were no safety, hygiene notices or safe working practice assessments displayed in the kitchen, laundry or ironing areas. There were no COSHH notices displayed. Runwood plc had assured the Commission for Social Care Inspection on 14th April 2005 these would be in place. Rosedale Court 156 S64180 RosedaleCourt 222931 200405 Stage4.doc Version 1.30 Page 16 An unattended, unguarded hot roller ironing machine had been left in operation. The member of staff who had left it unattended, later explained that she had no written operating instructions. The floor of the laundry area had a number of screwed up green hand drying papers on it, dirty dusters had been left along the side of a wall and the handwashing sink contained 2 incontinent pads. The sink itself was stained and required cleaning. It was noted that toilet cleaning brushes were being placed in all communal toilets, ensuites, staff and visitors toilets. The member of staff dealing with this was unable to discuss infection control issues. The Director of Care & Nursing for Runwood plc and the acting manager were unsure about why these had been ordered and distributed. There were no infection control measures in place concerning the management of hygiene/infection control issues concerning the use of toilet brushes. Visit on 26th April 2005 It was positive to note that that since the last inspection, notices had been displayed and other safe working documentations was available and the laundry area was cleaner and clearer, although the hand basin was still stained and required further cleaning. The home will take further advise from the relevant agency concerning the management of hygiene/infection control issues concerning the use of toilet brushes. Rosedale Court 156 S64180 RosedaleCourt 222931 200405 Stage4.doc Version 1.30 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 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 Standard No 16 17 18 Score x x x x x x x x x x 3 Rosedale Court 156 S64180 RosedaleCourt 222931 200405 Stage4.doc Version 1.30 Page 18 N/A 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 7 Regulation 13 Requirement The registered person must ensure that risk assesment documentaion for residents is put in place and reviewed at regular intervals The registered person must ensure that adequate food records are maintained Timescale for action 01/05/05 2. 15 16 01/05/05 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. 2. Refer to Standard 7 38 Good Practice Recommendations The registered person should ensure that staff are appropriately trained in all aspects of care planning documentation. The registered person should take advise from the appropiate agency concerning the management of hygiene/infection control matters. Rosedale Court 156 S64180 RosedaleCourt 222931 200405 Stage4.doc Version 1.30 Page 19 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Court 156 S64180 RosedaleCourt 222931 200405 Stage4.doc Version 1.30 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!