Inspection on 24/01/07 for Rosedale House

This inspection was carried out on 24th January 2007.

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

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

Other inspections for this house

Rosedale House 15/03/10

Rosedale House 14/01/09

Rosedale House 25/02/06

Rosedale House 17/08/05

Rosedale House 30/03/05

Rosedale House 14/09/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Rosedale House 163 West Town Lane Brislington Bristol BS14 9EA Lead Inspector Ashley Fawthrop Key Unannounced Inspection 24th January 2007 10:00 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 House DS0000026514.V328627.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 House DS0000026514.V328627.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosedale House Address 163 West Town Lane Brislington Bristol BS14 9EA 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) 0117 9714991 0117 9714991 Mrs Ann Rogers Ms Julie Edwards Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Rosedale House DS0000026514.V328627.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 23 persons aged 65 years and over, requiring personal care 25th February 2006 Date of last inspection Brief Description of the Service: Rosedale House is a privately owned care home registered with The Commission for Social Care Inspection to provide accommodation and personal care for up to 23 people aged 65 years and over. The home is situated in a residential suburb of Bristol near to main bus routes, local shops and amenities. The home has major roads on two sides and a large sports field across one of these roads. The property is an older detached building and the accommodation is provided in single rooms with four communal rooms on the ground floor. Access to the middle and top floor bedrooms is by passenger lift and a separate chair lift. The home is surrounded by well-kept gardens and has off road parking. Fees levied on the 24th January 2007 were £249.00 to £425.00. Additional charges are levied for Hairdressing £5.00 to £15.00 and Chiropody £5.00 Rosedale House DS0000026514.V328627.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out without prior notification and was conducted by one inspector. I case tracked three people using the service. Case tracking is the method used to assess whether people who use services receive good quality care that meets their individual needs. Where appropriate, issues relating to the cultural and diverse needs of residents and staff were considered. Pre inspection information was received before the visit was done and on the day of the inspection the staff were open and helpful throughout. The inspection included looking at records such as care plans and reviews of the care for people using the service and other related documents. I also read policies and procedures relating to the protection of vulnerable adults and health and safety. The views of the staff and people using the service were gathered either by face- to- face discussions or by surveys. What the service does well: The pre admission information and pre admission procedures are good. People wishing to use the service have good information and are able to make a decision as to whether the home can meet their needs or not. Pre admission information is sufficient enough to allow staff to start a care plan from admission. People living at the home are involved in the planning of their care. This makes sure the plan is individual to them. People are able to organise their own days and enjoy their own privacy, those wishing to join in activities are able to do so. People using the service said they were happy with the care they received, visitors are happy with the care offered and said they were kept up to date with any changes with the health and well being of their relative. Other professionals said that the staff were caring and friendly and had no concerns about the care offered. The home is comfortable well maintained and people’s rooms are individually decorated and furnished this gives the feeling of individuality and ownership. Rosedale House DS0000026514.V328627.R01.S.doc Version 5.2 Page 6 People using the service are protected by the homes policies and procedures relating to complaints and protection of vulnerable adults. Staff are recruited and trained well and the health and safety procedures are safe. 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 House DS0000026514.V328627.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 House DS0000026514.V328627.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): 1,2,3 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The pre admission information is sufficient and detailed enough for any one wanting to use the service to make an informed decision as to whether the home can meet their needs or not. The pre admission procedures are robust and make sure that only the people whose needs can be met by the home are admitted. EVIDENCE: There is a statement of purpose and service users guide available to all the people using the service and people who may be interested in using the service in the future. Both documents have information that relates to the service provided by the home. Rosedale House DS0000026514.V328627.R01.S.doc Version 5.2 Page 9 There is other information relating to the experiences and staff training, how to complain, some policies and procedures and activities. This information gives people a good insight into what the home is offering as a service. All people who use the service have a contract that records all the services the home offers with costs, any additional service offered that would levy an additional cost. People using the service know exactly the cost of the service including any additional costs. All three of the case records I looked at had pre admission assessments done by senior staff at the home. Those admitted into the home by the Social services have an assessment done by the Social Worker as well as the homes staff. Both assessments give staff good information prior to the person being admitted into the home allowing them to commence an informed care plan from the date of the admission. The manager told me that all the people wishing to use the service have the opportunity to visit the home before admission, but nothing is written in the care plan as evidence to this. I spoke to people who had recently come to the home and they told that they themselves had visited the home to look around before admission or members of their family had. Rosedale House DS0000026514.V328627.R01.S.doc Version 5.2 Page 10 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 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People receive the care from the staff that meets their needs but the recording of information should be kept up to date. The recording, storing and disposal are safe. People using the service are treat with consideration EVIDENCE: The three care plans that were case tracked were well set out, clear to read and contained a lot of information that assists the staff to give the right care. The care plans appear individual to the person and asks the person questions about themselves their likes, dislikes and daily routines. This involves the individual in the planning care and tailors it to their needs. Rosedale House DS0000026514.V328627.R01.S.doc Version 5.2 Page 11 Assessment relating individual risks to people in the home had been recorded with what action staff should take to reduce the risk. These showed staff were aware of the risks to individuals and were working to keep them safe. There was evidence that other health care professional were involved in the care of people where needed. These include doctors, district nurses and staff of other National Health facilities. Professional involved with the home had no concerns about how the home cared for people and said that staff were friendly and caring. The care plan of one service user did not reflect the care needed at that time as there was evidence that the individuals health had deteriorated quickly over recent days but the care plan had not been updated to reflect this. This is not good practice as the up to date care was not being recorded and any new staff would not know the care had changed. On other care plans some dates were missing so it was difficult to assess whether the information was up to date. On another relevant information about a person had not been added to the plan. This information may have affected the person emotionally and not all staff may have been informed leading to a misjudgement of the persons health needs. The care plans contained information on the requests made by the family and resident at the time of the resident’s death. Overall the care plans were well recorded and informative. People using the service said that their medical needs were either usually or always met. The medicine administration sheets, which were looked at and all been filled in correctly and were up to date. I spoke to the member of staff giving out the tablets and she was able to describe how it was done. The procedure was safe Medications were stored in locked cabinets, no tablets were held in stock and only prescribed medications were given. The handling and storage of medications is safe and the risk of mistakes is low. Several residents could describe how staff knocked before entering their bedroom and spoke to them in a polite respectful manner. Rosedale House DS0000026514.V328627.R01.S.doc Version 5.2 Page 12 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 and 15, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The residents are having sufficient recreational activities but they should be more involved from admission Residents are encouraged and supported by the staff to maintain contact with their families. Residents have control over their own lives and can make choices. Residents receive nutritional meals, which they are satisfied with. EVIDENCE: There are activities organised by the home. These include an entertainer who visits each month. He plays instruments and sings. The manager said that he interacts well with people and tries to involve new people who have recently come to the home and said this does help to settle people. There are a number of people who either go out to shop or go out with their family for the day or over night at weekends. Rosedale House DS0000026514.V328627.R01.S.doc Version 5.2 Page 13 Other activities include board games, bingo Arts and crafts, films and skittles. The manager said that it is difficult to engage some people in activities. I advised that the home should continue to offer activities and possibly focus on what people have done in the past as part of the admission process and try to facilitate them to continue with these. The residents regularly described their experience of living in the home, as what they did rather than what was being done to them by the staff. This was seen as evidence that residents felt able to express themselves. People who use the service said that they were able to move around the home as they wished. People said they could sit in their rooms if they wanted to and entertain their visitors in private. Residents were able to describe how their families came and went. During the visit visitors were offered the opportunity to express their view of the home. They said that the staff were always helpful and caring and that they were always kept up to date with changes in health and wellbeing of their relatives. During the visit visitors were seen to come and go. They knew the staff and the atmosphere was warm and friendly. The manager and cooks plan the menus on a weekly basis. People who use the service are involved by adding their preferences of meal and food. There is a choice at breakfast but the main and evening meals are set. Alternatives are offered and theses are recorded. I recommended to the manager that vegetable and fruit be identified on the menu. This evidence that people are getting five portions a day as recommended. Foods and meals from other countries can be prepared and this is part of care planning where people using the service are from other countries or ethnic backgrounds. The meals look nutritious and well balanced. People said that they usually or always enjoyed the meals. I observed the mid day meal the meal was not rushed and staff did not hover around people. Where help was needed this was given and people interacted well and gave the feeling of a social event. Rosedale House DS0000026514.V328627.R01.S.doc Version 5.2 Page 14 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 and 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use the service are protected by both the complaints and adult protection procedures. EVIDENCE: No complaints have been received by the Commission (CSCI). The home has a complaints procedure that is easy to understand and is available to people who use the service and their families. There is a procedure for dealing with complaints that includes an acknowledgement of the complaint and a letter detailing the outcome. This is good practice as it keeps the complainant informed of the investigation and the outcome of their complaint. People using the service said that they were aware of the complaints procedure and knew who to complain to and referred to the owner of the home and manager by name. There are policies and procedures relating to the protection of vulnerable adults. Rosedale House DS0000026514.V328627.R01.S.doc Version 5.2 Page 15 Training records showed that training was being given in “protecting residents from abuse”. None of the residents interviewed mentioned any problems with any of the staff. Residents said the staff were good and treated them like individuals. Rosedale House DS0000026514.V328627.R01.S.doc Version 5.2 Page 16 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, 20, 23, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a management team which works towards improving the home’s environment, keeping it clean and free from odours. People live in rooms which suit their needs, and that are individually furnished and decorated. EVIDENCE: The home continues to be well-decorated, clean, warm, tidy and adequately furnished. There were a range of communal rooms available to residents and all were being used. The garden was well maintained by one of the residents. On touring the building individual rooms were seen. These were individually decorated and furnished giving a feeling of individuality and ownership. Rosedale House DS0000026514.V328627.R01.S.doc Version 5.2 Page 17 People were seen to be enjoying the privacy of their own rooms and I was able to speak to a number in private. Their comments are reflected in this report. Since the last inspection the roof has been repaired where water was dripping into the dining room. There are staff that are employed as cleaners and there was evidence of cleaning equipment and materials available to keep the home clean and tidy. Equipment was available to help to neutralise any unpleasant odours. Disposable aprons and gloves were available to staff and liquid soap was available in toilets and bathrooms. This is good practice as it helps to control infection and cross infection. There are plans to improve the environment, the care park is to be enlarged and resurfaced. The paving into the garden is to be made good as this area is a trip hazard. The external paintwork is to be renewed. Rosedale House DS0000026514.V328627.R01.S.doc Version 5.2 Page 18 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are cared for by staff who have been trained and attend training courses. People are also protected from potential abusers by the homes recruitment and selection policies and procedures. EVIDENCE: There is a mix of staff both in age experience and qualifications. This is good as the people in the home benefit from wealth of experience and skill. All staff undertake a comprehensive induction. On their completion they are sent to an independent assessor and certificate is awarded on their completion. This is good practice because it is evidence that staff have a good knowledge of the home soon after employment. All staff undertake training monitoring as part of supervision, these show training that has been completed. Rosedale House DS0000026514.V328627.R01.S.doc Version 5.2 Page 19 Mandatory training such as first aid, moving and handling, basic food hygiene and health and safety is done as well as National Vocational Training at levels one and two. The recruitment and selection procedures include application from staff with a past work history, This is good practice as the manager can satisfy herself that any gaps in employment are not due to poor practice. Two written references are sought prior to employment and checks by the Criminal Records Bureau are done on all staff before employment. On the day of the visit, several of the staff on duty were trained to National Vocational Qualification level two or above. Staff records showed that they attend regular training and there was evidence of supervision. The staff were able to protect others from exposure to infection because they demonstrated they understood the infection control procedures. The home had the two policies that were requested on this visit. Rosedale House DS0000026514.V328627.R01.S.doc Version 5.2 Page 20 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): 31, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from a service that keeps their interests central to what is provided and the leadership is service user focused. EVIDENCE: A competent manager who continues her professional development runs the home. The manager is an NVQ assessor. The management team is committed to improving the quality of life for the residents. This can be demonstrated in the improvements made since the last visit. Rosedale House DS0000026514.V328627.R01.S.doc Version 5.2 Page 21 People who use the service have the opportunity to have a say on how the home is run and how services are delivered. Service Users are consulted individually at the reviews of their care and as a group at meetings. Staff also have meetings to discuss how the care is delivered and share ideas. Both these meetings are recorded and given to all staff. These meetings are good practice as they evidence those opinions of all the people at the home are important and not just that of senior staff. The home does not normally deal with the finances of people in the home. Families or representatives normally deal with these. Fees are normally paid by automatic banking. The home has a robust management system that includes all the Health and Safety policies relating to the home. All the major services have been inspected by people qualified to do so and include electrics, gas and water. The passenger lift hoists and other equipment are serviced regularly under contract. Rosedale House DS0000026514.V328627.R01.S.doc Version 5.2 Page 22 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 3 3 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 X 2 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 X X 3 X X 3 Rosedale House DS0000026514.V328627.R01.S.doc Version 5.2 Page 23 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 15(1) Requirement The registered provider must make sure that all information written in care plans is dated. Timescale for action 31/05/07 2 OP8 Schedule 3(3)(m) The registered person must 31/05/07 make sure that where the care for people changes, the care plan is updated to reflect this change. The registered provider must make sure that the paving in the garden is safe to walk on or find an alternative route 30/03/07 3 OP25 23(2)(b) Rosedale House DS0000026514.V328627.R01.S.doc Version 5.2 Page 24 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 OP14 Good Practice Recommendations Staff should make sure that the hobbies and pastimes of people coming into the home are explored and where possible facilitate the person to continue with these pastimes When planning menus the staff should record which fruits and vegetables are served as evidence that people receive the recommended five per day. 2 OP15 Rosedale House DS0000026514.V328627.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 House DS0000026514.V328627.R01.S.doc Version 5.2 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. 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!