Inspection on 23/04/07 for Rosedale Manor Care Centre

This inspection was carried out on 23rd April 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Rosedale Manor Care Centre 23/04/08

Rosedale Manor Care Centre 23/05/06

Rosedale Manor Care Centre 06/01/06

Rosedale Manor Care Centre 19/07/05

Rosedale Manor Care Centre 23/02/05

Rosedale Manor Care Centre 18/05/04

Rosedale Manor Care Centre 02/03/04

Rosedale Manor Care Centre 03/09/03

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

CARE HOMES FOR OLDER PEOPLE Rosedale Manor Care Centre Sherborne Road Crewe Cheshire CW1 4LB Lead Inspector Wendy Smith Unannounced Inspection 23rd April 2007 9:30 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 Manor Care Centre DS0000018738.V332725.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 Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosedale Manor Care Centre Address Sherborne Road Crewe Cheshire CW1 4LB 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) 01270 259630 01270 259640 Four Seasons 2000 Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Care Home 80 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (24), Mental disorder, excluding learning of places disability or dementia (1), Old age, not falling within any other category (56), Physical disability (10) Rosedale Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 80 service users to include: * Up to 56 service users in the category OP (old age not falling within any other category) may be accommodated. * Within the 56, 10 service users in the PD (physical disability) category may be accommodated. * Within the 56, 1 named service user in the MD(E) (mental disorder over 65 years of age) category may be accommodated. * Up to 24 service users in the category DE(E) (dementia over 65 years of age) on the Woodlands Unit. * Within the 24, 1 named service user in the category DE (dementia under the age of 65 years) may be accommodated until 7th August 2008. Date of last inspection 23rd May 2006 Brief Description of the Service: Rosedale Manor care centre is a two-storey purpose-built home set in its own grounds. The home is in a residential area approximately one mile from Crewe town centre. It is close to local shops and other facilities and is convenient for public transport. The home is divided into three discrete living units. On the ground floor, Willows unit provides accommodation and nursing care for ten younger adults with a physical disability, and Woodlands unit provides accommodation and nursing care for 24 people with dementia. Meadow Unit, on the first floor of the home, provides nursing and personal care for a maximum of 46 older people. 12 of these places are contracted with South Cheshire PCT to provide intermediate care. The weekly fee is from £343.34 to £743. Rosedale Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on 23rd April 2007 over seven hours. The home had a total of 78 residents, comprising eight younger adults with a physical disability, 24 people in the dementia care unit, 12 older people receiving short term care and 34 older people who live at the home. Two inspectors were involved in the inspection, one of whom spent time observing the experiences of residents living on the Woodlands Unit. A tour of the building, including all communal areas and some bedrooms, was completed. A sample of records was looked at on each of the units and time was spent in conversation with the home manager, area manager, residents, staff and a visitor. Some of the information contained in this report is taken from the preinspection questionnaire that was completed by the manager. Comments cards were provided for residents, visitors and visiting professionals but none had been returned at the time of the visit. What the service does well: People who are interested in going to live at Rosedale Manor have a full assessment to determine whether the home will be able to meet their needs. People admitted for intermediate care receive the support they need to enable them to regain optimum independence. The home employs two activities organisers who arrange outings for residents and social activities in the home. Residents spoken with said that they enjoyed their meals. Complaints are taken seriously and are fully investigated, recorded, and responded to in writing. All parts of the building were clean and there were no unpleasant odours. Enough staff are employed to meet the needs of the residents and agency staff are brought in to cover any shortfalls. The home provides employment opportunities for overseas nurses who are working towards a nursing qualification in the UK and for student nurses to have a work placement in the community. Rosedale Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 6 Staff have been provided with a wide variety of training opportunities. Plant and equipment is serviced and maintained on a regular basis. What has improved since the last inspection? What they could do better: Care plans should give clear instructions to staff about how residents needs are to be met. Staff must always follow established procedures for the safe administration of medicines. A record must be kept of the quantity of all medicines kept in the home, this to include items that are carried over from one month to the next. Hand-written entries on medication administration records must be signed and dated by the person writing them, and the quantity of medicines brought into the home must be recorded. Medicines must be stored within safe temperature limits. When providing care to residents, staff should be mindful of their dignity, in particular those residents who are no longer able to communicate verbally. Every effort should be made to ensure that mealtimes are an enjoyable experience for residents. Areas of the building that have become shabby should be improved to provide a pleasant environment for residents. On the Willows unit, work needs to be completed so that the bathroom can be used by residents. Provide a profiling bed for any resident who needs this equipment to keep them comfortable and safe. Rosedale Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 7 Always request a reference from an applicant’s last/current employer. Ensure that all staff are up to date with statutory training and keep records to show this. Ensure that residents and other stakeholders are given every opportunity to express their views about the home. 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 Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 8 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 Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 9 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 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People interested in coming to live at the home are assessed by a senior member of staff to ensure that their needs can be met in full. People admitted for intermediate care are supported to regain their independence. EVIDENCE: The home provides care for four different groups of people in four separate units. Each unit has a unit manager and its own team of staff, however staff may help out in other parts of the home to cover any shortage. Records looked at on the Meadow unit showed that, prior to admission, new residents had been visited by a senior member of the nursing team to assess their needs and determine whether these needs could be met at Rosedale Manor. A copy of the full assessment carried out by the person’s social worker was also on file. Rosedale Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 10 The twelve intermediate care places are now run as a separate unit and it appeared that this had addressed some of the difficulties identified at the last visit to the home. Some of the admissions are planned, and detailed written information is provided in advance to inform the home of the person’s care needs. In other cases the admission is made as a matter of urgency and information is given by telephone, however staff said that this is then followed up with a more detailed assessment and care plan as soon as possible after admission. A service user spoken with had spent just over two weeks at Rosedale Manor and was ready to return to her own home later that day. She very much appreciated the care she had received from the home’s staff and from therapists provided by the Primary Care Trust, and said that ‘nothing was too much trouble’ for them. Rosedale Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 11 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. Residents’ needs are identified in their care plans but there is not always clear guidance for staff about how individual needs should be met or about how their dignity should be protected. Good practice for the handling of medicines is not always followed. EVIDENCE: Each resident has a care plan, and the care plans are very large, complex and detailed. A sample was looked at on each of the units. In general the care plans contained thorough assessments of the residents’ needs and these were mostly kept up to date with monthly reviews. They were clearly written with good daily notes of the care and support provided. There remain some areas where care plans need further improvement. On the Woodlands unit the inspector identified an example of inappropriate language in a care plan, which referred to a resident as being ‘messy with food’ rather than making a positive description of the support that this person needed. Rosedale Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 12 Another care plan on the Woodlands unit identified that the resident had care needs due to sexual disinhibition, but there was no plan to advise staff how they should deal with this. The resident’s personal history indicated that he had expressed suicidal thoughts but there was no further reference to this in the plan for his care. A resident on the Willows unit had been reviewed by his social worker in January 2007. Concerns were expressed that he was gaining weight. There was evidence that he had subsequently been referred to a dietician but the care plan contained no clear guidance for staff about his diet. It was also suggested that a volunteer might be recruited to provide one to one support with his hobbies and interests but no evidence that this had been followed up. On the first floor a recently admitted resident was of Eastern European origin. Although he had lived in the UK for many years, the social worker assessment identified that, as his health condition has deteriorated, he tends to revert to his native language. This was not addressed by a care plan. In some cases there appeared to be confusion about the appropriate part of the care plan to record information in, for example tissue viability included in personal hygiene; difficulties associated with sleep and the risk of falling out of bed addressed through a care plan relating to sight. The manager said that further care plan training is booked for May 2007. A resident and her relative spoken with on the Willows unit expressed their satisfaction with the care and support provided. Communal areas on the Willows unit are very spacious for people using wheelchairs and there are supporting chairs of different types in the lounge. One of the documents in the care folder on the unit suggested that each morning named residents are partly washed and dressed by the night staff and then their personal care is completed by day staff. This was discussed with the manager who said that she would investigate whether this was the usual practice. Overall it appeared that the health needs of residents were met, with advice sought from the appropriate medical professionals as and when needed. The pre-inspection questionnaire completed by the manager indicated that 13 residents had a pressure sore. From further discussion it transpired that all except three of these were of a superficial nature, most were hospital acquired and all were either fully healed or responding well to treatment. Discussion with staff on the first floor indicated that profiling beds were not always available for all residents who would benefit from them. This included one resident who was presenting a challenge to staff in keeping her safe in bed. Rosedale Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 13 Four Seasons provides policies and procedures for the safe handling of medicines, however during the inspection a nurse clearly did not follow correct procedures when giving out lunch-time medication. When challenged the nurse appeared unaware of her poor practice. The incident was discussed with the home manager. Handwritten entries on medicine administration record sheets were not always signed or dated and quantities were not recorded. Nurses spoken with were not aware that they should record the quantities of medicines, for example as required analgesics, that are carried over from one month to the next. At the last inspection it was identified that the room temperature of the medicine store on the first floor sometimes exceeded the safe limit for storage of medicines. Unfortunately a cooling machine has failed to remedy the problem and it was 80 degrees during the visit. Rosedale Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 14 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. In general, the individuality of residents is respected and their social needs are catered for. There have been improvements to the catering service but mealtimes could be a more pleasant experience for residents. EVIDENCE: The home employs two part-time activities organisers. One of these staff was spoken with during the visit and it was pleasing to find that she retained her enthusiasm for the job. She was already planning for Christmas and trying to confirm arrangements for a pantomime for residents. She said that the other activities organiser is particularly involved in working with residents on the Woodland unit. Rosedale Manor shares a minibus with another home and makes good use of this to take residents out. An observation carried out on Woodlands unit over a two hour period showed that staff engaged well with residents who were active and able to converse, but there was little engagement with those who have a significant dementia and limited social skills. Rosedale Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 15 Each unit has its own dining room. On the Woodlands unit a visitor assisted her relative with lunch. She was relaxed and at ease with staff and was comfortable with the opportunity to assist her relative on a regular basis. It was disappointing that a senior member of staff was in conversation with someone else whilst assisting a resident with their meal. The Willows dining room is very large but only one resident was having lunch in the dining room. Another person had gone out for lunch. Some of the other residents are unable to take food by mouth and some stay in their rooms due to frailty or by choice. Menus showed a good choice of meals for residents. A service user receiving intermediate care said she had really enjoyed her meals at the home, particularly bacon at breakfast time, and two residents in the main dining room said that the food is very good. Arrangements for the serving of meals in the main dining room on the first floor have improved since the last inspection. A senior care assistant said that the time of staff meal breaks has been changed so that all staff are available to assist residents who need help with their meal. Residents requiring assistance have their meal at the first sitting. Unfortunately a radio was playing very loudly in the area of the dining room where they were seated and residents brought into the dining room for the second sitting were waiting at the tables for at least 15 minutes before the meal trolley arrived. The dining room was tidier than on previous visits and there was a table cloth, paper napkins and condiments on each table. However residents were given juice in tea cups (without saucers) and the cutlery was mis-matched. One resident at the dinner table, waiting for her lunch, had a considerable amount of breakfast cereal stuck on her jumper. She had clearly been brought into the dining room in a wheelchair by staff who either hadn’t noticed or hadn’t taken any action. Rosedale Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 16 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 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are fully addressed and there are established policies and procedures for the protection of vulnerable adults. EVIDENCE: Four Seasons has a complaints policy and this is included in the home’s service user guide. The manager keeps a record of complaints, and the records looked at showed that a number of complaints had been received at the home since the last Commission for Social Care Inspection visit. Most complaints referred to the intermediate care service and where appropriate had been investigated by the intermediate care team. Complaints dealt with by the home had been fully investigated and responded to in writing. Training records showed that Adult Protection training had been provided for staff however it was not possible to confirm whether all staff had attended. The new home manager said that she has previous experience of dealing with Adult Protection referrals. Rosedale Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 17 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 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is comfortable and safe for residents and all indoor areas are accessible for people with disabilities, however there are a number of areas that would benefit from refurbishment to provide more attractive environment for people to live in. EVIDENCE: The home is set in extensive grounds that are mainly grassed. The grounds were reasonably tidy but the grass needed cutting and there is scope to develop more garden areas for the enjoyment of residents. External windows have been re-painted and a number of double glazed units have been replaced. Rosedale Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 18 The home was purpose built and is spacious and accessible. Most areas seen were clean and well-maintained. One potential health and safety risk was noticed. This is the carpet in the first floor nurses office which is badly worn and damaged and is a trip hazard. Information provided by the manager indicated that twelve bedrooms have been painted since the last inspection. Some of the other bedrooms seen were in need of re-decoration. On the Willows unit, some areas of the corridors and bedroom doorways are badly knocked and need protection from wheelchairs and other equipment. The home manager and the area manager said that they would carry out an audit of the environment and prioritize areas that need attention. The home is due to have a major refurbishment in 2008 Work had started to improve bathing facilities on the Willows unit but was not completed and the bathroom is still out of use. Staff said it had been like that ‘for ages’. A small shower room is being used but is not suitable for all residents and a carer complained that the room has an unpleasant smell. Rosedale Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 19 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 adequate. This judgement has been made using available evidence including a visit to this service. The home employs enough qualified and experienced staff to meet the needs of residents. EVIDENCE: The home employs 22 nurses, 43 care staff and 19 ancillary staff. 22 of the carers have a national vocational qualification in care. Each unit has its own team of staff and its own staff rota. Rotas showed that there should be enough staff on duty at all times to meet the needs of residents, however there have been ongoing problems with staff sickness, which can be difficult to cover at short notice. The manager said that she is taking action to address issues of poor attendance. Agency staff are brought in to cover shortfalls. The number of staff on duty on the Woodlands unit in a morning has been increased from four to five, however on the day of the visit a member of staff had not turned up for her shift so there were only four. The intermediate care unit now has its own team of staff during the day and the intention is to have its own night staff in the near future. Staff are no longer required to accompany intermediate care service users to hospital appointments and this has relieved some of the pressure on staffing. Rosedale Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 20 The home is currently recruiting more staff and the manager said that she has received a good response. Staff files for recently recruited staff were looked at. Good recruitment procedures had been followed, with one exception, which was one member of staff who did not have a reference from their last employer. A Criminal Records Bureau disclosure had been obtained for each person, including a volunteer. The home provides placements for overseas nurses to do adaptation and for student nurses. The deputy manager takes lead responsibility for staff training. There has been a good range of training over the last year including moving and handling, fire safety, protection of vulnerable adults, first aid, food hygiene, health and safety, infection control, dementia care, challenging behaviour, wound care and pressure sore prevention. Unfortunately there was no training matrix available which meant that it was not possible to see whether all staff are up to date with essential training. The home manager and area manager said that they would collate this information as soon as possible. Rosedale Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 21 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, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Management systems are in place to ensure that the home is run in the best interests of residents. The manager had only been in post for two weeks so has not yet had the opportunity to demonstrate her ability. EVIDENCE: A new manager commenced employment at the beginning of April 2007. She is a registered nurse with fourteen years experience of working in care homes. This is her first manager post, her previous employment was as deputy manager of a large nursing home. The manager said that she has already enrolled to commence working towards the Registered Manager Award and has also started the process to register with the Commission for Social Care Inspection as manager. Rosedale Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 22 There was limited evidence of formal consultation between the home and residents, relatives and other stakeholders. Before the visit, Commission for Social Care Inspection survey forms were sent to the home for distribution to residents and visitors but none were returned. The area manager said that this may be because Four Seasons had just carried out their own satisfaction survey. A monthly coffee morning is held for residents and visitors to come and chat with the manager. During the inspection it was evident that visitors are comfortable to come and speak with nurses in the office. The manager sends a weekly ‘resident at risk’ report to head office. This includes full details of any accidents that have occurred, any complaints received and the incidence and treatment of pressure sores. Four Seasons have recently introduced a ‘Team Audit Process’. This is a very lengthy audit of all aspects of the service and is completed by various members of staff who work at the home. A monthly ‘regulation 26’ visit is carried out by the area manager and a report is sent to the Commission for Social Care Inspection, with a copy also going to the home manager. The home has two part-time administrators who deal with day to day financial procedures. Residents were previously able to keep personal spending money in the home’s safe, however one of the administrators said that she had been changing over to the Four Seasons system whereby residents’ personal money is paid into a bank account with a personal account for each resident and a float of money kept in the safe. Written and electronic records are kept. People admitted for intermediate care are not included in this system, but any money brought into the home by them may be put into the safe for safekeeping. The home does not act as appointee for any residents but some people have a solicitor or social services to look after their finances. One resident looks after her own finances and keeps bank documents in the safe. The manager provided evidence about the testing, servicing and maintenance of equipment and this was all up to date. Accident records were looked at and showed no areas of concern. The home provides regular fire safety training for staff. The Environmental Health Officer last visited in August 2006 and the report following this visit said that all issues had been addressed or were in hand. Rosedale Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 23 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 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 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 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 3 Rosedale Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 24 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 Standard OP9 Regulation 13(2) Timescale for action Keep a record of all medicines 30/04/07 kept in the home, this to include the quantity of any items that are carried over from one month to the next. Medicines must always be stored at a safe temperature. Timescale of 19/6/06 not met. 31/05/07 Requirement 2 OP9 13(2) 3 OP9 13(2) Hand-written entries on 30/04/07 medication administration records must be signed and dated by the person writing them, and the quantity of medicines brought into the home must be recorded. Staff must always follow safe 30/04/07 practice when administering medicines. Complete the work in the 31/05/07 Willows bathroom so that it can be used by residents. 4 OP9 13(2) 5 OP21 23(2)(j) Rosedale Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 25 6 OP22 23(2)(n) Provide the equipment that is 31/05/07 needed by residents, including enough nursing beds for all residents who need them. Ensure that all staff have 30/06/07 attended the statutory training required to protect the safety of residents. Timescale of 30/9/06 not met in full 7 OP30 18(1)(c)i 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 OP7 Good Practice Recommendations Care plans should give clear instructions to staff about how residents needs are to be met. There should be a programme of refurbishment for areas that have become shabby. 2. OP19 Rosedale Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Manor Care Centre DS0000018738.V332725.R01.S.doc Version 5.2 Page 27 - 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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