Inspection on 10/11/05 for Rosedale Nursing Home

This inspection was carried out on 10th November 2005.

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 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 Nursing Home 30/04/07

Rosedale Nursing Home 22/06/06

Rosedale Nursing Home 18/07/05

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Staveley Birk Leas Nursing Home

Carentan House

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

CARE HOMES FOR OLDER PEOPLE Rosedale Nursing Home The Old Vicarage Catterick Road Catterick Garrison North Yorkshire DL9 4DD Lead Inspector Mrs Anne Elaine Prankitt Unannounced Inspection 10th November 2005 09:45 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 Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 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 Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Rosedale Nursing Home Address The Old Vicarage Catterick Road Catterick Garrison North Yorkshire DL9 4DD 01748 833302/4948 01748 834468 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) Maria Mallaband Care Homes Limited Mrs Muriel Gazzard Care Home 71 Category(ies) of Old age, not falling within any other category registration, with number (71), Physical disability (71), Physical disability of places over 65 years of age (71) Rosedale Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service Users in category PD to be aged 50 years and above and to require nursing care. Service users to include up to 71 OP, up to 71 PD and up to 71 PD(E) up to a maximum of 71 service users 18th July 2005 Date of last inspection Brief Description of the Service: Rosedale is a care home providing nursing care and personal care only for up to 71 service users. It is located near the centre of the garrison town of Catterick. The home comprises of two buildings. It is set in extensive grounds with protected wooded areas to the north and west, and lawn to the south facing aspect of the home. The home is owned by Maria Mallaband Care Homes Limited. Main Building This building was previously a vicarage. There have been several additions to the original building since being opened in 1986; one on two floors as well as a twelve-bedded single storey unit. An additional 9 beds were provided in February 2004 in the main building with an extension and internal rearrangement of the internal spaces. The Lodge This is a separate 21-bedded unit within the curtilage of the grounds. It was opened in February 2004 and is being used for service users admitted for personal care only. Access to the upper floors in both buildings is facilitated by two vertical lifts. Rosedale Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over six and a half hours and was conducted by three inspectors; Anne Prankitt, Mary Slattery and Pauline O’Rourke. Four hours preparation took place prior to the inspection. In addition to this, comment cards were sent to residents, relatives, and also visiting professionals so that their views about the home could be sought. 23 comment cards from residents were returned. 31 comment cards from relatives were returned, and 8 were returned from visiting professionals. The majority of comment cards were entirely positive. Where matters were raised, these were addressed anonymously during the course of the inspection. The registered manager, Muriel Gazzard and area manager, Vicky Sanbora, were available throughout the course of the inspection, and both they and the deputy manager were provided with feedback at the close. During the inspection, time was spent in both the Main Building and The Lodge. Progress made towards meeting requirements and recommendations made at the last inspection were looked at. A meeting was held with care staff, time was spent talking with service users, observing care practices where appropriate, and inspecting care plans. A number of records were looked at, including some staff records, accident and complaints book. The medication system was also inspected. What the service does well: The premises are set in attractive surroundings, which are well looked after. Some of the rooms at the home overlook the grounds. The staff and management of the home have proven to be receptive, flexible and positive towards recent changes both in the ownership of the home, and also to the way that the home is run, and care is delivered. The area manager visits the home on a regular basis, and works closely with the registered manager towards making improvements for residents. Comments from relatives included: ‘My mother has been happy and well looked after from the first week she went to Rosedale’. ‘I have always been completely satisfied with the care’. ‘Staff are always marvellous’. ‘A friendly and relaxed atmosphere with attentive and caring service by staff’. ‘Excellent care home. Always considerate of my mother’s needs’. Rosedale Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: The routine at the home is much more flexible, and staffing levels were satisfactory. However, the registered manager should consider the reallocation of non care staff duties so that care staff are freed up to further improve the good progress that has been made in the provision of individualised care for residents. Consideration should be given to referral for advice when people suffer unexplained weight loss, and care plans should always include information for staff about how pressure sores are to be treated. The systems in the kitchen must be improved upon, including storage of foodstuffs and the adherence to cleaning programmes. Whilst improvements have been made to the menu, residents who need to have their meals liquidised must be afforded sufficient choice and nutritionally balanced meals, which must be served attractively. The home should have a visitors book, so that a record is kept of who has visited the home, and when. Rosedale Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 Page 7 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 Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 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 Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. (Standard 6 is not applicable.) Sufficient information is gathered prior to admission to assure service users that their needs have been considered, and can be met. EVIDENCE: Main Building The registered manager confirmed that all prospective service users are now assessed prior to admission, including those admitted for respite care and also under the rapid response scheme. The company has produced new documentation for this purpose, which meets the standard, and which was completed with sufficient information. Of those files seen from recent admissions, service users’ needs fell within the category of registration within which the home is permitted to admit. The Lodge The Lodge is run as a separate unit to the nursing home, and staffed by care workers. Whilst the day to day running of the unit remains the responsibility of Rosedale Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 Page 10 the registered manager, many tasks have been delegated to a senior carer. Currently all service users admitted to The Lodge have been assessed by the registered manager and a senior carer. Service user spoken with said that someone from the home had visited them prior to their admission. Discussions held with both the registered manager and senior carer indicate it is the intention that the senior carer will become responsible for admissions in the future with support provided by the registered manager on request. Rosedale Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Staff consider the holistic needs of service users. EVIDENCE: Main Building Care plans have now been relocated to an area of the home which is accessible to care staff as well as nurses. All information about service users’ needs is held within the care plan. Composite records are no longer kept. Care staff now receive a handover at the commencement of each shift. They stated that this was a positive move. They also now have a responsibility to record in the daily records. Daily records seen were completed respectfully, and considered the dignity of service users. The care plans have been completely revamped since the last inspection, and have been audited by the area manager, who provides feedback. The plans consider the holistic needs of service users, and explained where intervention was provided by nursing staff. Some care plan assessments and life histories were in the process of completion, and required additional information, such as attention to personal choices, for example the use of make up. However, the quality of the information provided was much improved, and staff have worked extremely hard in order to meet the action Rosedale Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 Page 12 plan agreed between the registered manager and area manager immediately following the last inspection. Plans were signed as agreed by the service user or their representative, and generally contained evidence of appropriate contact with outside professionals. However, in one file, it was evident that the service user has unexplained weight loss. In another, there were no details in place about the treatment required for a current pressure sore. Another service user who was admitted for assessment was clearly not happy, and staff were struggling to meet the service user’s needs. The registered manager arranged for an urgent review with the care manager, which took place the following day. It is recommended that in house reviews are carried out with the service user and their representative in line with those who are supported by the local authority. There was equipment available at the home for the promotion of tissue viability. Safety rails fitted to beds were risk assessed to ensure that they were safe, appropriate to the needs of the service user, and fit for use. The medication systems in the Main Building have been significantly improved upon, and unnecessary stock has been removed. Audits have been undertaken, the treatment room has been reorganised, and the practice of managing controlled medications made more robust. Records audited on the day were completed correctly and were up to date. It was confirmed that secondary dispensing no longer takes place, and night staff are no longer responsible for the administration of early morning medications. Service users appeared well groomed and comfortable in their surroundings. Care staff spoke to them with respect, and assisted with their care in private. The Lodge The service user files seen contained a care plan. This document included information gathered at the initial assessment. Service users spoken with were aware of their care plans and confirmed that staff spoke with them on a regular basis about the plan. Evidence in the file showed that the care plans are reviewed on a monthly basis. The registered manager stated that training in care planning has been provided for staff in The Lodge. The care plans clearly identified the service users’ health needs. Service users spoken with said that they could see their GP on request. Staff assist them to the surgery and will accompany them in if they wish. Evidence was contained in the service user files to show that specialist services such as optician, chiropodist and district nurse visits are accessed as required by the service users. The staff use a Monitored Dosage System for the medication. It is stored appropriately and separate storage is available for controlled drugs. A controlled drugs register is maintained and an audit trail was followed Rosedale Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 Page 13 successfully. A fridge is kept in the medication room and this contained eye drops and ointments. A daily record is kept of the fridge temperatures. The medication records were up to date and accurate. The registered manager, a qualified nurse, carries out a weekly audit of the medication to ensure that systems are being followed. All staff that handle the medication have completed a distance learning course in the Safe Handling of Medicines. The service users spoken with said that the staff always treated them with respect and during the inspection the interactions observed were friendly and relaxed. They said that staff addressed them by the name identified in their care plan information and always knocked before entering their rooms. Rosedale Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14 and 15 Improvements in the flexibility of the routine in the Main Building mean that service users’ individual needs can be better acknowledged. However, inconsistencies in the dietary provision means that the nutritional needs of some service users may not be fully met. EVIDENCE: Main Building A care staff survey has been carried out in order to determine the preferred rising and retiring times of service users. The information gathered has been included in individual care plans. Staff said that they now had more time to spend individually with service users, which they viewed as beneficial. Staff stated that both they and service users are adjusting to the new routine at the home, which they agreed was more flexible. Although the kitchen staff had become more flexible to meet the needs of the service, it was evident that in some cases care staff still struggled with their belief that they needed to help night staff by assisting some service users into their night attire in order that they are ready for bed. However, they were overcoming this. Rosedale Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 Page 15 The Lodge The service users are encouraged to maintain their own routines within the home and maintain any of their external interests. Service user said that they come and go at will. One gentleman was going out with his friends to the local pub. One of the service users set up a dominoes game. Another was playing scrabble with a member of staff and others were listening to classical music. Visitors were seen to come and go throughout the day. Those spoken with said that they could rise and retire when they wished and were encouraged to follow their own routines during the day. Several service users said that they like to remain in their own rooms during the day and join everyone else for meals. Several service users were seen to be coming and going from the building freely both with friends and independently. Service user meetings are held on a regular basis in order that they can plan activities, raise any areas of concern and keep informed about staffing issues. Records are kept of these meetings. Meals for all service users at Rosedale are prepared in the Main Building. Since the last inspection several changes to the meals have been implemented. A four-week menu is now followed and the times of the meals have changed so that the service users who require assistance now have their lunch at 12:00 and the more independent service users eat at 12:30. The registered manager took seriously a concern raised within one comment card about the arrangements for providing consistent assistance from staff for one service user who needs help with their meal. She assured that this matter would be addressed immediately. The tea meal in The Lodge is now taken at the table with the exception of a few service users who like to remain where they are for this meal. Service users in the Main Building are encouraged to eat meals in the dining areas, but may eat in their own rooms if this is their choice. The staff are still adjusting to the changes to their routine but still find the meal times rushed. New crockery has been purchased to replace the plastic items previously in use in the Main Building. The meals that are liquidised have all the ingredients mixed together so that a soup-like meal is produced. The cook was not putting any meat in to these meals and was using only potato, vegetables and gravy. It became apparent that service users who require a liquidised diet often receive the same meal choice at tea that they have eaten at lunchtime. The cook concerned was leaving on the day of the inspection and the registered manager and the new cook were made aware that the liquidised meals must improve so that the more vulnerable service users were having their nutritional needs met, along with the meal being more of a sensory experience. Rosedale Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Systems are in place to ensure that concerns and complaints are addressed. EVIDENCE: There have been no complaints made direct to the Commission for Social Care Inspection during the period since the last inspection. Three complaints have been made to the home. Action taken and outcome was recorded in two cases. The remaining complaint awaited an outcome. All staff have now been issued with a copy of the adult protection policy and procedure, and a training course has been held, with positive feedback from staff. One recent matter had been appropriately referred by the registered manager to social services for consideration of investigation under the vulnerable adults procedure. There was a good record of action taken following consultation with the care manager. Staff spoken with understood their responsibilities for reporting such matters. Rosedale Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Service users live in a warm comfortable environment that is subject to a programme of regular maintenance. EVIDENCE: Main Building The company intends to make improvements to the environment, including the provision of a reception area at the front entrance of the building. This will improve the overall security, and reception of visitors to the home. A comment card received from a relative raised a concern about the security arrangements at the home, because of the ability to access the building without staff being alerted. This was brought to the attention of the area manager at the time of the inspection, who organised for additional security measures to be put into place. This work was being completed the day following the inspection. On the day of the inspection, all areas of the home were free from malodour. Rosedale Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 Page 18 At the last inspection, limited access in one shared room resulted in a service user having no access to call bell facilities, and staff having only limited space in order to carry out moving and handling procedures whilst protecting the privacy and dignity of the service user concerned. This has now been addressed. The service user now has now been provided with single room accommodation. Restrictors have now been fitted to all windows that required them. Portable heaters have now been moved from bedrooms, or mounted and guarded where they were required. The building was warm on the day of the inspection. The staff smoking area, which was previously outside the premises, but next to a service user’s window, has now been relocated to a more appropriate position. There is a laundry with adequate facilities provided. Staff are available to work in the laundry over seven days each week. There was equipment available in order to reduce the risk from cross infection. The Lodge The Lodge is purpose built and all the bedrooms are single en suite rooms. The grounds are accessible via the front door and through French windows in the dining room. There is a large lounge for general use and all floors can be accessed by a passenger lift. The bedrooms are lockable. There was evidence in the service user files that the occupants had been offered a key for their bedroom door but had turned it down. All areas of the home were found to be clean and odour free. Rosedale Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Re allocation of non care tasks to ancillary staff would enhance the already improved input that care staff are able to provide to service users. Good recruitment procedures and a programme of staff training helps protect service users from unnecessary risk. EVIDENCE: Main Building The home was adequately staffed. The emphasis on a more flexible routine is beginning to have a noticeable effect on the atmosphere of the home, which at this inspection did appear to be more relaxed. However, staff still struggle to complete their tasks, together with the added responsibilities of report writing and spending one to one time with service users. The minority within the relative comment cards received reflected this concern. Care staff still undertake a number of duties which could be carried out by other members of the staff team. It is recommended that the registered manager give this further consideration in order that these tasks do not take priority over the time that they are able to spend with service users. The Lodge There were sufficient staff available at the time of the inspection for staff to spend quality time with service users. Rosedale Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 Page 20 Since the last inspection a training matrix has been developed and all staff have received the statutory training as required by the Care Homes Regulations 2001. Evidence was seen in staff files of other training provided which covers topics such as; visual impairment, diabetes, osteoporosis, dementia awareness, medication training, continence awareness, and the importance of hand hygiene. Less than 50 of the care staff has a National Vocational qualification level 2 although the registered manager is aware of this and is working to meet this recommendation. Since the last inspection, the registered manager has completed a full audit of the staff records. The staff files seen contained the necessary documentation as required by the Care Homes Regulations 2001. On two occasions staff had commenced work without a Criminal Records Bureau disclosure but there was evidence of a POVAFIRST check in their file. Staff spoken with confirmed they had not been able to commence their employment prior to the checks being carried out. Rosedale Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36 and 38 The robust management and auditing systems which have been developed at the home need to be extended upon in order that service users are protected from unnecessary risk by the provision of a clean and well managed kitchen. EVIDENCE: A care staff meeting was held as part of the inspection. The general conclusion was that there had been positive changes made at the home since the last inspection, and since the new proprietors took over. Comment cards sent to relatives as part of the inspection process included comments that the registered manager and deputy made a positive contribution to the management of the home. Quality assurance systems have been introduced at the home. The views of service users have been sought with regard to their personal routine. This is Rosedale Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 Page 22 now discussed at admission. Questionnaires have been sent from head office to relatives and service users about the service that the home provides. Audits have now been developed for the medication and care planning systems, and the area manager completes Regulation 26 visits, and provides a written report to the commission. In addition, she carries out a monthly audit which considers the national minimum standards. The views of the multi disciplinary team have also been sought. Where issues are raised, these are fed back to the appropriate staff through supervision. Service users’ money that is held in the office is maintained in separate accounts with supporting records. The cash is held separately for each service user and the records and cash amounts tallied. Receipts for any monies spent are also maintained. Evidence was available to show that staff receive supervision on a regular basis. A contract is drawn up between the supervisor and the member of staff. This outlines the topics to be covered during the discussions. Staff spoken with confirmed that they now receive supervision and find it a positive experience. The records kept do not give the full detail of the discussions held. Staff meetings have now been set up. There was no visitors book at the home. This must be provided. The maintenance man employed by the home is responsible for the regular checking of in house health and safety systems. Fire training has been provided for all staff by an external trainer. The health and safety issues identified at the last inspection have been addressed. The environment was free from obvious hazards on the day of the inspection. However, the following improvements must be made within the kitchen area: • • • The storage of dry goods was not adequate. Open packets were left in the stock room. Any dry goods opened must be stored in a sealed container. Butter was being stored on the shelf in the larder and not in the fridge. This was rectified at the time of the inspection. The fridge in the larder room was dirty. Dried blood was found in the bottom draw. Rotting salad stuff was also found in the fridge. The area manager was shown this and arranged for it to be cleaned forthwith. Whilst the staffing has changed in the kitchen the registered manager must ensure that a high standard of cleanliness is maintained at all times. Rosedale Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 1 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 1 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 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 1 1 Rosedale Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 Page 24 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 OP8 Regulation 14 Requirement Consideration must be given for referral to the dietician where a service user suffers unexplained weight loss. The treatment required for the treatment and prevention of pressure sores must be clearly recorded within the care plan The registered manager must ensure that liquidised diets provided for service users are properly balanced and provide sufficient choice, to ensure that their nutritional needs are fully and adequately met. Liquidised meals should be presented in separate portions to ensure that they are attractive and appealing. The registered manager must provide a means of recording all visitors who visit the home. The registered manager must ensure that a high standard of cleanliness is maintained in the kitchen at all times. In addition: Rosedale Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 Page 25 Timescale for action 10/11/05 17(1)(a) Sch3(p) 2 OP15 16 10/11/05 3 4 OP37 OP38 17(2)Sch 4(17) 13,16 10/11/05 10/11/05 • • • Fresh and dried foodstuffs must be appropriately stored and labelled. Food must be disposed of when it is no longer fit to eat. Food storage areas must be cleaned and kept clean. 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 OP27 Good Practice Recommendations The registered manager should consider the re allocation of non care staff tasks to others, such as setting up trolleys and trays, in order that care staff have sufficient time to fulfil their responsibilities of report writing and meeting the social needs of service users in a timely fashion. 50 of care staff should be qualified to at least NVQ level 2 in care by December 2005. The recording of supervision should be more thorough, and give a true picture of the topics discussed. 2 3 OP28 OP36 Rosedale Nursing Home DS0000064332.V259730.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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. 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