Inspection on 27/04/05 for Rosegarth

This inspection was carried out on 27th April 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

Rosegarth 18/02/09

Rosegarth 03/12/07

Rosegarth 31/05/06

Rosegarth 11/10/05

Rosegarth 13/10/04

Rosegarth 13/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Rosegarth 40 Moseley Road Cheadle Stockport SK8 4HJ Lead Inspector Kath Oldham Announced 27 April 2005, 08:00am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rosegarth F54 F04 rosegarth A s8584 v216069 270405 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Rosegarth Address 40 Moseley Road, Cheadle, Stockport, SK8 4HJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0161-485-3349 0161-485-8466 Rosegarth Limited Mrs E Reid Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Rosegarth F54 F04 rosegarth A s8584 v216069 270405 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 13 October 2004 Brief Description of the Service: Rosegarth is a Victorian building situated at the end of a quiet cul-de-sac in an area between Cheadle and Cheadle Heath. The home is set in gardens, surrounded by mature trees. Rosegarth provides care and support for up to 25 service users who are older people. Single bedroom accommodation is provided for all service users on the ground and upper floors. Service users are able to bring small items of furniture and personal possessions with them. A call system is installed in all rooms to enable service users to summon support or assistance from staff. Rosegarth F54 F04 rosegarth A s8584 v216069 270405 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and took place during the day, commencing at 8:00am. The inspection included conversations with service users, staff and management. The inspector observed routines and practices, in addition to looking at records which must to be kept in line with regulation. A partial tour of the premises was undertaken. Six of the staff on duty, nine of the 24 service users and four visitors were spoken with. Comment cards were sent out to service users, relatives and visitors and doctors who visit the home. At the time of writing the report, nine comment cards had been received. What the service does well: What has improved since the last inspection? On the last inspection there were two requirements, both of which have been addressed by the home, in relation to medication. Of the five recommendations identified on the last inspection, three have been achieved in full, with the remaining recommendations being partially achieved. These are repeated on this inspection. A number of service users’ bedrooms have been redecorated and new carpets fitted. Bathroom and toilet door locks have been replaced. Staff continue to receive NVQ training to further improve the service provided to service users. It is hoped that more of the staff will conclude NVQ training in the next few months. Rosegarth F54 F04 rosegarth A s8584 v216069 270405 stage 4.doc Version 1.30 Page 6 The home was clean and there were no unpleasant odours. A new cook has been appointed and service users commented on the quality and variety of the meals provided. A new handyman has been appointed on a part-time basis and this allows repairs to be undertaken quickly. Previous inspections had described that there were problems with how long it took to carry out maintenance. 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. Rosegarth F54 F04 rosegarth A s8584 v216069 270405 stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Rosegarth F54 F04 rosegarth A s8584 v216069 270405 stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3 & 5 Service users are provided with information to enable them to make a decision as to whether the home can meet their needs. EVIDENCE: Service users are provided with details about the home within the service user guide. These are placed in service users’ bedrooms. A contract for service users who are funded by the local authority is in place, in addition to a terms and conditions of residency for all service users. One service user reported that they were aware of a contract and that their relative dealt with all the paperwork. An assessment is carried out by the manager; this usually takes place in the service user’s home and includes themselves and any relatives who have an interest. Prospective service users and their friends or relatives are encouraged to visit the home to look round to see if the home is what they want. Rosegarth F54 F04 rosegarth A s8584 v216069 270405 stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 9 Systems are in place to ensure, as far as possible, service users maintain good health. EVIDENCE: Service users are registered with a GP. If their doctor is not willing to visit them at Rosegarth due to geographical boundaries, they are offered a list of visiting doctors from which they can make their choice. Examination of service user records identified appointments with chiropodists, district nurses and other health care professionals. One service user said they felt reassured that they were able to see the visiting district nurse if they had any health care problems or enquiries. Service users said they received their medication regularly and staff took time with specific service users to assist them with this. Examination of a sample of the medication records identified that medication administration was recorded. Some service users are prescribed controlled drugs; the records, in the main, were completed in accordance with Regulations. The records of receipt of controlled drugs medication needs to be amended. Rosegarth F54 F04 rosegarth A s8584 v216069 270405 stage 4.doc Version 1.30 Page 10 Each service user’s file inspected contained a care plan. However, the detail needs to be developed and attention taken to ensure that the comments are not judgemental. Service users have access to these records and they need to be accurate and specific. Observations of care practice identified that the support and interventions of staff promoted their privacy and dignity. A representative said that their relative had pressure sores on discharge from hospital and their health was failing. On admission to Rosegarth, staff support, care and interventions working in partnership with district nurses, had improved their relative’s quality of life. The representative said they had never seen their relative more content and settled. Rosegarth F54 F04 rosegarth A s8584 v216069 270405 stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 Activity, stimulation and menus are determined, discussed and provided to service users and visitors and families are included and involved if this is their choice. EVIDENCE: Service users spoken to said they enjoyed particular activities arranged by the home, others said they only took part in a specific activity by choice. One service user said they were bored. This was said to be due to recently coming into the home and adjusting to the change of living with other people. Staff were observed to be patient and sympathetic to individual service users’ abilities, taking time in activity. Some service users whose preference was not to take part in activity was respected by staff. One visitor said that their service user was promoted and encouraged to do what they wanted with staff support to suit them. A visitor explained her perception of the home to be an extended family with staff taking a genuine interest in the needs of service users and really caring. Rosegarth F54 F04 rosegarth A s8584 v216069 270405 stage 4.doc Version 1.30 Page 12 One service user said their relative came regularly and was made to feel welcome. Activity outside of the home was said to be quite infrequent. Service users said that transport was a problem as it cost too much money to hire a minibus. It was felt by service users that if the home had a minibus they could go out more often. Staff said that they would look into the possibility of sponsorship from local firms to get hold of a minibus. Service users said at the service user meetings they decide where they want to go. Inspection of the activities record detailed the activities that took place. This record is maintained centrally. There has been a new cook appointed at the home. Service users described the meals as enjoyable. It was said that the cook puts too much gravy on the meals, which affected their enjoyment. Service users said that this had been brought up in the recent residents meeting and they felt it would be addressed by the home. One service user said she didn’t eat very much but she knew she was eating enough as she was weighed monthly and wasn’t losing weight. A weight chart is maintained by the home and details all service users’ weight together. Rosegarth F54 F04 rosegarth A s8584 v216069 270405 stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 Systems and routines are in place to safeguard service users wherever possible. EVIDENCE: Service users said they had few, if any, complaints regarding the care they receive at Rosegarth and when they did, they would let the manager know. Residents meetings were described as an opportunity to talk things over and forward ideas for change. A complaints book is in place and contained very few recordings. Staff were described to have received guidance from the manager to record comments and complaints to assist in the development of the service, provided this continues to need developing. One visitor to the home said the home is run well and was complimentary regarding all aspects at Rosegarth. Another representative said that they couldn’t ask for any more from the staff at the home. A number of staff have received abuse training and demonstrated in conversation their awareness of what constitutes abuse. Additional abuse training for new staff is to be arranged. One service user said she felt secure at the home and staff had looked after her. One referral has been made to Social Services Department regarding an allegation of abuse; this was discussed and an investigation undertaken. The allegation was unproven. Rosegarth F54 F04 rosegarth A s8584 v216069 270405 stage 4.doc Version 1.30 Page 14 One complaint had been sent to CSCI regarding care practices and routines. This was to be investigated by the home. Rosegarth F54 F04 rosegarth A s8584 v216069 270405 stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 23, 24 & 25 The home was clean and well presented. The safety of service users was promoted by the systems in place. EVIDENCE: Some of the bedrooms had been re-decorated and had new carpets. There is an ongoing refurbishment programme in place with other bedrooms and areas of the home scheduled for redecoration. One service user said her bedroom had had a makeover and she was delighted with the result. The service user said she enjoyed the comfort her bedroom provided. A relative described the building to be homely and comfortable and just right for her relative. Rosegarth F54 F04 rosegarth A s8584 v216069 270405 stage 4.doc Version 1.30 Page 16 New bathroom and toilet door locks have been fitted which promotes service users’ privacy. Examination of records confirmed that the safety checks that should be in place were. Equipment checks were also recorded to be in place. The rear garden at the home was landscaped some months prior to the inspection. Contractors have returned to the home on a number of occasions in an attempt to rectify problems. Service users continue to be unable to use the grass area due to these problems. Service users said they were able to use the patio area but were disappointed that after all the work and money that has been spent on landscaping the gardens, they cannot use them. Flowerbeds are situated at the side of the house, which provide some colour and interest to service users. It is the home’s intentions, in the warmer weather, to include service users in the development of the side gardens. One service user who had failing sight said she would love to sit in a garden and be able to identify the flowers through smell and touch. A further service user suggested the home had some kind of water feature in the rear garden. Inspection of a sample of the bedrooms identified that service users had brought personal possessions and furnishings with them. A service user said this had helped her settle in, having her treasured belongings around her. The home was clean throughout. Service users said that the home was always clean and tidy but lived in. Service users described the home to be warm and, on occasions, quite hot. One relative said that the home was warm and at particular times windows were opened to let some fresh air in without people being cold or in draughts. Rosegarth F54 F04 rosegarth A s8584 v216069 270405 stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30 The home employs sufficient numbers of staff to meet the needs of service users. Safeguards were not always in place in the recruitment procedures. Staff have received appropriate training and qualifications. EVIDENCE: There were appropriate numbers of staff on duty throughout the day and at night. Examination of staff files identified omissions in the documents that must be kept in line with the Regulations. The recruitment and selection procedure had not been followed in the sample of staff files inspected. Staff have received training in keeping with safe practice guidelines. A number of staff have obtained NVQ qualifications. Service users commented on feeling confident in the staff abilities. Moving and handling techniques observed at the inspection appeared appropriate to the needs of service users. Rosegarth F54 F04 rosegarth A s8584 v216069 270405 stage 4.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 & 38 Management systems are in place to put the best interests of service users at the foremost of the service that is provided, however these need development in some areas. EVIDENCE: Service users commented positively on the management of the home and said they saw the owners on a daily basis, albeit for a short time. Families said that the home is comfortable and the staff are excellent, led by a dedicated and committed manager. The owners undertake monthly reports which are not routinely sent to the CSCI as required by Regulation. Rosegarth F54 F04 rosegarth A s8584 v216069 270405 stage 4.doc Version 1.30 Page 19 Staff meetings are arranged which provide staff with an opportunity to influence the way the home is run and contribute to the effectiveness of the home. Service user meetings are also arranged regularly. Staff supervision is in place that further develops the staff team’s skills. Rosegarth F54 F04 rosegarth A s8584 v216069 270405 stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x 3 3 3 x STAFFING Standard No Score 27 3 28 x 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 x x 2 x x x x 2 Rosegarth F54 F04 rosegarth A s8584 v216069 270405 stage 4.doc Version 1.30 Page 21 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13(2) Requirement The registered person must ensure that the receipt of controlled drugs medication is signed by two staff members. The registered person must ensure that all recruitment and selection procedures are followed and prospective employees complete comprehensive applications. The registered person must ensure that criminal record bureau checks are undertaken prior to staff commencement in post. The registered person must ensure that the reports undertaken in line with Regulation 26 are forwarded to CSCI routinely. The registered person must ensure that the CSCI is notified of any incidents that affect the health, safety and well-being of service users. Timescale for action 27/04/05 2. OP29 19 30/06/05 3. OP29 19 Schedule 2 26(3) 30/06/05 4. OP31 15/06/05 5. OP38 37 15/06/05 Rosegarth F54 F04 rosegarth A s8584 v216069 270405 stage 4.doc Version 1.30 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP7 OP12 OP12 Good Practice Recommendations The registered person should further develop the care plans, ensuring all areas of the service users care needs and interventions are detailed. The registered person should record service users individual and group activities, weights and bathing in individual service user care files. The registered person should introduce safeguards if staff are to take service users out in their own cars to include, at a minimum, obtaining driving licences, appropriate motor car insurance and MOT certificates, in addition to discussion with relatives or advocates and the allocation of trained care staff. The registered person should provide staff with training/ direction in what constitutes a comment/complaint and provide and facilitate the need to record these in the complaints book. 4. OP16 Rosegarth F54 F04 rosegarth A s8584 v216069 270405 stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 2nd Floor Heritage Wharf Portland Place Ashton under Lyne, OL7 0QD 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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