Inspection on 05/07/06 for Rosegarth Residential Home

This inspection was carried out on 5th July 2006.

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

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

Other inspections for this house

Rosegarth Residential Home 07/06/07

Rosegarth Residential Home 09/02/06

Rosegarth Residential Home 12/10/05

Rosegarth Residential Home 04/02/04

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

CARE HOMES FOR OLDER PEOPLE Rosegarth Residential Home 5 Clifton Road Ben Rhydding Ilkley West Yorkshire LS29 8TT Lead Inspector Ashley Fawthrop Key Unannounced Inspection 5th July 2006 09:30 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 Rosegarth Residential Home DS0000001300.V301037.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. Rosegarth Residential Home DS0000001300.V301037.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosegarth Residential Home Address 5 Clifton Road Ben Rhydding Ilkley West Yorkshire LS29 8TT 01943-609273 01943 603690 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) Mrs Carol Taylor Care Home 18 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (14), of places Physical disability over 65 years of age (1) Rosegarth Residential Home DS0000001300.V301037.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th February 2006 Brief Description of the Service: Rosegarth is a detached property providing accommodation for 18 service users in single rooms on two floors. There is one lounge, dining room and conservatory. There are bedrooms, bathrooms and toilets on both floors. There is a garden with sitting area and parking to the front of the premises. The home is close to Ilkley town centre. The home is registered to take older people with physical disabilities. The fees range from £400.00 to £5.50 and there are no extra charges for additional services. Rosegarth Residential Home DS0000001300.V301037.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out without prior notification and was conducted by one inspector over the course of one day. The inspection started at 9.30am and finished at 4.00pm. Before the visit, accumulated information about the home was reviewed. This included looking at the number of reported accidents and incidents, the action plan submitted following the previous inspection, and reports from other agencies, i.e., the Fire Officer. This information was used to plan the inspection visit. The inspector case tracked three service users. Case tracking is the method used to assess whether people who use services receive good quality care that meets their individual needs. Where appropriate, issues relating to the cultural and diverse needs of residents and staff were considered. Pre admission information was available to service users and pre admission assessments were done. Care plans are available for all service users, however, the need to be updated so they reflect the needs of the individual. The environment is comfortable and well maintained and decorated to a good standard. The staff turnover is low ensuring a consistent approach to the day-to-day care of service users. However, the turnover of managers has been high and this has had an effect on the development of the home as each manager has their own style of management and staff and service users have had to adapt at each change. What the service does well: The home provides a comfortable environment that is maintained and decorated to a good standard. Service users said they were happy with their rooms and have the opportunity to personalise these with furniture and personal effects. The staff turnover is low and staff have a good knowledge of the needs of the service users. Service users said they were happy with the staff and went as far as saying they considered them friends as well as carers. Rosegarth Residential Home DS0000001300.V301037.R01.S.doc Version 5.2 Page 6 Visitors are made welcome and they appear to have a good relationship with them. Comments made by relatives were positive and they were very happy with the staff team and said they were very caring. Social activities are taken seriously by the home and these are organised on a regular basis. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rosegarth Residential Home DS0000001300.V301037.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rosegarth Residential Home DS0000001300.V301037.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 and 5 Quality is adequate in this area. This judgement has been made using available evidence, including a visit to the home. Service users receive information about the home in sufficient detail prior to admission for them to make an assessment of whether or not the home can meet their needs. Appropriate assessments are undertaken and service users have the opportunity to visit the home. This ensures both the service users and the staff that the needs of the individual can be met. EVIDENCE: The statement of purpose that was updated in March 2006. This is made available to all prospective service users and their families prior to their admission. Rosegarth Residential Home DS0000001300.V301037.R01.S.doc Version 5.2 Page 9 Information includes a statement of rights relating to individual choice, independence, fulfilment and quality of care. There is information relating to the admission process and says that assessments will be made prior to admission so that the home is sure they can meet the needs of the individual. There is information on activities, religious observations and how service users will be consulted about the way the home operates. There is a statement about complaints and there is a complaints procedure that is clear and easy to understand. Pre admission assessments are undertaken and these identify the needs of the service user prior to admission. Where a pre admission assessment was not undertaken due to the prospective service user living in another county a letter was sent to the individuals representative explaining that the assessment would be undertaken on admission and that the trial period would be extended so that both the staff and the service user had time to ensure their needs could be met. There was evidence that service users and their representatives have the opportunity to visit the home prior to admission. Rosegarth Residential Home DS0000001300.V301037.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality is adequate in this area. This judgement has been made using available evidence, including a visit to the home. Care plans need to address all the identified needs of the service users. However, the care delivered is to good standard and there are good relationships between service users and staff. EVIDENCE: The care plans and other related records such as daily reports, accidents and medication records of three service users were inspected to see if the care provided was delivered to a good standard and well documented. The manager is in the process of updating the care plans. Information will be under named section so that information is easier to find and updated ensuring that care plans are accurate and up to date. On inspecting the plans there was evidence that problems had been identified but not what action had been taken to address the situation. Rosegarth Residential Home DS0000001300.V301037.R01.S.doc Version 5.2 Page 11 On one review the outcome had been that there had been a marked deterioration in the health of the service users but the care plan had not been updated to reflect this. Therefore there was no evidence that the staff had addressed the deterioration. The manager was informed that where reviews identify changes in the needs of service users the care plan must be updated immediately. There were assessments of daily living identifying how independent each service users was and the how much care the staff needed to deliver to maintain the independence of the individual. There was evidence that where specialist equipment such as pressure relieving mattresses and cushions were needed, these were available. Risk assessments in relation to falls were completed and accidents were written in the accident book. However, patterns of falls and accidents were not always reflected in the care plan so it appeared that staff were accepting that people fell in certain areas or certain times instead of trying to minimise an identified risk. Where service users had specialist needs there was additional information from agencies such as the Royal Institute for the Blind. This information gave staff an insight into specific conditions enabling them to understand the condition and provide the appropriate care. Where this is required other professionals are involved in the care plan and service users have access to opticians, dentists GP’s and other National Health Service Professionals. On reading information written about service users in the message book it was evident that some of the information about action that needed to be taken to improve the well being of individuals and should have been written in the care plan or should have acted as a prompt for the staff to review the present care. I informed the manager that message books should only be used to pass general information and document specific care related issues. The policies and procedure relating to medications were in place. The recording and administration of medications is safe. The medications are stored in appropriate cupboards, there were no gaps seen in the recording of medications. Medications were seen to be administered safely and staff have received training. Service users have the opportunity to enjoy the privacy of their own rooms some have telephones in their own rooms. Service users have the opportunity Rosegarth Residential Home DS0000001300.V301037.R01.S.doc Version 5.2 Page 12 to eat in their own rooms some do this due to their disabilities effecting their eating. Service users are happy with their care and say that staff are their friends as well as their carers. Rosegarth Residential Home DS0000001300.V301037.R01.S.doc Version 5.2 Page 13 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, 13, 14 and 15. Quality is good in this area. This judgement has been made using available evidence, including a visit to the home. Activities are addressed as a group but to make these more meaningful they should be addressed in the care plan and be addressed the same as physical needs. Service users are comfortable and experience a positive lifestyle and the meals are varied and appear nutritious. EVIDENCE: Many service users said they enjoy the comfort of their own rooms and enjoy watching television and entertaining their family in private. Some rooms on the ground floor have doors leading directly into the garden that some service users particularly like. Visitors are welcome at all times and those service users that do not go out much sit in the garden. Rosegarth Residential Home DS0000001300.V301037.R01.S.doc Version 5.2 Page 14 Activities are offered on a regular basis and these are recorded in the activities book. Activities include discussing currant affairs, sherry evenings, music and dance and trips out. The manager said that the trips out are to be increased to weekly during the summer as they are popular. The rotas have been altered to enable a member of staff is to work from 3pm to 8pm daily and concentrate on activities. There are a number of service users that either go out with family or with the staff at the home. There are a number that choose not to go out at all. Though social interaction and activities are addressed for service users as group. To ensure the activities offered are appropriate to the wishes and the abilities of the individual, activities should be linked to care planning to ensure the needs of all the service users are met. The main meal is at lunchtime with a lighter meal at teatime. The menu is set with and alternative. The cook has the responsibility for planning the menu, which is normally done one week in advance. The cook has worked at the home for four years and has undertaken basic food hygiene. She has a good relationship with service users and plans menus around the preferences of the service users. Menus include fresh fruit and vegetables on a daily basis as well as proteins in the form of various meat and fish and appear to be nutritionally balanced. Rosegarth Residential Home DS0000001300.V301037.R01.S.doc Version 5.2 Page 15 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 Quality is good in this area. This judgement has been made using available evidence, including a visit to the home. The complaints procedure is available and the registered provider takes complaints seriously and acts on them positively. Service users are protected by the homes adult protection procedures; however, training must be undertaken by staff to ensure their actions are appropriate if abuse is detected. EVIDENCE: Service users said that they were happy with the way the home runs and though there had been a change of managers the care was good and that they were happy to speak to any staff if they had complaints. Relatives said that the staff are very caring. There is a complaints procedure on display and a copy is available in the statement of purpose that is available to both service users and visitors. There are policies and procedures relating to the reporting of abuse and adult protection procedures that inform staff on the signs to look for if abuse is suspected. The Commission in the last twelve months has received two complaints. The registered person undertook both investigations with satisfactory conclusions. Rosegarth Residential Home DS0000001300.V301037.R01.S.doc Version 5.2 Page 16 The registered person and the staff are open and forthcoming when dealing with complaints. Staff had not undertaken training in Adult Protection. I informed the manager that it is important for staff to undertake this training if they are to protect service users effectively and should be offered to staff. Rosegarth Residential Home DS0000001300.V301037.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24 and 26. Quality is good in this area. This judgement has been made using available evidence, including a visit to the home. The registered individual has invested in the environment and the home is maintained and decorated to a good standard. EVIDENCE: The home and grounds are maintained on a regular basis and there are records kept of work that has been completed. The home is decorated to a good standard and all the bedrooms are single. Service users said that they were comfortable. On touring the building there was evidence that service users have the opportunity to personalise their rooms with personal items and furniture. Rosegarth Residential Home DS0000001300.V301037.R01.S.doc Version 5.2 Page 18 There are sufficient bathrooms and toilets on both floors and are easy to reach from the lounge and dining room. The home was clean and tidy with no odours and there are cleaning materials and equipment for staff to maintain a clean environment. Rosegarth Residential Home DS0000001300.V301037.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality is good in this area. This judgement has been made using available evidence, including a visit to the home. Mixes of well-trained and experienced staff care for the service users. The recruitment and selection process protects service users from abuse. EVIDENCE: The staff turnover continues to be low and this promotes consistency in care. Changes have been made to the rota to include an activity coordinator allowing staff to concentrate on the day to day caring of service users. There is a robust recruitment and selection process that includes application forms, references and checks with the Criminal Records Bureau. Staff continue with NVQ training at levels 2, 3 and 4. Other training includes food handling, dementia care, emergency first aid and moving and handling. Training planned for this year includes fire training, the safe handling of medications and infection control. Rosegarth Residential Home DS0000001300.V301037.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected 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 Quality is adequate in this area. This judgement has been made using available evidence, including a visit to the home. Service users benefit from the managers style of management. Service users are protected by the financial and health and safety policies. EVIDENCE: There have been a number of prospective managers since the last registered manager left in 2004. This has caused some inconsistency in the management and development of the home. There has been a change of manager since the last inspection. She has been in post since March 2006 and undertook a three week induction at the home to Rosegarth Residential Home DS0000001300.V301037.R01.S.doc Version 5.2 Page 21 familiarise herself with all the practices and procedures before commencing her management tasks. Staffing levels have been increased so she can concentrate on management rather that having to do hands on caring. She has introduced a new key worker system giving service users access to named staff. There are clear guidelines for staff about their responsibilities within the system. Service users continue to have a say in the running of the home through meeting and personal reviews of their care. The manager has commenced supervision and had completed seven at the time of the inspection. The financial policies and procedures for the managing and safekeeping of service users monies are safe and easy to understand. The maintenance of the fire system, the stair-lift and the hoist were all up to date. There were safety certificated available for the mains services including gas, electricity and water. There are policies and procedures available to staff relating to Health and Safety. Rosegarth Residential Home DS0000001300.V301037.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 X X X 4 X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 3 X 3 Rosegarth Residential Home DS0000001300.V301037.R01.S.doc Version 5.2 Page 23 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 OP7 Regulation 15(1)(a) Requirement Timescale for action 30/11/06 2 OP8 12(2) 3 OP12 16(2)(m) 4 OP31 8(1) The service users care plan must be kept under review. Where changes have been identified these must be updated immediately. Where risk has been identified as 30/11/06 in falls assessments then action should be taken to minimise the risk and a continuous assessment maintained. The manager must consult 30/11/06 service users about their social interests and make arrangements for social activities on the results of such consultations. The registered person must 31/10/06 ensure that the person managing the home completes an application to be registered under the fit person process. Rosegarth Residential Home DS0000001300.V301037.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Rosegarth Residential Home DS0000001300.V301037.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rosegarth Residential Home DS0000001300.V301037.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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