Inspection on 11/10/06 for Rosehill House

This inspection was carried out on 11th October 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 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

Rosehill House 08/10/08

Rosehill House 26/01/06

Rosehill House 18/07/05

Rosehill House 22/02/05

Rosehill House 21/07/04

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 Rosehill House Moresby Whitehaven Cumbria CA28 6SF Lead Inspector Mrs Margaret Drury Unannounced Inspection 11th October 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rosehill House DS0000022619.V306142.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. Rosehill House DS0000022619.V306142.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosehill House Address Moresby Whitehaven Cumbria CA28 6SF 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) 01946 695235 Mrs Pamela Hill-Eades Mrs Pamela Hill-Eades Care Home 19 Category(ies) of Dementia - over 65 years of age (2), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (1), Old age, not falling within any other category (19) Rosehill House DS0000022619.V306142.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social care Inspection. A maximum of nineteen older people (19OP) including two people with dementia (2DE(E)). One named older person with a mental disorder (1MD(E)). Date of last inspection 26th January 2006 Brief Description of the Service: Rosehill House is registered to provide care and accommodation for up to 19 older people. The home is owned by Mr and Mrs Hill-Eades, with Mrs Hill-Eades responsible for the day-to-day running of the home. Rosehill House is a detached, older style property set in its own grounds approximately three miles from Whitehaven. Access to the home is by a shared driveway with the nearby Rosehill Theatre. The accommodation for residents is on the ground and first floors with a stair lift giving access to the first floor. There are thirteen single rooms and three doubles, two of which are currently shared and the remaining one used for single occupation. The home has one assisted bathroom, an assisted shower room and toilets close to communal areas. All the bedrooms have en-suite toilet and washbasin facilities. The external areas are pleasant and well maintained with seating areas and ample car parking. The fees for this home are £348.00 - £600.00 per week as at the date of the visit. There are extra charges for newspapers, magazines, hairdressing and some personal toiletries. Rosehill House DS0000022619.V306142.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit that forms part of the key inspection took place over one day in October. The registered manager had not completed a preinspection questionnaire, prior to the visit, as this had not been received. A second form was sent to the home and the manager completed this the day after the visit. Six questionnaires were received from residents, three from district nurses who visit the home, two from visiting doctors and five from relatives of residents living in Rosehill House. All the comments were positive and one from the community nurse remarked on the high level of care provided recently to a resident who subsequently died and the excellent lines of communication between the home and the healthcare professionals. During the visit the inspector spent time with the registered manager discussing the operation of the home and looking at the administrative procedures. A tour of the building looking at the environment was undertaken. During the afternoon time was spent speaking to staff residents and visitors to the home. Comments from residents confirmed that the staff provided an extremely high level of care. “They are wonderful” and “the staff are so caring, nothing is too much trouble” were comments received from residents. Visitors remarked on the caring attitude of the staff and the patience they showed when providing support. What the service does well: Residents and visitors spoke very highly of the staff and praised the level of care and support provided. The inspector observed warm interaction between staff and residents and visitors said they were “always made welcome and offered tea and biscuits”. The home provides a warm and homely atmosphere with staff supporting residents in their daily life and ensuring the routines within the home are applicable to the needs of the residents. Care plans are well kept with all the monthly reviews up to date. Information on them was relevant and provided sufficient detail for the care staff to meet the assessed needs. Evidence on some care plans showed that professional healthcare and psychological advice was sought when necessary. Medication records were up to date and correctly completed, with details of all prescribed medication recorded on the care plans. Rosehill House DS0000022619.V306142.R01.S.doc Version 5.2 Page 6 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. Rosehill House DS0000022619.V306142.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 Rosehill House DS0000022619.V306142.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): 2, 3, 4 & 5 Quality in this outcome area is good. This judgement was made using available evidence including a visit to this service. The manager ensures that care needs assessments are completed prior to admission, which ensures the care given is appropriate to meet the needs of the residents. EVIDENCE: Admissions to Rosehill House do not take place until the manager or her deputy has completed a full assessment of needs. The dependency levels of those already living in the home are also taken into consideration when assessing prospective residents. This ensures that the staffing levels within the home are able to fully meet the needs of all those living there. Family members are encouraged to be present during the assessment visit as this ensures all concerned know that the home is able to meet the needs of those hoping to move in. All prospective residents and their families are invited and encouraged to visit the home prior to their admission. This gives opportunity for them to meet the staff and talk to other people living in the home. Rosehill House DS0000022619.V306142.R01.S.doc Version 5.2 Page 9 All residents, even those funded by Social Services are given a contract and terms and conditions of residency and there is a copy held on each resident’s file. Rosehill House DS0000022619.V306142.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, 10 & 11 Quality in this outcome area is good. This judgement was made using available evidence including a visit to this service. An effective and efficient care planning system is in place showing that personal, social and healthcare needs are being met effectively. Medical records demonstrate care is taken to ensure resident’s safety at all times. EVIDENCE: Each resident has a care plan that is used as a working tool and is understood by all staff. It is written in clear language with resident and/or family member involvement wherever possible and is used to ensure the correct level of care is provided. Each care plan includes a comprehensive risk assessment. Management of risk takes into account the needs of residents and demonstrates a balanced view in maintaining safety while also offering choice. The rights of others living in the home are also considered when drawing up an assessment of risk. Rosehill House DS0000022619.V306142.R01.S.doc Version 5.2 Page 11 The care plans are updated each month by the deputy manager and checked by the manager. Discussions with the manager during the visit confirmed that the staff at the home have an excellent working relationship with the healthcare professional that visit the home on a regular basis. This is particularly so of the work with the district nursing service. This is also confirmed by comments written on the completed questionnaires received prior to the visit. The residents who spoke to the inspector said, “ I only have to ask and a doctor’s visit is arranged”. They also said how much they appreciated the support of the nurses when they visited. Medication is received from the pharmacy in a monitored dosage system and checked in by the manager or deputy. There is one resident who takes her own medication, the details of which are recorded on the plan of care. The home has in place a procedure for conducting a weekly audit of all medicines received, taken and returned. This ensures the safety of the residents and is a protection for those responsible for giving the medication. Residents who spoke with the inspector said that the staff always treated them with respect and kindness and that any personal care required is given in the privacy of their own rooms with doors and curtains closed. They are always asked how they wish to be addressed when coming to live at the home. Visitors also confirmed they were impressed with the caring and polite attitude of the care staff. The home has a policy and procedure for dealing with the death of a resident and all staff receive internal training in this subject, in particular what to do immediately after death. This is dealt with in a supportive and caring manner with staff in attendance at all times. Comments from one of the district nurses confirmed that management and staff at the home are able to deal with this type of situation, writing “ the care the resident received was excellent and the support of the family” and “I have nothing but praise for the way they care” Rosehill House DS0000022619.V306142.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement was made using available evidence including a visit to this service. The routines of the home are planned around the residents’ needs and wishes and are flexible enough to meet the changing needs of the individual. EVIDENCE: Routines in the home are flexible and suit the needs of the residents. Those who spoke to the inspector were pleased that they could spend their days as they wish. Some residents choose to take their meals in their rooms Cultural needs are met by regular visits by the clergy and communion is provided for those residents who wish to take it. There is a Communion service each month and some residents receive personal visits from their minister to receive Communion. One resident is able to go to her own church every week. There are some activities organised but the manager and members of staff told the inspector it was not always possible to persuade the residents to take part. There are entertainers who visit the home on a regular basis and the residents told the inspector that they enjoyed the musical activities. They told the Rosehill House DS0000022619.V306142.R01.S.doc Version 5.2 Page 13 inspector their favourite pastime is sitting in the lounge “ having a good crack with the staff and other residents”. The activities organiser has recently left the home and arrangements are being made to employ another as soon as possible. Visitors to the home are welcome at any time and are invited to stay for a meal if their visit coincides with lunch or tea. Three visitors who spoke with the inspector said what “a lovely welcome they received” and they were “always given refreshments when they arrived”. A visit to the kitchen was made when the inspector discussed the daily menus with the cook. Dried goods and produce are purchased locally and meat is delivered directly to the home. Diabetic meals are prepared for those requiring them and soft diets are made available if necessary. There is a choice at each meal and there is always an alternative too. This can often result in 4or 5 different meals at teatime. Rosehill House DS0000022619.V306142.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement was made using available evidence including a visit to this service. Residents feel confident that any issue they raise will be dealt with promptly. Residents are safeguarded by the home’s adult protection policies. EVIDENCE: The home has a complaints book in place but there have been none to record. The home encourages open dialogue and many of the residents are well able to express their opinions. Details of the complaints procedure forms part of the terms and conditions given to each resident and there is a copy on display. There are policies and procedures in place that outline the rights of those living in the home and these also form part of the terms and conditions of residency. Adult protection issues are discussed during staff induction and this area is also covered in the NVQ training course. Staff interviewed showed a good awareness of abuse issues and the process to follow should this be necessary. The home has a set of video recording dealing with this subject that are available at all times for internal training purposes. Rosehill House DS0000022619.V306142.R01.S.doc Version 5.2 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 the following standard(s): 19, 20, 22, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement was made using available evidence including a visit to this service. Residents live in a home that is clean, hygienic and maintained to a good standard. This helps to ensure their safety and comfort. EVIDENCE: This home provides a comfortable environmental standard with good quality furniture and fittings. The manager conducts regular inspections of the home and notes any repairs that may be required. As the home employs a part time handyman /gardener minor repairs are carried out as soon as possible. Some parts of the home have been refurbished to include carpets and curtains and three of the bedrooms have also been redecorated. Rosehill House DS0000022619.V306142.R01.S.doc Version 5.2 Page 16 There is ample communal space with two lounge/ dining rooms, one of which is a very large room. There is also a small sitting area on the first floor that, unfortunately, is not often used by the residents. There are large, well kept gardens with ample parking facilities. Rosehill House is a large Victorian property that has been converted and extended for its present use as a care home. This means that all the bedrooms are individual in size and design and personal to each resident. Each room has a washbasin and en-suite toilet. There are lots of pictures, ornaments and radios and televisions in the rooms. There are three rooms that are currently registered for two people, with one occupied by two ladies, with their agreement. There is a screen provided to ensure privacy. One of the other remaining double rooms is currently being used for single occupation. The home provides the necessary aids and adaptations to enable residents to retain as much independence as possible. There are two hoists on each floor, assisted bathing and shower facilities and rails on the corridors allowing movement around the building. The installation of a platform lift has greatly enhanced the quality of life for the residents. Rosehill House DS0000022619.V306142.R01.S.doc Version 5.2 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 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 & 30 Quality in this outcome area is good. This judgement was made using available evidence including a visit to this service. There is a trained and experienced staff team to care for the residents that has been recruited using the home’s robust policies and procedures. EVIDENCE: Rosehill House has a stable staff team with a very low staff turnover. The staffing arrangements in this home are good with 3 members of care staff on duty in the morning and two in the afternoon, plus the manager and/or the deputy on duty during the day and 2 waking staff at night. There are also catering and domestic staff employed. The staff team is experienced and qualified, with eight care staff having already completed National Vocational Qualification (NVQ) level 2 or above. One of the domestic staff has also completed this qualification in the appropriate discipline. There is one of the care staff that has almost completed the qualification and three others hoping to start in January. The inspector was able to observe the staff and found their attitude to be caring, supportive and enabling. This attitude ensures that the residents can maintain as much independence for as long as possible even though many residents have quite high dependency needs. Rosehill House DS0000022619.V306142.R01.S.doc Version 5.2 Page 18 There is a full recruitment and selection process that ensures all the legal checks are completed prior to new staff starting work. All staff have enhanced CRB checks, which ensures the safety and security of the residents. Rosehill House DS0000022619.V306142.R01.S.doc Version 5.2 Page 19 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 & 38 Quality in this outcome area is good. This judgement was made using available evidence including a visit to this service. The home is run by a competent, qualified and experienced manager who ensures it is run in the best interest of the residents. EVIDENCE: The manager has the required qualifications and experience and is competent to run the home. There is a strong emphasis of being open and transparent in all areas of running of the home. Discussions with the registered manager confirmed her commitment to giving the highest level of care to the residents. She works closely with the staff team to ensure all the assessed needs are met. During the inspection she demonstrated clear lines of responsibility and delegation to the deputy manager, but also provided a “hands on approach” when necessary. Rosehill House DS0000022619.V306142.R01.S.doc Version 5.2 Page 20 Discussions with the residents, staff and visitors evidenced that she ensures the home is run in the best interest of the residents and that all appreciated her help and support. All staff supervision and appraisals are in place with records held on staff files. The home does not manage any personal monies on behalf of the residents as this is considered to be the responsibility of family members or the resident’s representative. The home has a full set of policies and procedures in place and the manager is always looking at ways to ensure these are kept completely up to date. All policies are reviewed annually. All equipment is serviced under annual contracts. The manager’s husband is responsible for health and safety and all fire safety procedures are in place. He ensures that fire drills are conducted and fire safety equipment is tested on a regular basis. Arrangements have been made for a professional organisation to spend time in the home in order to complete a full health and safety audit. All risk assessments are in place and reviewed at the same time as the care plans. Staff are aware of the need for preventing cross infection and are provided with protective clothing and gloves. Quality assurance questionnaires are sent to residents, and relatives every year with the manager analysing the replies and preparing a report. Resident meetings are also held which give the everyone the opportunity to have their say about the running of the home. Rosehill House DS0000022619.V306142.R01.S.doc Version 5.2 Page 21 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 Rosehill House DS0000022619.V306142.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action 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 Rosehill House DS0000022619.V306142.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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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