CARE HOMES FOR OLDER PEOPLE
Rosehill House Moresby Whitehaven Cumbria CA28 6SF Lead Inspector
Margaret Drury Unannounced 18 July 2005 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. F58 F10 s22619 rosehill house v234436 180705 ui stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Rosehill House Address Moresby Whitehaven Cumbria CA28 6SF 01946 695235 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) Mrs Pamela Hill-Eades Care Home 19 Category(ies) of OP - Old Age registration, with number DE(E) - Dementia, over 65 of places MD(E) - Mental Disorder, over 65 F58 F10 s22619 rosehill house v234436 180705 ui stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The service must at all times employ a suitably qualified and experienced manager who is registered with the National Care Standards Commission. 2. A maximum of nineteen older people (19OP) including two people with dementia (2DE(E)). 3. One named older person with a mental disorder (1MD(E)). 4. When single rooms of less than 12 sqm usable floor space become available they must not be used to accommodate wheelchair users, and where existing wheelchair users are in bedrooms of less than 12 sqm they must be given the opportunity to move to a larger room when one becomes available. Date of last inspection 22 February 2005 Brief Description of the Service: Rosehill House is registered to provide care and social support to up to 19 older people. The home is owned by Mr and Mrs Hill-Eades, with Mrs Hill-Eades as the registered manager. The home is a detached, older style property set in its own grounds approximately three miles from Whitehaven. Access to Rosehill 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 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. F58 F10 s22619 rosehill house v234436 180705 ui stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection of the home, and took place over one morning. Time was spent talking to the owners, manager, care staff, residents, and visitors. Records to do with the day-to-day running of the home and care practices were examined and many parts of the home were looked at. What the service does well: What has improved since the last inspection?
A new activities co-ordinator has been appointed to works with the residents three afternoons a week. Excellent activities are organised with new ones planned for the future. A record is kept of the activities arranged and an individual record of what each resident takes part in. Plans have been passed for alterations to the home to include a platform lift. This will enhance the quality of life for all the residents especially those who are les mobile.
F58 F10 s22619 rosehill house v234436 180705 ui stage 4.doc Version 1.40 Page 6 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. F58 F10 s22619 rosehill house v234436 180705 ui stage 4.doc Version 1.40 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 F58 F10 s22619 rosehill house v234436 180705 ui stage 4.doc Version 1.40 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) 3, 4 & 5 Residents benefit from a good assessment and admission procedure that ensures their needs can be met. Residents and their families benefit from the chance to visit the home prior to admission, to meet the staff and other people living in Rosehill House. EVIDENCE: There is a clear admission process, which includes a full assessment of needs and capabilities carried out by the manager and deputy, a record of which is held on the care plans. This ensures the correct level of care can be provided. Prospective residents are invited to spend some time at the home to meet the staff and other residents. This gives an opportunity to see the facilities on offer and to decide if they want to move in and if their needs can be met. F58 F10 s22619 rosehill house v234436 180705 ui stage 4.doc Version 1.40 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, 10 &11 The home’s clear and consistent care planning system, ensures residents ’health and social needs are met in a way that promotes their privacy, dignity and independence. EVIDENCE: The care plans contain information about residents’ care needs, including moving and handling assessments. They are reviewed and updated every month with the involvement of the resident where possible. The plans provide the care staff with the information they need to meet resident’s needs. Records are kept about GP appointments and when district nurses visit, and residents said that they are able to see the doctor or nurse when they request. The care staff speak to residents in a courteous and polite way, knocking before entering bedrooms, and closing bedroom doors when assisting people with personal care tasks. Information about residents’ preferences after death is held on the care plans and residents know their wishes will be followed. F58 F10 s22619 rosehill house v234436 180705 ui stage 4.doc Version 1.40 Page 10 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 & 15 Social activities and meals are varied and provide residents with a range of choices and opportunities on a daily basis. EVIDENCE: The home has recently appointed a new activities co-ordinator and the residents said how much they enjoyed the planned activities. If any resident does not want to or is unable join in, the co-ordinator works with them on a one to one basis. This is greatly appreciated. A detailed record of the activities is kept on file and was available for inspection. Local ministers visit the home and conduct communion services and the home has recently held a joint garden party with the day nursery next door. There is a three-week menu in place with an choice given at each meal and also an alternative offered. A record of all meals taken is kept. Visitors are welcome at any time and they are always offered refreshments when in the home. F58 F10 s22619 rosehill house v234436 180705 ui stage 4.doc Version 1.40 Page 11 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 & 17 Residents benefit from a satisfactory complaints system with evidence that they feel that their views are listened to and acted upon. Staff understand adult protection issues, which safeguard residents from abuse. EVIDENCE: Residents are given information about how to complain when moving into the home, and said that if they had any issues to raise it is dealt with promptly. Information about making a complaint is displayed in the entrance area of the home. Adult protection training is covered in the NVQ qualification and staff who spoke with the inspector showed an awareness of all the issues involved. Residents take part in the national and local elections through the postal voting system. Senior care staff assist people with this if it is necessary. Details of the local advocacy are on display for anyone who may need to use the service. F58 F10 s22619 rosehill house v234436 180705 ui stage 4.doc Version 1.40 Page 12 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, 21, 22, 25 &26 Residents benefit from warm, comfortable and secure surrounding in which to live. EVIDENCE: Rosehill House provides a warm, safe and friendly environment for the residents. It is well maintained with the joint owner responsible for the fabric of the building and grounds. There is good access to all parts of the building and also to the grounds. All the rooms have en-suite toilet and washing facilities and there is a disabled shower and bath for use by the residents. There are four communal toilets. The home has four hoists to assist people with a disability. Furnishings in the home are comfortable and suitable to meet the assessed needs. Domestic arrangements in the home mean it is clean, pleasant and hygienic. Plans are in place for some alterations to include a platform lift.
F58 F10 s22619 rosehill house v234436 180705 ui stage 4.doc Version 1.40 Page 13 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, 28 &30 A qualified and experienced staff team, who are appointed following a comprehensive recruitment process, cares for the residents. This ensures protection for all living in the home. EVIDENCE: There are three care staff plus the manager on duty in the morning and two care staff plus the manager during the afternoon. The deputy manager is also on duty four days a week. There are two waking night staff with senior staff on call. There are also two cooks and domestic staff employed. Many of the staff are already qualified to NVQ level 2 or above and the manager hopes to enrol the remaining staff later this year. With the qualifications and experience of the staff the residents feel safe at all times. All staff training is up to date, with the manager accessing as much external training as possible. F58 F10 s22619 rosehill house v234436 180705 ui stage 4.doc Version 1.40 Page 14 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) 31, 32, 33, 36 &38 The manager has a clear vision for the home and is supported well by the senior staff. Residents benefit from clear leadership and a staff team that shows an awareness of their roles and responsibilities. EVIDENCE: The manager is very motivated and it was obvious during the inspection that she spends time talking with the residents to make sure they are happy with the care and services they receive. The staff group find the manager supportive and approachable, which motivates them to improve their knowledge and skills and so continue providing good care to the residents. Staff supervision is completed every 8 weeks, with the records showing that the time is well spent and provides good support for the staff. The home has good health and safety policies and procedures in place and staff have
F58 F10 s22619 rosehill house v234436 180705 ui stage 4.doc Version 1.40 Page 15 completed health and safety training. The joint owner is responsible for the safety of the building and grounds and conducts regular audits in order to keep the building as safe as possible. F58 F10 s22619 rosehill house v234436 180705 ui stage 4.doc Version 1.40 Page 16 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 x x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 2 14 x 15 3
COMPLAINTS AND PROTECTION 3 3 3 3 x x 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 x x 3 x 3 F58 F10 s22619 rosehill house v234436 180705 ui stage 4.doc Version 1.40 Page 17 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 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. 1. Refer to Standard Good Practice Recommendations F58 F10 s22619 rosehill house v234436 180705 ui stage 4.doc Version 1.40 Page 18 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
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