Inspection on 24/11/05 for Rosehill House Residential Home Limited

This inspection was carried out on 24th November 2005.

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

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

Other inspections for this house

Rosehill House Residential Home... 04/12/07

Rosehill House Residential Home... 06/12/06

Rosehill House Residential Home... 09/03/06

Rosehill House Residential Home... 10/01/05

Rosehill House Residential Home... 27/09/04

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Queensmount

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Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Rosehill House Residential Home Limited Rosehill House Middleway St Blazey Gate Par Cornwall PL24 2LB Lead Inspector Alan Pitts Unannounced Inspection 10:00 24 November 2005 th 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 Residential Home Limited DS0000060416.V255360.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rosehill House Residential Home Limited DS0000060416.V255360.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Rosehill House Residential Home Limited Address Rosehill House Middleway St Blazey Gate Par Cornwall PL24 2LB 01726812424 01726812424 rosehillres@btconnect.com 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) Rosehill House Residential Home Limited Mrs Lynn Jenkins Care Home 30 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (30) of places Rosehill House Residential Home Limited DS0000060416.V255360.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th January 2005 Brief Description of the Service: Rosehill House is a privately owned care home providing care and accommodation for older people, up to 10 of whom may have dementia. It is an older property with an extension. The home changed ownership in July 2004 but continuity for the service users has been maintained as the manager has become the registered manager and the staff have remained constant. Accommodation is offered on two floors, which are connected by a shaft lift and stairs. The majority of rooms are for single occupation and some are en suite. There is a choice of communal sitting areas and a dining room on the ground floor. Toilets are sited throughout the property. Externally the gardens are well-kept and accessible to service users. A summerhouse in the garden offers a place to sit in good weather. Adequate car parking is available to the side of the home. In addition to providing residential care Rosehill House provides a limited number of day places to local people. Rosehill House Residential Home Limited DS0000060416.V255360.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 24th November 2005, over a period of approximately 5 hours. The inspector met with the registered manager, staff, service users, and a visitor to the home. The inspector toured the building, and inspected care documentation. What the service does well: What has improved since the last inspection? What they could do better: The staff showed a good understanding of service user needs and capabilities, but the care plans could be improved. The registered manager is aware that there is work still to be done in respect of the ‘administrative’ or managerial aspects of running the home. Rosehill House Residential Home Limited DS0000060416.V255360.R01.S.doc Version 5.0 Page 6 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 Residential Home Limited DS0000060416.V255360.R01.S.doc Version 5.0 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 Residential Home Limited DS0000060416.V255360.R01.S.doc Version 5.0 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, 2, 6 Service users have the information they need in order to make an informed choice. EVIDENCE: The home’s Statement of Purpose and Service User Guide is available and given out by the home to service users or their representatives. These documents are current and accurate. Contracts are provided to all service users, which clearly state the fee and the service user’s room. The home does not provide intermediate care. Rosehill House Residential Home Limited DS0000060416.V255360.R01.S.doc Version 5.0 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 the following standard(s): 7, 11 The registered manager and care staff demonstrated a good understanding of service user’s care needs. Service users confirmed that the staff treat them with respect and sensitivity. EVIDENCE: Care plans were discussed at some length, as the registered manager recognised that the existing format did not provide the information needed in order to give informed direction for the care of a service user. The process of care needs assessment leading to a care plan (1. a clear statement of the service user care need; 2. the aim of the care; 3. the actual intervention needed), which is reviewed monthly with the involvement of the service user (where possible) was discussed. The inclusion of the name and signature of the author of a care plan, the date of writing, and the intended date for review was also discussed. It was recognised that the current 24-hour guide used would fit well into part 3 (above) of a care plan. The registered manager and staff demonstrated a good understanding of the service user’s care needs and their capabilities. The registered manager should review the care documentation used in order to ensure that there is an operational care plan for each service Rosehill House Residential Home Limited DS0000060416.V255360.R01.S.doc Version 5.0 Page 10 user, which is reviewed monthly with the involvement of the service user, where possible. Information in respect of service user’s spiritual wishes, or wishes in respect of dying and death are not routinely ascertained. The registered manager should ensure that the home has the information necessary in order to provide care in keeping with service user’s wishes. Service users spoken with confirmed that staff are respectful and considerate. Rosehill House Residential Home Limited DS0000060416.V255360.R01.S.doc Version 5.0 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 the following standard(s): 13, 15 All the service users spoken with were complimentary about the quality of the food provided and confirmed that an alternative is always available to them. Service users confirmed that there are no restrictions on visiting and they are free to see whom they wish. EVIDENCE: Rosehill House welcomes visitors, and people are able to receive visitors in private if they wish. Service users are encouraged to go out with families and friends if they wish. A visitors book is available in the entrance to the home. Service users are offered three meals daily with drinks and snacks at other times including nighttime if they are wanted. A choice is provided at breakfast, lunchtime and teatime. A record of each service users’ choice at lunch and teatime is kept. There is always a cooked option available to service users at teatime. All the service users spoken with were complimentary about the quality of the food provided and confirmed that an alternative is always available to them. Rosehill House Residential Home Limited DS0000060416.V255360.R01.S.doc Version 5.0 Page 12 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): 18 Service users are protected from abuse. EVIDENCE: The home has an abuse policy in place. The registered manager should ensure that there is a Protection Of Vulnerable Adults procedure that provides clear step-by-step instruction to staff in the event of an allegation of abuse, including relevant contact information. Service users spoken with said that they would feel able to express any dissatisfaction or concerns, and were complimentary about the care provided and the attentiveness and consideration of the staff. Rosehill House Residential Home Limited DS0000060416.V255360.R01.S.doc Version 5.0 Page 13 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, 21, 26 Rosehill House provides a clean, homely, well maintained, and safe environment. There are sufficient bathing and toilet facilities for service users. EVIDENCE: The home is well maintained and pleasantly decorated, providing a homely environment for the service users. The registered provider is gradually refurbishing and redecorating the home. Access throughout the home is assisted by the provision of handrails and grab handles at strategic points. There is lift for access to the first floor. There are six steps at one point, which cannot be overcome by mechanical means. This means that not all parts of the home are accessible to people who are not fully mobile. This factor is taken into consideration when offering accommodation. The registered manager advised the inspector that consideration is being given as to how the existing facilities and access may be improved. There are four bathrooms, two of which have been refurbished and redecorated to a high standard. The registered manager advised the inspector Rosehill House Residential Home Limited DS0000060416.V255360.R01.S.doc Version 5.0 Page 14 that the work is planned for the remaining two. Two downstairs lavatories have also been refurbished and redecorated. There is a rolling programme of refurbishment, and the home has employed a part-time handyman. The accommodation and communal space were seen to be clean and well maintained. The laundry was also inspected and discussion took place as to how a rearrangement of this room might improve the space available. The registered manager should audit the hand washing facilities available to staff in the bathrooms and toilets and provide suitable provision where necessary. The registered manager should ensure that red dissolving sacks are used for fouled laundry. Rosehill House Residential Home Limited DS0000060416.V255360.R01.S.doc Version 5.0 Page 15 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): 28, 29 There has been a relatively recent change of ownership and management, and it is evident that there is a commitment to the welfare of the service users. EVIDENCE: There are 18 care staff, of which 5 have achieved NVQ Level 2 or above, although a further 4 staff are currently undertaking this training. There is an induction programme for new staff. The Registered Manager should implement a National Training Organisation compliant induction programme (Skills for Care – www.topss-england.net). Contracts and a statement of conditions are in place, but those seen were in the name of the previous owners of Rosehill House. The registered provider has written to the Commission for Social Care Inspection informing them that the existing documentation is legal and staff are aware of their, and the registered provider’s, rights and responsibilities. Rosehill House Residential Home Limited DS0000060416.V255360.R01.S.doc Version 5.0 Page 16 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, 34, 37, 38 There has been a relatively recent change of ownership and management, and it is evident that there is a commitment to the welfare of the service users. The service users spoken with were complimentary about the registered manager and the staff. EVIDENCE: The registered manager is an experienced carer, and has worked at Rosehill House for approximately 7 years, starting as a senior carer, then assistant manager. The registered manager has achieved the D32/33, NVQ Levels 2 and 3 qualifications, and is undertaking the Registered Managers Award. The registered provider is not preparing written reports for the Commission for Social Care Inspection, or the registered manager. This is a requirement. The registered provider was advised of this following the previous unannounced inspection but has not complied. The registered provider must provide the Rosehill House Residential Home Limited DS0000060416.V255360.R01.S.doc Version 5.0 Page 17 Commission for Social Care Inspection and the registered manager with written reports following monthly-unannounced visits to the home. Failure to comply will result in the Commission seeking to enforce this. Quality assurance questionnaires are in use, but the registered manager should review these and expand them to include visitors to the home and visiting professionals. The registered manager should consider how best the information obtained could be used and published (e.g. in the Service User Guide). The registered provider is clearly investing in the home, and the furnishings and decoration were seen to be of a good standard generally. There is no reason to doubt the financial viability of this home. The registered manager has reviewed, and amended where necessary, all of the home’s policies and procedures. The policies and procedures are kept in the office, but the registered manager undertook to review how these are best made available to staff. Records are stored securely. The registered manager works a 40-hour week and has approximately half of this time available for managerial/administrative duties. The registered manager advised the inspector that the home’s riskassessments are currently under review. The home’s maintenance/safety documentation was inspected and seen to be in order. The registered manager undertook to confirm when the last hard-wiring (IEE) inspection took place and to arrange this 5-yearly requirement if necessary. Rosehill House Residential Home Limited DS0000060416.V255360.R01.S.doc Version 5.0 Page 18 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 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 X 10 X 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 3 X 3 X X X X 2 STAFFING Standard No Score 27 X 28 2 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 2 3 X X 3 3 Rosehill House Residential Home Limited DS0000060416.V255360.R01.S.doc Version 5.0 Page 19 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 OP32 Regulation 26 Requirement The registered provider must provide the Commission for Social Care Inspection and the registered manager with written reports following monthlyunannounced visits to the home. Failure to comply will result in the Commission seeking to enforce this. Timescale for action 31/12/05 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 OP7 Good Practice Recommendations The registered manager should review the care documentation used in order to ensure that there is an operational care plan for each service user, which is reviewed monthly with the involvement of the service user, where possible. Information in respect of service user’s spiritual wishes, or wishes in respect of dying and death are not routinely ascertained. The registered manager should ensure that the home has the information necessary in order to DS0000060416.V255360.R01.S.doc Version 5.0 Page 20 2. OP11 Rosehill House Residential Home Limited 3. OP18 4. OP26 5. OP28 provide care in keeping with service user’s wishes. The registered manager should ensure that there is a Protection Of Vulnerable Adults procedure that provides clear step-by-step instruction to staff in the event of an allegation of abuse, including relevant contact information. The registered manager should audit the hand washing facilities available to staff in the bathrooms and toilets and provide suitable provision where necessary. The registered manager should ensure that red dissolving sacks are used for fouled laundry. The Registered Manager should implement a National Training Organisation compliant induction programme (Skills for Care – www.topss-england.net). The registered manager should review the quality assurance questionnaires and expand them to include visitors to the home and visiting professionals. The registered manager should consider how best the information obtained could be used and published (e.g. in the Service User Guide). 6. OP33 Rosehill House Residential Home Limited DS0000060416.V255360.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 Rosehill House Residential Home Limited DS0000060416.V255360.R01.S.doc Version 5.0 Page 22 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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