Inspection on 06/12/06 for Rosehill House Residential Home Limited

This inspection was carried out on 6th December 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 Residential Home... 04/12/07

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

Rosehill House Residential Home... 24/11/05

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

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

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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 Key Unannounced Inspection 6th December 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 Residential Home Limited DS0000060416.V322097.R02.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 Residential Home Limited DS0000060416.V322097.R02.S.doc Version 5.2 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.V322097.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th March 2006 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. Rosehill House currently charges £405 per week. In addition to providing residential care Rosehill House provides a limited number of day places to local people. Rosehill House Residential Home Limited DS0000060416.V322097.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a period of approximately 5.5 hours on the 6th December 2006. The inspector met with the registered manager, staff, and 5 residents, toured the premises, and inspected documentation. Residents’ comments were, without exception, very positive in respect of the kindness of staff and the care provided. Overall the home provides a good level of service to the residents. What the service does well: What has improved since the last inspection? What they could do better: The registered manager advised the inspector that sickness levels amongst staff had been high over recent months, requiring the registered manager to spend more time helping to deliver care rather than attending to managerial duties. As a result the home has slipped in performance in some areas where they were previously meeting requirements. The registered manager must ensure that the home operates a robust employment procedure, which Rosehill House Residential Home Limited DS0000060416.V322097.R02.S.doc Version 5.2 Page 6 includes the acquisition of references, Criminal Records Bureau checks, Protection Of Vulnerable Adults checks, and a properly completed and informative application form. The registered manager must ensure that all residents have a plan of care. 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. The summary of this inspection report can be made available in other formats on request. Rosehill House Residential Home Limited DS0000060416.V322097.R02.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 Residential Home Limited DS0000060416.V322097.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. National Minimum Standards 1, 3, and 6 were inspected. This judgement has been made using available evidence including a visit to this service. The home produces a Statement of Purpose and Service User Guide. Residents felt that they received the information they needed in order to make an informed choice. The home is good at providing residents and prospective residents with details of the services available, enabling an informed decision about admission. The registered manager and care documentation demonstrate a good understanding of the care needs of the service users. There is opportunity for prospective service users and their representatives to visit the home prior to admission. The home does not provide intermediate care. EVIDENCE: The home have a regularly reviewed Statement of Purpose and Service User Guide, which the registered manager advises are provided either to each Rosehill House Residential Home Limited DS0000060416.V322097.R02.S.doc Version 5.2 Page 9 resident or to their representative. Residents spoken to were not aware of the Statement of Purpose or Service User Guide, but two believed that their family members might have these documents. All the residents felt that they receive the information they need. The most recent admission file shows that the resident was fully assessed prior to admission. However, discussion with the registered manager revealed that two recent ‘emergency’ admissions were not assessed. This was discussed fully with the registered manager. The registered manager undertook to ensure that all prospective residents are assessed prior to admission, so that the home can be sure that they can meet the care needs of the resident. The home does not provide intermediate care. Rosehill House Residential Home Limited DS0000060416.V322097.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. National Minimum Standards 7, 8, 9, and 10 were inspected. This judgement has been made using available evidence including a visit to this service. All but one resident have a plan of care. Residents and the care documentation confirm that health care needs are met. Residents are protected by the home’s medicine systems. Residents were enthusiastic in their praise of the staff and the care provided. EVIDENCE: One resident did not have a plan of care. The care documentation is under review, with a new system being introduced. The old system continues to be used until all the resident’s files have been transferred to the new system. Care plans inspected were clear and informative, showing evidence of regular review, at least once a month, and the involvement of the resident or their representative. Care plans are comprehensive in the range of issues covered, including spiritual needs. Equality and diversity is recognised by the registered manager as an ongoing consideration, and the new care plan system allows for the entry of any such issues. The care documentation shows that residents Rosehill House Residential Home Limited DS0000060416.V322097.R02.S.doc Version 5.2 Page 11 have access to relevant health care professionals as necessary. The registered manager must ensure that all residents have a plan of care in use. Residents confirmed that their health care needs are well met, and the care documentation shows that they have access to health care professionals as needed. One resident described their recent health care needs, confirming that they had had access to the appropriate professionals and that further follow-up was arranged. The home has a variety of equipment and aids to assist in meeting the healthcare needs of the residents. All the residents are registered with a GP. The care documentation includes a number of assessments, such as manual handling, risk-assessment, etc. The registered manager and staff ensure that professional advice is sought as necessary, as confirmed by the experience of one resident who recently underwent specialised hospital treatment. Medicines were inspected and generally seen to be in order. The home uses the monitored dosage system, and the registered manager advised the inspector that they are looking to purchase a bigger medicine trolley, or possibly a second medicine trolley. Medicines are stored securely. Medicine training is included in the training opportunities available to staff. There is an appropriate medicine policy in operation at the home. Medicine Administration Records were seen to be clear and accurate. The registered manager should ensure that two initials are entered when manually transcribing prescriptions onto Medicine Administration Records. Residents spoken with were “very happy” with the care provided, the attitude and kindness of the staff, and their accommodation. One resident said “we’re treated like royalty”, and another confirmed that living at Rosehill House was like being “home from home”. Residents also confirmed that staff always knock before entering their rooms. Rooms are personalised, and staff were observed to recognise the individuality of the residents in their interactions with them. Residents were seen to be wearing their own clothes, and the laundry system provides individual baskets for clean clothing. A significant number of residents have their own telephone in their rooms, though a telephone is available to all. Rosehill House Residential Home Limited DS0000060416.V322097.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. National Minimum Standards 12, 13, 14, and 15 were inspected. This judgement has been made using available evidence including a visit to this service. Comments from the residents, and the care documentation support the view that residents’ lifestyle matches their expectations. Residents are free to maintain contact with family and friends as they wish. A commitment to the individuality of the residents and their right to choose is evident, though improvements are possible in respect of menu choices. EVIDENCE: There are good daily entries in the care documentation, informative of how the residents spent their day. The entries show that regular social activities are available. There is a visitors’ book, which shows regular and frequent visitors to the home. Residents spoken with confirmed that they are free to determine whom they see or don’t see, and that they have regular contact with family and friends. Residents said that they had enough to do to keep themselves occupied, and that staff were only too willing to assist them if they needed help. Residents also said that they were free to determine their own lifestyle within the parameters of their care needs. Rosehill House Residential Home Limited DS0000060416.V322097.R02.S.doc Version 5.2 Page 13 The home handles only small amounts of money for the residents, and where this happens there is an accurate record, supported by receipts, available. The residents felt that they were provided with the information they needed in order to make informed choices. Evidence of personal possessions was seen around the home, the degree to which rooms were personalised varying according to the individual residents’ circumstances. There is a 4-week menu in operation, which demonstrates choice at meals, though a choice at lunch is not currently communicated to the residents. This was discussed with the registered manager, who undertook to ensure that residents’ choice for lunch would be ascertained, and recorded, at morning coffee each day. The registered manager should ensure that the kitchen maintains a record of food provided to each resident on a daily basis. The residents spoken with were complimentary about the quality of the food provided, and whilst confident that an alternative would be provided if requested confirmed that a routine choice is not offered at lunch. Rosehill House Residential Home Limited DS0000060416.V322097.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. National Minimum Standards 16, and 18 were inspected. This judgement has been made using available evidence including a visit to this service. The home has a comprehensive complaints procedure, an adult protection procedure, and staff training is undertaken to protect residents from abuse. EVIDENCE: The residents spoken with were not specifically aware of the home’s complaints procedure, but all thought that their representatives probably were, and all felt that they were able to voice any concerns if they had any. The complaints procedure is displayed in the entrance to the home. The Commission for Social Care Inspection have not received any complaints in the 9-month period since the last inspection. There is an adult protection procedure, which sets out clear instruction for staff to follow in the event of an allegation of abuse. Residents spoken with confirmed that they felt safe and had confidence in the management and staff at the home. Staff training opportunities undertaken include ‘No Secrets’ training. Rosehill House Residential Home Limited DS0000060416.V322097.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. National Minimum Standards 19, and 26 were inspected. This judgement has been made using available evidence including a visit to this service. Rosehill House provides a clean, homely, well maintained, and safe environment. There are sufficient bathing and toilet facilities for residents. The home provides appropriate sitting, recreational and dining space. Residents’ rooms are clean and pleasant and personalised to varying degrees, overall creating a comfortable and safe environment. 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, and a stairlift to assist access to all parts of the home. Disabled access has been provided at a side entrance to the home. Rosehill House Residential Home Limited DS0000060416.V322097.R02.S.doc Version 5.2 Page 16 There are four bathrooms. Two downstairs lavatories have been recently refurbished and redecorated. There is a rolling programme of refurbishment and redecoration. There is one room offering shared accommodation, the remainder are single occupancy rooms. The accommodation and communal space were seen to be clean and well maintained. The residents spoken with were all more than content with their accommodation. The laundry was also inspected, and whilst this room is small it is functional. Rosehill House Residential Home Limited DS0000060416.V322097.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. National Minimum Standards 27, 28, 29, and 30 were inspected. This judgement has been made using available evidence including a visit to this service. Staff numbers, skill mix, and training available reflect a commitment to service user welfare and staff development. The registered manager must adhere to a robust employment procedure in order to protect residents. Failure to adopt stringent employment procedures could put residents at risk. EVIDENCE: The following is a generalisation of the usual staffing complement: • Morning: Manager 5 carers (1 senior carer) • Afternoon/Evening: Manager 3 carers (1 senior carer) • Night: 2 carers (1 registered manager or senior carer on call) The on call rota is shared between the registered manager, the assistant manager and two senior carers. There is a current and accurate duty rota which shows the staff on duty day and night. There is additional support staff, such as domestic staff, employed. The comments of the residents, and the care documentation show that the staffing levels are currently sufficient to meet the care needs of the residents. Rosehill House Residential Home Limited DS0000060416.V322097.R02.S.doc Version 5.2 Page 18 There is evidence of ongoing staff training on file, and copies of certificates were seen at the time of the inspection. The registered manager advised the inspector that a new system will be introduced in order to better enable ‘at a glance’ awareness of individual training needs. A National Training Organisation induction programme is in use for new staff, and the registered manager has undertaken to obtain General Social Care Council handbooks (http:/www.gscc.org.uk/Home) for each member of staff. Records show that just under 50 of care staff have achieved NVQ Level 2 or above, though a further 3 staff are undertaking this training. Staff were observed to be occupied with their duties, but not overly hurried, and they were seen to have the time and willingness to interact with residents in a respectful yet friendly manner. The personnel file of the most recently employed staff member was inspected. The documentation showed: an inadequate application form, which does not ask for the applicants’ employment history: one old generic reference. The registered manager must ensure that a robust employment procedure is adhered to, including proof of identity, the acquisition of two current, positionspecific references (one from the most recent employer), a Criminal Records Bureau check, Protection Of Vulnerable Adults check, and it is recommended that a record of interview is kept. The home does have an equal opportunities policy and there is a statement to this effect in the Statement of Purpose. Residents views of the staff were, without exception, positive and complimentary. Rosehill House Residential Home Limited DS0000060416.V322097.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. National Minimum Standards 31, 35, 36, and 38 were inspected. This judgement has been made using available evidence including a visit to this service. There is a commitment to the welfare of the residents. The residents spoken with were complimentary about the registered manager and the staff. Residents’ financial interests, and their health, safety, and welfare are safeguarded. EVIDENCE: The registered manager is an experienced carer, and has worked at Rosehill House for approximately 9 years, starting as a senior carer, then assistant manager. The registered manager has achieved the D32/33, NVQ Levels 2 and 3 qualifications, and the Registered Managers Award. There is a clear hierarchy Rosehill House Residential Home Limited DS0000060416.V322097.R02.S.doc Version 5.2 Page 20 of responsibility, and the home and the residents benefit from a relatively stable staff team. The residents spoken with felt that they would have no difficulty approaching the registered manager, or indeed any of the staff, if they needed to discuss anything of importance to them. The registered manager did express a view that recent months (staff sickness) had required her to be more active in the provision of care, rather than in her managerial role, and that this had resulted in the lapse of attention to the latter (as evidenced by the inspector’s comments on employment). The registered manager advised the inspector that a meeting was planned with the registered provider to discuss an increase in the managerial hours allocated. It is the inspector’s opinion that such an increase is necessary, and would be of benefit to the home and the residents. The registered manager is appointee for 1 resident. Residents’ financial records were seen to be in order, and supported by receipts. A sample of supervision records was inspected and this shows that staff supervision is ongoing and regular. The premises are well maintained and safe. Documentation relating to the safety of the premises was inspected, including: • Fire training and equipment tests/maintenance. The registered manager undertook to ensure that two in-house trainers undertake the Fire Warden training programme. • Pest control contract. • Accident book. • Gas safety certificate. • Hoist maintenance. • Environmental Health Officer inspection. • Appliances testing. • IEE test • Lift and stair lift maintenance. Rosehill House Residential Home Limited DS0000060416.V322097.R02.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 3 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 3 X 3 Rosehill House Residential Home Limited DS0000060416.V322097.R02.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO 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. 2. Standard OP7 OP29 Regulation 15 19 Requirement Timescale for action 01/01/07 The registered manager must ensure that all residents have a plan of care in use. The registered manager must 06/12/06 ensure that a robust employment procedure is adhered to, including proof of identity, the acquisition of two current, position-specific references (one from the most recent employer), a Criminal Records Bureau check, Protection Of Vulnerable Adults check, and it is recommended that a record of interview is kept. 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 OP9 Good Practice Recommendations The registered manager should ensure that two initials are entered when manually transcribing prescriptions onto Medicine Administration Records. DS0000060416.V322097.R02.S.doc Version 5.2 Page 23 Rosehill House Residential Home Limited 2. OP15 The registered manager should ensure that the kitchen maintains a record of food provided to each resident on a daily basis. Rosehill House Residential Home Limited DS0000060416.V322097.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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