Inspection on 04/05/05 for Rosehill Rehabilitation Unit

This inspection was carried out on 4th May 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rosehill Rehabilitation Unit 23/01/08

Rosehill Rehabilitation Unit 08/02/07

Rosehill Rehabilitation Unit 27/10/05

Rosehill Rehabilitation Unit 11/11/04

Rosehill Rehabilitation Unit 06/05/04

Similar services:

The Vicarage

7 Hyde Road

5 Seafield Road

Trevaylor Manor

12 Orchard Mews

Stallcombe House

Stepping Stones

Cornerstones

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

CARE HOME ADULTS 18-65 Rosehill Rehabilitation Unit Lower Warberry Road Torquay Devon TQ1 1QY Lead Inspector Rachel Proctor Unannounced 4th May 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Rehabilitation Unit D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Rosehill Rehabilitation Unit Address Lower Warberry Road, Torquay, Devon, TQ1 1QY 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) 01803 291909 info@craegmoor.co.uk Parkcare Homes Limited Mr Terence John Beverton Care Home with nursing 27 Category(ies) of Physical disability (27) registration, with number of places Rosehill Rehabilitation Unit D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 04/05/05 Brief Description of the Service: Rosehill Rehabilitation Unit provides rehabilitation nursing care for Service Users who have traumatic brain injury. The home is part of Parkcare homes limited, which is a member of Craegmoor Group limited. Rosehill is about half a mile from Torquay. It is registered for 27 Service Users. The home chooses to provide single room accommodation, which reduces their maximum occupancy to 21 Service Users. The home employs registered nurses, physiotherapists and occupational therapists. A 1st level Registered Mental Health Nurse with several years experience manages the team. This includes 1st and 2nd level Registered General nurses and Health Care Assistants with a National Vocational Qualification in care. A local general practitioner with a special interest in Traumatic brain injury is available. A specialist nurse practitioner in acquired brain injury provides professional support for the registered nurses. The home has a comprehensive assessment and care planning system, developed in conjunction with the wider multidisciplinary team. The accommodation is spread over three levels, ground, mezzanine and first floor. The home has an equipped physiotherapy gym, a specially adapted domestic kitchen for assessment purposes as well as the homes main kitchen and laundry area. Specially adapted bath shower rooms and toilets are available for disabled Service Users, including independent wheel chair users. A shaft lift is available to Service Users areas. The grounds are wheelchair accessible and have ramps and grab rails provided for Service Users use. Rosehill Rehabilitation Unit D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The commission for social care inspection has introduced key standards to be inspected over each inspection year. Therefore, unless it is felt necessary by the inspector, some standards will not be inspected. To obtain a full picture of the home it is recommended that previous reports also be taken into consideration. This inspection was unannounced and took place on the 4th of May 2005 between 10 a.m. and 4 p.m. The inspector spoke to 6 residents, 2 relatives and 4 members of staff. The inspector joined the residence for the lunchtime meal. A tour of the home was completed and some records were inspected. What the service does well: What has improved since the last inspection? Some of the resident’s rooms and the communal areas have been redecorated since the last inspection. The pine furniture in some resident’s rooms has been revarnished. This has improved the over al environment to the benefit of the residents. More staff have been appointed reducing the need for agency staff to cover shifts. The training coordinator now plans the training of the staff team. This has enabled the residents to be cared for by a member of staff they know who understands them. Residents meetings have restarted. Following the residents and relatives suggestion a new activities coordinator has been appointed and the type of activities provided change. The new disinfecting sluice has been fitted to the first floor since the last inspection. This reduces the risk of cross infection for the residents. Rosehill Rehabilitation Unit D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rosehill Rehabilitation Unit D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Rosehill Rehabilitation Unit D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 5, The statement of purpose and service users guide provide clear information for the residents and their relatives to make an informed choice about the home and it’s services. The residents can be assured that the way assessments are completed enables the staff to understand their individual personal, health and social care needs. EVIDENCE: The assessments for residents are well documented. Four residents spoken to advised that the staff responsible for their care asked them about their preferences. The assessments include risk assessments for the activities the residents have chosen to undertake. One resident who like to smoke had a risk assessment to manage the possible risk. Another service user who liked going outside the home had a risk assessment to instruct staff how to facilitate this. The statement of purpose and service users guide has been revised to reflect the management changes at the home. These were readily available for residents and relatives. Residents are given written contracts, which provide information about the fees charged and services provided. The residence or their representative had signed those seen. Rosehill Rehabilitation Unit D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 9 One residents relative stated they had had the opportunity to find out about the home before their relative was admitted. They had the opportunity to meet staff prior to admission. Another service user stated they had visited the home for a short period prior to making the decision to stay. Rosehill Rehabilitation Unit D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 8, 7, 9,10, The way the resident’s health and social care needs are assessed and provided enables them to influence their care and promotes independence. EVIDENCE: The individual plans of care reflected the residents changing needs and personal goals. Chosen activities had been risk assessed to allow the resident to make an informed choice. Those asked said they liked living at Rosehill. The preset care plan template in use identifies basic care needs for the individual resident. These had been personalised to reflect the individual’s health and personal care needs. A brief description of the disease process and how this affected the resident is included. Staff were observed to assist residents to go out into the garden, smoke, walk around the home and eat their meals. The mealtimes were designated no smoking times. Staff were seen facilitating this in a firm and fair way with the residents. The residents asked said the staff were very friendly and supportive. Staff were observed to take time to communicate with a resident who used a Rosehill Rehabilitation Unit D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 11 communication aid. This resident advised that they liked to know what was going on and felt involved. Rosehill Rehabilitation Unit D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13, 14, 16, 17, The residents are able to influence how they use their time and what they eat. The meal times are a pleasant social event for the residents and staff. EVIDENCE: Three residents had been on a holiday in North Devon recently, one asked said they had enjoyed this. A staff member reported that the residents had been encouraged to make choices during the holiday. One of the residents was starting to make plans to move on. A new activities coordinator had been appointed since the last inspection. She advised that she was starting to get to know the residents before planning the activities with them. During the inspection the activities coordinator was spending time with individual residents on a one-to-one basis. On arrival at the home some residents were still in bed others were eating breakfast. One resident spoken to advised that they had chosen to stay in their room until the relative visited at lunchtime. Rosehill Rehabilitation Unit D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 13 The risk assessments for activities clearly indicate how the resident’s rights are respected. One resident who had a risk assessment for leaving the home was observed speaking to staff. The staff were supporting the residents, talking to them reminding them of the possible risks of going outside the home alone. The resident chose to stay after speaking to staff. Residents were eating their lunchtime meal in the lounge area and dining room, some residents had requested to eat their meals in their own rooms, this had been facilitated. Very little wastage was seen at the lunchtime meal. Residents asked said they enjoyed the food. One resident commented that they had a little booklet to enable them to choose the meals. Rosehill Rehabilitation Unit D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20, The residents at Rosehill are able to influence the way they care is provided and the activities they undertake. Holistic assessments and care management plan enable the residents to make choices. Medication practices within Rosehill a good ensuring the residents receive the medication they require. EVIDENCE: The three of the residents plans viewed had the individuals personal choices and preferences recorded. How the residents were encouraged to do the things for themselves that they could had been recorded. One resident had improved significantly since the last inspection. They were in the process of looking at the possibility of moving on. Psychological assessments are part of the residents care plans. The psychology assistant appointed since the last inspection had completed profiles for each of the residents. This enabled the care provided to the individuals to be targeted to their indivdual needs. The staff team includes physiotherapists, occupational therapists, registered general nurse, registered mental health nurses and health care assistants. The community multidisciplinary team also supports them. The resident’s reviews recorded how individual staff members and the multidisciplinary team had enabled the care of the residents to be tailored to their individual preferences and needs. Rosehill Rehabilitation Unit D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 15 Resident’s medication was stored in a locked treatment room and the medication in use stored in a locked trolley. Staff were observed giving residents their medication and signing their medication sheets after this was given. A risk assessment process is in place for residents who self medicate. However none of the current residents were able to do this. Rosehill Rehabilitation Unit D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23, The residents at Rosehill can have confidence that any concerns or wishes that they raise will be dealt with sensitively by the staff. EVIDENCE: Information for staff is available in the office relating to the homes policy for adult protection. These were easily available to staff. The training staff had received an adult protection was discussed. Staff observed interacting with residents were doing so in a respectful supportive way. The money held for residents were stored in a safe and individual residents money and expenditure had been recorded separately Rosehill Rehabilitation Unit D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26, 30, Some of the carpets/floor covering and furniture within Rosehill are still in need of repair or renewal. This detracts from an otherwise pleasant homely environment for the residents. EVIDENCE: Separate accommodation with a domestic style adapted kitchen and separate lounge had been redecorated and was being used during the inspection. This unit was being used to enable residents to prepare them independence. Two of the residents in this unit were in the process of preparing to leave. Some of the resident’s rooms and communal areas had been redecorated since the last inspection. Some of the pine furniture had been stripped and revarnished. The handyman advised how he was in the process of revarnishing all the pine furniture in the home. The handyman was covering the pipe work adjacent to the radiator covers during the inspection. He is advised that this was being done as a result of a risk assessment that identified possible injury to residents if they fell against the pipe work. Rosehill Rehabilitation Unit D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 18 Manual handling hoists were available in the home these have the dates of the last service recorded on them. This ensures that the equipment is safe for the residents. The home was fresh and clean and free from odour during the inspection. Infection control policies and procedures were in place. Staff observed we use in gloves and aprons when attending to the resident’s personal care. Some outstanding repairs were noted during the inspection. The laundry floor had still not been recovered. The broken areas on the floor covering in the laundry did not allow the floor to be easily cleanable. This poses a possible cross infection risk for the residents. Reassurances were given that the floor covering was on order and would be fitted as soon as possible. A disinfecting sluice had been fitted to the first-floor since the last inspection. A little used residents toilet adjacent to a disabled bathroom had been used. One en suite shower unit continues to have a problem caused by the water pressure. The manager advised that he was exploring ways to correct this. One resident’s room does not have a hand washbasin. This residents risk assessment identified the reasons why having washbasin unit would be detrimental to the resident. Although the home is registered for 27 when the shared rooms. All accommodation was being used a single reducing the number available to 21. Rosehill Rehabilitation Unit D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35, 36 A motivated well-trained staff team, who received good supervision and support from the management team within the home, care for the residents. EVIDENCE: The manager advised that a new training and development coordinator had been appointed. The coordinator provided information on the training staff had received so far; she advised that the training provided would be linked to the needs of the residents. Staff training and development plans are part of the appraisal system in place. One new member of staff said she had been helped to settle into work within the home systems. A supervision system is in place. However the supervision staff had received had not been documented in every instance. The manager advised he was working towards this, and anticipated that the training and development coordinator would provide training and development plans for all the staff. Staff spoken to during the inspection stated the manager had made a difference to the staff morale in the home. The staff observed were working well together to support the residents. They were clear lines of accountability within the staff team. Job descriptions are provided for staff however these were still in the process of being updated. Rosehill Rehabilitation Unit D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 20 Rosehill Rehabilitation Unit D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39, 41, 42, The residents are able to influence the way their care is provided allowing them to maintain their individuality. Clear record-keeping enables the resident’s best interests to be safeguarded. However some outstanding requirements relating to the furniture and floor covering in the home has still to be completed. This detracts from an otherwise pleasant homely environment that values the residents. EVIDENCE: A quality assurance system is in place; completed residence questionnaires were available for inspection. The results of an internal audit and the health and safety audit of the home were available. The completed questionnaires identified that the resident’s and relatives would like resident’s meetings. The minutes of the first residents meeting were provided. These showed how the residents had been able to influence the way the home is managed. Rosehill Rehabilitation Unit D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 22 There were two maintenance men working in the home during the inspection. They reported that they are responsible for ongoing repairs and renewals in the home. They confirmed that staff speak to them each day and discuss urgent problems. The home has a comprehensive assessment process and care planning system to record the care needs of the residents. This enables the staff to have clear information about the way the resident’s care is to be given. The staff observed talking to residents appeared to have a good understanding of the care needs. The majority of the outstanding repairs and renewals identified at the last inspection had been completed. The flooring in the laundry still had three broken areas, which could harbour dirt. The manager confirmed that new flooring had been ordered and would be fitted as soon as possible. SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 Rosehill Rehabilitation Unit Score 3 4 x x Standard No 22 23 ENVIRONMENT Score x 3 D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 23 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 3 x x x 2 Standard No 11 12 13 14 15 16 17 x x 3 3 x 3 4 Standard No 31 32 33 34 35 36 Score x x x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x 3 2 x Rosehill Rehabilitation Unit D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 24 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. 2. 3. Standard YA24 YA30 YA42 23(2)(b)( d) 23(2)(b)( d) Regulation 23(2)(b)( d) Requirement The laundry floor must be easily cleanable and none permeable The laundry floor must beeasily cleanable, none permeable and kept clean. Outstanding manintenance and repairs must be completed Timescale for action 01/03/05 extended 01/07/05 01/03/05 extended 01/07/05 01/03/05 extended 01/07/05 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 YA10 Good Practice Recommendations Information reguarding data protection registration should be available for inspection Rosehill Rehabilitation Unit D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 25 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Rehabilitation Unit D54-D07 S28792 Rosehill Rehab Unit V221427 040505 Stage 4.doc Version 1.20 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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