Inspection on 23/04/07 for Rosehill Residential Home

This inspection was carried out on 23rd April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 Residential Home 09/02/06

Rosehill Residential Home 08/08/05

Rosehill Residential Home 20/09/04

Rosehill Residential Home 19/04/04

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

CARE HOMES FOR OLDER PEOPLE Rosehill Residential Home Rosehill Carlisle Cumbria CA4 8AA Lead Inspector Mrs Margaret Drury Unannounced Inspection 23rd April 2007 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 Residential Home DS0000022604.V328710.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rosehill Residential Home DS0000022604.V328710.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosehill Residential Home Address Rosehill Carlisle Cumbria CA4 8AA 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) 01228 513660 The Henry Lonsdale Trust Mrs Anne Bell Care Home 40 Category(ies) of Dementia - over 65 years of age (40) registration, with number of places Rosehill Residential Home DS0000022604.V328710.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th February 2006 Brief Description of the Service: Rosehill Residential Home is registered to provide accommodation for up to 40 older people with varying forms of dementia. The home is owned by The Henry Lonsdale Charitable Trust with Mrs Mary Styth being the responsible individual. The registered manager is Mrs Anne Bell. The home is situated in a residential area not far from the city of Carlisle and all its amenities. Rosehill is an older property that has been adapted, extended and renovated for its present use as a care home. Accommodation for the residents is all on the ground floor, which is divided in to four units, with ten bedrooms and a lounge/dining room in each. There are small sitting areas around the home that enable residents to have private visits if they wish. All rooms are for single occupancy, with ten of them having en-suite toilet facilities. The communal toilets and bathrooms are equipped for people with a disability and there are handrails on the corridors to assist with movement around the home. There are large, well kept gardens and car parking is available at the front of the building. The fees for this service currently range £422.00 per week, with extra charges for newspapers, private chiropody and hairdressing. This home does not provide intermediate care. Rosehill Residential Home DS0000022604.V328710.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit, which forms part of the key inspection, took place over one day in April. Mrs Elaine Brayton, regulation manager joined the inspector for a short time in the afternoon. During the inspection time was spent talking to residents, the manager, care officers and members of the care and ancillary staff. The inspector was also able to speak to visitors and a district nurse who were visiting the home at the time of the inspection. Observations on the interaction between staff and residents were also made. Completed survey forms were received back from residents, relatives and healthcare professionals, all of which contained complements about the high level of care provided by the home. Records pertaining to the care of residents were inspected and discussions about the general running of the home took place. A tour of the building took place, during which the physical aspects of the environment were inspected. What the service does well: Rosehill Home provides a safe and comfortable environment in a building that has been extended and adapted for it’s stated purpose. The residents benefit from a trained, experienced and stable staff team who, together with the manager and other members of the senior team, deliver an extremely high standard of care. There is an in-depth admission process with all prospective residents fully assessed prior to admission. Arrangements are made for anyone wishing to move into the home to visit and enjoy a meal and meet the residents and staff prior to deciding whether or not to move in. Dietary needs of residents are well catered for with a balanced and varied selection of good quality food and home cooked meals. The home has completed the “safer food – better business” course, which has been useful when planning menus and looking at dietary needs. The home has an excellent set of policies and procedures that ensure the safety and wellbeing of the residents and staff. Rosehill Residential Home DS0000022604.V328710.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Rosehill Residential Home DS0000022604.V328710.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rosehill Residential Home DS0000022604.V328710.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4 & 5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a comprehensive admission procedure that ensures a full assessment of needs is completed prior to admission. Information provided guarantees all that use the service know the home will meet their needs. EVIDENCE: The manager has recently updated the statement of purpose to include all the recent qualifications obtained by the staff. This, together with the comprehensive service user guide and brochure ensures all prospective residents and their families and/or friends have all the necessary information to make an informed choice about moving into the home. The registered manager assesses all new residents prior to their admission and this is used as a basis for the plan of care. No resident is admitted without the needs assessment that is provided by the social worker as this also assists with the preparation of the initial care plan. Rosehill Residential Home DS0000022604.V328710.R01.S.doc Version 5.2 Page 9 Prospective residents and their families are invited and encouraged to visit the home to view the facilities and meet the staff and those living in Rosehill. This also gives an opportunity to enjoy a meal and meet the staff and other people who live in the home. Rosehill Residential Home DS0000022604.V328710.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on individual need and the principles of respect, dignity and privacy are adhered to at all times. EVIDENCE: The statement of purpose sets out clearly the aims and objectives of the home and the philosophy of care outlines how residents’ individual needs will be met. The staff team are trained and knowledgeable in the care of older people and work well as a team to ensure all the assessed needs are met. All residents have a plan of care that sets out personal and healthcare needs and details how these will be met. The inspector spent time looking at the care plans for 4 residents, during which an in-depth examination of all the documentation was made. Information was relevant and easy to understand. Each care plan showed a risk assessment to ensure any accidents are kept to a minimum. Rosehill Residential Home DS0000022604.V328710.R01.S.doc Version 5.2 Page 11 The care officers complete monthly reviews of the care plans with input from the key workers to ensure that the correct level of care is provided at all times. Currently there is limited resident or family involvement in the care planning process although, wherever possible, this is discussed with the residents and/or family members. However, after discussions with the manager and care officers it was decided that, in future, if the residents are unable to discuss their care needs, a family member or advocate will be invited to discuss the monthly reviews and, if possible sign the care planning documentation. The registered manager does check the care plans on a regular basis and is present during some of the monthly reviews. Details of all healthcare visits/appointments are highlighted in the daily record, which ensures no appointments are missed. Residents can retain their own GP if they wish and many have requested this. Chiropody, optical and dental services are organised when required and the manager confirmed that the home has a good working relationship with the district nursing service. This was also confirmed when the inspector spoke with a district nurse who was attending a resident on the day of the visit. Medication is provided in a monitored dosage system and all the senior staff responsible for giving medication have been appropriately trained. The records were checked and found to be up to date and in order. Regular audits are completed and recorded by the registered manager to ensure there are no medication errors. The home had no controlled drugs prescribed at the time of the visit although there is a procedure for the recording and giving of such medication. Observations made during the visit evidenced the care and attitude of the staff when interacting with the residents. Dignity, privacy and respect are considered to be of prime importance to those delivering care. The residents who spoke with the inspector all said the staff treated them with the utmost respect and that their privacy was respected in every way. Rosehill Residential Home DS0000022604.V328710.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to make choices about their life style and to retain their independence for as long as possible. Social and recreational activities meet the residents’ expectations and needs. EVIDENCE: The home promotes the individual resident’s right to live a life that is fulfilling and meaningful. Daily activities are organised and the inspector was able to watch whilst staff interacted with the residents in a positive way. Two residents and staff members went out to Carlisle for coffee on the morning of the visit and said they “had a great time”. There are a number going to visit the Chinese Circus later this month and other favourite activities include the “nature walks” that take place in the garden and the weekly bingo games. Many activities with the residents are on a “one to one” basis when staff spend time talking with them about their life before that came into the home. Monthly church services are arranged by 2 of the near-by churches and there are some residents who are able to attend their own churches when they feel Rosehill Residential Home DS0000022604.V328710.R01.S.doc Version 5.2 Page 13 able. Holy communion that does not form part of the services is provided on an individual basis for those requesting it. The inspector was able to speak to the chef when he was serving lunches. He said he was extremely happy and really liked talking to the residents. All the food is home prepared and the residents who spoke with the inspector said they enjoyed their meals, and there was always a choice. Assistance given to those residents who needed it was given in an appropriate manner ensuring dignity was preserved at all times. Rosehill Residential Home DS0000022604.V328710.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to express their concerns through an effective and accessible complaints procedure. Residents are safeguarded by an efficient adult protection policy. EVIDENCE: Residents who were able to speak with the inspector confirmed that they can express concerns and opinions at any time and that they are always listened to. Staff confirmed that they were aware of the importance of listening to the residents and responding to any issues that may be raised. All residents and their families are given a copy of the complaints procedure and the path to follow should they need to voice a concern. There is a complaints book in the home but there have been none to record since the last inspection. There is a copy of the complaints procedure on display. The home has a warm and open atmosphere that enables residents to feel safe and supported, with policies and procedures in place to ensure the residents are protected at all times. The manager organises regular in- house training in adult protection and the new induction programme recently introduced has a large module covering “recognising and responding to abuse at work”. This subject is discussed during staff meetings and supervision to ensure staff are aware of all adult protection issues. Rosehill Residential Home DS0000022604.V328710.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22, 23, 24, 25 & 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enable the residents to live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: The Lonsdale Trust, which owns Rosehill Home ensures that the physical environment of the home provides an environment appropriate to meet the needs of the residents. The home is well maintained, warm and comfortable with staff that encourages all residents to see the home as their own. There is an annual repair and maintenance plan and the manager was able to confirm that the yearly schedule for the redecoration of ten bedrooms has been completed. One of the lounges is due to be completely refurbished, to include Rosehill Residential Home DS0000022604.V328710.R01.S.doc Version 5.2 Page 16 carpet and curtains, later in the year. One of the bathrooms has been completely refurbished and a new specialist bath installed. Discussions with the staff confirmed that all the residents “love this bathroom”. Four lounge/dining rooms provide communal space and there are also a small sitting areas that can be used for private visits or for families to use when visiting the home. These amenities give ample space for enjoying organised activities and for sitting quietly or chatting with friends. The home has extensive and well-kept gardens, which provide an excellent amenity for the residents during the warmer weather. Rosehill has forty single rooms and all were occupied on the day of the visit. All of the residents’ rooms are well appointed with ten of them having en-suite toilet and washing facilities. They are well furnished with matching bedding and curtains and many have views overlooking the gardens. The residents have personalised their rooms with furniture, pictures and photographs brought from their own homes. Laundry facilities are provided and situated away from the main living and food preparation areas and the home employs staff whose main responsibility is to ensure the laundry is dealt with in a timely manner. Rosehill Residential Home DS0000022604.V328710.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff in this home are trained, skilled and in sufficient numbers to provide a high level of care and support those living there. EVIDENCE: Rosehill has a full recruitment and selection policy managed by the human resources officer at head office. The organisation sees the recruitment of good quality staff as essential to the delivery of an excellent service. Application forms are completed, references taken up and interviews arranged. All new staff are appointed after all the required legal checks have been completed and no new member of staff work without a mentor until their induction programme has been completed. The staffing ratio is excellent; with 5 – 6 carers on duty during the day plus 2 care officers and the registered manager. The home also employs 1 domestic/laundry assistant 3 domestic assistants 2 cooks and 1 kitchen assistant. Night duty is covered by 2 waking staff but, should it ever be necessary, the manager can bring in an extra member of night staff if this would benefit the residents. This level of staff ensures those living in the home are safeguarded at all times. Rosehill Residential Home DS0000022604.V328710.R01.S.doc Version 5.2 Page 18 There is an ongoing staff training programme and there is over 80 of the care staff qualified to National Vocational Qualification (NVQ) levels 2 and 3, with the 4 care officers all qualified to level 4. One of the care officers is also a qualified NVQ assessor. All mandatory training is up to date, including manual handling, food hygiene, and risk assessment covering environmental issues and substance/ cleaning products. Training planned for the future includes, care of the dying, dementia and protection of vulnerable adults. Details of staff training are held on file, which means that updates are completed within the required timescale. All of this results in a diverse staff team that has the balance of skills and experience to meet the needs of people living in the home. Discussions with the staff evidenced that they all work as a team and support each other, although they are aware of their own roles and responsibilities. Rosehill Residential Home DS0000022604.V328710.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect. There is an effective quality assurance system that ensures residents are fully satisfied with the care and support they receive. EVIDENCE: The registered manager has the required qualifications and experience, and is highly competent to run the home and ensure it meets its stated aims and objectives. She has the best interests of the residents at heart and has a clear vision of the home that is based on the organisation’s values and priorities. She has a high profile within the home and those residents who spoke with the inspector said she “is very approachable and I can speak to her when I want Rosehill Residential Home DS0000022604.V328710.R01.S.doc Version 5.2 Page 20 to”. There is a very open atmosphere in Rosehill that stems from the manager and the senior team and is much appreciated by those living there. Relatives/visitors, professional agencies and residents complete quality audit questionnaires and the Trust consider that an important part of the quality monitoring programme is to involve the residents and their relatives. Residents’ meetings are occasionally held, which give opportunity for those attending to share their views and make any suggestions about the running of the home. The manager confirmed that such meetings are not always easy to organise but said that she found it more beneficial to speak to residents and families individually asking for their views about the home. The home has efficient systems for effectively safeguarding individual’s personal money. The records pertaining to the cash held on behalf of residents were examined and found to be correct, with money signed in and out by 2 members of staff as an extra security check. All receipts for goods purchased are retained for reference. Staff supervision take place every 2 months with records held on file. The meetings give opportunity for staff to discuss the policies and procedures that are in place and also to talk about any training needs they may have. Annual appraisals are also in place. There are working practices in place to minimise the risk of accidents and the home has a comprehensive range of policies and procedures in place to promote and protect residents and staff. The manager and senior team have a good understanding of health and safety issues and risk assessments covering all aspects of the running of the home. Rosehill Residential Home DS0000022604.V328710.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 4 4 4 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 4 4 X 4 4 4 4 4 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X 4 4 X 4 Rosehill Residential Home DS0000022604.V328710.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Rosehill Residential Home DS0000022604.V328710.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: 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. Extracts may not be used or reproduced without the express permission of CSCI Rosehill Residential Home DS0000022604.V328710.R01.S.doc Version 5.2 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!