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Inspection on 08/08/05 for Rosehill Residential Home

Also see our care home review for Rosehill Residential Home for more information

This inspection was carried out on 8th August 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The manager and a care officer complete assessments of people before admission to the home to ensure their individual needs can be met and the correct level of care given. Care planning systems are in place and the staff are given all the information required to provide a good standard of care. All healthcare needs are met, with a record of all professional healthcare visits and external appointments highlighted on the daily record sheet. There is a programme of activities, and residents are sometimes escorted to the nearby shops. Efforts are made to ensure that a nutritious and varied menu is provided with a choice at each meal.

What has improved since the last inspection?

One of the small kitchen areas has been refurbished and another is due to be completed in the near future. A new staff induction programme has just been introduced for all new members of staff. Internal re-decoration is ongoing, which ensures a very high standard throughout the building.

What the care home could do better:

Although care plans are in place and reviewed monthly, the format is not easy to follow. It is recommended that the manager and care officers look at the present format to see if any improvement could be made. Residents and family members should always be given the opportunity to be involved in the care planning process The requirements outlined on the last inspection report have now been met and the home continues to provide an extremely high standard of care.

CARE HOMES FOR OLDER PEOPLE Rosehill Residential Home Rosehill Carlisle Cumbria CA4 8AA Lead Inspector Margaret Drury Unannounced 08 August 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rosehill Residential Home F58 F10 s22604 rosehill res home v235910 080805 ui stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Rosehill Residential Home Address Rosehill Carlisle Cumbria CA4 8AA 01228 513360 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) The Henry Lonsdale Trust Anne Bell Care Home 40 Category(ies) of DE(E) - Dementia, over 65 registration, with number of places Rosehill Residential Home F58 F10 s22604 rosehill res home v235910 080805 ui stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20 September 2004 Brief Description of the Service: Rosehill is owned by The Henry Lonsdale Charitable Trust with Mrs Mary Styth being the responsible individual. The home is run on a day- to-day basis by the registered manager 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. Accomodation 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 hand rails 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. Rosehill Residential Home F58 F10 s22604 rosehill res home v235910 080805 ui stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of the home, and took place over one day. During the visit, time was spent talking with the registered manager, trust manager,care officers, and staff on duty, looking at records to do with the day-to-day running of the home and the care of residents. Time was spent with the residents individually and in groups. During the inspection all parts of the home were looked at. What the service does well: What has improved since the last inspection? One of the small kitchen areas has been refurbished and another is due to be completed in the near future. A new staff induction programme has just been introduced for all new members of staff. Internal re-decoration is ongoing, which ensures a very high standard throughout the building. Rosehill Residential Home F58 F10 s22604 rosehill res home v235910 080805 ui stage 4.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rosehill Residential Home F58 F10 s22604 rosehill res home v235910 080805 ui stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Rosehill Residential Home F58 F10 s22604 rosehill res home v235910 080805 ui stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3, 4 & 5 Residents benefit from a detailed admission process that includes a full assessment of need. Residents and their families benefit from the opportunity to visit the home prior to admission. EVIDENCE: All new residents are given a contract/ terms and conditions and copy of the complaints procedure upon admission. There is a clear admission process, which includes a full assessment of needs and capabilities. This ensures the home can adequately meet the individual needs. Prospective residents and/or their families are invited and encouraged to visit the home prior to admission to ensure the home is able to meet the assessed needs. Rosehill Residential Home F58 F10 s22604 rosehill res home v235910 080805 ui stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 &10 The home’s care planning system, ensures residents’ health and social needs are met in a way that promotes their privacy, dignity and independence. EVIDENCE: The care plans contain information about residents’ care needs and also include details of moving and handling needs. Members of the senior team update the plans monthly. The care plans are not easily followed and it is recommended that the format be looked at to show more clearly when the monthly reviews have been completed. Details of healthcare needs and professional visits are highlighted on the daily record sheet. The care officers said that they receive excellent support from the local doctors and district nurses, several of whom visit the home on a regular basis. Some residents have been provided with special mattresses and cushions to help with pressure area care. The care staff speak to the residents in a courteous and polite manner and always knock before entering bedrooms. Although conversation with the residents was limited it was clear from observation that the staff ensure that privacy and dignity is respected at all times. Rosehill Residential Home F58 F10 s22604 rosehill res home v235910 080805 ui stage 4.doc Version 1.40 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 & 15 Residents benefit from an activity programme and visiting entertainers. Links with the local community are good and meals offer both choice and variety with special diets catered for. EVIDENCE: There is a programme of activities for those residents who wish to join in. This includes visiting entertainers, pets as therapy dogs and games. There is a church service arranged each month by two of the local churches and a team from the hospital visit to work with residents on a one to one basis. Visitors are welcome at anytime and there are places in the home where private visits can take place if required. All residents are given a choice of meals and where understanding is difficult they are shown the alternatives to choose from. Special diets are catered for. Rosehill Residential Home F58 F10 s22604 rosehill res home v235910 080805 ui stage 4.doc Version 1.40 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 17 & 18 Staff have a good knowledge of adult protection issues, which protects residents from abuse. Residents benefit from the opportunity of taking part in elections with the help of their families. EVIDENCE: The home has a protection of vulnerable adults policy, which includes whistle blowing. The care staff showed an understanding of adult protection issues and said they would report anything suspicious to the manager or senior staff. Residents are given the opportunity to vote in the elections with the assistance of their family members. Rosehill Residential Home F58 F10 s22604 rosehill res home v235910 080805 ui stage 4.doc Version 1.40 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 25 &26 The standard of the environment within this home is excellent, providing the residents with an attractive and homely place to live. EVIDENCE: The on-going programme of maintenance in the home ensures that residents live in an extremely well kept environment. The decoration, furniture and fittings are of a very high standard and the enclosed, well-maintained gardens provide extra communal space for the residents to enjoy. The home is divided into four units with ten bedrooms and a bathroom, equipped for people with a disability, in each. There is also a lounge/diner and small kitchen in each unit. Domestic arrangements in the home mean it is clean and hygienic at all times. Rosehill Residential Home F58 F10 s22604 rosehill res home v235910 080805 ui stage 4.doc Version 1.40 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30 Residents benefit from a staff team that have a good understanding of the residents’ support needs. This is evident from the positive relationships that have been formed. EVIDENCE: Although there are currently staff vacancies the manager ensures the home is fully staffed at all times. The staff team is both experienced and qualified with the majority qualified to NVQ level 2 or above. It is expected that all the remaining care staff will be qualified in the near future. There is a full recruitment and selection policy in place with all the legal checks completed prior to the commencement of employment. Rosehill Residential Home F58 F10 s22604 rosehill res home v235910 080805 ui stage 4.doc Version 1.40 Page 14 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 35 & 36 The manager is supported by the senior team in providing clear leadership throughout the home with all the staff demonstrating an awareness of their roles and responsibilities. EVIDENCE: The manager is highly motivated, has completed the Registered Manager’s Award and is now enrolled to complete NVQ level 4 in care. It was obvious from discussions with her that the home is run in the best interests of the residents and their families. The staff group said the manager is supportive and readily available for help and advice. Management supervision motivates the staff to undertake training, which assists in the improvement of their skills and knowledge. Good financial procedures and records safeguard residents’ interests. Rosehill Residential Home F58 F10 s22604 rosehill res home v235910 080805 ui stage 4.doc Version 1.40 Page 15 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 x x 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x 3 3 3 3 3 x 3 3 x x Rosehill Residential Home F58 F10 s22604 rosehill res home v235910 080805 ui stage 4.doc Version 1.40 Page 16 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Rosehill Residential Home F58 F10 s22604 rosehill res home v235910 080805 ui stage 4.doc Version 1.40 Page 17 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith, Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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