CARE HOMES FOR OLDER PEOPLE
Rosehill (Robins` Hill) Raleigh Hill Northam Bideford EX39 3PA Lead Inspector
Adele Adams Announced 12 May 2005
th 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 (Robins` Hill) D54-D07 S22177 Rosehill (Robins Hill) V215383 270405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION
Name of service Rosehill (Robins` Hill) Address Raleigh Hill, Northam, Bideford, Devon, EX39 3PA 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) 01237 477625 Mrs Beryl May Jago Care Home 10 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (10) of places Rosehill (Robins` Hill) D54-D07 S22177 Rosehill (Robins Hill) V215383 270405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 09/02/2005 Brief Description of the Service: Rosehill provides 24-hour residential care for 10 older people some of who may have dementia. The home is a large detached Victorian house standing in its own grounds and is a short drive away from the centre of Bideford. Access into the home up a number of steps from the car park. There is wheelchair access from the car via a side entrance. Two bedrooms are on the ground floor, with the remainder on the first and second floors. All vary in size and outlook. One bedroom is shared. A chairlift operates from the ground floor. A small section between the first and second floor is not covered by the stair lift. Service users living on the second floor need to be mobile. The home has the ‘Investor In People’ award. Rosehill (Robins` Hill) D54-D07 S22177 Rosehill (Robins Hill) V215383 270405 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 announced starting at 09:50 and ended at 14:50. The inspector was shown around the home; this included viewing residents’ rooms, the bathrooms, toilets, laundry, dining room, kitchen, two lounges and the conservatory. The inspector spoke with 9 residents as a group and two visitors. The inspector observed staff and residents both inside the home and in the grounds and read residents care records, staff records, duty rotas, policies and procedures, the previous inspection report and the pre inspection questionnaire provided by the owner before the inspection. What the service does well:
This inspection showed that the residents at Rosehill live in homely, comfortable surroundings and that well-trained dedicated staff care for the residents. The residents at Rosehill feel that ‘everything at the home is done well’; they placed a lot of value on feeling safe and well cared for. The owner holds regular meetings with the residents and there is a warm and open atmosphere, this helps the residents to feel secure and confidant that they seen as individuals and that their views count. Residents, and relatives have confidence that residents’ health needs are well managed and that the owner and staff understand all of the residents care needs. One of the residents spoken with in the inspection described how their health had improved considerably since moving to the home. Great importance is placed on staff training by the owner, which helps to make sure that the care staff at Rosehill have the up to date skills and knowledge they need to give a good level of care to residents. Rosehill (Robins` Hill) D54-D07 S22177 Rosehill (Robins Hill) V215383 270405 Stage 4.doc Version 1.20 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rosehill (Robins` Hill) D54-D07 S22177 Rosehill (Robins Hill) V215383 270405 Stage 4.doc Version 1.20 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 (Robins` Hill) D54-D07 S22177 Rosehill (Robins Hill) V215383 270405 Stage 4.doc Version 1.20 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) 3 and 5 Each resident’s needs are assessed before they move into Rosehill, pre admission assessment documentation is not in place for privately funded residents; this makes it difficult to show that Rosehill was the right choice of home. Potential residents and relatives do visit Rosehill as part of the decision making process and find this is informative and reassuring. EVIDENCE: The inspector saw social services assessments for 4 residents and read the records of a private resident. The inspector spoke with 9 residents and 2 relatives. The owner described the admission process to the inspector. Rosehill (Robins` Hill) D54-D07 S22177 Rosehill (Robins Hill) V215383 270405 Stage 4.doc Version 1.20 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 and10 Resident’s needs are met in a respectful way. Each resident has a record detailing their needs and showed that they are treated as individuals. EVIDENCE: The inspector spoke with 9 residents who told the inspector that GP’s; District Nurses, Opticians and Chiropodists regularly visited the home. The inspector read three residents care records each was different showing the different level and type of care needs. The residents were very complimentary about living at Rosehill and feel the staff are ‘wonderful’ and that they are spoken to courteously and are respected and valued. The inspector observed staff and residents interactions. Rosehill (Robins` Hill) D54-D07 S22177 Rosehill (Robins Hill) V215383 270405 Stage 4.doc Version 1.20 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) 13, 14 and 15 Residents at Rosehill are able to have a full and varied life depending on their wishes, which shows that their choices and decisions are respected. EVIDENCE: The inspector spoke with 2 visitors to the home. The inspector spoke with 9 residents, 3 described outings with the home, outings with their families and when they chose not to join in with events and/or activities. Several of the residents describe how they enjoy each other’s company also. The residents told the inspector about the meals arrangements at the home and how their preferences are catered for. The inspector ate at the home on the day of the inspection. Rosehill (Robins` Hill) D54-D07 S22177 Rosehill (Robins Hill) V215383 270405 Stage 4.doc Version 1.20 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) 16 and 18 Rosehill has a formal complaints procedure and staff empower residents and their views and requests are acted upon. Residents feel safe at Rosehill; and are cared for by well-informed staff. EVIDENCE: Three of the residents told the inspector that they feel much safer now they live at Rosehill and are not alone and that they trust the staff. The inspector read 3 staff records. Staff have attended Vulnerable Adult Training and have had CRB checks undertaken. Residents attend meetings and the inspector read the minutes of 2 of these. Residents stated that they have no complaints. Rosehill (Robins` Hill) D54-D07 S22177 Rosehill (Robins Hill) V215383 270405 Stage 4.doc Version 1.20 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) 19,20,23, 24, 25 and 26 Rosehill provides a safe, comfortable, clean and homely environment for residents to live in. EVIDENCE: The inspector toured the inside and outside of the home which included the residents rooms, bathrooms, toilets, laundry and kitchen. The inspector spoke with residents about the accommodation at the home and they said it was very good ‘a hotel with more – they look after us so well’. The inspector read contractors maintenance records. The owner advised the inspector of the contact the home had had with the local infection control department. Rosehill (Robins` Hill) D54-D07 S22177 Rosehill (Robins Hill) V215383 270405 Stage 4.doc Version 1.20 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, 28 and 30 Residents at Rosehill are well cared for in a timely manner by appropriately skilled and vetted staff. EVIDENCE: The inspector spoke with residents about their care and asked if there are enough staff with enough time to care for them – residents said there are enough staff and that staff have time for them. Duty rotas were read by the inspector. The inspector saw training certificates in staff files; the owner is strongly committed to training. X 1 care staff has completed NVQ 3 and is undertaking the assessors course another member of staff confirmed they were doing NVQ Level 2. The manager advised she is keen for her staff to do a dementia course. Rosehill (Robins` Hill) D54-D07 S22177 Rosehill (Robins Hill) V215383 270405 Stage 4.doc Version 1.20 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) 33, 35 and 38 The owner runs the home very effectively putting residents first. Residents’ financial affairs are managed in such a way that residents are financially protected. Generally, the residents and staff’s health and safety are managed well however, the home still needs to assess for the risk of legionella and asbestos to meet Health & Safety legislation as identified at the previous inspection. EVIDENCE: The inspector spoke with residents who described a fire drill and an evacuation that had taken place and felt it was important ‘it makes you feel safer when you all know what to do’. The inspector did a random check of residents ‘pocket money’ records. A resident told the inspector how finances are managed within the home, which corresponded with the owners account.
Rosehill (Robins` Hill) D54-D07 S22177 Rosehill (Robins Hill) V215383 270405 Stage 4.doc Version 1.20 Page 15 Staff records x 2 held recent Health and Safety training certificates. Safety records were read by the inspector. Rosehill (Robins` Hill) D54-D07 S22177 Rosehill (Robins Hill) V215383 270405 Stage 4.doc Version 1.20 Page 16 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. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 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 x 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 x x 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 2 Rosehill (Robins` Hill) D54-D07 S22177 Rosehill (Robins Hill) V215383 270405 Stage 4.doc Version 1.20 Page 17 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. 2. 3. Refer to Standard 3 7 38 Good Practice Recommendations A pre admission assessment should be in place for each service user. The monthly review of care should be clearly recorded. Assess risk of legionella and asbestos to meet Health & Safety legislation.Health and Safety Executive (1993) Health & Safety in Residential Care Homes (HS(G)104). Sudbury: Health and Safety Executive.This is outstanding from the previous inspevtion. Rosehill (Robins` Hill) D54-D07 S22177 Rosehill (Robins Hill) V215383 270405 Stage 4.doc Version 1.20 Page 18 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
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