CARE HOMES FOR OLDER PEOPLE
Rosehill (Robins` Hill) Raleigh Hill Northam Bideford Devon EX39 3PA Lead Inspector
Adele Adams Unannounced Inspection 11:00 24 January 2006
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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 (Robins` Hill) DS0000022177.V255035.R01.S.doc Version 5.0 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 (Robins` Hill) DS0000022177.V255035.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Rosehill (Robins` Hill) Address Raleigh Hill Northam Bideford Devon EX39 3PA 01237 477625 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) 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) DS0000022177.V255035.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 12th May 2005 Brief Description of the Service: Rosehill provides 24-hour residential care for 10 older people some of who may have dementia. The service is run in 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 is up a number of shallow steps from the car park. There is also wheelchair access from the car via a side entrance. The majority of bedrooms are located on the first and second floors, two bedrooms are on the ground floor, all vary in size and outlook and one bedroom is shared. A chairlift operates from the ground floor providing assistance with access for those that need it. There is a small section between the first and second floor that is not covered by the stair lift., therefore residents living on the second floor need to be mobile. The home has the ‘Investor In People’ award. Rosehill (Robins` Hill) DS0000022177.V255035.R01.S.doc Version 5.0 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 starting at 11:00 and ended at 13:10. The inspector on this occasion saw the dining room, two lounges and the conservatory. The inspector spoke with 7 residents as a group and observed a visitor to the home. The inspector observed staff and residents, read residents care records, staff records, the previous inspection report and spoke with the owner and briefly with care staff. What the service does well: What has improved since the last inspection?
The last inspection took place in May 2005 and recommended that the owner took advice and action in 3 areas. This inspection found that that the home has taken action in 2 of these areas: the resident’s pre admission assessments were all available for the inspector to read which shows that no-one is admitted to the home unless the assessment shows that the home can meet their needs, a complete asbestos survey of the home has been undertaken that
Rosehill (Robins` Hill) DS0000022177.V255035.R01.S.doc Version 5.0 Page 6 shows the home has no problems in relation this and that the service meets with this Health & Safety law. A new care record has been introduced and this will help with the management of the monthly review of care that makes sure that residents and staff have the opportunity at least once a month to discuss care needs. 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 (Robins` Hill) DS0000022177.V255035.R01.S.doc Version 5.0 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 (Robins` Hill) DS0000022177.V255035.R01.S.doc Version 5.0 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 the following standard(s): 3 All resident’s needs are assessed before they move into Rosehill this helps to show that Rosehill was the right choice of home for them. EVIDENCE: This standard was revisited, as the pre admission assessment for one resident was not available at the last inspection. The inspector read the pre admission assessment that had previously not been available. There have been no new admissions to the home. Rosehill (Robins` Hill) DS0000022177.V255035.R01.S.doc Version 5.0 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 the following standard(s): 7 Each resident has a record detailing their individual needs this helps to make sure that each resident’s needs are met and communicated well. EVIDENCE: This standard was being revisited as the previous inspection found that not all records were being reviewed on a monthly basis. The manager / owner of the home told the inspector that the service has recently introduced a new care record system. The inspector read three residents care records, which demonstrated the new type of care records; each was different showing the different level and type of care needs. A senior carer showed and explained to the inspector how the monthly review of care is to be managed. Rosehill (Robins` Hill) DS0000022177.V255035.R01.S.doc Version 5.0 Page 10 Rosehill (Robins` Hill) DS0000022177.V255035.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 12 Residents at Rosehill are able to have a full and varied life depending on their wishes and preferences. EVIDENCE: The inspector spoke with the homeowner/manager who described which residents like to pursue things outside the home and what residents enjoy in the home. The inspector observed a visitor to the home who was taking their relative out for a short time, on their return the resident advised the inspector they had enjoyed their outing and it was something that is done on a regular basis. Another resident told the inspector that they sometimes go to a church group. The inspector spoke with a group of residents, 3 described how they had enjoyed the Christmas arrangements at the home, and when they chose not to join in with events and/or activities. The inspector saw photographs of the Christmas celebrations at the home. Rosehill (Robins` Hill) DS0000022177.V255035.R01.S.doc Version 5.0 Page 12 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 the following standard(s): X The key standards were inspected at the last inspection and were met satisfactorily. EVIDENCE: X Rosehill (Robins` Hill) DS0000022177.V255035.R01.S.doc Version 5.0 Page 13 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 the following standard(s): X The key standards were inspected at the last inspection and were met satisfactorily. EVIDENCE: X Rosehill (Robins` Hill) DS0000022177.V255035.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 Residents at Rosehill are cared for by staff that only work unsupervised once all recruitment checks have been undertaken and are known to be satisfactory. EVIDENCE: The owner/manager described the recruitment process that is in place at Rosehill. The inspector read the recruitment files for 2 staff. There were no newly recruited staff on duty – therefore this standard will be revisited at the next inspection. Rosehill (Robins` Hill) DS0000022177.V255035.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 and 38 The owner runs the home effectively. The residents and staff’s health and safety are generally managed well however, the home still needs to assess for the risk of legionella to meet Health & Safety legislation as identified at the previous 2 inspections. EVIDENCE: Mrs Jago has owned and managed Rosehill since 1988 and is not responsible for any other home. Mrs Jago completed the Registered Manager’s Award in April 2005. There are clear lines of accountability in the home, Mrs Jago told the inspector she is supported by 2 senior carers. Mrs Jago undertakes all mandatory training and a Dementia course was attended 28/9/05. Standard 38 was revisited in relation to Asbestos and legionella this was to follow up on action taken since the last inspection.
Rosehill (Robins` Hill) DS0000022177.V255035.R01.S.doc Version 5.0 Page 16 The owner /manager provided the inspector with documentation (a letter and report) that clearly shows that an asbestos survey of the building has taken place – this was dated 24/11/2005, this had a satisfactory outcome. Mrs Jago told the inspector that Legionella risk assessment had not yet taken place. Rosehill (Robins` Hill) DS0000022177.V255035.R01.S.doc Version 5.0 Page 17 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 2 Rosehill (Robins` Hill) DS0000022177.V255035.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 OP38 Good Practice Recommendations Assess risk of legionella 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 2 inspections. Rosehill (Robins` Hill) DS0000022177.V255035.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Ashburton Office 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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