Inspection on 25/02/08 for Roseland

This inspection was carried out on 25th February 2008.

CSCI found this care home to be providing an Good service.

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

Roseland 30/04/07

Roseland 05/01/06

Roseland 14/07/05

Roseland 10/01/05

Roseland 29/07/04

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Roseland Roseland Garratts Lane Banstead Surrey SM7 2EQ Lead Inspector Andrea Leverett Unannounced Inspection 25th February 2008 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 Roseland DS0000013772.V360206.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. Roseland DS0000013772.V360206.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Roseland Address Roseland Garratts Lane Banstead Surrey SM7 2EQ 01737 355022 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) Banstead, Carshalton & District Housing Society Limited Mrs Sandra Parr Care Home 39 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (39), of places Physical disability over 65 years of age (5) Roseland DS0000013772.V360206.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The age/age range of the persons to be accommodated will be: OVER 65 YEARS Of the older people accommodated up to five (5) may have a physical disability. Of the older people accommodated up to three (3) may be people who suffer from dementia These Management arrangements must be reviewed should there be any change to the registered persons - Mrs Parr as Registered Manager or Mr Stevens as These Management arrangements must be reviewed should there be any change to the registered persons - Mrs Parr as Registered Manager or Mr Stevens as the Responsible Individual. 30th April 2007 Date of last inspection Brief Description of the Service: Roseland’s was purpose built in the 1950s and now accommodates up to 39 older people. Up to five residents may have a physical disability and up to three residents may have dementia. A sister home under the same management is situated nearby. The home is sited in its own grounds with well-maintained, level gardens, which are accessible to residents. Limited car-parking facilities are available to the front of the home. The home has been modernised and developed and is currently extending the main lounge, adding a conservatory and extending a number of bedrooms to provide en-suite facilities. A passenger lift and stairs enable all residents to access both floors of the home. The fees at this home range from £ 415.00 to £ 590.00. Roseland DS0000013772.V360206.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This unannounced Key inspection took place on the 25th of February 2008. 10 people who use the service were spoken with as well as 2 members staff the manager and responsible individual. of A tour of the premises was undertaken during the site visit and 5 people who use the services files and 3 staff files were inspected. Judgements about quality of life and choices were taken from direct conversations with and observations of people who use the service, followed by discussion with support staff and evidencing records held at the home. Feedback from people spoken to have been taken into consideration and comments have been reflected in this report. The inspector concluded that people are given a good service at Roselands. A high standard of support and good access to health services is provided and the range of activities are good. The Home has met all requirements made at the last inspection. Further improvements could be made in the area of record keeping and the management of the homes kitchen and recommendations have been made in these areas. What the service does well: It was evident that residents had access to routine and specialist health services as needed. Access to dentists and opticians was good and the Home will escort residents to health appointments if need. Feedback from residents was very positive about the standard of direct personal care provided by staff and observation on the day of the site visit showed that staff were very respectful and tentative to individual needs. Feedback from residents and observation on the day of the site visit showed that a range of activities are provided including exercise classes, Religious services are also facilitated in the Home and transport is provided for those wishing to attend church services in the community. Roseland DS0000013772.V360206.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. Roseland DS0000013772.V360206.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 Roseland DS0000013772.V360206.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): 3, People who use the service experience good quality outcomes in this area. Residents can be confident that their needs will be assessed before they move into the Home and that these will be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: 5 residents assessments and care plans were looked at as part of the inspection process, including those most recently admitted to the Home. All had full assessments in place, which had been undertaken by the manager before the person was admitted to the Home. The information included key areas such as mobility, sensory, dietary, personal care, emotional and social needs and interests. Information was clear and detailed enough to guide individual care plans and identified risks to ensure that needs could be met and people could be cared for safely. All residents recently admitted to the Home are privately funded and therefore local authority assessments would not have Roseland DS0000013772.V360206.R01.S.doc Version 5.2 Page 9 been undertaken for those people. The manager informed the inspector that local authority funded residents would have an appropriate care manager assessment in addition to the homes own pre admission assessment in place. Roseland DS0000013772.V360206.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 and 10 People who use the service experience good quality outcomes in this area. On the whole residents benefit from having comprehensive health, personal and social care needs set out in an individual plan of care, which are followed. The home has a medication policy and medication records are up to date and Medication systems follow good practice. Residents feel they are treated with dignity and respect and their right to privacy is upheld. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Five care plan and risk assessments were looked at including residents most recently admitted to the Home. 4 of the 5 plans were in place and included risk assessments and clear information to guide staff practice and ensure needs Roseland DS0000013772.V360206.R01.S.doc Version 5.2 Page 11 are met. Records also showed that these documents are now being reviewed on a monthly basis. However daily care notes for 1 resident showed that their needs had changed and although staff practice had changed to accommodate this their care plan and risk assessment had not been updated. A recommendation has been made that the manager audits these documents regularly and ensure that information is kept up to date and accurate. Daily notes seen evidenced that regular health checks are being undertaken and residents had good access to routine and specialist health services including GP’s district nurses, dentists opticians and chiropodists as required. The responsible individual and the manager informed the inspector that they regularly escort residents to attend health appointments outside the Home and feedback from residents confirmed this. Although the Home is not a nursing Home the ethos is to support people as long as possible and evidence was seen to demonstrate that the Home works hard with the help of appropriate health professionals to enable this to happen. 1 resident whose health has deteriated was being cared for in an effective and dignified manner. The resident had an airflow mattress to ensure comfort and protect against bedsores and records showed that a fluid chart and turning records were in place as recommended by the district nurse who attended the Home regularly. The responsible individual informed the inspector that the Home has purchased its own supply of airflow mattresses so that these can be put in place immediately as needed for the benefit of residents. It was also clear that staff took time to sit and talk to the resident to ensure that social and emotional needs were met and not just care and health needs. Roseland DS0000013772.V360206.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 People who use the service experience good quality outcomes in this area. Resident’s find the lifestyle experienced in the Home matches their expectations and preferences and they can maintain contact with family and friends and contact with the local community as they wish. On the whole residents receive a wholesome appealing balanced diet in pleasing surroundings but more could be done to ensure this is consistently provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Home provides a range of activities including keep fit, quizzes, film shows and shopping trips. In addition the Home provides Lifts to local churches and places of worship, and an ecumenical service in the Home each Sunday. Holy Communion is offered to all believers once a month. Roseland DS0000013772.V360206.R01.S.doc Version 5.2 Page 13 On the day of the site visit residents were seen taking part in activities and feedback from residents spoken to also confirmed that a range of activities are provided which are in keeping with their needs and wishes. It was also evident that staff took time to be with residents who were not well enough to join in activities. The majority of residents were happy with the food and observation on the day of the site visit showed that a range of good quality food was provided. A range of choices are offered for the main meal and deserts and residents were observed being able to make choices as food was served. Feedback showed that drinks and snacks are available throughout the day including early morning cups of tea in bed if that is their wish. An inspection of the homes kitchen showed that a range of fresh fruit and vegetables are purchases and individual special dietary needs are catered for. However it was noted that some fresh food items are being kept too long before being served and feedback from one resident confirmed that this sometimes happened and that generally the quality of food served was not consistent. A recommendation regarding this and the management of the kitchen in general has been made. (See environment standards for more details.) Feedback from residents showed that they are supported to maintain contact with families and friends and visitors are welcome at any time. Typical comments included: “You get an early morning cup of tea and I have horlicks before I go to bed, there are a lot of activities, keep fit and quizzes.” “ I find the food very good and I like the activities such as concerts, bingo and outings.” “The food is not as good as it was 2 months ago, it could be better.” Roseland DS0000013772.V360206.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 and 18 People who use the service experience good quality outcomes in this area. Service users are confidant that their complaints will be listened to, taken seriously and acted upon and that they will be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Home has had no complaints since the last inspection and feedback from residents showed that they would be confident to raise concerns and complaints and felt they would be acted upon. A copy of the homes complaints procedure was on the residents’ notice board and several letters received complimenting the Home and its staff on the standard of care given and the friendly support of staff. Records showed that staff are given training in order to safe guard residents from abuse and neglect and procedures and policies are in place to guide staff practice in this area and ensure concerns are dealt with appropriately. Roseland DS0000013772.V360206.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 and 26 People who use the service experience good quality outcomes in this area. The Home is decorated, furnished and maintained to a good standard and is clean and free from offensive odours throughout. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises was undertaken and this showed that on the whole the Home is maintained to a good standard and is clean and free from offensive odours. The Home has 3 spacious lounges including a conservatory area. Communal areas and bedrooms are decorated and furnished to a good standard and the Home is currently in the process of extending the property to enable all residents to have en suite bedrooms. Roseland DS0000013772.V360206.R01.S.doc Version 5.2 Page 16 The garden is large and well maintained with wheelchair access and a range of garden furniture. The dining room is spacious and decorated and furnished to a good standard. The Home uses matching linen table clothes and napkins and residents felt that they were able to eat their meals in pleasing surroundings. Feedback from the manager and observation on the day of the site visit showed that the building and facilities and equipment are serviced and maintained appropriately to ensure the comfort and safety of residents. The homes kitchen was inspected and although this was generally clean some areas could have been improved upon and food storage could be more organised. A recommendation has been made regarding this. Roseland DS0000013772.V360206.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 and 30 People who use the service experience good quality outcomes in this area. Resident’s benefit from being supported by appropriate numbers of staff with the skills to meet their needs. The Home ensures that service users are supported by staff that is trained and competent to do their job. Service users are supported and protected by the homes recruitment policy and practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Records seen and observation and feedback on the day of the site visit showed that the Home employs a stable and long-standing well-trained workforce who really care for other’s wellbeing. Training records showed a range of training was provided including Moving and Handling, First Aid, infection control, medication administration, adult protection, Fire Safety, dementia awareness, Food Hygiene and Nutrition. In Roseland DS0000013772.V360206.R01.S.doc Version 5.2 Page 18 addition the Home is making good progress towards meeting the 50 target for staff receiving NVQ training at level 2 or above. It was noted that some staff are involved in taking residents blood pressure and a recommendation has been made that they receive formal training to do this. A sample of staff records were seen including those staff most recently employed. Information showed that the Home has a robust recruitment procedure, which is followed, and all relevant documentation and checks are undertaken before staffs commences employment. The Home has 6 care staff on each morning shift, 5 care staff in the afternoon including 1 senior carer on each shift, 3 waking night staff, 3 full time kitchen staff including a cook and kitchen manager and 3 domestic staff on each shift. In addition the Home employs an exercise tutor and several volunteer workers who help facilitate activities. Typical comments included: “I think staff are very good, marvellous, very helpful, they have the patience of saints.” “Staff are very kind here.” “ Staff are excellent in every way I couldn’t fault the place.” “ Staff are very good, very a tentative and helpful.” Roseland DS0000013772.V360206.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): 31,33,37 and 38 People who use the service experience good quality outcomes in this area. Residents live in a Home that is run in their best interest, with good leader ship and management. The health, safety and welfare of service users and staff are promoted and protected but more could be done to improve record keeping in the home. This judgement has been made using available evidence including a visit to this service. Roseland DS0000013772.V360206.R01.S.doc Version 5.2 Page 20 EVIDENCE: The Home has a registered manager who is experienced and qualified to undertake her role. She is also the registered manager of the organisations sister Home that, is located close by. The Home also employs a full time head of care, who takes charge of the day-to-day care provision and deputies for the manager in her absence. The homes responsible individual also spends time in the Home most days and works closely with the manager to oversee the service. Feedback from residents and staff was very positive about the management team and it was clear that they promoted a caring ethos and worked hard to ensure ongoing improvements to the quality of the service. The manager conducts an audit of the service every 6 weeks and records of these and information taken from the homes own annual assessment showed that areas for improvement are identified and plans are put in place to address them. It is also acknowledged that the shortfalls noted at this inspection had already been identified by the management team and all requirements made at the last inspection have been met. Although residents felt consulted and listened to on an individual bases regular residents meetings are not currently facilitated and a recommendation has been made regarding this. Observation on the day of the site visit and information taken from the homes own monitoring information showed that equipment and facilities are maintained and appropriate risk assessments are in place to ensure the health and safety of residents and staff. On the whole record keeping in the Home could be improved. Although appropriate information was generally recorded it was not always in a manner that enabled efficient and effective Monitoring. For example medical appointments and health interventions are recorded in resident’s daily notes and not in a separate health record. It was clear from discussions with residents and observation on the day of the site visit that the Home responded quickly to meet peoples changing needs but care plans and risk assessments did not always accurately reflect current care practice. A recommendation has been made regarding record keeping issues. Roseland DS0000013772.V360206.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 X 3 X X X 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 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X 2 3 Roseland DS0000013772.V360206.R01.S.doc Version 5.2 Page 22 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 Roseland DS0000013772.V360206.R01.S.doc Version 5.2 Page 23 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 OP7 Good Practice Recommendations It is recommended that the manager audit care plans and risk assessments regularly and cross-referenced to ensure that in all cases both documents accurately reflect any changes to residents care needs. Consultation with residents could be improved upon by facilitating residents meetings. More could be done to improve and monitor the management of the homes kitchen and food provision for the benefit of residents. The Home should ensure that staff are provided with additional training from a suitably qualified person, when undertaking the measuring and recording of residents blood pressure. More could be done to ensure that record keeping is improved in the Home. For example a separate record of medical interventions and appointments should be kept in order that resident’s health can be monitored more effectively. 2 3 4 OP14 OP15 OP27 5 OP37 Roseland DS0000013772.V360206.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Roseland DS0000013772.V360206.R01.S.doc Version 5.2 Page 25 - 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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