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Inspection on 20/06/05 for Roseleigh Care Home

Also see our care home review for Roseleigh Care Home for more information

This inspection was carried out on 20th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

Meals are varied and choices and alternative foods are available. The residents enjoy home cooked foods and they were very complimentary about the quality of foods served. The care delivered to the residents is of a good standard. The environment is well maintained and clean. Residents enjoy a range of activities that is suitable for their dexterity and ability.

What has improved since the last inspection?

Some of the areas in the home have been refurbished making the home comfortable with a homely atmosphere. Since the last inspection the management team have continued with a decoration and furnishings programme throughout the home that has enhanced the environment immensely. It is a warm and pleasant environment for residents to live in.

What the care home could do better:

The senior management team must make changes to care records and improve the quality of the policies and procedures to allow staff to be informed. All staff records should be kept up to date and need to include training certificates. Resident`s views about life in Roseleigh should be considered.

CARE HOMES FOR OLDER PEOPLE Roseleigh Care Home Lytton Street Middlesbrough TS4 2BZ Lead Inspector Lyn Burrell Unannounced 20 June 2005 10:00 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. Roseleigh Care Home B51-B01 S56173 Roseleigh V234127 200605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Roseleigh Care Home Address Lytton Street Middlesbrough TS4 2BZ 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) 01642 656122 01642 659700 Mimosa Healthcare (No 9) Ltd Mrs Lauren Ann Cannell Care Home 50 Category(ies) of OP - Older People (24) registration, with number DE - Dementia (26) of places Roseleigh Care Home B51-B01 S56173 Roseleigh V234127 200605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 03/02/05 Brief Description of the Service: Roseleigh is a care home for older people and also for people suffering with dementia. The home can accommodate up to 50 residents. all rooms are single and have en-suite facilities with a WC and hand basin. There are two separate units in the home; the ground floor accommodates older people and the first floor accommodates people suffering with dementia. It is situated in an urban area and overlooks a greenbelt and play area for children. The home is enclosed and has a paved area where people can sit outside. The home was purpose built and is four years old. The home is owned by Mimosa Healthcare, the Responsible Individual is Anthony Massouras and there is a registered manager in post. Roseleigh Care Home B51-B01 S56173 Roseleigh V234127 200605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 3 hours with 2 inspectors. There remain outstanding requirements from the last inspection and the home meets 75 of the National Minimum Standards. A tour of the home showed that it was clean, tidy and well decorated. Six of the residents interviewed were very satisfied with the care they received. They said they felt happy and well cared for. Two relatives who were visiting the home also confirmed the care delivered to the residents was very good. What the service does well: What has improved since the last inspection? Some of the areas in the home have been refurbished making the home comfortable with a homely atmosphere. Since the last inspection the management team have continued with a decoration and furnishings programme throughout the home that has enhanced the environment immensely. It is a warm and pleasant environment for residents to live in. Roseleigh Care Home B51-B01 S56173 Roseleigh V234127 200605 Stage 4.doc Version 1.30 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. Roseleigh Care Home B51-B01 S56173 Roseleigh V234127 200605 Stage 4.doc Version 1.30 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 Roseleigh Care Home B51-B01 S56173 Roseleigh V234127 200605 Stage 4.doc Version 1.30 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 All residents have a copy of the terms of reference of residency that meets the National Minimum Standards. Resident’s needs are assessed prior to admission to the home EVIDENCE: The residents’ agreement is detailed and includes all of the required information. Nursing assessments continue to be used, these assessments are not appropriate for the residents who live in the home and the staff are not trained to understand the concept of any of the nursing assessment tools. This was identified at the last inspection and needs to be addressed. An assessment to meet personal needs of the residents must be implemented. Roseleigh Care Home B51-B01 S56173 Roseleigh V234127 200605 Stage 4.doc Version 1.30 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 There are care plans in place that reflect the residents’ needs. Health care needs are not fully met as they demonstrate out dated practises e.g. continence is not managed appropriately. EVIDENCE: The care plans would improve if they were tailored to meet the needs of residents who need personal care and not nursing. It is evident from reading care records that the staff do not have an understanding of effectively managing continence. Some care plans show that institutional practises are carried out. These issues need to be addressed and staff training implemented. It is recorded in the records that health care professionals visit the residents’ at the home. Roseleigh Care Home B51-B01 S56173 Roseleigh V234127 200605 Stage 4.doc Version 1.30 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) 15 The meals in this home are good, offering both choice and variety and catering for special dietary needs. EVIDENCE: There was a 4-week menu planner in place that is changed seasonally. The menu was appealing and offered an alternative choice at each mealtime. Breakfast ranges from full English to toast and cereals. Wholemeal bread and white bread is also available as is fruit and fruit juices. The residents who were interviewed said that they enjoyed the meals enormously. Roseleigh Care Home B51-B01 S56173 Roseleigh V234127 200605 Stage 4.doc Version 1.30 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) 18 A system is in place to ensure residents are protected from harm. EVIDENCE: A policy is in place for the staff to follow in the event of an abusive situation being suspected. This protocol is in keeping with the Tees wide interagency policy known as “No Secrets”. There is training for staff to attend annually. Prior to a member of staff commencing employment an application form is completed. Two references are requested one being from the previous employer and also a criminal records check is undertaken. Roseleigh Care Home B51-B01 S56173 Roseleigh V234127 200605 Stage 4.doc Version 1.30 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) 19,22,26 The standard of the environment is good and provides the residents with an attractive and homely place to live. There is lifting equipment available in the home to assist the less mobile resident. The home was noticeably clean and tidy throughout and there were no odours evident. EVIDENCE: The home was bright and cheerful throughout and homely. Resident’s bedrooms had some of their own furniture from home, photographs and ornaments. Bathrooms and toilets were spacious and disabled people could easily access them. The domestic staff work hard to ensure the home remains clean and tidy. The upstairs lounge is spacious, however if it was partitioned this would improve the environment for the residents and encourage them to move around in different areas. Roseleigh Care Home B51-B01 S56173 Roseleigh V234127 200605 Stage 4.doc Version 1.30 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) 30 A system is in place for staff training this covers health and safety and care practise issues. This enables the staff to carry out their roles effectively. EVIDENCE: The staff induction booklet is detailed and in line with Skills for Care training requirements. The training plan was in place for 2005 however the staff training records were not up to date. Within the staff records there were out of date certificates or no certificates. Bank staff do not appear to receive any training. Supervision records were also not kept up to date. Roseleigh Care Home B51-B01 S56173 Roseleigh V234127 200605 Stage 4.doc Version 1.30 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) 33,36 The home regularly reviews aspects of its performance through their procedures within the quality assurance manual. However residents’ views have not been included as yet. There is a system for staff supervision to be carried out periodically but this is not up to date. Policies and procedures do not reflect the care the residents at Roseleigh require and advise the staff appropriately. EVIDENCE: The customer satisfaction survey had not been implemented up to the inspection taking place. However the regional manager performs a monthly quality audit to meet the requirements of regulation 26 of the Care Standards Act 2000. Roseleigh Care Home B51-B01 S56173 Roseleigh V234127 200605 Stage 4.doc Version 1.30 Page 15 It has been noted in previous inspections that there are nursing policies and procedures in the manuals that are not relevant to the care setting. The policy for managing MRSA lacks information and the staff have “Barrier Nursing” posters on residents doors. There is no “Barrier Nursing” policy in the home and following discussion with the staff it is clear they have no understanding of basic control of infection. Roseleigh Care Home B51-B01 S56173 Roseleigh V234127 200605 Stage 4.doc Version 1.30 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. 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 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x 3 x x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x 2 x x 2 x x Roseleigh Care Home B51-B01 S56173 Roseleigh V234127 200605 Stage 4.doc Version 1.30 Page 17 yes 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. 2. 3. Standard 3 7,8 30 Regulation 15,16 13,15,17 17,18,19 Requirement Each resident must have their needs assessed using the appropriate assessment tool. Nursing assessment must not be used by staff who are not registered nurses. Training must be given to all staff who work at the home. They all must receive regular supervision from thei supervisor and a record kept. Residents views must be sought to ensure they are satisfied with the service they receive. Policies and procedures in the home must reflect the needs of the service user and also too protect the staff. Timescale for action 31 July 2005 31 July 2005 31 July 2005 4. 5. 33 36 24,25,26 18 31 July 2005 31 July 2005 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 19 Good Practice Recommendations Consideration should be given to restructuring the large 1st floor lounge into four smaller areas to benefit the residents B51-B01 S56173 Roseleigh V234127 200605 Stage 4.doc Version 1.30 Page 18 Roseleigh Care Home Commission for Social Care Inspection Unit B, Advance St Marks Court Teesdale Stockton-on-Tees TS17 6QX 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. Extracts may not be used or reproduced without the express permission of CSCI Roseleigh Care Home B51-B01 S56173 Roseleigh V234127 200605 Stage 4.doc Version 1.30 Page 19 - 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!