Inspection on 10/12/08 for Rosemary Lodge

This inspection was carried out on 10th December 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

Rosemary Lodge 12/02/07

Rosemary Lodge 21/02/06

Rosemary Lodge 23/08/05

Rosemary Lodge 25/10/04

Rosemary Lodge 05/05/04

Rosemary Lodge 27/11/03

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Rosemary Lodge 191 Walsall Road Lichfield Staffordshire WS13 8AQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Keith Jones     Date: 1 0 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Rosemary Lodge 191 Walsall Road Lichfield Staffordshire WS13 8AQ 01543415223 F/P01543415012 Roselodgehome@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Abivue Limited T/A Rosemary Lodge Residential Home Type of registration: Number of places registered: care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Rosemary Lodge is a care home providing care for 32 older people over sixty-five years of age. The home is operated by Abivue Limited and can accommodate people with varying dependency needs. Located in Lichfield, the home is a two-storey property providing twenty-eight single bedrooms and two double bedrooms. There are Three separate living areas, each having a lounge-dining room, with adjacent bedrooms, bathroom and toilets. First floor accommodation is accessed by a passenger shaft lift. Externally there is a car park and the rear garden offers an enclosed area for people using the service. The location of this home ensures that there is a wide range of community facilities nearby that can be readily accessed. The home is also on a public transport route and a short taxi or bus ride from Lichfields two railway stations. Care Homes for Older People Page 4 of 30 Over 65 31 1 0 0 Brief description of the care home The full range of fees were not detailed in the service?s Statement of Purpose or Service User Guide documents as routine. The reader may wish to contact the service to obtain more detailed and up to date information about fees. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We conducted this unannounced inspection with the care manager (designate) and senior care staff on duty, and an expert by experience, whose input contributed to this report. An expert by experience is a person who, because of their shared experience of using services and ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in, or use the service. Our inspection of the building allowed us free access to all areas and open discussion with people who use the service, relatives and staff. There were 29 people in residence on the day of our inspection. We looked at how care is being arranged and supported for a range of people with personal care needs. To do this we looked at (case tracked) three peoples files from admission referral to the present time, and three staff files Care Homes for Older People Page 6 of 30 were examined. We also looked at other information such as complaints, incidents, events and other professional reports. We took the opportunity to speak with a number of people who are using this service, relatives and members of staff, who took an active role in our inspection process, their input contributed to the subsequent report. We acknowledged receipt of the Annual Quality Assurance Assessment (AQAA), and seven survey forms returned. We inspected a sample review of administrative procedures, practices and records, confirming consistent good practice and effective management. There followed a report feedback with the care manager, in which we offered an evaluation of the inspection, indicating those recommendations resulting from the inspection. What the care home does well: What has improved since the last inspection? We found an improvement in the assessment process, with relatives and those people who may be coming to the home, being more actively involved in the planning of care. We examined and confirmed that care files have been re-organised to provide a more focused document. Activities have been enhanced to include more opportunities to get involved in outings and social events. The support of an activity coordinator has offered an environment more attuned to meeting person centred care objectives. Various comments through surveying from people in the home: Mum has been taken out to the town and pubs for meals, and more recently to a garden centre. One resident commented that she would prefer to talk to someone than to play catch. I feel that talking in itself is a worthy activity, and communication is a tool in reminiscence work as well as providing stimulation. The recognition of a volunteer mediator has had a significant effect upon the motivation of people and added to the impact of an improved activity programme. We have acknowledged that there have been significant improvements in the furnishings and decor throughout the home. Our discussions with staff confirmed an improvement in the standards of staff morale, motivation and training, through sound management. Information gathered from the AQAA and discussed during our inspection found this to be true. Medication administration and management has been improved to provide a safe and Care Homes for Older People Page 8 of 30 effective system. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of people who may use the service are appropriately assessed before they are offered a place. They and their relatives can be confident that the service will be able to meet their needs. Evidence: We examined the services Statement of Purpose and Service User Guide, and found them to provide an informative description of Rosemary Lodges aims, objectives, and the way it operated, although needing a review in light of the process of change. We acknowledged that the documents were presented to all enquirers, and a copy placed in each bedroom for people to read. We advised that the Service User Guide be produced in large print and an audio version, and that fees presented to private applicants are to be included in the Guide. The Statement of Purpose indicates the terms and conditions, which are discussed with people who may use the service and relatives prior to admission. Care Homes for Older People Page 11 of 30 Evidence: Our examination of three peoples care records and plans, clearly identified the preadmission and admission assessments. We identified that the care manager or her deputy, at the point of referral, conducts the pre-admission assessment. We found each record showed the attention to individuality, with the assessment formulating a care support plan, based on individual needs, with focused aims and interventions. This assessment is produced with the involvement of those people admitted and family, allowing them to have an influence in the direction of care. Comments received from surveys sent in showed to us a confidence that people had in the service: My son checked other homes and selected Rosemary Lodge after visiting six others in the area, after consulting with me, I was made welcome and felt involved at all times. From discussions it was evident that people are able to visit and assess the quality, facilities and suitability of the home at any reasonable time, to meet with staff and management. No intermediate care took place in the home. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are addressed through the care planning process, meeting clear principles of respect, dignity and privacy. Medicine administration systems are safe and secure. Evidence: We found that care records, through case tracking showed that this standard is met, maintaining a good quality process of assessment. The pre admission assessment represented the foundation for an organised care planning process, in association with Social Services reports if available. There is a need to ensure that pre admission assessments are fully documented with signature of assessor and dated. Each persons health, personal and social care needs are assessed in an individual plan of care that is reviewed monthly, including those peoples, and relatives views, to reflect their changing needs, reinforced through a thorough daily report. Three individual s care files were examined in detail, each demonstrated essential information on the individual, their life style and needs, events and contacts, procedures and actions monitored on a daily basis and reviewed monthly. Effective risk assessments had been Care Homes for Older People Page 13 of 30 Evidence: completed in areas such as manual handling, falls, nutrition, personal hygiene, and continence. The process has also established a social awareness for each person, as an addition to care records, which has proved to be useful in enhancing understanding of personal needs. We confirmed through our discussions with staff an effective understanding of need, enabling staff to identify risk areas and put systems in place to reduce risks. We had evidence that care, psychological and special needs are assessed and documented as appropriate. The General Practitioner (GP) service is supportive; through which arrangements are made to provide professional support. Case tracking confirmed to us that specialist support and advice are sought as needed, with access to a local Doctor, Dentist, and Chiropodist. Comments received from several people using the service: The Doctor is always contacted if there is a problem, Ive always found them to very good at their job, and pleasant, Extremely happy with the staff and home. Carers were seen to interact with people who use the service with understanding and friendly compassion. In the process of meeting people who use the service it was acknowledged that their general appearance indicated that their health and personal care was attentive and effective, and of a good standard. Several relatives who were visiting were asked by us for their comments on the quality of the service and care given. There was a clear appreciation of the openness and opportunity to contribute. Comments were complimentary of standards, facilities and staff: A very relaxed, friendly and homely atmosphere, we have always found it to be very welcoming to us. The expert by experience offered a comment from her discussions with people: All residents felt they were treated well. One resident stated that she could speak to staff at any time, if they were busy they would explain that, and always return to her as soon as possible. We found the administration of medicines adhered to procedures to maximise protection to people who use the service. The storage was secure, with good environmental controls, including a medicines fridge. Our examination of the record of administration of medicines showed consistency, with no omissions observed. A controlled drug register was examined and we found to be up to date when checking drug stocks. Staff training continues to be pursued actively by the care manager. Transcribing of medicines need review in obtaining an authorised General Practitioners agreement on new peoples medicines regime, with two staff signatures and dates on record. We found an effective and smooth process of ordering, receiving, storing, administering and disposing of medicines. Records were seen to be complete and easy Care Homes for Older People Page 14 of 30 Evidence: to follow through, with no observed breaches in the system. It is stated in the services Statement of Purpose and the AQAA, that independence, privacy and dignity are encouraged, with the full involvement of family in all matters concerning the well being of people. This was confirmed in our discussions with people who use the service. visitors and staff, and that relatives have freedom of visiting, which emphasised the importance of maintaining social contact. We looked at bedrooms, which offered privacy for the individual, allowing medical examinations and personal care procedures being performed in private. In our discussions with people who use the service and staff, it was recognised that diverse needs were accommodated within the planning of care. Dietary, religious and personal matters were identified, along with the diverse physical needs. Our case tracking confirmed that the policies were implemented, with people we talked to being complimentary of the degree of respect given, by each and every member of staff. We were impressed with the confidence and closeness within the Home and the mutual respect that prevailed. Our discussion with visitors on the day was an helpful exchange, with all being very complimentary of care: We like the open visiting, and we were kept up to date on all matters that affected care, and we come and go as we wish. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples rights to live a meaningful life are central to the homes aims and objectives, and are offered opportunities to exercise choice and control over their lives. People are offered a healthy, well balanced diet. Evidence: We found the daily routine to be flexible, offering choices for meal times, personal and social activities, including recognition of varied religious needs. Our discussions with people who use the service and staff, clearly identified a relaxed and informal atmosphere in which the peoples needs were respected, with the security that there are familiar events to the day they could relate to. We recognise the principle that activities are a key element in the socialisation approach to care, with visitors encouraged to be involved in a partnership style with care staff. The home has appointed a part time activity coordinator who, in our discussion indicated that the home is committed to enhance the role and resources available. We were informed that the Home is planning extended activities to add to those already in place, with occasional trips to the locality. During the course of the inspection we saw staff interact with people in a positive and polite manner. Care Homes for Older People Page 16 of 30 Evidence: Comments received from people confirm their appreciation and involvement with the progress of their health and social status, including: Mum has been taken out to the town and pubs for meals, and more recently to a garden centre. A volunteer mediator, who was a carer before retirement, comes in for most days to talk with, and spend time with people on a one to one basis. All the people we spoke with found her to be very agreeable, and looking forward to having a chat and spending some time with her: She is a really nice lady who is always interesting and a good listener, I always enjoy speaking with Jane, a lovely person. Comments received from the expert by experience were: The activities I observed were board games and catching a soft ball. When asked about these activities, one resident commented that she would prefer to talk to someone than to play catch. I feel that talking in itself is a worthy activity, and communication is a tool in reminiscence work as well as providing stimulation. I would suggest more structure to activities, and a timetable available to all. One resident stated she felt stuck in the home and had particularly enjoyed a trip to a local garden centre recently. The mediator described her role as providing the time for clients that carers are unable to give, due to task pressures. I found her to be a valuable addition to the staff team. All comments I received from the residents concerning the staff, their individual rooms and the food were positive. The variety of food was described as good by all residents I spoke to, and some choice was given daily. Residents have access to their rooms throughout the day if they wish, and are able to eat in their rooms if they chose. I spoke to a gentleman who had recently moved to the home and he felt being able to eat where he chose had helped his transition into care. It is stated in the Statement of Purpose that personal choice and reasonable self determination are respected in policy and action. Throughout the inspection we found this to be true. Those individuals rooms inspected showed a significant influence of personalisation in the inclusion of belongings, some furniture and general decor. Our inspection of the Home demonstrated a degree of expressed individuality in most of the bedrooms inspected. Relatives and friends are encouraged to maintain social links as part of the planning of care. We found that the standards of catering offered a satisfactory service, to which those people we spoke with were complimentary of all aspects of quality. A menu on a four weekly cycle offered a wholesome, varied and suitable choice. We observed a very pleasant lunch served during inspection, with choices available. A menu for the day was inspected and seen to offer a wide choice of meals throughout the day, served in a comfortable and spotlessly clean dining room. The quality and quantity of the food offered on the day was observed to be of a good standard. People interviewed Care Homes for Older People Page 17 of 30 Evidence: confirmed that that the quantity and quality food provided was good: Varied and well presented, good quality, and Very good standard of cooking and choice available. Its always set out so nice. We saw that staff offered discreet assistance to those who required it. The choice of dining room, lounge or bedroom was at peoples discretion. We confirmed that the cook knew each person using the service, and some of the relatives. We discussed diversity with the cook, who indicated an awareness in meeting individual needs; there were no special needs at the time. Individual preferences were recorded in assessment and conveyed to the catering staff, who met with, and discussed their requirements. Care Homes for Older People Page 18 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a meaningful complaints policy. People are given opportunities to freely express any concerns, and these are quickly responded to. People are protected from abuse, and their human rights are promoted. Evidence: There were a few minor concerns, which we feel would be better dealt with through a record of concerns, complaints and safeguarding, to record peoples concerns in a meaningful and effective manner. From our talks with people who use the service, and staff, it was evident that any small matters were handled immediately, discretely and to the satisfaction of all concerned. All people had received information on the procedure to complain, including reference to us. This process was evidenced through the Service User Guide, on examination and case tracking and discussion. We identified that there had been one complaint received and dealt with satisfactorily by the care manager, and no allegations made to us since the last inspection. Comments we received from people who use the service through the surveys returned: In 18 years have hardly ever had to. I would (her son) make sure that any problems are relayed back to the staff. I know there is a structure. Our discussion with the care manager confirmed that there is satisfactory evidence of Care Homes for Older People Page 19 of 30 Evidence: a protocol and response, to anyone reporting any form of abuse, to ensure effective handling of such an incident. The policy and procedure for handling issues of abuse was examined, and found to be appropriate. We examined three staff records to confirm that staff were suitably checked through Criminal Records Bureau (CRB), and Protection of Vulnerable Adult (POVA) disclosure. We found staff received training on abuse at induction, this includes the right to whistle blowing, consistent with the Public Disclosure Act, 1998. Care Homes for Older People Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Rosemary Lodge provides a safe, well maintained, clean and comfortable environment for the people who use the service. Evidence: Our inspection of the home verified that the premises were generally fit for purpose, clean warm and tidy, and being satisfactorily maintained. External car parking is limited. The grounds were found to be satisfactory and well maintained, with an attractive patio area and lawned area; overlooked from some of the rooms and the lounge. The state of repair and maintenance is generally very good, offering a comfortable, homely yet secure environment. The surrounding garden areas were well maintained providing a pleasant area for relaxation within warmer months. A chicken coop has proven to be a very popular distraction, and focus for discussion. We were informed that on admission the care manager assesses each individuals needs for equipment and necessary adaptations, we found this to be correct, and saw those facilities available throughout the Home, with suitable fittings of hand and grab rails, in adequate, well lit and airy corridors. Wheelchair access was satisfactory throughout the Home. Efforts had been made to provide a homely atmosphere and the decor in most areas of home was found to be pleasant and personalised. Care Homes for Older People Page 21 of 30 Evidence: The home provided two lounge areas that were pleasantly decorated providing essential furnishings and items to provide a comfortable area where people were able to interact with others, or to entertain their guests. The conservatory, recently fitted with central heating, provided a tranquil area where people could experience the views of the surrounding grounds. There was a spacious dining area where people were able to dine in comfort. Toilets and bathrooms were located on both floors and were in close proximity to bedrooms and communal areas. We acknowledged the fitting of a new passenger lift, which provides a much improved service. Bedrooms were well maintained to meet peoples personal preferences. On inspection, most bedrooms were highly personalised, with some displaying personal furniture, and most with personal belongings. It is the policy that on bedrooms becoming vacant that each room is reappraised for redecoration, as confirmed during the Inspection. We confirmed the good quality of outcome from a major refurbishment of bedrooms, to which people spoken to expressed a sense of belonging and satisfaction in the quality and presentation of their living areas. The care manager expressed a willingness to meet any reasonable demand for special needs. A locked facility and lockable bedroom doors are made available on request, following suitable risk assessment. Comments we received from the expert by experience: The home is well presented; it is light and airy with coordinating colour schemes that are modern in design. Residents are able to bring their own furniture to the home, and I observed that rooms held personal belongings and treasured photographs, which I feel add to a sense of belonging. The communal areas felt homely but impersonal, some personal touches may have helped to provide a more stimulating environment, for example, pictures, memorabilia appropriate for the residents histories. Picture signs for the bathroom/toilet facilities may be useful and individual identification for rooms could be considered. The home presented to us a generally clean and pleasant atmosphere, much to the credit of staff. To complement the presentation there were numerous floral and decorative displays. Toilets and bathrooms were located in close proximity to bedrooms and communal areas. We found the kitchen presentation showed satisfactory standards of cleanliness, and evidence of sound food hygiene practices. We found the laundry was well organised and equipped to a good standard, regulations were available, and would be enhanced with posters clearly displaying, and relevant to, solutions in use. Care Homes for Older People Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels ensure that suitably trained staff are provided to meet the needs of people who use the service. Recruitment processes are consistent and robust, protecting the people who use the service from harm and abuse. Evidence: We found that there were 29 people using the service on the day of inspection. We examined three weeks of duty rotas, providing evidence that the home is suitably staffed in numbers, skills and qualifications to ensure the needs of people are met. We recognised that the care manager is supernumerary to the staffing roster. Flexible rostering with agreed overtime are used to meet shortfall due to sickness and absence; agency staff are not employed. There are adequate support staff for housekeeping, catering, administrative and maintenance. The care manager has the Registered Managers Award (RMA), and we were informed through the AQAA that all staff have National Vocational Qualification (NVQ) level II, and 45 at level III. This was confirmed on examination of training records and speaking with staff. It is noted that the training programme was not consistent in the recording and organising of sessions, although staff maintain they had received the necessary Care Homes for Older People Page 23 of 30 Evidence: mandatory training. The care manager agreed to implement a more organised structure of training for all staff. There are eight members of staff qualified in first aid with a valid certificate. The Provider and care manager have established, and continue to pursue satisfactory procedures for interview, selection and appointment of staff. The thoroughness of staff selection has a significant effect upon the provision of care to ensure protection of people. Three staff were interviewed and confirmed the policies in action. All new staff go through a detailed induction process, that will ensure that they are going to be the right person for the home. All staff have the General Social Care Council code of conduct. We advised that the staff record be reviewed in the way information is organised and presented. Staff meetings are held on a monthly basis. Care Homes for Older People Page 24 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care team promote the health, safety and welfare of people using the service, and working practices are safe. People who use the service can be assured that the home is run in their interests, based on openness and respect. Evidence: The experienced care manager has over the past two years demonstrated effectiveness in establishing a solid management foundation, implemented to achieve a good standard of set aims, objectives and care. We acknowledge that she has been actively engaged in quality reviews and audits with the Registered Provider, following our last inspection, meeting compliance to requirements and addressing recommendations we made. She has as yet not been interviewed for registration with us, although we understand that an interview is imminent. She has achieved her Registered Managers Award qualifications, and is presently planning a higher level management course. We observed an openness, professional and pleasing confidence Care Homes for Older People Page 25 of 30 Evidence: in the interactions of staff, relatives and people who use the service, based on mutual trust and respect. Comments from those people we met and surveyed included: If there is anything you need to speak about you can see the manager or another member of staff at any time. I am happy and well looked after at Rosemary Lodge. Extremely happy with the staff and the home, very relaxed, friendly, homely atmosphere. The expert by experience assessor stated: In conclusion to my report, I found Rosemary Lodge to be a home that provides good care and staff are attentive to the needs of the residents. All residents felt they were treated well. One resident stated that she could speak to staff at any time if they were busy they would explain that and always return to her as soon as possible. Through the inspection process we found appropriate risk assessments in place for people using the service, through care planning and monitoring, staff selection and of the general environment, these are up to date and accurate. Health and safety notices can be seen throughout the Home, although chemical safety notices should be prominent in areas of use and storage. An examination of administrative, monitoring, planning and care records showed to us a generally diligent attitude to effective record keeping, although needing review in the way they are organised and presented. We found them to be generally well maintained in ensuring that the peoples rights and best interests are safeguarded. The care manager offered evidence of procedures and safe working practices including: medicines administration, first aid, and abuse awareness. The procedure manual has not been reviewed for some years, and would be of greater help to staff to be updated to meet new situations. The accident book was seen and found to be in order, with a regular analysis of trends and frequency. Our examination of those records showed an effective follow through of action taken, including a review of care plans if necessary. We were informed through the AQAA, and by the manager that financial arrangements are supervised and administered by the Registered Provider and care manager in respect of pocket money, comfort fund and petty cash management. The administration and management of the home is considered by us to be efficient, uncomplicated, and sensitive to the needs of people. Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 That the Statement of Purpose and Service User Guide be updated to reflect change and that consideration be given to producing the documents in larger print and audio versions, to assist people with poor eyesight to make an informed decision. To make sure that new people are fully informed about the home the Service User Guide should contain information regarding the up to date fees charged. That two senior staff, who are suitably qualified, ensure all transcribing have signature and dates ascribed to the document, to be countersigned by the General Practitioner at the earliest opportunity. This will ensure consistency for all new admissions, to maximise safe procedures in administrating medicines. A Concerns, Complaints and Allegation book be established to more effectively monitor incidents. To increase safety of people who use the service, visitors and staff a full unit risk assessment inventory be established. To increase safety Control of Substances Hazardous to Health (COSHH) laminates should be displayed in all areas to complement existing procedure sheets. 2 1 3 9 4 5 16 24 6 26 Care Homes for Older People Page 28 of 30 7 30 That a staff training programme be established on a formal structured basis to ensure that all mandatory training is recorded as achieved within the given time. Update procedure manual to reflect changes and meet new regulation and legislation. This will offer staff a more relevant and up to date assistance in applying policy effectively. A full risk assessment of all rooms to establish a development plan for 2009/2010. All staff to receive adequate formal supervision, 6 times a year, to ensure that all staff have the opportunity to review all aspects of practice, discuss policies and consider career development needs. As a course of good practice COSHH posters should be located in areas where chemicals are stored to enhance health and safety conditions at work for all staff. 8 33 9 10 33 36 11 38 Care Homes for Older People Page 29 of 30 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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