Inspection on 26/08/05 for Rosemary Lodge

This inspection was carried out on 26th August 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.

Other inspections for this house

Rosemary Lodge 18/06/07

Rosemary Lodge 29/11/06

Rosemary Lodge 24/02/06

Rosemary Lodge 23/11/04

Rosemary Lodge 14/04/04

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

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

CARE HOMES FOR OLDER PEOPLE Rosemary Lodge 9 The Drive Wimbledon London SW20 8TG Lead Inspector Janet Pitt Unannounced 26 August and 2 September 2005 11:45 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. Rosemary Lodge G54-G04 S19118 rosemary Lodge V225951 230805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Rosemary Lodge Address 9 The Drive Wimbledon London SW20 8TG 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) 020 8946 6963 020 8296 0025 The Wimbledon Guild Mrs Margaret Sephton Care home with nursing (N) 44 Category(ies) of Physical disability (PD) registration, with number Dementia - over 65 years of age (DE(E)) of places Mental disorder, excluding learning disability or dementia - over 65 years of age (MD(E)) Rosemary Lodge G54-G04 S19118 rosemary Lodge V225951 230805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1- One named female service user aged 55 years of age. Date of last inspection 23 Novemebr 2005 Brief Description of the Service: Rosemary Lodge is situated in a residential area of Wimbledon, close to local bus routes. The home is within a twenty minute walk to Wimbledon Village. The home provides nursing and personal care for up to forty seven older people. Rosemary Lodge is registered to provide care for up to four people with dementia and up to twenty-seven people who may have physical disabilities. The home is owned and managed by the Wimbledon Guild a registered charity. Accomodation is provided over three floors and includes a lounge, sun lounge, dining room, thirty-two single bedrooms and four shared bedrooms. Two passenger lifts serve each floor. Rosemary Lodge has access to a large level garden which is mainly laid to lawn, with a paved area, pond, shrubs and trees. There is limited parking to the front of the home, however parking is also available on the street. Rosemary Lodge G54-G04 S19118 rosemary Lodge V225951 230805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took placed over two days, by one inspector. The total inspection time was seven hours and forty-five minutes. On the first day of inspection the inspector commenced at 11:45am and concluded at 4:30pm. On the second day of inspection the inspector commenced at 2:55pm and concluded at 6pm. During the time the inspector spoke with two relatives, four service users and three members of staff. Care documentation, policies and procedures were examined. Accident records and training records were inspected. A tour of the premises was undertaken and lunch was observed. What the service does well: What has improved since the last inspection? What they could do better: Although there has been improvement in care planning and documentation, the home must ensure that daily records reflect the care given to ensure that residents’ care is appropriately carried and care needs are met. Residents are consulted about their wishes in the event of death, but this must be consistently documented to ensure that these wishes are respected and carried out. Religious needs of residents are not consistently documented. The home must ensure that religious needs are identified and addressed. Rosemary Lodge G54-G04 S19118 rosemary Lodge V225951 230805 Stage 4.doc Version 1.40 Page 6 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. Rosemary Lodge G54-G04 S19118 rosemary Lodge V225951 230805 Stage 4.doc Version 1.40 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 Rosemary Lodge G54-G04 S19118 rosemary Lodge V225951 230805 Stage 4.doc Version 1.40 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) 1, 2, 3, 4 and 5 Residents are able to make an informed choice about Rosemary Lodge and can be confident their care needs will be appropriately assessed. EVIDENCE: Residents are able to gain information on the service provided from the Statement of Purpose and Service User Guide. Both documents include details of how to contact the Commission for Social Care Inspection if required. This was a requirement in relation to both documents at the previous inspection. Resident assessments clearly identify and detail the care needs of the residents and include risk assessments such as skin integrity and risk of falling, which promotes the safety of residents. The assessments include information on past and present medical history, behaviour histories and hobbies and interests. Assessments of residents are undertaken prior to and on admission. Staff document when information is unable to be obtained, for example use of the depression score, if someone is unable to communicate. Relatives spoken with indicated that they were included in the assessment process and were able to visit prior to admission. Rosemary Lodge G54-G04 S19118 rosemary Lodge V225951 230805 Stage 4.doc Version 1.40 Page 9 Rosemary Lodge G54-G04 S19118 rosemary Lodge V225951 230805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10 and 11 Residents care plan detail care required, however the home must ensure that actual care given is recorded accurately. Religious needs and wishes in the event of death are discussed with residents and their representatives, but this must be consistent. Residents were noted to be treated with respect and their privacy maintained. EVIDENCE: Residents care plans were noted to lead from the assessments and give clear instruction on how care needs should be met. The care plans contain details of specific care interventions such as Naso-gastric feedings and continence promotion. However the daily records did not always reflect the care given. The afternoon staff handover was observed and it was clear from the handover that staff were aware of care needs, but were not consistently documenting the care they had given, but were writing phrases such as ‘washed and dressed’, ‘full care needs met’ and ‘remains confused at times’, with no record of interventions. This places residents at risk of not having their care needs evidenced as met or changes in their condition noted. Rosemary Lodge G54-G04 S19118 rosemary Lodge V225951 230805 Stage 4.doc Version 1.40 Page 11 This issue was discussed with the Head of Care, who confirmed that she was aware of the poor quality of the daily records and she plans to implement a new recording system, in order that the records reflect actual care given. Religious needs of residents were noted on admission, but not consistently. On the first day of the inspection a multi-faith communion was being held. The manager explained that this occurs once a month and Catholic Mass is offered weekly. Residents wishes on what to do in the event of death were not recorded consistently, which could lead to a lack of sensitivity and care. Staff were observed addressing residents with respect, using the title that residents preferred. Two members of staff were seen assisting a resident and made sure that they informed the resident of what they were going to do, prior to the actions being carried out. Two residents spoken with confirmed that the staff ‘were good’ and ‘nice to them’. Medication training has been carried out, as required at the previous inspection, to ensure that staff are competent to administer medicines. The training included an assessment of competence and gave clear details of professional accountability of staff administering medicines. Rosemary Lodge G54-G04 S19118 rosemary Lodge V225951 230805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 and15 Residents are able to decide how they spend their day and are able to receive visitors, who are made welcome to the home. Residents are able to have a varied menu, which reflects their personal choices. EVIDENCE: Two visitors and two residents spoken with said that the meals were ‘good’ and of an appropriate size. One of the residents said that quite often alternative meals were prepared for them, if they did not like the menu choice and staff were aware of food likes and dislikes. The lunch served on the day was hot and well presented. Staff ensured residents had had sufficient to eat and residents were able to eat in the dining room, the lounge or in their rooms. The inspector was able to enjoy a cup of coffee and a chat with one resident, who confirmed that visitors are welcome at any time. The resident was able to go out and visit their family at short notice. The resident said that they enjoyed reading a daily paper and had a television in their room, which they enjoyed watching in the evening. The home offers a variety of activities, which reflect residents’ interests and activities undertaken by residents are recorded in their records. Visitors spoken with confirmed that they are able to participate in activities organised by the home, such as barbecues. One resident said that at a recent barbecue they did not wish to go outside, but staff ensured that food prepared was brought to the resident. The two Rosemary Lodge G54-G04 S19118 rosemary Lodge V225951 230805 Stage 4.doc Version 1.40 Page 13 visitors said that they were ‘impressed’ with the effort involved and their relative had been enabled to go outside for the barbecue, even though they required continuous oxygen. Rosemary Lodge G54-G04 S19118 rosemary Lodge V225951 230805 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Residents and their representatives have access to an appropriate complaints policy, but the home must ensure that complaints are handled in a satisfactory manner at a local level, to maintain confidence in the procedure. EVIDENCE: Visitors spoken with said that initially when their relative moved into the home, there were ‘niggling issues’ with batteries for their relatives hearing aid, which still causes some problems. Other ‘teething problems’ had been sorted out in a satisfactory manner. Staff must ensure that small issues are dealt with promptly to prevent dissatisfaction with the service provided. The complaints policy indicated the stages that are implemented if there are any complaints and detailed the Commission for Social Care Inspection’s role. The home has received one complaint since the previous inspection, which was recorded and noted to be dealt with appropriately, and outcomes were present on the record. No complaints have been received direct to the Commission since the previous inspection. Rosemary Lodge G54-G04 S19118 rosemary Lodge V225951 230805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25 and 26 Residents are cared for in a maintained, clean and tidy environment. Residents are able to personalise their rooms and there is sufficient communal facilities for their use. EVIDENCE: Residents’ rooms were noted to be personalised and many people had their own television sets. There was evidence of personal items of furniture and photographs. There was appropriate equipment in place for residents’ needs, such as hoists and wheelchairs. Bathroom and toilet facilities were situated close to residents’ rooms, with hand basins in each room. Rosemary Lodge was clean and tidy at the time of inspection. The dining and lounge areas provided sufficient seating for residents. Rosemary Lodge G54-G04 S19118 rosemary Lodge V225951 230805 Stage 4.doc Version 1.40 Page 16 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 Residents are cared for by staff that have access to appropriate training, which develops their skills. The training is individualised and planned in a professional competent manner. EVIDENCE: Staff training records evidence that they have received training in medication and dementia care, along with mandatory training, such as fire and moving and handling. The file contains details of what is included in the course. The Head of Care indicated that when staff undertook the medication training, as required at the previous inspection, she ensured that staff were competent to undertake the task of administering medicines by use of a test and one to one discussion. The Head of Care is also responsible for training and is a qualified Nurse Tutor, therefore has specialist knowledge of what is required and has the ability to implement appropriate training for staff within the home. Appropriate training ensures residents are supported by competent staff. Rosemary Lodge G54-G04 S19118 rosemary Lodge V225951 230805 Stage 4.doc Version 1.40 Page 17 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) 31, 32 and 33 Residents live in a home, which is run and managed in their best interests. EVIDENCE: Residents are supported by a staff team who are able to input into the running of the home, staff meetings are undertaken monthly and minuted. Actions and outcomes are present. The manager has been responsible for the home for many years and is suitably qualified and experienced. At the time of inspection the manager demonstrated an awareness of individual residents and their needs. The manager was approachable to staff, residents and visitors. Rosemary Lodge G54-G04 S19118 rosemary Lodge V225951 230805 Stage 4.doc Version 1.40 Page 18 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 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 x 28 x 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x 3 3 3 x x x x x Rosemary Lodge G54-G04 S19118 rosemary Lodge V225951 230805 Stage 4.doc Version 1.40 Page 19 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. Standard 7 10 Regulation 15 and Scehdule 3 (3) (k) 12 (4) (b) Requirement The registered person must ensure that daily records refelct actual care given. The registered person must ensure that religious needs are noted on admission and addressed. The registered person must ensure that residents wishes in the event of death are documented. The registered person must ensure that complaints are handled in a satisfactory manner at a local level. Timescale for action 30th November 2005 30th November 2005 30th November 2005 30th November 2005 3. 11 12 (2) 4. 16 22 (3) 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 Good Practice Recommendations Rosemary Lodge G54-G04 S19118 rosemary Lodge V225951 230805 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Ground Floor 41-47 Hartfield Road Wimbledon London SW17 3RG 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 Rosemary Lodge G54-G04 S19118 rosemary Lodge V225951 230805 Stage 4.doc Version 1.40 Page 21 - 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!