Inspection on 17/10/06 for Rosemary Park Nursing Home

This inspection was carried out on 17th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 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 Park Nursing Home 26/06/07

Rosemary Park Nursing Home 09/01/06

Rosemary Park Nursing Home 19/06/05

Rosemary Park Nursing Home 18/02/05

Rosemary Park Nursing Home 22/06/04

Similar services:

Thorndene

Sutton Lodge Nursing Home

Wingham Court

Bethany Lodge

17 John Street

Red Oaks

Clare House Nursing Home

Broad Oak Manor Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Rosemary Park Nursing Home Marley Lane Haslemere Surrey GU27 3PX Lead Inspector Mrs A Peace Unannounced Inspection 10:00 17 October 2006 th 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 Rosemary Park Nursing Home DS0000024204.V307129.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. Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosemary Park Nursing Home Address Marley Lane Haslemere Surrey GU27 3PX 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) 01428 643125 01428 652137 rosemaryparknh@yahoo.com Oldercare (Haslemere) Limited Mrs Patricia Ann Jeffery Care Home 78 Category(ies) of Dementia (56), Dementia - over 65 years of age registration, with number (56), Mental disorder, excluding learning of places disability or dementia (78), Mental Disorder, excluding learning disability or dementia - over 65 years of age (56), Physical disability (22) Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A total of 78 service users may be accommodated at any one time. Of whom 22 service users who are in the category MD over the age of 30 years may be admitted who have a physical disability (PD) due to a chronic progressive neurological organic disease. No service users may be admitted with an addiction problem or problematic acute psychosis. Service users in the category DE will be aged 50 years or over. 3. 4. Date of last inspection 9th January 2006 Brief Description of the Service: The service is privately owned by Oldercare (Haslemere) Limited. Rosemary Park is located in its own grounds on Marley Heights near Haslemere. Rosemary Park offers facilities to cater for residents of varying ages and levels of mental health illness and impairment. The home is separated into three different areas providing accommodation to meet the varying mental health needs. In the main house service users accommodation is on two floors, there are 27 single rooms and 6 double rooms available and a number of them offer en-suite facilities. This caters for service users suffering from a moderate or severe dementing (organic) illness. Communal facilities available consist of 2 lounges, a conservatory and a dining room. The Courtyard Wing is on one level and service users accommodation consists of 11 single rooms and 4 apartments, all offer en-suite accommodation. Communal facilities consist of a lounge, a conservatory and a dining room. The unit caters for service users suffering from enduring mental health problems or acquired brain injury. The East wing is on three levels, service user accommodation is on the first and second floor and consists of 18 single rooms and 2 double rooms all offer en suite accommodation. The unit caters for service users suffering from early or middle stages of dementing (organic) illness or long standing (functional) illness. A passenger lift accesses all areas with a security keypad system in operation throughout the home. Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Mrs Ann Peace, Mrs Diane Peel Regulatory Inspectors and Mrs J Datoo Pharmacy Inspector carried out this unannounced inspection on Tuesday 17th October 2006. This is the first inspection for the year 2006-2007. It is called a key inspection and will determine the frequency of visits/inspections hereafter. A Lay Inspector who has had experience of using mental health services also accompanied the inspectors to give her view and observations from a different perspective of whether the home was meeting needs of the residents. Prior to the inspection all records held on file since the last inspection were reviewed. On arrival the home was warm, welcoming and clean with no unpleasant smells. Managers and staff were friendly and open with regulatory inspectors and the lay inspector. During the inspection all of the staff made the inspectors feel at ease. The lay inspectors first impression was: ”That the home is beautiful in its own stunning grounds there is an air of grandeur in the receiving rooms which would make visitors very impressed and residents very proud”. “It could almost be a country hotel, and the initial atmosphere is very positive and not at all institutional”. For the inspection a tour of the home was carried out and the majority of the rooms in all three units visited. Records relating to the care of residents and the administration of the home, including a number of staff records were examined. A case tracking exercise for a number of residents in each unit was carried out. Information was taken from their records since pre-admission and tracked to care being given, medication review, the continuity of that care and any equipment used. This exercise showed that a robust admission system is in operation, appropriate equipment is supplied and that staff have the training to meet the needs of the residents. When the inspectors and the lay inspector spoke to staff about the residents they showed awareness of the personalities and diverse care needs of the residents in their care. Staff said they felt well supported by the company and senior staff. Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 6 A number of residents were able to give an opinion about the home and the staff and were complimentary. Some of the comments from residents were: “The staff are friendly and look after me well”. “I like the food here”. “The staff let me stay in bed if I want and they bring me my meals”. “Staff do listen to me when I am feeling down”. Four visitors were spoken to and they were all very complimentary about the home the managers and the staff. Their comments included: ”It is a wonderful place with wonderful care”. “I am very happy my husband is here, he is very well looked after and the staff are brilliant”. “My father is very ill but could not be looked after any better and the food served is very good”. “Staff look after my father wonderfully and also support me and my family”. “Staff always welcome us and we are always offered refreshments”. “Visits are sometimes difficult but the staff give use the support we need”. The conclusion of the Regulatory Inspectors and the Lay Inspector was that Rosemary Park gives an excellent standard of care from a caring and committed team who have the training and knowledge to care for residents with a wide range of mental health problems. Requirements made at the previous inspection have been complied with; no requirements were made following this inspection. Any matters arising from the inspection were discussed with Mrs Jeffery at the conclusion of the inspection. One recommendation was made following compilation of the evidence. What the service does well: Mrs Jeffery and the managers of the units, support residents in their care and ensure staff have the training and supervision to ensure an excellent quality of care is provided. Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 7 Staff work hard to meet the needs of the residents in a respectful and friendly manner. Communication and support between staff is very good. Care records are clear and comprehensive; numerous comprehensive risk assessments are carried out to try to minimize risks to residents. Care records are updated regularly and residents have access to a Consultant Psychiatrist, a Consultant Psychologist and other outside health professionals routinely. Staff are knowledgeable about the residents their identified risks and their differing nursing, mental health and social needs, they were seen to support residents with severe mental health difficulties in a caring manner. The Registered Providers are committed to improving services and staff support systems are in operation. The company has its own teaching unit in Portsmouth where staff are instructed in all levels of care from basic nursing care, clinical and mental health care through to management of residents with diverse needs and management of staff. Outside lecturers are also bought into the unit when necessary. The home has been accredited as a suitable training placement for adaptation students and the home has commissioned a study into how adaptation students relate to nursing practice to establish if they can further support adaptation students and therefore improve the care for residents. The catering service is of a very high standard. There is a choice of good wellbalanced nutritious meals prepared by experienced and dedicated staff. The home is clean and homely and well maintained, the maintenance staff do daily rounds of the home. Some staff accommodation and staff transport is provided. What has improved since the last inspection? Work continues to refurbish both the exterior and the interior of the premises. New windows and doors have been fitted to the main house. The staff training programme continues to be expanded to meet changing needs and ancillary staff have also been offered training related to residents with mental health needs. A new security system has been installed which will evidence that checks on residents are being carried out at the required intervals. A new educational centre has been recently built and new build staff accommodation has been provided. The company has undertaken a survey for quality and monitoring purposes. Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 8 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. Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 9 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 Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5. The quality in this outcome area is excellent. The judgement has been made using available evidence including a visit to the service. People who use this service have good information about the home in order to make an informed decision about whether the home is right for them. The home has a robust pre assessment and assessment process and residents, relatives and their representatives are able to visit to ensure the home will be able to meet their needs. All of the residents have a contract. Trial visits are encouraged. Intermediate care is not provided at Rosemary Park. EVIDENCE: The Statement of Purpose and Service Users Guide is available. These documents give residents and their representatives a clear picture of what the home offers. Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 11 Various information about the home and a copy of the previous inspection report is available in the foyer of the home. Evidence from the case tracking exercise in all three units indicated that potential residents are visited and a pre assessment undertaken by qualified staff to establish if the home can meet their needs. Mrs Jeffery was reminded to ensure staff always date the pre assessment record. Once admitted for a trial period, a fuller assessment is undertaken and any risk assessments carried out. Care plans are written to ensure staff know what care the resident needs. Care records are maintained to a very good standard and comprehensive risk assessments covering many potential risks are compiled. All residents have contracts and current placement policy is to accommodate residents with a higher level of functional ability in The Courtyard Wing and residents who require a higher level of care in the Main House. The East Wing caters for residents suffering from early or middle stages of dementing (organic) illness or long standing (functional) illness. Four visitors were spoken to and all said they had been given good information to enable them to make a decision about whether the home would be suitable. Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11. The quality in this outcome area is excellent. The judgement has been made using available evidence including a visit to the service. Residents are cared for at Rosemary Park to an excellent standard and are respected and treated kindly by the staff. Staff meet the varying and diverse mental health and nursing needs of the residents in a friendly and professional manner. Residents have up to date assessments, risk assessments and care plans, which instruct staff how to meet their needs. Specialist psychiatric support is provided. The medication procedure is safe and staff are trained to administer medication. EVIDENCE: Mrs Jeffery is the Registered Manager and so has the overall responsibility for the care of residents. Mrs Jeffery is well supported by unit managers and other senior staff. It was clear to Regulatory Inspectors and the Lay Inspector that the team at the home work well together, communicate well to residents and their families and provide support to each other and the other staff. Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 13 A case tracking exercise was undertaken for a number of residents in all three units in which Inspectors looked at records and tracked care being given, to equipment used, and staff knowledge about those residents. Day and night care plans and risk assessments for medical, nursing, personal and environmental risks are clear and contain information staff need to care for the residents. Daily records of care are kept to ensure all needs are met on a daily basis and plans are regularly updated and show the changing needs of residents. Regular observations about the wellbeing of the residents and any changes are recorded. Night care consists of hourly checks if necessary, these are recorded to say whether the resident was asleep, awake or needed turning. Residents who suffer from incontinence are changed two hourly. Records showed that specialist psychiatric services are available on a monthly basis from a Consultant Psychiatrist who visits the home and when necessary a Consultant Neuro Psychologist visits. Other visits from health professionals are recorded. Staff were spoken to on each unit and were aware of the individual needs of the residents in their care and in all 3 units staff were noted to speak to residents in a respectful, caring and sensitive manner. One inspector noted that the charge nurse showing them around the home has a very good relationship with residents, joking with those that approached him which demonstrated that he knew them really well and they felt safe with him. There were plenty of staff to supervise and help residents in all communal rooms and residents who choose to stay in their rooms are checked regularly and these checks are recorded. During the visit all inspectors noted that there was lots of good-hearted banter between some of the more able residents and the staff, this added to the positive and friendly atmosphere in the home. One Inspector noted that ”I noticed lots of smiley faces and I received some happy waves as I went around”. The Statement of Purpose records that behaviour modification programmes may need to be considered, but that this would be in discussion with the resident and their representatives, and a care plan would be agreed on. Out of courtesy overseas staff speak English while on duty and Englishspeaking courses are offered when necessary, the need for this to remain a high priority this was discussed at the conclusion of the inspection. Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 14 One Charge Nurse showed the lay inspector around the home when she first arrived, the lay inspector said “that he was extremely knowledgeable and experienced and had a wonderful disposition with the residents”. Residents are able to make choices about their daily lives and activities and were seen to be able to maintain an independent lifestyle as safely as possible; some were still in bed through choice. Through talking to staff and observing residents it was noted that there was a good indication that each resident was being given the opportunity to express themselves and contribute to their own wellbeing and that also individual needs were being noticed and met. One visitor whose father was very ill said that the staff are nursing him very well and they also give support to her and her family. A pharmacy inspector carried out an inspection in all three units, the conclusion was that the medication administration procedures operated in the home are satisfactory and safe, one recommendation has been made. Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. The quality in this outcome area is excellent. The judgement has been made using available evidence including a visit to the service. A comprehensive range of activities is available for residents and the home promotes a lifestyle that respects the privacy and dignity of residents. The home operates an open door policy for family and friends if residents choose. Meals served are to a very high standard, varied, nutritious and well balanced. EVIDENCE: Following risk assessments residents can choose to stay in their rooms if they wish, residents who wish to stay in their rooms are checked at regular intervals and these checks are recorded. Others sit in the lounges or conservatories; there is plenty of communal space for residents to wander if they wish, during the visit it was noted that staff were in attendance in each communal room. Residents can sit inside or outside weather permitting and one visitor told one of the inspectors that they often Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 16 play golf on the lawn when they can which brings some normality to the daily life of the resident. During the visit, 2 visitors were enjoying a picnic with one of the residents on the patio, they told one of the inspectors that staff always respected their wishes and were very friendly and helpful and that since coming to the home the resident had improved tremendously to the stage where a lot of his medication has been able to be discontinued. There is a wide age range of residents and they are all well catered for by activity co-ordinators who undertake a range of activities with residents who wish on a regular basis. The Occupational Therapy Department is always busy and staff encourage residents to make full use of the facilities. One of the Inspectors talked to the art therapist about the art sessions that are provided. Residents are encouraged to take part if they choose. The Inspector noted that there was a relaxed atmosphere and the facility was very creative and upbeat. One member of staff told the Inspector that one lady resident whose behaviour had been very disruptive and who never rested, had, after taking part in the activities provided, calmed to such a point that she had taken to retiring to her room for a quiet period in the afternoon. During the visit a session of dancing activity was taking place with uplifting music and some residents were singing or dancing. There are quiet areas where residents sit and watch television or just sit in peace. There is also a smoking area in one of the units. One resident told the Inspector “she loved having her hair done and that she liked the music and the dancing”. The residents in the east wing and the courtyard tend to take part in different activities to the residents in the main house due the differing levels of dependency. One Inspector went into the garden with the residents and saw where they take part in gardening activities including growing their own vegetables. The home has its own minibus and residents confirmed that they could go out to the shops, pub and church and that staff accompany them. The conclusion of the inspectors was that residents are given to opportunity to contribute to their well being and their individual needs are noticed and met. The kitchens were visited and the inspectors were impressed by the quality and care given to delivering high quality meals for residents. The menus are on Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 17 a four-week rotation, and there was a good selection of fresh food. Alternative menus are available and specialised diets catered for. Fresh fruit and snacks are available during the day. It was pleasing to note that although this is a large home the likes and dislikes of residents are recorded and kitchen staff show awareness of individual nutritional needs. The Lay Inspector took her meal in the main dining room and was impressed with the way the staff look after the residents and help them with their meals when they need it. She said that “there was a superb choice of freshly cooked food on the menu the dining room was bright and clean and there was a convivial atmosphere at mealtime with plenty of staff to help with feeding for those residents who needed help. “The staff serving the food were cheerful and all of the residents happy and eating well”. Visitors who were spoken to all said they were impressed with the quality of the food served. One visitor whose husband had recently arrived at the home said that for the first time in years her husband had put on weight and looked better for it. Each unit has been adapted to the residents catered for and in the Courtyard unit there is a small kitchen with a fridge containing an assortment of food and a microwave should residents wish meals outside of the usual routine. The staff in the main house and the east wing have easier access to the main kitchen should residents wish a snack. There are plenty of pleasant places to meet visitors outside of residents rooms and there is also seating outside in the gardens. Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 18 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. The quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The clear complaint procedure enables those using the service or their representatives to have confidence that their complaint will be responded to within 28 days. The home operates the West Sussex Adult Protection Guidelines and staff have been trained to recognise abuse and follow the procedure. EVIDENCE: There is a clear complaint procedure available. The Commission has received no complaints since the last inspection. One adult protection alert has been instigated since that last inspection when there was an incident between 2 residents, the appropriate agencies were involved. Following a strategy meeting it was recommended that senior staff re familiarise themselves with which agencies that need to be informed if an incident of this sort should occur again. Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 19 During this visit one Inspector confirmed that this had been dealt with by the supervision systems in operation in the home. Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26. The quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. Residents live in a safe, clean and comfortable environment with aids and equipment to meet identified needs. EVIDENCE: The home is clean and fresh in all three units. Since the last inspection improvements to the lounge/conservatory area have been completed which has made the communal space in the main house nicer for the residents. The kitchens were inspected and all areas and equipment very clean a very high standard is maintained and the chef is very conscious of the environmental health issues and the potential risks to residents. All areas are decorated and furnished in a homely fashion, a number of doors in the main house were in the process of being re varnished during the visit. Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 21 The resident’s rooms are comfortable and meet the needs of the residents. The Lay Inspector described the rooms in the Courtyard as “immaculate and decorated with personal effects”. In all units residents and their relatives have been encouraged to personalise their rooms to make them more homely and to keep them as they wish. Locks are not routinely provided for all doors but at previous inspections it has been discussed that they could be, based on a risk assessment. Comprehensive environmental and personal risk assessments are carried out and are updated. Charts are kept in the bathrooms and were seen to be filled in by staff who test the water to ensure the bath water temperature is safe for residents. The maintenance staff carry out daily rounds and will carry out work as necessary, an issue relating to bedroom doors was discussed at the conclusion of the visit and Mrs Jeffery said it would be attended to. The home is in a rural area surrounded by wooded areas with lots of wildlife for residents to watch. Gardens in the immediate vicinity of the main house are pleasant and well maintained these lead into wooded areas with lots of wildlife for residents to watch. Some seating is provided on the patio and more supplied on the lawns in the better weather. There is a patio to the rear of the main house which was being used by a family during the visit. The Courtyard has furnished enclosed gardens which are well maintained and safe for residents to wander in or sit in. Other safe gardens are accessible for residents who want to work or walk in them. Residents in their rooms did have call bells to hand and a new security system has been installed in the main house, Mrs Jeffery said that this now incorporates the call bell system. The windows in the main house have been replaced and this has led to the improvement of the temperature in many of the rooms used by residents and staff and has improved the overall look of the home. Fire safety checks and other maintenance checks are being carried out as required. A new education block and staff accommodation for 12 has been built in the grounds this is nearly finished. Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 22 The driveway from the road, which belongs to The National Trust, has been relayed with funding provided by the Company. Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. The quality in this outcome area is excellent. The judgement has been made using available evidence including a visit to the service. The ratios of staff to residents in all three units is very good with an appropriate skill mix to meet the needs of the residents, staff have received training related to residents needs and health and safety requirements. The recruitment policy and procedure for the home is robust and protects residents. EVIDENCE: Duty rotas were available and these indicated that a good number of staff are employed with the appropriate skill mix to meet the needs of residents over the 24-hour period. Trained nurses and care staff work in three teams to cover each wing to ensure all areas of the home are covered by staff at all times. Residents who could offer an opinion were complimentary about all of the staff and the way they care for them. Visitors were very complimentary about the staff and the way they look after the residents and their families. Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 24 Rosemary Park along with other homes in the company is taking part in a research project with Surrey University for adaptation training for overseas nurses. The person undertaking the research spoke to one of the inspectors in depth and said, “In their opinion staff care for residents very well”. The home employs overseas adaptation students who are trained nurses in their own country. While undertaking their studies the students work as carers. The researcher spends a lot of time in the home observing staff’s interaction with the residents and said they were “gentle, deferential and caring and that he felt this added to the quality of care given”. The home meets the practical aspect of the adaptation course and oversees the theoretical learning. Supervisors and assessors visit the home to monitor standards. The Lay Inspector observed the carers and nurses throughout the home to be “helpful, smiling and willing in their demeanour towards residents”. A random selection of staff records were examined and found to be in order and well maintained. Some staff accommodation and staff transport is provided. Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 25 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37,38. The quality in this outcome area is excellent. The judgement has been made using available evidence including a visit to the service. The home is well managed and run in the best interests of the residents by a caring and committed team. Residents are protected by the environmental, health and safety practices of the home. EVIDENCE: Mrs Jeffery is The Registered Manager for the home and is well supported by Unit Managers. Mrs Jeffery, and the managers of the units have all recently completed their Registered Managers Award, this ensures that they are up to date with the Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 26 requirements of their roles and that they operate and monitor best practice throughout the home. Mrs Jeffery has a general and mental health nursing qualification. The majority of the senior nurses also have mental health qualifications. The home continues to be very well run under Mrs Jeffery’s strong leadership and Mrs Randall’s support to the benefit of residents. Mrs Jeffery continues to ensure staff deliver a good standard of care through regular supervision training and monitoring. Mrs Jeffery and the unit managers displayed sound knowledge of the resident’s mental illnesses. Mrs Jeffery is a strong leader and is a good role model for other staff. Staff at all levels when spoken to said that Mrs Jeffery was always high profile in the home and that they felt well supported. The lay Inspector noted, “that it was a real bonus that someone in charge of the home had a wonderful understanding of mental health issues”. Mrs Jo Randall The Responsible Individual visits the home on a regular basis and writes informative monthly reports on the conduct of the Care Home. The Commission is kept well informed by the managers of any incidents that occur at the home and managers do make unannounced visits to the home during unsociable hours as part of the quality assurance programme for the home. Mrs Jeffery also carries out monthly audits to ensure the residents care records indicate any changing needs of the residents and that staff are keeping up to date with the care required. Evidence was available to support this. Since the last inspection The Company has undertaken a quality assurance and monitoring survey with the relatives and representative of residents. This covered all aspects from the environment, through to care, staff, administrative procedures, food and activities. To date they have received 33 replies. Some of the comments are: ”care excellent and staff always friendly”. “Issues are dealt with promptly”. Very professional, beautiful place and always clean”. Superb food, well presented”. There were 2 negative minor comments which the home has already dealt with to put right. The scores in the survey denote that the majority of replies scored the staff and the home between good and excellent in all areas. From speaking to staff and visitors, touring the home and by examining records the inspector concluded that the health and safety procedures and the training for staff in the home protect residents living at the home. Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 27 Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 28 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 4 4 4 4 4 x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 4 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 3 3 3 4 4 Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP9 Good Practice Recommendations Known allergies to medicines should be recorded on the resident’s medication administration records. Rosemary Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Park Nursing Home DS0000024204.V307129.R01.S.doc Version 5.2 Page 31 - 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. 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