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Inspection on 26/06/07 for Rosemary Park Nursing Home

Also see our care home review for Rosemary Park Nursing Home for more information

This inspection was carried out on 26th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is well managed, and continues to develop the service provided for residents. The home is friendly, relaxed, and welcomes visitors. There is a stable and well trained staff team, which benefits from use of the learning centre which is in the grounds of the home. A high standard of care is provided. There is a good programme of outings and activities in place, which is supported by activities workers and visiting entertainers and therapists. Meals are home cooked, balanced, and much enjoyed by residents. The premises and gardens are well maintained, and decorated and furnished to a good standard.

What has improved since the last inspection?

There has been a substantial programme of redecoration and refurbishment taking place. Improvements also include the development of a sensory room, and new garden furniture being provided. The staff training programme has been developed further. Safety improvements include the provision of a less steep ramp.

What the care home could do better:

Hot water temperatures should continue to be monitored to ensure a supply of safe hot water in areas accessed by residents. Care plan reviews should record what the wishes and views of the resident and/or their relative are concerning the care provided.

CARE HOMES FOR OLDER PEOPLE Rosemary Park Nursing Home Marley Lane Haslemere Surrey GU27 3PX Lead Inspector Mr E McLeod Unannounced Inspection 26th June 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rosemary Park Nursing Home DS0000024204.V338758.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.V338758.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.V338758.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 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. Date of last inspection 17th October 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 dementia (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 dementia (organic) illness or long standing (functional) illness. A passenger lift accesses all areas with a security keypad system in operation throughout the home. The range of fees is £580 per week to £1600 per week. Rosemary Park Nursing Home DS0000024204.V338758.R01.S.doc Version 5.2 Page 5 Rosemary Park Nursing Home DS0000024204.V338758.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was arranged to update assessments made at the previous inspection. Information from the previous inspection report and from the CSCI annual quality assessment (AQAA) received from the provider were used in the planning of this inspection visit. Some of the information provided in the AQAA has been used in the writing of this report. We also received written replies to a CSCI survey from two relatives of people living in the home. The visit was undertaken by one inspector over six and a half hours on the 26th June 2007. We spoke with the registered manager and five members of the staff team. We undertook a partial tour of the premises, and sampled five sets of preadmission and care planning records. Four sets of staff recruitment and training records were also sampled. Four people living in the home and one visitor were interviewed. Health and safety records and other records relating to the management of the home and the care provided were sampled. The observation of interactions between staff and residents also contributed to the assessment. What the service does well: The home is well managed, and continues to develop the service provided for residents. The home is friendly, relaxed, and welcomes visitors. There is a stable and well trained staff team, which benefits from use of the learning centre which is in the grounds of the home. A high standard of care is provided. There is a good programme of outings and activities in place, which is supported by activities workers and visiting entertainers and therapists. Meals are home cooked, balanced, and much enjoyed by residents. The premises and gardens are well maintained, and decorated and furnished to a good standard. Rosemary Park Nursing Home DS0000024204.V338758.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Rosemary Park Nursing Home DS0000024204.V338758.R01.S.doc Version 5.2 Page 8 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.V338758.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good information on the service to be provided is given to residents and prospective residents, which allows them to make an informed choice about where they live. Pre-admission assessments are ensuring that only people whose needs can be met in the home are being admitted to the home. Prospective residents, relatives and their representatives are able to visit to ensure the home will be able to meet their needs. EVIDENCE: A welcome pack provides easy to read information on the aims of each of the three units for residents and prospective residents. Pre-admission Rosemary Park Nursing Home DS0000024204.V338758.R01.S.doc Version 5.2 Page 10 arrangements include a full tour of the home and explanation of the individual’s rights, and an assessment of needs is recorded. Relatives and/or advocates are encouraged to contribute to the assessment of the care needs prior to admission. Prospective residents are visited prior to admission by a senior nurse manager to assess whether or not the individual’s needs can be met in the home. The service seeks to obtain relevant information on the individual’s care needs. One relative responding to a CSCI survey found the information brochure very good, and said that they met with the nursing officer who carried out the preadmission assessment (at the resident’s previous placement) and who answered many questions at that visit. The relative added “I looked at many homes for dementia patients and I think that I chose the best for a patient like my father”. The pre-admission assessment form and welcome pack have been updated. Information provided by the home in the annual CSCI quality assessment indicates that most admissions are planned. Three sets of admission records were sampled, and these indicated that peoples’ needs are assessed before the decision to admit them is made. We sampled an additional set of admission records where the decision was taken that at that time the person’s needs could not be met and therefore the decision was taken not to admit. Rosemary Park Nursing Home DS0000024204.V338758.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Care plans which provide the basis for the care for the individual resident are recorded and reviewed. Care planning would be improved by ensuring that people and their relatives or advocates (where appropriate) have their views recorded in care plan reviews. Subsequent to the inspection the manager advised that a working group to look at how this could be best achieved was established. Also taking into account the home’s good record of compliance with requirements, no requirement has been made concerning this. People at Rosemary Park are supported to access the health care services they are in need of. There are good procedures in place for the storage, administration and disposal of medicines. This helps ensure medicines are being administered safely. Rosemary Park Nursing Home DS0000024204.V338758.R01.S.doc Version 5.2 Page 12 The arrangements for health and personal care are ensuring that the person’s privacy and dignity are respected at all times. EVIDENCE: We sampled five sets of care plans which included people living in each of the three units at Rosemary Park. All people newly accommodated have a 72 hour risk assessment, which contributes to the initial care plans, and we sampled some of these. Where applicable, Care Programme Approach reviews are documented. Risk assessments including falls risk assessments are carried out and contribute to the care plan. Staff interviewed said they write care plans to include what the person’s choices and preferences are, and that they talk to relatives when they are reviewing the care plan. Care plans are reviewed by the nurse in charge. Risk assessments are audited each month by the management team of each unit. There is a monthly audit where managers randomly choose assessments to look at. Staff receive training in care planning and in the monitoring of goals and outcomes. Not all care plan reviews sampled indicated if the person or their nearest relative or advocate had been involved in the review of the care plan. The monthly care plan reviews sampled did not refer to the views of the person accommodated or their advocate or relative (where appropriate) on the care plan. Staff observed when assisting people to mobilise and be transferred did this in a gentle and supportive way using equipment designed for the task when needed. The service has developed an expertise in working with people whose behaviour and illness can be challenging, and therefore the service necessarily Rosemary Park Nursing Home DS0000024204.V338758.R01.S.doc Version 5.2 Page 13 maintains a close working relationship with mental health professionals in the local area. A relative responding to a CSCI survey advised us that “the home keeps me informed at all times about his health and behaviour”. Another relative wrote that her mother’s mobility, communication skills and wellbeing have all greatly improved after having been at the home for six months. She wrote that “she now sleeps in a bed, her swollen legs are reduced, she smiles and makes an attempt to talk to us”. Examples of how the privacy and dignity of residents is ensured when personal care is being provided were given by staff interviewed. Relatives responding to our CSCI survey felt that staff were considerate and supportive, and paid attention to the privacy and dignity needs of the person being assisted. There are private areas set aside where people can meet with their relatives. The service retains a consultant psychiatrist who oversees the care of people accommodated. The range of services provided includes behavioural programmes and specialist risk assessment tools. Care plans sampled indicated that people are accessing the health services they are in need of. In-house training for all care staff includes a session on care delivery covering bed bathing, dignity and privacy of people accommodated, bed making and assisting with meals. Continuity of care is also being supported by a stable staff team. Medication training and medication rounds are monitored regularly by nursing tutors. We noted that suitable arrangements are in place for the safe storage, administration and disposal of medicines, and this has been confirmed by a recent inspection carried out by the home’s contracted pharmacist. Care plans sampled included a note where there was a known allergy to medication. Rosemary Park Nursing Home DS0000024204.V338758.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Activities made available are flexible and varied to suit the expectations, preferences and capacities of people at Rosemary Park. People are able to have visitors at any reasonable time and links with the local community are developed and/or maintained in accordance with peoples’ preferences. People receive a wholesome and appealing diet which is balanced and meets their individual nutritional needs. EVIDENCE: Improvements to the service include an increase in activities schedules and time devoted to one to one activities. One resident, for example, has pursued hobbies in needlework and art. Rosemary Park Nursing Home DS0000024204.V338758.R01.S.doc Version 5.2 Page 15 An aroma therapist is employed two days per week, and was observed on the day of the inspection to be providing treatments which residents found relaxing. A qualified art therapist visits twice per week, and has a dedicated room in which to work which is suitably equipped. Examples of art work done by residents were on view. There are 2 activities co-ordinators (covering six days a week) who spend time in each of the units, and the rooms dedicated to activities have been further equipped and developed since the previous inspection. A hairdresser visits twice per week, and has a suitably equipped room which is used for hairdressing and beauty treatments. Musicians visit three times per week, and one relative interviewed described how much these visits were enjoyed by people living in the home. The programme of events arranged also includes visits to farms and shows. A fully equipped kitchen has been added which people accommodated can use (where capable and under supervision) to make their own meals or contribute towards baking or cake decoration. A woodwork and potting shed and raised vegetable plots have been provided for residents interested in these hobbies. One of the activities now being taken up is flower arranging. The provider has advised the Commission that some of the people using the service are, due to their illnesses, difficult to engage or have short attention spans, and recent improvements such as the introduction of gardening and woodworking are aimed at addressing this. The resident group has remained stable, which has allowed the development of interests such as knitting, cooking and gardening. A monthly newsletter is produced, and a programme of activities and options is displayed in communal areas. Transport and escort is provided which is allowing people to access the local community, and residents interviewed found this helpful. Rosemary Park Nursing Home DS0000024204.V338758.R01.S.doc Version 5.2 Page 16 Staff assist with transport to places of worship for people accommodated who wish this. Records are made of activities undertaken by the individual. An example of how visitors are made welcome was given by a relative responding to our survey, who said “there is always a nice place to sit away from other residents when we visit. This is very welcome, and they never forget a cup of tea”. The sociable aspect of mealtimes is encouraged in the dining room. The food and food presentation was observed during the lunch time on the day of the visit to be of high quality. One relative commented in writing to us “the cooks are very good. Food always looks attractive”, and residents interviewed said they enjoyed the food. The service seeks to provide a varied and healthy diet, and have found that, for example, offering freshly cut fruit in the afternoons has been welcomed by residents. In discussion with the chef we learned that a range of diets are being catered for, and that food is home made and is arranged around the individual resident’s likes and dislikes. Alternatives to the main menu are provided. Rosemary Park Nursing Home DS0000024204.V338758.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a clear complaints procedure which enables those using the service or their representatives to have confidence that their complaint will be responded to within 28 days. People living at Rosemary Park are protected from abuse. EVIDENCE: The complaints procedure is openly displayed in the home, and is included in the welcome packs and contracts which people receive. One complaint has been received in the past 12 months, and the records of this seen indicate that it was dealt with quickly and with fairness. Safeguarding adults information is displayed in the home. It was the view of relatives that any concerns or complaints they had would be listened to and acted upon. Rosemary Park Nursing Home DS0000024204.V338758.R01.S.doc Version 5.2 Page 18 The whistle blowing policy is included in all staff contracts. The providers advise that open communication in the home is encouraged. Records seen for an incident of restraint indicated that the incident was managed well and with minimum use of restraint. Staff receive training in restraint techniques. Risk assessments in the home are reviewed monthly. The registered manager advised that there have been no adult protection referrals made since the previous inspection. The registered manager said she was trained to provide staff training in safeguarding adults. She said she had not attended any recent briefings on changes to local safeguarding adults procedures, but agreed that doing so would assist in her understanding of local safeguarding adults procedures. Managers believe that the ability of the staff team to deal with potentially challenging behaviours and issues has been improved by positive management approaches. The provider believes that the contact staff have had with local mental health teams, the mental health review tribunal process, advocacy and guardianship arrangements has highlighted human rights and duty of care issues for them. The provider has advised that training in the Mental Capacity Act will be provided for staff. Rosemary Park Nursing Home DS0000024204.V338758.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People live in a safe, well maintained environment which continues to be improved in order to better meet their needs. People have access to safe and comfortable indoor and outdoor communal facilities. Two en suite bathrooms were found to have hot water being provided at temperatures not safe for the people accommodated. Subsequent to the inspection, the manager advised that temperatures had now been lowered at those outlets, and thermostats were to be fitted. No requirement concerning this was therefore made. The home is clean, pleasant and hygienic. Rosemary Park Nursing Home DS0000024204.V338758.R01.S.doc Version 5.2 Page 20 EVIDENCE: A partial tour of the premises was carried out. The home is well maintained, and the communal areas and garden are being further developed to better meet the needs of people living there. The collective needs of residents are being met in a comfortable and homely way, and all decoration, furnishings and fittings are of a good standard. Main improvements to the premises since the previous inspection visit have been the continuing programme of redecoration and refurbishment, and the development of the sensory room. New garden furniture has also been provided, which is encouraging people to use the garden more. The garden has been developed to better suit the needs of people accommodated. Improvements also include digital radios being provided in most rooms in the main house, and digital televisions being provided in some communal areas. Redecoration in underway in the main house, which will also benefit from new glazing. New flooring has been provided in the Courtyard dining and communal areas, which managers believe has improved cleanliness and hygiene standards. The purchase of steam cleaning equipment has assisted in improving hygiene in the home. Refurbishment of en suite and communal bathrooms is planned within this year. There are extensive gardens and woodland, and these are being well maintained and developed by a new gardener who has introduced sensory and colourful new plantings for the benefit of residents. Three full time maintenance staff are employed, and there has been full refurbishment of fixtures and fittings in the main house during the past year. Maintenance records are monitored daily. Rosemary Park Nursing Home DS0000024204.V338758.R01.S.doc Version 5.2 Page 21 Environmental risk assessments have been carried out for all areas of the home, and each person has an individualised risk assessment of their bedroom. Hot water temperature records were sampled, and indicated that safe hot water was being provided. However, hand testing of hot water in two en suite hand basins indicated that these were not set at levels safe for the people using them. The appointment of a full time housekeeper has helped improve laundry and general cleanliness. Training with staff in infection control has improved staff awareness of the need to wash hands thoroughly. All areas of the home visited were clean and hygienic, and free from offensive odours. Rosemary Park Nursing Home DS0000024204.V338758.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Peoples’ needs are met by the numbers and skill mix of staff. People accommodated are in safe hands at all times. People are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. EVIDENCE: On the day of the inspection visit, the needs of residents were being met by the staffing and skill mix of qualified and unqualified staff. There are 72 care staff, 61 of whom have the national vocational qualification (NVQ) at level 2 or above and a further 10 are working towards NVQ2 or Rosemary Park Nursing Home DS0000024204.V338758.R01.S.doc Version 5.2 Page 23 above. There are 6 bank care staff who can be called on, and 16 auxiliary staff are employed. The managers advise that 55 of care staff are qualified in the National Vocational Qualification (NVQ) in care to at least level 3, and that they hope to increase these levels. There is a stable staff team, which has meant that agency staff have not been required in the home. Bank staff who know the people living at Rosemary Park are employed for individual shifts. Managers indicate that there has been an increase in the number of staff employed who are trained in mental health, and that this is having a positive impact on the care of people with mental health needs. CSCI are advised that all staff who have worked in the home in the past 12 months have had satisfactory employment checks. Four sets of staff recruitment records were sampled, which indicated that all required checks and references are being obtained for prospective staff. There is an induction programme for new staff to help familiarise them with the way the home works and the standards expected of them, and two sets of induction training records were sampled. The service has its own educational unit, which provides a package of training for staff. Training is provided at times which allows staff on different shifts to access training. Staff have access to the Internet, libraries and nursing journals in the education unit. Interviews with staff and training records indicated that a good training programme is in place to ensure staff can continue to develop their skills. We were advised that a spreadsheet which allows managers to see at a glance which staff need to refresh or undertake which training is being developed. The registered manager, Mrs Jeffery, believes that training is assisting staff to think about what they’re doing and why they’re doing it. There has been more emphasis in training provided on basic skills. Improvements planned include senior care assistants mentoring junior staff and increased supervision of care staff by nursing staff. Rosemary Park Nursing Home DS0000024204.V338758.R01.S.doc Version 5.2 Page 24 Nurses on an overseas nursing programme are employed, and trained nurse mentoring of these students is felt to benefit the home by nurses maintaining an interest in new research and practice. Employees receive induction training on the rights of people supported. There is a policy that people will be enabled to explore sexual diversity if they wish to. All staff have attended training on age discrimination legislation. Care planning and risk assessments enable people to be supported with their needs and beliefs. Managers see staff supervision as increasing staff development, and are aiming to provide one to one staff supervision on a more frequent basis. Managers also believe that there has been increased staff involvement in the management of the service, and that this has made the staff team more cohesive and effective. Staff interviewed said they felt that their views were being listened to and acted on. Some staff supervision records were sampled, and staff interviewed advised that all staff receive one to one sit down supervision which gives them time to reflect on the job they are doing and to consider their training and career needs. Rosemary Park Nursing Home DS0000024204.V338758.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed, and the registered manager is ensuring that the service continues to develop and improve. The views of people accommodated and their relatives are being listened to and contribute to the planning of the service. The health, safety and welfare of people living and working in the home are promoted and protected. EVIDENCE: Rosemary Park Nursing Home DS0000024204.V338758.R01.S.doc Version 5.2 Page 26 We were advised that the responsible person and the registered manager now share an office, which has helped shared the burden of running and managing such a large and complex service. This has also helped share the paper workload, and allows the manager to be more visible and accessible to staff, visitors and residents. A relative responding to our survey wrote that “the atmosphere in the home is lovely. Pat the manager is always available to you and nothing is too much trouble”. We also received the comment that “the warmth and care from the manager and staff shines through in our mum’s face each time we visit”. Staff interviewed said that they make suggestions at staff meetings, some of which are taken up, so they feel they are being listened to. The provision of more computers and phone equipment on the premises has helped improve communication in the home. Staff meetings provide opportunities to discuss what people using the service have said to staff that could lead to improvements in the service. Records made by external therapists and activities co-ordinators allow the managers to monitor the needs and requests of individuals. There are annual questionnaires to people using the service and/or their representatives to seek views on the service provision. Improvements made further to responses received from previous questionnaires have included an increase in activities provided including one to one activities, and new flooring in dining and communal areas in the Courtyard unit. The provider has advised us of the most recent equipment and service checks which have taken place, including fire checks. We are advised that COSHH assessments and contract arrangements for disposal of drugs and sharps are in place. Arrangements for infection control are in place, and all staff have received training in this. The provider has advised us of the most recent reviews of required policies and procedures that have been carried out. Rosemary Park Nursing Home DS0000024204.V338758.R01.S.doc Version 5.2 Page 27 Safety improvements made include a wheelchair ramp being made less steep and more safe. The kitchen was visited, and records for cleaning schedules and temperature checks were sampled. The Safer Food system is in operation in the kitchen. Rosemary Park Nursing Home DS0000024204.V338758.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 X 3 x x x N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 X X X X 3 3 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X X X X 3 Rosemary Park Nursing Home DS0000024204.V338758.R01.S.doc Version 5.2 Page 29 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. 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. Refer to Standard Good Practice Recommendations Rosemary Park Nursing Home DS0000024204.V338758.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rosemary Park Nursing Home DS0000024204.V338758.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. 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