Inspection on 29/06/05 for Rosemary Residential Care Home

This inspection was carried out on 29th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Rosemary Residential Care Home 29/08/08

Rosemary Residential Care Home 11/09/07

Rosemary Residential Care Home 02/08/06

Rosemary Residential Care Home 03/03/06

Rosemary Residential Care Home 11/05/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Rosemary Residential Care Home 2 Guinea Lane Fishponds Bristol BS16 2HB Lead Inspector Sandra Jones Unannounced 29 June 2005 09:30 th 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Residential Care Home D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Rosemary Residential Care Home Address 2 Guinea Lane Fishponds Bristol BS16 2HB 0117 9584190 0117 9020515 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) Mrs Regina Odeh Mrs Regina Odeh PC Care Home 10 Category(ies) of MD(E) Mental Disorder -over 65 (10) registration, with number MD Mental Disorder (10) of places LD Learning disability (10) Rosemary Residential Care Home D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate up to 8 persons with mental disorder aged 19 - 64 years May accommodate up to 1 person with a learning disability aged 50 years and over May accommodate up to 1 person with mental disorder aged 65 years and over Date of last inspection 8-Mar-2005 Brief Description of the Service: Rosemary is situated off Fishponds Road close to shops, places of worship and parks. Originally, the property was two domestic dwellings, converted to provide accommodation to ten people with mental health care needs. The home blends well with its local environment. It is operated by Mrs R. Odeh and registered to accommodate nine adults and one person over 65 years. Rosemary Residential Care Home D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted on the 29th June 2005, 29th July 2005 and 11th August 2005. Since the last inspection, the home has kept the CSCI informed of any incidents and occurrences that relate to Regulation 37. As a result of this inspection monitoring visits will take place to support the home with meeting the requirements of this legislation. Two requirements based on supervision and POVA training were not followedup as the timescale has not lapsed. The service provider has taken action by arranging POVA training for the staff. Members of staff on duty gave feedback on the service providers style of management and four residents were consulted. Other sources used to support the practices of the home were the records kept in the home and a tour of the premises. What the service does well: What has improved since the last inspection? Since the last inspection a training programme was developed and staff are eager to attend training. Staff have attended POVA and Infection Control training. Rosemary Residential Care Home D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rosemary Residential Care Home D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Rosemary Residential Care Home D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 & 5 The admission criteria is clearly described in the Statement of Purpose. Care plans are developed by the placing agency before the admission and include the person’s assessed needs. Contracts are in place for permanent residents. EVIDENCE: An Admission and Emergency procedure was devised as required at the previous inspection. It incorporates the accommodation that can be offered under the Mental Health Act. Within the Statement of Purpose the admission criteria lists the specific statuses under the Mental Health Act that can be accommodated at the home. It was understood that once the training programme is established, members of staff will read and sign the home’s policies and procedures. One admission has taken place since the last inspection and there is clear evidence that assessments are conducted before an admission to the home. An enhanced level care plan and other documentation was provided by the placing agency. The core needs and developmental goals are described within the care plan. Rosemary Residential Care Home D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 9 A standard contract is in place and informs the person on the admission process, terms and conditions. The contract describes the facilities, rules and expectations. It was updated to meet NMS by the inclusion of the fees, room number and the name of the person. Rosemary Residential Care Home D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8 & 10 Action plans must include a person centred approach and the person’s signature. For residents subject to section under the Mental Health Act, the action to be taken for any breeches for conditions must be incorporated. Documentation must evidence that residents have opportunities to make individual and group decisions. The Confidentiality and Record Keeping policy must be updated to reflect good practice and staff must sign the policy to indicate their awareness for handling information about residents. EVIDENCE: Steps were taken to review the home’s care plans. Action plans must detail the manner in which the person wishes their needs to be met. With their preferred routines in sufficient detail to guide the staff to meet the assessed needs. The signature of the person must be included to evidence their participation in the process. Within the care plans the support required by residents to visit GP’s and NHS community facilities is stated. Rosemary Residential Care Home D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 11 Risk assessments for aggression and violent behaviours are detailed and describe the triggers and actions to diffuse these behaviours. For residents under section of the Mental Health Act, care plans must list the actions to be taken by staff for breeches of conditions. Once a person centred plans are developed, documentation will evidence that residents are empowered to make choices about all aspects of their lives. There are no restrictions imposed on residents. Social workers are involved in the care of the current residents and an advocate is involved in the care of one resident. Residents manage their own finances. It was understood from the staff that informal discussions take place on a 1:1 basis. The records of house meetings indicate that structured meetings have not taken place in the last year. Documentation that evidences group decisions must be provided. House meetings must be the forums used for menu planning and feedback on the standards of care. To evidence established practices, systems must be introduced to demonstrate that residents have opportunities to make group decisions. Record Keeping and Confidentiality policies are in place. It describes the aim policy and sets out the procedure to be followed. The policy must be updated to ensure the content is within good practice and staff must read and sign the policy. Rosemary Residential Care Home D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11 & 17 Residents can access community-based activities. Residents must have input into the menu planning. Adequate standards of hygiene are maintained at the home. EVIDENCE: Residents described their daily activities. One of the three residents consulted, attends the drop in centre and the other two residents choose not to participate in structured daytime activities. Watching television, reading and having time alone are the leisure activities undertaken at the home. The service provider prepares menus and it was understood that the records of food provided are completed on the previous day. However, there was no evidence that residents have any input into menu planning. Rosemary Residential Care Home D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 13 It was understood from a senior member of staff that minimum stocks of food are kept in the kitchen cupboards with larger stocks held in the pantry. Frozen meat and vegetables are used at the home. Since the last inspection a visit from an Environmental Health officer took place. The report of the visit indicated that adequate standards are maintained. Two fridges were also replaced since the last inspection. One resident explained during the inspection, that from choice a number of residents purchase their own tea, coffee, milk and other refreshments for their personal use. Rosemary Residential Care Home D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 Medication practices are safe but individual drug medication profiles must be developed. EVIDENCE: Medications are administered through a monitored dosage system by the staff. Records of administration indicated that staff sign the records immediately after administration. Records were found to reflect medications held within the system. Individual medication profiles that describe the purpose of the medication, with their side effects and compatibility with homely remedies must be devised. Information leaflets from the pharmacist must be appended onto the drug profiles to provide greater information about the medication. Rosemary Residential Care Home D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 Residents feel their views are listened to and acted on. EVIDENCE: The residents reported that the service provider is approached with complaints. Their comments suggested their confidence that their complaints would be taken seriously and acted upon. Rosemary Residential Care Home D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26, 27, 28 & 30 Remedial action to maintain the property is prompt. With one exception, bedrooms are single There is sufficient shared space for residents accommodated. Residents use the dining room for smoking Disposable gloves must be available and accessible, seamless and well fitting EVIDENCE: Rosemary care home is situated off the Fishponds Rd. close to shops, places of worship and parks. Originally, the property was two separate domestic dwellings converted to provide accommodation to ten adults with mental health care needs. The property retains its domestic appearance, blending with its immediate environment. Rosemary Residential Care Home D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 17 During the tour of the premises, it was noted that remedial action was needed. The wallpaper was bubbling on the landing and the carpet in the lounge required replacing. By the second visit the service provider had investigated the bubbling and replaced the carpet in the lounge. It is evident that a rolling programme of maintenance is in place. Empty bedrooms were redecorated and lounge furniture updated since the last inspection. With one exception, bedrooms are arranged into singe occupancy. Residents bedrooms were found to contain a combination of the home’s furniture and personal belongings. Residents confirmed that keys to bedrooms are provided. One bedroom is currently en-suite and three people share a full bathroom on one side of the home. On the other side of the home there is a full bathroom, shower and toilet. Shared space consists of a lounge and two dining rooms, one of which is used as a smoking area by residents. It was understood from the service provider that from preference, members of staff purchase their own gloves. For general cleaning procedures latex, nitrile or vinyl gloves are appropriate and latex gloves are recommended for noninvasive procedures and for handling chemicals. Disposable gloves must be available and accessible, seamless and well fitting. Since the initial visit to the home, three staff have attended Infection Control training. Rosemary Residential Care Home D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 34 & 35 The rota in place suggests that four-six staff are rostered to work at the home. The members of staff suitability to work with vulnerable adults is confirmed. The intended training will ensure staff have the skills and abilities to meet the residents category of needs. EVIDENCE: Six members of staff are currently employed at the home and between four and six staff are rostered to work each day, with the service provider undertaking hands on duties. Members of staff stated that there is always a minimum of two staff on duty at the home. Members of staff files were examined and found to contain a current photograph, completed application forms, statements of physical and mental fitness. With the exception of two, in progress, CRB’s were obtained for the staff working at the home. Rosemary Residential Care Home D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 19 Steps were taken by the service provider to establish a training programme at the home. As the category of registration is mental health care, seven staff are to attend Mental Health Awareness Foundation Training with Enhanced level training following. All staff are to attend Adult Protection training and Infection control training for three staff. Five staff will go on a two-day Values of Care course, based on the Skills Foundation for Care. The training programme will ensure that staff have the skills and abilities to meet the needs of the residents accommodated. Training programmes will be monitored at subsequent inspections. Statutory training is provided at the home by an outside trainer. Manual Handling, fire training and Food Hygiene was provided. However, First Aid is out of date. First Aid training must be included within the training programme for the home. Rosemary Residential Care Home D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 & 41 The residents and staff were positive about the management approach at the home. Residents do not keep cash in safekeeping at the home and records of fees must be kept at the home for inspection. EVIDENCE: The residents currently accommodated manage their own finances, the facilities for keeping cash in safekeeping at the home is not used. Individual schedules of fees were not available for each resident accommodated. From the schedules available, the fees range from £251.03£720.38. Records of fees charged at the home must be available for inspection. Rosemary Residential Care Home D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 21 The staff on duty were consulted on the service providers, style of management. Members of staff made positive comments about the access to training and discussed the training already attended. It was reported that an outcome of attending Infection Control training, gloves and aprons are available. In terms of consistency of care, staff stated that discussions on the needs of the residents take place regularly. Residents giving feedback on the standards of care reported that the staff employed were good. The roles performed by the staff was described by the residents and the service provider would be approached with complaints. Rosemary Residential Care Home D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 2 x 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 3 3 x 2 Standard No 11 12 13 14 15 16 17 3 x x x x x 2 Standard No 31 32 33 34 35 36 Score x 2 x 2 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Rosemary Residential Care Home Score x x 2 x Standard No 37 38 39 40 41 42 43 Score x 3 x x 2 x x D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 23 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. Standard Standard 6 Regulation Requirement Timescale for action 30.12.05 2. Standard 6 3. Standard 7 4. 5. Standard 17 Standard 20 Standard 30 Standard 35 Standard 41 6. 7. 8. Regulation Care plans must have a person 12(2) centered approach to meeting residents needs. With the persons signature. Regulation For residents subject to section 18(1) (a) under the Mental Health Act, care plans must detail the consequences for any breeches. Regulation Residents must be enabled to 12(3) make decisions about all aspects of their lives including group living. Regulation Residents must be involved in 12(3) menu planning. Regulation Medication profiles must be 13 (2) developed for each resident that has regular prescribed medication. Regulation Disposable gloves must be 13 (3) available and accessible, seamless and well fitting. Regulation Members of staff must receive 13(4) first aid training. Regulation Records of fees charged at the 17(2) home must be available for Schedule inspection. 4.8 30.12.05 30.1.06 30.10.05 30.10.05 30.10.05 30.1.06 30.12.05 Rosemary Residential Care Home D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 24 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 Residential Care Home D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection 300 Aztec West Almondsbury South Gloucestershire BS32 4RG 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 Residential Care Home D56 D05 S26565 Rosemary RCH V233872 29-6-& 11-8-2005 Stage 4.doc Version 1.30 Page 26 - 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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