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Inspection on 02/09/05 for Rosemeadow Residential Home

Also see our care home review for Rosemeadow Residential Home for more information

This inspection was carried out on 2nd September 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.

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

Residents feel "the home is one of the best" and feel pleased that they have been able to get a place there. Provides a very homely atmosphere in which residents are treated with respect by staff who know them well and ensure that they receive the support they require to live as independently as possible. The view of the residents spoken with was that the care they receive was excellent. From observation it was clear that people were cared for sensitively and respectfully.

What has improved since the last inspection?

A new manager has been recruited. An additional single en-suite room is almost completed. Hot water is regulated to safe temperatures.

What the care home could do better:

The provider, to ensure that residents are receiving appropriate care must now address the outstanding requirements. Care plans must be reviewed and the necessary improvements made in recording all of the needs of the resident. Staff recruitment must be compliant with the National Minimum Standards to ensure residents are safeguarded from people who may be unsuitable to work with vulnerable adults. The complaints policy must be reviewed to ensure that people are fully informed about how they can complain. The Adult Protection policy must reflect the Nottingham Vulnerable Adults policy to ensure that staff are aware of how to investigate and report in the event of allegations or suspicion of abuse. There must be contact made with the Health and Safety department for advice on what controls may be necessary for the control of Legionella in the water systems in the home as part of the appropriate infection control practice.

CARE HOMES FOR OLDER PEOPLE Rose Meadow Care Home 119 Station Road Misterton Doncaster DN10 4DG Lead Inspector Mary OLoughlin Unannounced 2nd September 2005 at 10:00 am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rose Meadow Care Home C03 C53 S61213 Rose Meadow V247839 020905 Stage 2.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Rose Meadow Care Home Address 119 Station Road Misterton Doncaster DN10 4DG 01427 891190 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) Mr J Clayton Care Home 12 Category(ies) of Old Age - 12 registration, with number of places Rose Meadow Care Home C03 C53 S61213 Rose Meadow V247839 020905 Stage 2.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 01/03/05 Brief Description of the Service: Rosemeadow Care Home is an adapted family home set within large enclosed gardens. The house retains many of its original features making residents rooms very individual. Situated within a rural area, there is access by public transport to local towns. There is a stair lift installed and hand rails fitted to assist with mobility problems. Rose Meadow Care Home C03 C53 S61213 Rose Meadow V247839 020905 Stage 2.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted unannounced over three hours. The manager was on annual leave but the registered provider was present and assisted with the inspection. The main method of inspection used was to look at the care plans of three residents and discuss with them their life at the home and the care they receive. Residents’ bedrooms were inspected and a tour of the premises took place. The home was warm and clean throughout. All those spoken with were very happy with the care they were receiving and felt fortunate to have found a place at the home. It was not possible to judge whether people were receiving care according to their assessed needs as risk assessment and care planning was not sufficiently comprehensive. Residents looked well cared for and no complaints or issues of concern have been notified to the Commission at this time. Many of the standards assessed are not met but the outcome of the care that residents receive gave no cause for concern, indeed the care and support provided was seen to be and confirmed by the residents to be very good. Whilst the home have failed to make progress in achieving the previous requirements set at the last inspection, the Commission for Social Care Inspection have considered the circumstances that have delayed progress and have set a revised timescale for action to be taken by the provider. Failure to meet the requirements set may result in enforcement action being taken. What the service does well: Residents feel “the home is one of the best” and feel pleased that they have been able to get a place there. Provides a very homely atmosphere in which residents are treated with respect by staff who know them well and ensure that they receive the support they require to live as independently as possible. Rose Meadow Care Home C03 C53 S61213 Rose Meadow V247839 020905 Stage 2.doc Version 1.40 Page 6 The view of the residents spoken with was that the care they receive was excellent. From observation it was clear that people were cared for sensitively and respectfully. 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. Rose Meadow Care Home C03 C53 S61213 Rose Meadow V247839 020905 Stage 2.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Rose Meadow Care Home C03 C53 S61213 Rose Meadow V247839 020905 Stage 2.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1-3-6 Lack of appropriate assessment and care planning do not ensure that residents needs will be met by the home. EVIDENCE: The statement of purpose was not seen at this inspection, the provider has agreed to forward a copy of the revised statement as required at the previous inspection. The records of the most recent admission, a privately funded resident did not have a comprehensive pre-admission assessment, as this was an emergency admission. However the records did not indicate that an assessment had been undertaken as within Standard 3 of the National Minimum Standards within the 5 working days. The assessment document was only partially completed and there were only two areas of need that had a care plan, this was not sufficient for staff to ensure that all of her needs were met. Daily records had been completed and there was evidence that specialist nurses had seen the resident since admission, however a care plan did not indicate this involvement. Rose Meadow Care Home C03 C53 S61213 Rose Meadow V247839 020905 Stage 2.doc Version 1.40 Page 9 The newly admitted resident was spoken with and was happy with the care being provided at the home and happy with the arrangements that were made at such short notice for her to come to the home. Intermediate care is not provided by the home. Rose Meadow Care Home C03 C53 S61213 Rose Meadow V247839 020905 Stage 2.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7-8-9-10 Inadequate care planning has the potential to put residents at risk. EVIDENCE: The previous inspection required the Provider to ensure that care plans describe the action needed to be taken by staff to meet every assessed need. The Provider has employed a new manager in May 2005 and this action has not been completed. The care plans examined during this inspection did not meet the Minimum Standard. There was no evidence that the plans were drawn up with the involvement of the resident or their relatives. There was no evidence of a falls risk assessment either in the pre-admission information or the monthly reviews. There was evidence of the referral to the District Nurse for health problems, which is appropriate practice. Rose Meadow Care Home C03 C53 S61213 Rose Meadow V247839 020905 Stage 2.doc Version 1.40 Page 11 One resident with a pressure sore did not have a care plan describing the District Nurses involvement or the management of her care. The resident was provided with appropriate pressure relieving equipment and this was seen in use. The resident was being well cared for and all appropriate support was being given, however this is not documented and may put the resident at risk if the staff rely on verbal communication only. Residents with mental health problems did not have care plans relating to the external support or the actions staff were to take to safeguard them from harm. The records held contain some good systems of recording information such as Doctor’s visits, night care plans and bereavement details, however the ones viewed had not all been completed. Medicine record sheets indicated that residents receive their medicines as prescribed and residents confirmed that they did receive them. Staff were advised to ensure that any softclix blood testing pens must be used for individuals only as per Department of Health instruction. Residents all spoke of how good the staff were and how their privacy and dignity was maintained. Rose Meadow Care Home C03 C53 S61213 Rose Meadow V247839 020905 Stage 2.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: Not assessed at this inspection. Rose Meadow Care Home C03 C53 S61213 Rose Meadow V247839 020905 Stage 2.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16-18 The homes own policy does not reflect the local guidelines and may not provide a robust system for ensuring that staff are aware of the appropriate action to take in the event of ant suspicion or allegation of abuse. EVIDENCE: The complaints procedure has not been reviewed as required at the last inspection. The procedure needs to specify that complaints will be responded to in 28days. The previous inspection also required that the provider obtain a copy of the Nottingham Vulnerable Adults procedure and the website address was provided by the inspector. This has not been obtained. At this inspection the inspector gave the provider the telephone number of the Adult Protection Unit to obtain one. There have been no recorded complaints or adult protection investigations since the last inspection. Rose Meadow Care Home C03 C53 S61213 Rose Meadow V247839 020905 Stage 2.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19-20-21-2223-26 A comfortable and safe standard of accommodation is provided for the residents. Essential equipment for the residents is in place to meet their needs. EVIDENCE: The home was clean and warm. There was no malodour. The registered provider has submitted plans to extend and refurbish the original accommodation. The building has a number of outstanding repairs that will be rectified during the proposed building work. An application has been submitted to the Commission for Social Care Inspection for one additional room. The inspector viewed the room and found it fit for purpose, although further work on the en-suite requires completion before the Commission can register this room. Rose Meadow Care Home C03 C53 S61213 Rose Meadow V247839 020905 Stage 2.doc Version 1.40 Page 15 The present accommodation is safe and well maintained. Individual residents rooms were well appointed, they were personalised and provided a safe environment with all appropriate safeguards in place. Rooms are lockable and residents can be issued with a key to their door. There are call bells fitted throughout the home. Assisted bathing is provided via hydraulic hoists. Staff have appropriate moving and handling equipment in place. Residents case tracked were very happy with the standard of the accommodation and had access to all the required equipment to support their needs. The gardens are accessible and provide seating areas. Rose Meadow Care Home C03 C53 S61213 Rose Meadow V247839 020905 Stage 2.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 Residents may not be supported and protected by the home’s recruitment practice. EVIDENCE: Two staff files were examined, one file did not contain the required evidence that appropriate recruitment practice had been undertaken to safeguard vulnerable residents. Rose Meadow Care Home C03 C53 S61213 Rose Meadow V247839 020905 Stage 2.doc Version 1.40 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: Not assessed at this inspection. Rose Meadow Care Home C03 C53 S61213 Rose Meadow V247839 020905 Stage 2.doc Version 1.40 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 3 3 3 3 3 x x 3 STAFFING Standard No Score 27 x 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 x x x x x x x x Rose Meadow Care Home C03 C53 S61213 Rose Meadow V247839 020905 Stage 2.doc Version 1.40 Page 19 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 4 Requirement Timescale for action December 31st 2005 2. 3 14 The Registered Person must complete the homes statement of purpose and forward a copy to the Commission. November The Registered Person must in 1st 2005 the absence of a Community Care assessment ensure that the needs of the prospective resident are; 1. assessed within 5 working days if the admission is in an emergency, or prior to agreeing an admission for arranged admissions. 2. The assessment must contain all of the elements of standard 3.3 of the National Minimum Standards. PREVIOUS TIMESCALE OF 01/04/05 NOT MET. 3. 7&8 15 The registered person must ensure that; 1. Care plans are drawn up with the involvement of the resident or their relative and wherever possible signed by them. 2. That the plan contains risk assessment with particular regard to falls risk. C03 C53 S61213 Rose Meadow V247839 020905 Stage 2.doc November 1st 2005 Rose Meadow Care Home Version 1.40 Page 20 3. That the plans describe the actions needed to meet each assessed area of need. PREVIOUS TIMESCALE OF 30/04/05 NOT MET The Registered Person must December review the complaints procedure 31st 2005 and ensure that it refers to the 28day timescale within which complaints must be responded to and the address to which the complaint should be sent to in the first instance. PREVIOUS TIMESCALE OF 01/04/05 NOT MET. The Registered Person must ensure that the homes policy on dealing with abuse reflects the Nottingham Adult Protection Policy. PREVIOUS TIMESCALE OF 01/04/05 NOT MET. The Registered Person must ensure that staff files contain; 1. Proof of identity 2. Recent photograph 3. Documentary evidence of any qualifications 4. Two written references 5. CRB disclosure and POVA check. 6. Any other correspondence relating to the employment See Schedules 2 and 4 . PREVIOUS TIMESCALE OF 30/04/05 NOT MET The Registered Person must contact the Health and Safety Executive to advise upon the control of legionella. PREVIOUS TIMESCALE OF 01/04/05NOT MET. Rose Meadow Care Home C03 C53 S61213 Rose Meadow V247839 020905 Stage 2.doc Version 1.40 Page 21 4. 16 22 5. 18 13 December 31st 2005 6. 29 19 October 1st 2005 7. 38 13 October 1st 2005 8. 9 13 The Registered Person must ensure that the homes policies and practices relfect the Department of Health Guidance on the use of Softclix devices for blood testing, ensuring that this equipment is used for individual use only and not for any other person (regardless of the change of needle) October 1st 2005. 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 Rose Meadow Care Home C03 C53 S61213 Rose Meadow V247839 020905 Stage 2.doc Version 1.40 Page 22 Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Rose Meadow Care Home C03 C53 S61213 Rose Meadow V247839 020905 Stage 2.doc Version 1.40 Page 23 - 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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