Inspection on 16/01/07 for Rosemere

This inspection was carried out on 16th January 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.

Other inspections for this house

Rosemere 04/01/06

Rosemere 15/07/05

Rosemere 24/02/05

Rosemere 28/06/04

Rosemere 23/05/02

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

CARE HOMES FOR OLDER PEOPLE Rosemere 13 Grimston Gardens Folkestone Kent CT20 2PT Lead Inspector Wendy Gabriel Key Unannounced Inspection 16th January 2007 10:15 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 Rosemere DS0000023515.V327673.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. Rosemere DS0000023515.V327673.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosemere Address 13 Grimston Gardens Folkestone Kent CT20 2PT 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) 01303 255775 01303 255775 Rosemere Care Home Ltd Mrs Marcella Frances Permall Care Home 12 Category(ies) of Learning disability over 65 years of age (1), registration, with number Mental Disorder, excluding learning disability or of places dementia - over 65 years of age (11) Rosemere DS0000023515.V327673.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One (1) service user with Dementia whose date of birth is 28.10.1940 Date of last inspection 4th January 2006 Brief Description of the Service: Rosemere is an older semi-detached property, located in a residential road opposite large gardens that may be accessed by residents of the houses surrounding it. Three of the bedrooms are double occupancy. There is parking available in the road to the front of the property. Public transport, shopping, church and leisure facilities are within walking distance. The home is not suitable for full time wheelchair users. Fees are in the range of £367.82 - £447.70. Rosemere DS0000023515.V327673.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was clean, well presented and fully staffed at the unannounced inspection. An accompanied tour of the home was undertaken and some records were seen. Conversation with a visiting psychiatric community nurse, social worker, staff and some of the Service Users took place. The atmosphere in the home was warm and friendly and Service Users were observed interacting with staff in an appropriate and positive manner. Mrs Permall, the Registered Manager was in the home and confidently and calmly managed the unexpected visits to the home by a number of people who wished to speak to her during the morning. Mrs Permall stated that the refurbishment planned for the previous year had had to be delayed but would be completed this year. One bedroom in particular had new furniture and décor chosen by the occupant and that was due to be completed by the end of the month. What the service does well: What has improved since the last inspection? Radiator covers have been provided where recommended and the laundry now has washable walls for improving infection control. Rosemere DS0000023515.V327673.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Rosemere DS0000023515.V327673.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Rosemere DS0000023515.V327673.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective Service Users have their needs assessed to assure they will be met. Intermediate care is not undertaken. EVIDENCE: The admission procedure for the home includes recording basic information about the individual as well as speaking to the person and their family or advocates. The visiting community psychiatric nurse and social worker confirmed that the Registered Provider communicates with them about the admission of prospective Service Users. They both said that she is always ‘honest’ with them and will state if she considers the home not to be a suitable placement. The Registered Manager stated that intermediate care is not undertaken. Rosemere DS0000023515.V327673.R01.S.doc Version 5.2 Page 9 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): 7,8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users health personal and social needs are identified in care plans. Service Users health care is promoted. Service Users are protected by the homes medication policies and procedures. Service Users are treated with respect and the right to privacy. EVIDENCE: Two care plans were viewed. Care plans contain suitable information to enhance the needs of Service Users and these are updated monthly by keyworkers. One plan had the signature of the Service User indicating agreement with different aspects of her care. Key-workers are a fairly new concept to the home and the Registered Manager said she had hoped it would increase staff interest in their duties. Rosemere DS0000023515.V327673.R01.S.doc Version 5.2 Page 10 Health issues are monitored and the community psychiatric nurse said that he visited every two weeks for medication input for a named individual and that he considered the medication system was in order. He also said that the Registered Manager always kept him and other health care professionals informed about changes. Both the community psychiatric nurse and the social worker were visiting to assess a Service User and confirmed that regular assessments take place. Medication has suitable policies and procedures and medication is stored in a locked dedicated container and within a locked room. All the staff receives medication administration training and then are subject to in-house supervision before they are allowed to administer any medication. The Registered Manager described scenarios and staff actions to protect Service Users privacy. The Inspector had the opportunity to discretely observe and listen to staff communicating and assisting Service Users. In all situations staff used discretion, tact and thoughtfulness. This is good practice. Rosemere DS0000023515.V327673.R01.S.doc Version 5.2 Page 11 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): 12,13,14,15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Social activities enhance Service Users preferences and expectations. Social contact is encouraged and maintained. Service Users know that they will be helped to exercise control and choice over their lives. Service Users know that their diets are well balanced and appealing. EVIDENCE: There was ample evidence of a variety of social activities for the Service Users. A diary recorded daily activities; a weekly itinerary of activities was on display as well as notices of other entertainments. Current affairs are discussed daily and the Registered Manager said that this is to do with reality orientation and helps Service Users be aware of life outside of the home. Some have particular interests such as the royal family, so staff look out for special items of interest. The Registered Manager confirmed that she welcomed the staff taking time to sit with Service Users as this often encouraged conversation or activities between Service Users. A member of staff confirmed this. Rosemere DS0000023515.V327673.R01.S.doc Version 5.2 Page 12 Regular church services are undertaken in the home. The home does not have its own transport but taxis are provided for outings. Risk assessments clearly detail needs and required assistance. Visitors are welcomed at reasonable times. The home has sound financial systems in place for Service Users. Individual Service Users have solicitor, family, court of protection or county council supporting their financial requirements. Staff take it in turns to cook and the meal that day looked and smelled appetising. The meal was well presented and different choices were seen being enjoyed by Service Users. Staff confirmed that fresh produce is used. The menu is on a rota and may be changed to accommodate individual choice. Two Service Users said they had enjoyed their meal. The kitchen was clean and tidy and well organised. Meals may be taken in the dining room, small visitors room or in individual bedrooms according to choice. Rosemere DS0000023515.V327673.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service Users and their families know that their complaints will be listened to and acted upon. Service Users legal rights are protected. EVIDENCE: A complaints policy is on display. A member of staff said that all staff would be prepared to speak to the Registered Manager if they were concerned about any behaviour that may be abusive to Service Users. Two members of staff confirmed they had received training regarding adult abuse and one expressed sound views on adult protection. Service Users were observed talking to staff in a comfortable and friendly manner that was enhanced by the staff listening to and checking that they had understood what was being said to them. This is good practice. CRB checks and POVA are in place. The home has an adult protection policy as well as whistle blowing policy. Staff have undertaken training in adult protection and managing challenging behaviour. Rosemere DS0000023515.V327673.R01.S.doc Version 5.2 Page 14 The Registered Manager is a trainer and provides in-house training as well as accessing other courses outside of the home. Rosemere DS0000023515.V327673.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,23,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is homely will be enhanced by further planned redecoration. Single and shared bedrooms were comfortable and personal to the occupants. Infection control measures are in place to control the spread of infection. EVIDENCE: An accompanied tour of the premises was undertaken. A previous recommendation to carry out the plan of redecoration of the home has not yet been fully met although plans were still in place for this to happen. The home was warm and comfortable with no unpleasant odours. Service Users were seen accessing various parts of the home and warmly greeted the Inspector when introduced. Rosemere DS0000023515.V327673.R01.S.doc Version 5.2 Page 16 Bedrooms were individual and one room is being completely refurbished and decorated within the next few weeks with furniture chosen by the current occupant. Three of the bedrooms are double occupancy. There are adequate w.c. and bathroom facilities and all were clean and hygienic. One bathroom is expected to be re-fitted later in the year. Radiator guards have been fitted where recommended and the laundry now has a washable wall surface. Policies and procedures are in place for infection control. The kitchen was clean and very tidy despite a cooked meal being prepared at the time. There is a dedicated cleaner on the premises 5 days a week. Records for fire safety and maintenance were up to date and included fire training and drill given by a fire officer in September 2006. There is a small garden to the rear and a small frontage to the building. Rosemere DS0000023515.V327673.R01.S.doc Version 5.2 Page 17 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): 27,28,29,30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service Users know the staff employed will meet their needs. All staff have achieved NVQ2 or equivalent. The recruitment procedure ensures the protection of Service Users. Enthusiastic and well-trained staff support Service Users. EVIDENCE: Staff were very keen to talk about the Registered Manager, saying how supportive and kind she is both at work and in private life when she has supported staff through personal difficulties. The staff team are committed and enthusiastic and a number of staff have worked in the home for a number of years. A member of staff said that the Registered Manager “is gentle, firm but fair”. Suitable recruitment policies are in place and appropriate recruitment has been undertaken. Required documentation is in place for staff including CRB and POVA checks. The Registered Manager confirmed that staff from overseas has qualifications that are equal to NVQ3. The remaining staff has achieved NVQ2. Rosemere DS0000023515.V327673.R01.S.doc Version 5.2 Page 18 Induction training is in place. Staff confirmed the on-going training and that training is undertaken for matters directly to do with the needs of the Service Users such as mental health needs and dementia, as well as mandatory courses. Three carers and the Registered Manager are on duty in the mornings, there are two carers on duty after 16:00 and two on duty at night. Rosemere DS0000023515.V327673.R01.S.doc Version 5.2 Page 19 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): 31,32,33,35,38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Registered Manager is qualified, competent and experienced. The Registered Manager provides leadership that supports Service Users and staff. The home is run in the best interests of the Service Users. Service Users know that their financial interests are safeguarded. The Registered Manager promotes safety and welfare. Rosemere DS0000023515.V327673.R01.S.doc Version 5.2 Page 20 EVIDENCE: Staff said that the home is well run by the Registered Manager. It was noticeable that although the home had several unexpected visitors during the morning, staff and the Registered Manager dealt with everyone in a calm, relaxed and professional manner. It was apparent through observation, that staff put the needs of the Service Users before others. Staff were pleased to say that the home has an inclusive and positive atmosphere and this was evidenced by communication between, staff, Service Users and the Registered Manager. As detailed in the previous report; the Registered Manager is a qualified RMN, has a Diploma in Care Home Practice Management, and a Diploma in European Business. She is an Adult Protection Trainer, Moving and Handling and Risk Assessor Trainer, Health and Safety and Infection Control Trainer and Food Hygiene Trainer. She has completed the Registered Manager Award. She is a well-qualified, experienced Manager and the home benefits from her vast experience and knowledge in caring for older people with mental health needs. The Registered Manager provides questionnaires and Service Users meetings are regularly held. The home is a member of a law employment consultancy. Health and safety is promoted and annual maintenance checks were in date. The fire book was in order. Rosemere DS0000023515.V327673.R01.S.doc Version 5.2 Page 21 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 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 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 3 X X X 3 X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 X 3 X X 3 Rosemere DS0000023515.V327673.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP19 Good Practice Recommendations The home is to continue to carry out the plan of refurbishment and decoration of the home Rosemere DS0000023515.V327673.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Rosemere DS0000023515.V327673.R01.S.doc Version 5.2 Page 24 - 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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