Inspection on 06/06/07 for Rosemont

This inspection was carried out on 6th June 2007.

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 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

Rosemont 22/04/09

Rosemont 06/12/08

Rosemont 22/04/08

Rosemont 20/07/06

Rosemont 07/03/06

Rosemont 03/08/05

Rosemont 23/02/05

Rosemont 28/09/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Rosemont Yealm Road Newton Ferrers Plymouth Devon PL8 1BX Lead Inspector Graham Thomas Unannounced Inspection 6th 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 Rosemont DS0000003798.V335136.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. Rosemont DS0000003798.V335136.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosemont Address Yealm Road Newton Ferrers Plymouth Devon PL8 1BX 01752 872445 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) Mr D M Beckhurst Mr D M Beckhurst Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Rosemont DS0000003798.V335136.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th October 2006 Brief Description of the Service: Rosemont is a care home registered to provide care for 19 people in the category of old age only. It is owned and managed by Mr Beckhurst, who is assisted by another staff member who is known as the Care Manager. The home is registered to accommodate up to 19 people. Two rooms have en-suite facilities. The premises comprise a large, older property that stands in its own grounds, overlooking the picturesque creek of Newton Ferrers. There are a dining room, two lounges and a conservatory. The home has a stair lift to the mezzanine level and ramps to provide access in and out of the building. Those service users with limited mobility are provided with accommodation on the ground and mezzanine floors as there are a few steps remaining to access the first floor. Adjoining the property are two privately owned flats that are not connected to the care home. The proprietor and his family live in one flat and the second is used as staff accommodation. Current weekly fees range between £350 and £450. This does not include chiropody, hairdressing or magazines and newspapers Rosemont DS0000003798.V335136.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Before the Inspection, Mr Beckhurst provided information about the home in a pre-inspection questionnaire. Questionnaires were sent to people using the service, staff and professionals. These were returned by seven people living at the home (some completed by relatives on their behalf), four staff, and seven professionals. The Inspector visited the home on 6th and 7th June and spent a total of nine hours there. During the visits the Inspector spoke with six people living at the home and interviewed three staff. Other staff were spoken with informally. All the rooms were examined during a tour of the home. Records were inspected including care plans, staff files and records concerning the administration of medicines. What the service does well: What has improved since the last inspection? What they could do better: • Risk assessments need to be reviewed to keep people safe from potential harm Rosemont DS0000003798.V335136.R01.S.doc Version 5.2 Page 6 • • • • • • Improvements are needed in the way the home manages medicines to ensure that the system is safe All rooms must be kept free of offensive odours Labels are needed on skin creams to make sure that people are better protected from infections Improvements are needed to the way staff are recruited so that people are kept safe. The activities available for people in the home need to be reviewed and revised so that they meet people’s expectations. Everyone needs to be clearer about the management arrangements and when managers are available. 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. Rosemont DS0000003798.V335136.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 Rosemont DS0000003798.V335136.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 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People considering moving into Rosemont can feel confident that the home will make sure it can meet their needs before offering them a permanent place. EVIDENCE: The files of the two most recently accommodated residents were examined. Both of these people had been admitted from hospital in a different part of the United Kingdom. For this reason, initial information had been taken from hospital staff and families. A trail period had been offered during which an assessment had been completed and a care plan produced. When this had been done, letters had been sent confirming that the home could meet the needs of the individuals concerned. Keeping an accurate record of such events is important in case it is needed for medical or other purposes. Of the seven people returning surveys, only two stated that they had received a contract. However, copies of the contracts were seen and six of the seven Rosemont DS0000003798.V335136.R01.S.doc Version 5.2 Page 9 stated that they had received enough information before moving into the home. Rosemont does not routinely accommodate people whose needs are solely for intermediate care. Rosemont DS0000003798.V335136.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Generally, people living in the home receive a sufficient level of care and support. However, poor practice concerning the use of medicines poses a potential risk to their health and wellbeing. EVIDENCE: People living at Rosemont had an individual file containing their plan of care. The individual files were clear and well organised. Four of these were examined in detail. These included plans for the two people who had most recently moved into the home. Copies of the plans were held in a separate file for dayto-day staff reference. There were also daily notes for each person. Individual risk assessments were also available in individual files. Three of the four plans had been reviewed within the last month. One had not apparently been reviewed since February 2007. Where possible, the review had been signed by the person or their representative. Reasons were given where this was not possible. Some risk assessments had been reviewed recently. However, in one instance a moving and handling assessment had not Rosemont DS0000003798.V335136.R01.S.doc Version 5.2 Page 11 apparently been reviewed since 2003. Another concerning working areas had not apparently been reviewed since 2003. It is important to keep such assessments under review to ensure that the person’s current needs are identified and understood by staff. The files contained sufficient information about each person. Aims concerning the person’s care were clearly set out in the plans. However, it was not clear from the plans or the daily notes what work was being done in support of these aims. Many of the entries in the daily notes consisted of comments such as “fine” or “no problems”. One aim referred to encouraging the person to maintain their mobility. There were, however, no references to this other than the aim set out in the plan. People’s medical needs were described in individual files. There was evidence that these needs were being monitored and addressed. For example, one person was receiving frequent visits from a District Nurse to monitor the person’s skin condition. Another had fallen several times. This pattern had been noted by the senior member of staff who had arranged for the person to be referred to a physiotherapist by her GP. A visiting Therapist was seen by the Inspector conducting an assessment during the visit. She felt that, in general, the home complied with any treatment regimes recommended for individuals. She was particularly pleased that staff were always present when assessments were conducted to observe and discuss the findings. Correspondence was seen in individual files concerning optical assessments. Of the seven people returning surveys, one felt that they always received the medical help they needed and three felt this was usually the case. Two felt this was only sometimes the case. One person commented that this help was “very haphazard” and another commented that it was very difficult to get medical attention when the local medical centre was closed. One person commented, “When the Doctor or Nurse is required only occasionally does it happen” and felt that more able residents did not receive the care and support they needed. The home’s systems concerning the use of medication were examined. A “Nomad” system was in use. This system uses cartridges in which the Pharmacy supplies medicines arranged according to the time of day. Some medicines are also supplied in their original packaging. A number of shortfalls were identified during this inspection: • • • One cartridge contained two sets of tablets that had been signed for as administered. Another record showed no signature for two doses of medicine that had apparently been administered. One person’s Paracetamol had been labelled “as directed” (with maximum and minimum doses) by the Pharmacy. The medicines administration record indicated that this should be taken “as required”. No further guidance was available as to what this meant. There were, therefore, no specific DS0000003798.V335136.R01.S.doc Version 5.2 Page 12 Rosemont • • • directions for the use of this medicine. The Paracetamol had been prescribed for another person. There was no supply for the person using it. This was obtained by the Registered Person during the inspection. Three people were using a supply of Movicol prescribed for one person. There was no supply for two of the three people. This was obtained by the Registered Person during the inspection. No records was available as to the quantities of medicines received by the home. This meant it was not possible to establish a clear audit trail of the medicines. The Registered Person reviewed and revised these records during the inspection Aqueous cream prescribed for one person was found in the room of another. The person in charge of medicines at the time of the inspection was unaware of any controlled drugs in use or which drugs might be controlled. Some homely remedies such as Lemsip were available for use. A list had been produced but this was not approved by an appropriately qualified person. One person was looking after their own medication. This had been risk assessed. There was no lockable storage for this medicine in the person’s room. Other medicines were safely stored in a locked cupboard in the home’s office. All the people with whom the Inspector spoke regarded staff as kind, helpful and felt they were treated with respect. Rosemont DS0000003798.V335136.R01.S.doc Version 5.2 Page 13 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): 12-15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home’s routines are sufficiently open and flexible to meet people’s social needs. However, the level of structured and organised activity does not sufficiently meet their expectations. EVIDENCE: The information returned by the Registered Person listed a range of activities for people living at Rosemont. These included slide shows, outings, games, lunch clubs and church services. However, of the seven surveys completed by people using the service or their representatives, six stated that there were activities only “sometimes” (one added “rarely” to this) and one stated “never”. One commented, “It would be nice to have some sort of exercise”. Another stated “There is no encouragement to participate in village activities though there are many…..transport and communication has to be done by the resident.” Conversation with people using the service during the inspection tended to confirm this view. Rosemont DS0000003798.V335136.R01.S.doc Version 5.2 Page 14 The Registered Person stated that residents often declined to participate in activities when these were offered. Also, Trips to the local village with staff tended to be overlooked when residents were asked about their daily activities. During the inspection people were seen in small groups in the lounge and sun lounge chatting with fellow residents or staff. One resident went out to lunch with a relative. Some people remained in their rooms and watched television or listened to music. One person with a visual impairment had access to talking books provided by the RNIB which he particularly enjoyed. People with whom the Inspector spoke confirmed that they had the opportunity to participate in communion. Some were able to attend church services. Visiting arrangements were seen to be open and flexible and people confirmed that they could receive visitors at any reasonable time. The Inspector visited the home’s kitchen and spoke with the cook. Menus were examined and the food stores and refrigerated storage were inspected. The midday meal being prepared on the first day of the inspection comprised of roast pork with fresh vegetables followed by plum crumble and custard. Tea on this day was soup, salmon salad and ice cream with jelly. The menu showed a variety of dishes. The cook stated that an alternative was available on request. This was confirmed by some people living in the home. However, not all were aware of this possibility and one stated categorically that there was no choice. There was a plentiful supply of fresh vegetables and other food in the dry store, refrigerator and freezer. One person required a liquidised diet. All the ingredients of this person’s meals were being liquidised together. The cook stated that this followed the preference of the person and consultation with the family. The Inspector observed part of a meal taken in the home’s dining room. This appeared relaxed and convivial. Some people took meals in their room and one was taken out for lunch by a relative. In response to the Commission’s survey one person responded that “Luncheon usually good. Suppers usually poor” Conversation with people during the inspection reflected the view that suppers were generally less popular with people living in the home. Rosemont DS0000003798.V335136.R01.S.doc Version 5.2 Page 15 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 and 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. An adequate complaints procedure is in place. Staff are not sufficiently well trained in safeguarding adults from abuse. EVIDENCE: The home has an accessible complaints policy and procedure. Of the seven people who responded to a survey, six responded that they always or usually knew who to speak to if they were unhappy. One person commented, “I know who to speak to but wonder if it is taken into account. Promises are made but in a short period of time forgotten”. All stated that they knew how to make a complaint. The Registered Person stated that no complaints had been received since the last inspection and this was reflected in the home’s complaints record. Staff had received some training in safeguarding vulnerable adults from abuse. However, staff with whom the Inspector spoke were not all able to identify those outside the home to whom they would report allegations or incidents. One staff member also stated firmly that abuse would not happen in the home. Rosemont DS0000003798.V335136.R01.S.doc Version 5.2 Page 16 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 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is sufficiently clean and well maintained. However, shortfalls in infection control pose some risks to the health and wellbeing of people living in the home. EVIDENCE: Rosemont is situated on the outskirts of the village of Newton Ferrers. Shops and other amenities are within walking distance. Externally the home has well maintained grounds with ramped access to the garden where seating is provided. The home has a good range of comfortably furnished communal space including a lounge / dining room, a separate lounge, and a conservatory with views of the estuary. Rosemont DS0000003798.V335136.R01.S.doc Version 5.2 Page 17 Many of the bedrooms are very large, with one offering a lounge area as well as a bedroom. Two bedrooms provide en suite shower facilities. Rooms were found to be generally comfortable and personalised with the occupant’s own belongings. One person and her family had chosen to furnish her own room completely and this has been accommodated by the service. There are adequate bathing and toilet facilities on each floor to meet the needs of people living in the home. Two of the 3 bathrooms are fitted with aids to assist service users with poor mobility. A shower in the ground floor bathroom is used as a storage area. Facilities such as booster seats and toilet frames were seen. The toilet on the first floor does not have a wash hand basin. Waterless gel hand cleaner has been supplied to this toilet to minimise the risk of cross infection. Liquid soap and paper towels were supplied at communal hand basins. One paper hand towel dispenser was waiting to be fitted at the time of inspection. Several bedrooms contained unlabelled skin creams and one bedroom contained aqueous cream prescribed for another person. This poses a risk of cross infection if creams are confused and used by more than one person. During the inspection the home was found to be adequately clean and free from odours with the exception of one room where there was a very strong offensive odour. Radiators were covered for service users’ safety. One room contained a freestanding heater for which a risk assessment was not seen. The Registered Person has stated that all baths had been fitted with hot water regulating valves and that these were being fitted to hand basins on the basis of risk assessment. Evidence was seen of ongoing maintenance internally. This included the painting and refurbishment of one bedroom. A log of all maintenance was available for inspection. Most people were satisfied with the cleanliness and maintenance of the home. However, one expressed dissatisfaction with the time taken to address maintenance issues and the cleaning regime. A sample of windows were tested and found to be appropriately restricted. The home’s laundry is separated from the kitchen and has cleanable floors and washable walls. Bags are provided for transporting laundry to the kitchen. There were machines for washing and drying. Staff confirmed that the machines have hot wash cycles. A system was in place for the disposal of infected waste. One staff member was seen handling dirty laundry without protective clothing. This presents a risk of infection. Rosemont DS0000003798.V335136.R01.S.doc Version 5.2 Page 18 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 - 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The arrangements for staff recruitment are not sufficiently robust to ensure that the interests and welfare of people living at the home are protected. EVIDENCE: The Inspector examined four staff files including those of the most recently recruited. Training records were inspected as well as staff rotas supplied by the Registered Person. Three staff were interviewed and others were spoken with informally. Verbal and written comments received by the Inspector about the staff were mostly positive. For example, one professional commented on a survey form “staff always very friendly and available”. A relative remarked, “staff are always pleasant and helpful”. This was also reflected in conversations with people living at the home. The rotas supplied by the Registered person showed that between 8:00am and 2:00pm there were two or three staff on duty. This includes the Care Manager who supports the Registered Person in the management of the home. There are then two staff on duty until 8:00pm. Between 8:00pm and 8:00am there is one staff member on duty and one on call. The staff on call live in the nearby flats within the grounds. In addition there is a cook and a cleaner. During the inspection additional staff were called in. It was evident that the staff on duty Rosemont DS0000003798.V335136.R01.S.doc Version 5.2 Page 19 were largely engaged mostly in immediate physical care such as bathing, laundry, toileting and administering medication. Completed and partially completed booklets showed evidence of recently introduced induction training to national standards. Of eight care staff, three held a National Vocational Qualification in care at level 2 or above. Two staff were working towards a qualification at level 3. Evidence of other training was seen such as food hygiene and dementia care. Staff had been trained in first aid though seven of the ten who had received training had not updated for over a year. One of the certificates seen stated that it was valid for one year only. All staff except the Care Manager, had received recent training in safeguarding vulnerable adults from abuse. However, as stated above, it was evident from staff interviews that not all staff had a clear understanding of the procedures for alerting outside agencies of abuse. Staff recruitment records did not meet legal requirements. For example, one file did not contain sufficient proof of identity. Not all files contained UK criminal records checks. Two files did not contain two references. One person had been recruited via an agency on a two year student visa to attend a sandwich course in care. The registered person stated that the agency had conducted all the necessary checks. However there was no evidence on the person’s file of the checks which had been conducted. Files of foreign workers all contained work permits. Rosemont DS0000003798.V335136.R01.S.doc Version 5.2 Page 20 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, and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is adequately well managed on a day-to-day basis. However, people living at the home and others associated with it are not sufficiently confident about the management arrangements. EVIDENCE: Mr Beckhurst is the Registered person and therefore has overall managerial control of the home. A senior staff member known as the Care Manager assists him in this. They have, respectively, 20 years and 10 years managerial experience. Both the Care Manager and Mr Beckhurst have were said to be undertaking the Registered Manager’s Award. Mrs Coleman has completed the award and was awaiting verification at the time of the inspection. Rosemont DS0000003798.V335136.R01.S.doc Version 5.2 Page 21 The Care Manager takes responsibility for care planning, medication and other areas of care, including the associated administrative tasks. Mr Beckhurst oversees finances, maintenance issues, and other day-to-day tasks. The Care Manager works on five days a week between 8:00am and 2:00pm during which time she is also involved in direct care of people living in the home. Mr Beckhurst has his own accommodation nearby and stated that he is in the home on most days. At the time of this inspection visit, the Care Manager was on holiday. Comments about the management of the home were received from people living there, relatives, staff and visiting professionals. Comments from all these groups suggested dissatisfaction with the availability of senior staff. For example: “Whoever is responsible and is in charge is often not there or is not made apparent”; “…problems originate from the management who is rarely apparent..”; “Unfortunately there is often not a qualified member of staff to converse with..” Evidence was seen of a new quality assurance system which was being introduced. Some of the homes systems for recording had recently been audited though many of the audits were undated. The findings of the audits concerning staff recruitment processes and medication were not confirmed by the findings of this inspection. The Registered Person stated that the home is not involved in any way in the finances of people living there other than to hold small amounts of cash for safe keeping. Individual finances are managed either by the person concerned, their relatives or other representatives. This was confirmed in conversation with people living in the home. A sample of the cash held was examined. This appeared to be correct and in good order. Certificates in staff files and other records showed that they had received training in health and safety topics such as food hygiene, fire safety and infection control. Ongoing plans were in place to provide further training in moving and handling. It was noted that of the 10 staff who had received training in first aid, 7 had not received recent updates. Records of maintenance and servicing were examined. Fire equipment had received recent inspections and tests. Bath lifts had been serviced and were due to receive further servicing in August 2007. The testing of personal electrical appliances had not been conducted for four years. The Registered Person stated that this would be done within the next two weeks. Accidents and other events affecting the welfare of people living in the home had been reported to the Commission in accordance with regulation. Rosemont DS0000003798.V335136.R01.S.doc Version 5.2 Page 22 Rosemont DS0000003798.V335136.R01.S.doc Version 5.2 Page 23 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 2 X 3 X X 3 Rosemont DS0000003798.V335136.R01.S.doc Version 5.2 Page 24 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. 1 Standard OP7 Regulation 13(4)(c) Requirement The Registered Person must ensure that individual risk assessments are be regularly reviewed and kept up to date in order to protect people from unnecessary risks to their health and welfare The Registered Person must ensure that the home’s systems concerning the use of medicines confirm to the guidance of the Royal Pharmaceutical Society. In particular: • All medicines administered must be signed for. • A clear account must be given for any medicines not administered as prescribed • Medicine prescribed for one person must not be administered to another. • Supplies of prescribed medicines for each person must be available in the home • Where medicines are labelled “as directed”, clear directions must be sought from the prescribing GP • Clear directions for staff must be available regarding any DS0000003798.V335136.R01.S.doc Timescale for action 31/07/07 2 OP9 13(2) 30/06/07 Rosemont Version 5.2 Page 25 3 OP26 16(2)(k) 4 OP26 13(3) 5 OP29 19(1)(b) and (c) medicines prescribed “as required” • Homely remedies in use for individuals must be approved by an appropriately qualified person. The Registered Person must 30/06/07 ensure that all rooms in the home must be kept free of offensive odours The Registered Person must 30/06/07 ensure that all skin creams are be labelled with the name of their user to ensure the risk of cross-infection is minimised. The Registered Person must 31/07/07 instigate a robust recruitment procedure in which all the information described in Schedule 2 Care Homes Regulations 2001 is obtained and kept available for inspection 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 2 3 4 5 Refer to Standard OP7 OP8 OP10 Good Practice Recommendations Individual care plans and daily records should demonstrate a clear cycle of assessment, planning, action and review. An audit should be conducted of referrals to health professionals to ensure that such referrals are promptly made and followed up. People living in the home should be made aware that an alternative is available if they do not wish to take the meal on offer. The Registered Person should consult people living at the home and their relatives about their preferred activities and produce a programme which meets their expectations. Checks should be made and recorded that training for staff in safeguarding vulnerable adults from abuse has been understood. In particular, staff should be aware of DS0000003798.V335136.R01.S.doc Version 5.2 Page 26 OP12 OP18 Rosemont 6 7 8 OP26 OP28 OP32 processes for alerting of potential or actual abuse. Staff should be reminded of the need to wear protective clothing when handling soiled laundry or other potentially infected materials. A minimum of 50 of care staff should have a National Vocational Qualification or equivalent. The Registered Person should ensure that people living at the home, their relatives, staff, and professionals are aware of the management arrangements and when managers are available. Rosemont DS0000003798.V335136.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Rosemont DS0000003798.V335136.R01.S.doc Version 5.2 Page 28 - 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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