Inspection on 17/03/08 for Rosemount

This inspection was carried out on 17th March 2008.

CSCI found this care home to be providing an Adequate service.

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

Rosemount 18/09/07

Rosemount 03/08/06

Rosemount 19/01/06

Rosemount 01/07/05

Rosemount 19/11/04

Rosemount 20/05/04

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

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

CARE HOMES FOR OLDER PEOPLE Rosemount Sunningdale West Monkseaton Whitley Bay Tyne & Wear NE25 9YF Lead Inspector Suzanne McKean Key Unannounced Inspection 09:30 17 & 18th March 2008 th 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 Rosemount DS0000028819.V357833.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. Rosemount DS0000028819.V357833.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosemount Address Sunningdale West Monkseaton Whitley Bay Tyne & Wear NE25 9YF 0191 251 0856 0191 2510866 rosemount@fshc.co.uk 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) Cotswold Spa Retirement Hotels Limited (wholly owned subsidiary of Four Seasons Healthcare Ltd) Position Vacant Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (59), Physical disability (1) of places Rosemount DS0000028819.V357833.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 18th September 2007 Brief Description of the Service: Rosemount is a purpose built care home of traditional brick build design on one level, there is a car park to the front of the building. This allows level access to the home. It is situated in the residential area of West Monkseaton, Whitley Bay. The home is easily accessed by metro, bus and car. All accommodation is provided in single, en-suite bedrooms and there are a selection of communal facilities, including lounges, dining rooms and a conservatory. There are no shared rooms. The home charges fees between £356 and £505 depending upon the needs and requirements of the individual residents. The home provide information about the service through the service user guide and a copy of the last inspection report from Commission for Social Care Inspection is available in the entrance to the home. Rosemount DS0000028819.V357833.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. Before the visit: We looked at: • Information we have received since the last visit on 18th September 2007. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 17th March 2008 and a further visit was made on 18th March 2008. During the visit we: • Talked with people who use the service, relatives, staff, the manager & visitors. • Looked at information about the people who use the service & how well their needs are met, • Looked at other records which must be kept, • Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, • Looked around the building/parts of the building to make sure it was clean, safe & comfortable. We told the manager what we found. What the service does well: The people living in the home are happy with the way they are treated by staff. An example of what they said is “the staff are lovely” and “nothing is too much trouble”. No resident enters the home without having a detailed assessment undertaken to ensure that the home can meet their needs before care is offered. Rosemount DS0000028819.V357833.R01.S.doc Version 5.2 Page 6 The home has good wide corridors and all residents have single rooms with their own toilet and washbasin in an ‘ensuite’ room. The standard of decoration is now very good and the home is clean and safe. 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 Rosemount DS0000028819.V357833.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Rosemount DS0000028819.V357833.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rosemount DS0000028819.V357833.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6 (the home does not provide intermediate care) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessment process is comprehensive and ensures that people’s needs are clearly identified before decisions are made about admission to the home. EVIDENCE: The care plans contain comprehensive pre-admission assessments, which is based on the activities of daily life, but include an overview of the individuals social and health history. Either the Manager or one of the nurses carries this out. The records were well documented and detailed enough to form the basis of the care planning. The care plan also contains a care management assessment. This is carried out by the placing social worker who uses it to look at what the individual person needs and how they can be met. It is given to the home on admission or Rosemount DS0000028819.V357833.R01.S.doc Version 5.2 Page 10 before admission. It is from these documents that an individual care plan is developed. Rosemount DS0000028819.V357833.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Good care is given to the people living in the home but this is not shown effectively in the care planning documentation. The poor management of medication administration puts residents at risk. EVIDENCE: All residents have an individual plan of care, based on the admission assessment, which is then added to during the placement. The care plans looked at contained a large amount of information regarding the care of the resident. The section entitled “Support and Care to be provided” did not contain the information necessary to inform staff of how to provide the care. There are risk assessments available for the nutrition, wound care, moving and assisting, and continence promotion. Not all of the care plans were being regularly reviewed and updated to ensure that they contain up to date and accurate information. Fluid balance records are not up to date and do not allow the staff to determine if residents are receiving enough fluids to maintain Rosemount DS0000028819.V357833.R01.S.doc Version 5.2 Page 12 their health. Fluids were being given to residents on a regular basis both through meals and at additional times using the “tea trolley”. However this was not recorded effectively. The care plans showed that the residents have access to all NHS services and facilities. There was a good range of pressure relieving mattresses in use for the prevention of pressure sores. The Community Matrons are working with the manager to improve the standards in the home. However this does not replace the need for good internal management and leadership. The new manager agreed that although there have been significant improvements the further planned changes were necessary. Basic care practices have been improved and advice from visiting professionals is now being taken and recorded in the care plans so that staff can be sure that the care they are given is planned and co-ordinated effectively. The visiting advisers are now more satisfied with the care being provided in line with their advice. The policies and procedures systems for managing medicines in the home are good however have not always been following these is the recent past. The new manager has carried out an audit and removed all of the overstocked items. Medicines ordering are now being managed more effectively and better stock control is being maintained. No residents are currently managing their own medication. Recent problems with administration of medication have are being dealt with by the manager however this is a similar situation as was found at the last inspection and suggests that there are ongoing problems with the staff complying with safe medicine procedures. The manager has planned a programme of auditing the medication systems, which needs to be undertaken to identify the action that needs to be taken. An audit of the controlled medicines kept in the home was carried out with the manager during the visit. There were discrepancies, in that there was 100ml of a controlled medicine in the cupboard for which a record could not be found. The record of controlled medicines was therefore not accurate. The manager agreed to take urgent action to address this and make sure that a system is put into place to check the management process on a regular basis. Rosemount DS0000028819.V357833.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, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are well supported to live satisfying lives in line with their abilities and according to their cultural, social, religious and recreational interests and needs. But people activities are limited for people who are frail. EVIDENCE: The residents described the ways they are encouraged to take control of their daily routines in simple but important ways including the time they get up, what and when they eat and how they spend their time. Staff confirmed that they assist residents to make choices about how they spend their day. Some organised activities are available and staff said that residents are able to choose whether or not they are involved. The home employs an activities coordinator who has a weekly programme of activities offering differing opportunities. This is still not sufficiently developed to offer individualised activities for the residents who are particularly dependent or physically frail. Also due to the dependency level of some of the residents a number of the Rosemount DS0000028819.V357833.R01.S.doc Version 5.2 Page 14 activities offered need to be less active and provided on a more one to one basis. The records of the activities provided are now more detailed. Residents have visitors at any time and are able to use their own rooms, the small lounges or the larger, busier lounges to receive them. Relatives are given information within the residents’ guide about visiting arrangements. Residents said they were satisfied with the arrangements for visitors and that staff welcome them. During the visit the food being served looked well presented and was at the appropriate temperature. During the breakfast time the residents were supported to enjoy their food in a pleasant atmosphere. A selection of cooked food was available as well as breakfast cereals and ether white or brown toast or bread. The residents said the enjoyed this and cleared their plates. An example of resident’s comments was one who said, “there is always lots to choose from” and “ the food is lovely”. A relative reported that the cook had taken time to speak to them and they’re relative to find out their choices when they have come into the home. And also that when the resident “went off their food” had again met with them to try to find food that they would prefer. The head cook has been recently completed the NVQ 3 in “Supervising food safety” and “Safer food better business” training. This has given her additional skills and knowledge to prepare her for her role. Rosemount DS0000028819.V357833.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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good complaints and protection of vulnerable adults policy in place, which is well managed and gives the residents the opportunity to have their concerns dealt with and their safety maintained. EVIDENCE: The complaints procedure is available in the service users guide and a copy is available at the front entrance and is displayed in the home. The records of the complaints were examined. The complaints received since the last inspection has been investigated and the records of these are in place. A number of concerns have been raised during the relative/resident meeting, which the manger has agreed to address as part of her improvement plans. This is recorded in the notes from the meetings. The records are detailed including the response to the complainants and any action for improvement taken in response to the issues raised. Residents and relatives contacted understood how to make a complaint, and could identify the way this would be dealt with. Three relatives who were visiting the home were aware of the complaints procedure and had raised concerns in the past. Rosemount DS0000028819.V357833.R01.S.doc Version 5.2 Page 16 Staff are given protection of vulnerable adults training both as part of the inhouse training package and from outside organisations. The home has written guidance in place regarding the protection of vulnerable adults through detailed policies and procedures. These are included in the induction training and ongoing in-house training. Staff confirmed that they knew about the guidance and could identify the action they would take if they were made aware of or had any concerns regarding this issue. The manager works within the safeguarding frameworks and is familiar with her responsibility in these processes. Rosemount DS0000028819.V357833.R01.S.doc Version 5.2 Page 17 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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is generally comfortable, well maintained, clean and a pleasant place for the residents to live. EVIDENCE: There have been significant improvements made in the decoration and replacement of the furnishings in the home. The main corridors in the home and the lounges are now decorated to a high standard and are more pleasant for the residents to live in. There has been an improvement in the provision of specialist bathing equipment and decoration of the bathrooms. It is now only the completion of the refurbishment of the remaining bathrooms that is outstanding in this part of the redecoration programme. Rosemount DS0000028819.V357833.R01.S.doc Version 5.2 Page 18 A number of the bedrooms have been refurbished and these are now pleasant and fresh. Where this has been done the built in furniture has been replaced with free standing items, which has meant that the rooms can be better organised to meet the needs of residents. There is liquid soap and disposable paper in the on-suites and appropriate waste bins have been purchased so staff are able to dispose of them without leaving the room. The home was generally odour free except for one very localised area (which was identified to the manager during the visit), which was very malodorous. A requirement has not been made regarding this however the manager is aware of the problem and is attempting to look at strategies to resolve the problem. Appropriately coloured aprons were available to allow staff to follow control of infection policies, and staff were seen to be using them correctly. Red dissolvable laundry bags are available and staff were therefore not handling soiled linen prior to it being washed. The kitchen area was clean and tidy, and there is a cleaning schedule in place to demonstrate the way in which this is being achieved. Changes are being made to this area to make it more practical workspace. Rosemount DS0000028819.V357833.R01.S.doc Version 5.2 Page 19 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 adequate. This judgement has been made using available evidence including a visit to this service. The home has good recruitment and selection procedures. But the staff are not trained sufficiently to make them competent and confident in the work they do. EVIDENCE: Staff recruitment and selection records were complete including two references and a completed application form. The requirement to have a CRB and POVA check in place is applied to all of the staff in the home. The interviews are recorded formally in the staff record giving the Manager a record of the full process. On the day of the visit three staff rang in sick and although the manager attempted to get cover by arranging for one staff to come in on her day off and other staff to come in early or work. However the numbers could not be brought back to the numbers required. Staff rota’s show that the staffing levels is not being maintained during all shifts. The staffing rota’s showed that sufficient numbers of staff are scheduled to work however sickness is regularly resulting in insufficient numbers of staff on duty. Relatives said that they were concerned that there are not enough staff Rosemount DS0000028819.V357833.R01.S.doc Version 5.2 Page 20 on duty and that there were times when the nurse call buzzers were not being answered within a reasonable time scale. The records showed that moving and handling training is not up to date for those who have already had initial training and three members of staff had not had any training since they were recruited. The manager has scheduled training. The training records are not in place to demonstrate that safeguarding training is up to date for all of the staff. The staff have been offered a number of training opportunities including pressure area care and care plan training. The staff are encouraged to undertake National Vocational Qualifications (NVQ 2) once they have had their induction training. The records show that the training programmes for prevention, detection, and action to take in the event of a fire. Training is provided six monthly for day staff and three monthly for night staff. Rosemount DS0000028819.V357833.R01.S.doc Version 5.2 Page 21 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, 33, 35 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Recent management problems are being dealt with by the new manager who is making improvements, including improving the health and safety practices and staff training. EVIDENCE: There have been a number of changes in the management of the home. The temporary manager was in post during the period when significant improvements in the fabric of the building. There were improvements seen to the care plans seen at the random inspection in December 2007 and additional training has been given to the staff since then. Rosemount DS0000028819.V357833.R01.S.doc Version 5.2 Page 22 There is now a permanent manager in post who is an experienced registered nurse with a lot of experience working with older people. She has taken some time to familiarise herself with the home and has developed a plan to improve the standards. She is yet to register with Commission for Social Care Inspection. The records of the arrangements to ensure that persons working at the care home receive suitable training in fire prevention and by means of fire drills and training in the procedures to be followed in the case of fire were examined and were adequate. During the tour of the premises it was noted that there were no obvious risks and the Manager confirmed that she undertakes daily tours herself to ensure that it remains so. Records were examined of the staff meetings, which take place regularly, and the contents of these suggest that there is a broad spectrum of relevant issues discussed. The Manager also facilitates meetings with the relatives and residents as appropriate, which she is using to consult the residents, relatives and other interested parties to review the service provided. A number of relatives have said that they feel that the new manager is taking time to consult with them and keep them informed of the improvements she has planned and introduced. The personal records kept in the home for residents who are receiving assistance to manage their finances were examined and are detailed, logical and appropriate. Receipts were in place for purchases made on behalf of residents and signatures of either two staff or one and the service user were in place. The home has good systems for looking after the homes equipment and ensuring that the premises are safe and well maintained. Good records are kept by the handyman of the checks made. Records are in place to prove that the home has contracts for the premises and equipment safety and service certificates are kept. Rosemount DS0000028819.V357833.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 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 1 28 2 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X X X X 3 Rosemount DS0000028819.V357833.R01.S.doc Version 5.2 Page 24 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 OP7 Regulation 15 Requirement Each resident must have an up to date care plan containing sufficient information for the staff on the care to be provided. The management of medicines including controlled medicines must be improved to make sure that it is safe and secure. The home must provide adequate numbers of staff to meet the needs of the people living in the home. The home must ensure that the staff working in the home have the skills and experience necessary for the work they do. The home must submit an application to register a manager with Commission for Social Care Inspection. Outstanding since 01/01/08. Timescale for action 01/08/08 2. OP9 13 (2) 01/08/08 3. OP27 18 01/07/08 4. OP30 19 01/08/08 5. OP31 8 01/07/08 Rosemount DS0000028819.V357833.R01.S.doc Version 5.2 Page 25 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. Refer to Standard OP26 OP12 Good Practice Recommendations It is recommended the Manager introduce an audit of the bedroom cleaning to ensure the standard is not being allowed to fall. Social activities for more the more dependent or physically frail residents should be developed further. Rosemount DS0000028819.V357833.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Rosemount DS0000028819.V357833.R01.S.doc Version 5.2 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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