Inspection on 24/10/06 for Rosemount

This inspection was carried out on 24th October 2006.

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

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

Other inspections for this house

Rosemount 13/10/08

Rosemount 28/10/05

Rosemount 17/05/05

Rosemount 11/01/05

Rosemount 24/06/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Rosemount Rosemount 79 Medomsley Road Consett Durham DH8 5HL Lead Inspector Kathy Bell Unannounced Inspection 24th and 25th October 2006 10 :30 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 DS0000007499.V310174.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 DS0000007499.V310174.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosemount Address Rosemount 79 Medomsley Road Consett Durham DH8 5HL 01207 590774 P/F No e-mail 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) Rosemount Trust Mrs Lucy Graham Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Rosemount DS0000007499.V310174.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th October 2005 Brief Description of the Service: Rosemount is a well established care home which provides care, but not nursing care, for up to 16 older people. The home also provides an integrated day care service for up to two day care service users per day. The home was opened in 1984 and is owned by the Rosemount Trust. The home is a two storey building close to Consett town centre. There are 12 single rooms and two doubles and five of the bedrooms have a screened toilet provided in them. Downstairs there are two lounges, a dining room and a sun lounge, though this is reached by way of three steps. The home is well maintained and decorated in a domestic style. The home was set up by local people who are Christians and has kept this character. The home charges £364.50 per week. This information was provided to CSCI in September 2006. Rosemount DS0000007499.V310174.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place during two days in October 2006. During the inspection, the Inspector, Kathy Bell, looked around the building and looked at records. She talked to five residents, two relatives and four members of staff, as well as the manager, trainee manager and one of the trustees of the home. She also received written comments from eight visitors to the home and seven residents. What the service does well: What has improved since the last inspection? The manager has worked to improve how she records any risks to residents, and how the home will reduce the likelihood of them coming to harm. The home has reduced the number of double bedrooms by one, and replaced some windows and carpets. Rosemount DS0000007499.V310174.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. Rosemount DS0000007499.V310174.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 Rosemount DS0000007499.V310174.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): Standard 3. The home does not provide intermediate care so standard 6 was not assessed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are assessed before they are admitted so that the home can be sure it will be able to meet their needs. EVIDENCE: Residents are assessed by a care manager before they are admitted. The manager explained that most residents have been coming to the home for day-care for some time before they move in. This gives staff a good opportunity to get to know them and to find out what care they will need and how they get on with other residents. One lady who had recently come into the home for respite care had not done this but the manager had visited her in hospital and spoke with nursing staff as well. Rosemount DS0000007499.V310174.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): Standards 7, 8 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans explain clearly the help each person needs to make sure that staff know how to care for everyone. Residents health care needs are well met. The home has satisfactory systems to look after and give out residents medication safely but needs to take more care in recording. EVIDENCE: All the care plans seen included detailed information about the help each person needed with their personal care, including whether they needed any equipment to move around. Staff looked at whether the residents were at risk of developing pressure sores and whether they needed special help with their diet to maintain their weight and health. The care plans were reviewed every month. In one case a care plan was not absolutely up-to-date but staff knew what they were meant to do at that time. They explained how the manager made sure that they were kept up-to-date with any changes and they felt that the system worked well. A full care plan was in place for a resident who had only come into the home three days before. Rosemount DS0000007499.V310174.R01.S.doc Version 5.2 Page 10 Records showed that staff noticed any changes in residents which might mean they needed medical help, and made sure they saw a doctor. One record showed how they had obtained pain relief for a lady who would not have been able to say directly that she needed it. One relative said that they were spot on in looking after the health of residents. Another confirmed that the manager was very good at seeing when someone was not quite themselves. Five of the residents who filled in a questionnaire said that they always received the medical support they needed, two said they usually did. There are established systems to make sure that medication is looked after and given out safely. Staff have received external, assessed, training in handling medication. However more care needs to be taken when completing the record of administration of medication which tells staff which medication to give each person, how often it should be given etc. In one case, the homes record of administration said that one pill was to be given only as required. However it had been prescribed to be given four times a day. The drug was for pain relief and the home was right in listening to the opinion of the person who took it about when she needed it. However they should be giving out medication exactly as it has been prescribed by a doctor. In this situation, they should discuss with the GP and resident whether the drug should be as required or not. The record for another person did not show the maximum number of an as required drug which could be taken in a day. The maximum dose which could be taken in a day was written on the label on the box containing the drug so staff could have read this if they were unsure. However medication procedures are intended to make it as difficult as possible for mistakes to be made, and correct recording on the administration sheet is an essential part of these procedures. Rosemount DS0000007499.V310174.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): Standards 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. Residents can take part in a range of enjoyable activities. Relatives feel welcome and if they wish can continue to help with the care of their resident. Residents remain part of the local community. Residents can make decisions about their day-to-day lives. They have a choice of food, generally enjoy the meals and staff take care that needs for special diets are met. EVIDENCE: The home employs a member of staff specially to provide activities in the home. In good weather, residents have trips out. Entertainers visit the home, and also local schoolchildren. Everyday activities include singalongs, bingo and gentle exercise classes. Staff make watching a video more of a social event by providing drinks and chocolates. Residents said that they could choose whether to take part in these activities and some preferred to enjoy television etc in their own rooms. Relatives commented particularly about how welcome staff made them feel. One relative who chooses to do so, has been able to continue helping with the care of his resident. Relatives felt that they were kept informed about the care of their family members. Rosemount DS0000007499.V310174.R01.S.doc Version 5.2 Page 12 The manager described how they used to take one resident to a lunch club she had enjoyed before her admission until she decided she no longer wanted to go there. The activities organiser takes some residents out into the town and the home has links with local schools. All the residents who commented felt that they did have control over their dayto-day lives. They could decide whether to stay in their rooms or sit with others, and get out and go to bed when they wanted. All the residents who filled in a questionnaire said that staff always listened and acted on what they said. Residents have a choice of main meal and breakfast. The evening meal is buffet style so they can choose what they want. Residents mostly said that they always or usually enjoyed the meals. One said Always plenty to eat and drink and excellent cooks. Each residents care plan explained if they needed any special help to eat or if they had special dietary needs. One lady with diabetes confirmed that the staff were aware of what she could eat. The manager described how they were helping a new resident gain weight by providing frequent snacks. Guidance on providing a good diet for older people was available in the home and some staff are doing a course on nutrition and health for older people. The menus kept showed a varied diet. Rosemount DS0000007499.V310174.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): Standards 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives know how to complain if they want to. The owners of the home try to resolve any problems before they reach the complaints stage. The home does all it can to protect residents from abuse. EVIDENCE: The home has a satisfactory complaints procedure and all the residents and relatives who commented said that they knew how to complain if they want to. One resident said Were free to say what we like. She also said that the manager was approachable and that they could talk to her any time. Records were kept of when the owners of the home had talked with a resident who had not made a formal complaint but appeared dissatisfied. One complaint was properly recorded and dealt with. New staff are checked to make sure that only suitable people are employed. Staff understand that the manager has clear expectations about how they will respond to residents. All but two of the staff have received training in how to recognise abuse. The manager knows what action to take if abuse was reported or suspected. Rosemount DS0000007499.V310174.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Although the home was not purpose-built, it still provides a comfortable and well maintained place to live. The home is kept clean and hygienic. EVIDENCE: The home consists of a large, extended house and a newer extension. There are two floors, with a lift and a flight of stairs which some residents can use. Over the years, the owners have made improvements to bring the building closer to meeting current standards. There are two lounges, a small sitting area and separate dining room. A large sun lounge can also be reached by a flight of three steps so is not easily used by all residents. All but one single bedroom are more than 10 m square in size. There are two double bedrooms but these have screens available for privacy. Five of the bedrooms have an ensuite toilet but these are screened by curtains rather than being a separate room. The building is furnished and decorated in a domestic style and residents arrange their rooms as they wish. Rosemount DS0000007499.V310174.R01.S.doc Version 5.2 Page 15 Carpets etc are replaced and rooms redecorated when they need to be. There is a bathroom with hoist on each floor and separate toilets around the building. The building seemed clean on the days of inspection. All the residents who completed the questionnaire said that it was always kept fresh and clean. Staff have received training in infection control and said that they had gloves etc to help them prevent the spread of infection. Rosemount DS0000007499.V310174.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Enough staff are on duty at all times to meet residents needs. Staff have the skills and personal qualities required for their job. The home make sure that only suitable people are recruited. Staff receive full training to make sure that they can do their jobs well. EVIDENCE: At the time of the inspection there were 16 residents in the home. Three care staff are on duty from 7 am to 3 pm each day. On three days a week, the activities organiser is available from 9 am to 3 pm. These means there are plenty of staff and they can provide activities for residents. Either the manager or the trainee manager is on duty each day and they are actively involved with the care of residents. In the evening only two staff are on duty. They also have to serve the cold buffet evening meal which the cook has prepared. Staff report that this is manageable at the moment with current needs of residents. The manager is aware that she needs to keep under review whether the evening staffing levels are satisfactory. Two waking staff are on duty during the night, which is satisfactory. Half the staff have achieved the recognised qualification for care staff (NVQ 2 in care) which meets the target set in the National Minimum Standards. Residents and their relatives praised the personal qualities of staff. Rosemount DS0000007499.V310174.R01.S.doc Version 5.2 Page 17 They were described as being respectful, kind and loving, having good manners and helpful. Records kept of the recruitment of new staff showed that the home had carried out the required checks of criminal records and the list of people who are barred from working with vulnerable adults. They also took up two references. Sometimes the home had let someone start work before the full Criminal Records Bureau check was completed, as they are allowed to do. They had arranged that the new person would only be on duty when senior staff were available to supervise them but the home must formally write down the arrangements for supervision of staff when this happens. The manager said that often new staff are already known to her in a personal capacity and this helps her choose people who will be able to provide care in the way she expects. Staff receive training in core areas such as food hygiene, moving and handling and first aid. They have received training in the protection of vulnerable adults, infection control and fire safety. Three are currently doing a distance learning course in the safe handling of medication and others of course in nutrition. They also make use of training provided about specific conditions, such as Parkinsons Disease and diabetes. Rosemount DS0000007499.V310174.R01.S.doc Version 5.2 Page 18 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): Standards 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has the experience and qualifications to run a care home and provides good leadership to staff. The trustees who run the home do seek feedback from relatives and residents but need to develop systems to make sure they find out what people think of the home. The home protects the financial interests of residents by keeping proper records of money handled for them. In most ways the home is a safe place to live and work but the manager needs to identify risks and how these will be made safe, particularly the use of mobile heaters. Rosemount DS0000007499.V310174.R01.S.doc Version 5.2 Page 19 EVIDENCE: The manager has a nursing qualification and an NVQ 4 in management and hospitality which was the previous qualification for care home managers. She has many years experience in care and regularly updates her skills and knowledge. She sets clear expectations for staff about the way residents should be cared for and respected. The trustees who run Rosemount carry out the monthly visits required by Regulations. During these visits they talk to residents. The manager has recently restarted residents meetings and found out their views on the meals and activities. She told the Inspector of plans to carry out a formal survey of the views of residents and relatives. This would help the trustees be sure that they are aware of any issues which residents have not told them about. Records are kept of any money the home looks after for residents and receipts are kept of money spent. Relatives handle residents financial affairs and if residents are not able to look after their own money, they leave a small pot of money in the safekeeping of the home. Sometimes the resident may need to spend money before their savings have been topped up by their relative and the home loans them small sums when this happens. The way this has been recorded has meant that it is not clear how much the resident temporarily owes the home. The records seen showed that the uncertainty has always meant the resident pays back too little rather than too much. Although the manager says that she doesnt mind this, it would be safer to establish a system which shows exactly how much has been borrowed. The building is safely maintained and equipment is serviced regularly. Regular checks are made of the hot water temperatures and the fire alarm system. Fire drills are done six monthly. The safety of portable electrical appliances is checked yearly. The manager has identified certain risks to residents and needs to develop the way she records how staff will reduce the chances of these risks causing harm. Some residents have portable heaters in their bedrooms, either from choice or as a necessary supplement to the central heating. The surfaces of these heaters can be very hot and the manager must identify how she will avoid residents burning themselves on these by accident. Rosemount DS0000007499.V310174.R01.S.doc Version 5.2 Page 20 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 4 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 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 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 X X 2 Rosemount DS0000007499.V310174.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 OP9 Regulation 13 Requirement Staff must always record on the medication administration record if medication is to be given as required, and how often in one day it can be given. They must check with the GP if medication which they believe is to be givenas required is not prescribed to be given as required. The home must record who is responsible for the day-to-day supervision of any member of staff who starts work before a full Criminal Records Bureau check is received. The home must set up a system for finding out the views of residents, relatives, care managers etc. When the home lends residents money, this must be accurately recorded. The home must record its assessments of any risks faced DS0000007499.V310174.R01.S.doc Timescale for action 25/11/06 2 OP29 18 01/12/06 3 OP33 24 31/01/07 4 OP35 13 01/12/06 5 OP38 13 01/12/06 Rosemount Version 5.2 Page 22 by residents and describe how it will reduce the possibility of harm coming to residents. This must include considering the risks of mobile heaters. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Rosemount DS0000007499.V310174.R01.S.doc Version 5.2 Page 23 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 DS0000007499.V310174.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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