Inspection on 03/08/06 for Rosemount

This inspection was carried out on 3rd August 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Rosemount 17/03/08

Rosemount 18/09/07

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 3rd August 2006 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.V290820.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.V290820.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) Mrs Sylvia Huntingdon 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.V290820.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th January 2006 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, which 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. 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.V290820.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over 10 hours during three visits; it covered all of the core standards. Ten residents, and eight relatives were spoken to directly although more were chatted to briefly. Four staff were spoken to and asked for their views. Four care plans, training records and the records for medication, staff files and training, and health and safety records were examined. Ten resident and ten relative questionnaires were sent out. Five relative and four residents questionnaires were returned and the contents of these have been including in this report. There were no requirements identified during the last inspection and only two recommendations. Three requirements have been identified as a result of this inspection although the Manager was in the process of addressing them by the end of the inspection process. Two recommendations have been made. What the service does well: What has improved since the last inspection? The Registered Manager and staff continue to work toward improving the standard of the care being delivered. The Manager is improving the way she consults with the residents, their families and outside agencies to ensure that she is aware of their opinions and wishes. There is now a settled staff group and although the morale has been low in the past this is now improving. Rosemount DS0000028819.V290820.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. Rosemount DS0000028819.V290820.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 DS0000028819.V290820.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. No resident is admitted into the home until there is a comprehensive assessment undertaken by the staff. This then forms the basis for the development of the care plan. The home does not offer intermediate care. EVIDENCE: Four care plans were examined and each has comprehensive pre-admission assessments. Either the Manager or the senior staff carries this out. The records seen were well documented and detailed enough to form the basis of the care planning. The care plans also contained a care management assessment, which is provided to the home on admission, and from these documents an individual care plan is developed. Rosemount DS0000028819.V290820.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, & 10 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The residents are having their needs met and the individual care planning is identified in the care plans which are up to date and detailed. The residents are treated with respect and their privacy is being maintained. The residents receive their prescribed medication in line with safe working practices. The medicines in the home are well managed and safely disposed of as necessary. EVIDENCE: All residents have an individual plan of care, based on an admission assessment, which is then added to during the placement. Four care plans were examined all of which contained a large amount of information regarding the care of the resident and there were relevant risk assessments available for the nutrition, wound care, moving and assisting, and continence promotion. The plans were being regularly reviewed and updated to ensure that they contain up to date and accurate information. The care plans showed that the residents have access to all NHS services and facilities. There was a good Rosemount DS0000028819.V290820.R01.S.doc Version 5.2 Page 10 range of pressure relieving mattresses in use for the prevention of pressure sores. The systems for managing medicines in the home were found to be appropriate. The staff record the medicines being ordered, the prescriptions are then checked on receipt from the General Practitioners and are then sent to the Chemist for dispensing. The medicines are then again checked against the records when received into the home so that any errors can be picked up. The home has a contract with a Pharmacist, which included giving advice as necessary. No residents are currently managing their own medication. There have been some problems with the management of the medicines recently (not effecting residents), which have now been resolved, however the Manager is monitoring this to ensure that further issues do not occur. The Manager, nursing and care staff, and support staff provided information to show that they aware of the needs of the residents. Questionnaires returned from both residents and relatives were complementary about the way the care is being delivered by the staff in a friendly and respectful way. Rosemount DS0000028819.V290820.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, & 15 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Residents are generally satisfied with the flexibility of their routines for daily living, which are appropriate to meet their cultural, social, religious and recreational interests and needs. There are not enough opportunities available for the residents to be involved in varied and individualised social activities, which must be recorded in detail. The food being served offers a nutritious and balanced diet with choice and variety, the catering staff work hard to accommodate individual residents needs within the restrictions of multi-occupancy living. However the cook is not adequately trained to ensure that she is fully competent in all aspects of her role. Arrangements for residents to maintain contact with their family and friends and the local community are suited to each individual’s needs and vary accordingly Rosemount DS0000028819.V290820.R01.S.doc Version 5.2 Page 12 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. However, due to the dependency level of some of the residents a number of the activities offered are less active and provided on a more one to one basis. The home employs an activities coordinator who has a weekly programme of activities offering differing opportunities. This is not sufficiently developed to offer individualised activities for the residents in line with their social assessment. The records of the activities provided are not detailed, and it is necessary that this be developed further to show the full extent going on in the home. 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. On the second visit the food being served was steak and onion, with mashed potatoes, and peas. The alternative was cheese and bacon flan, and chips. The desert was semolina pudding or ice cream or yoghurt. The mealtime was well organised and the food being served was well received by the residents. An example of this was one who said, “this is lovely” and “ the food is always nice”. During the visit one resident said that she was dissatisfied with the breakfast she had been served. This was brought to the attention of the cook who met with the resident and they agreed the improvements needed to ensure that would receive the food served in the way she preferred. The cook has recently been appointed to the position of head cook and there is also a new assistant cook. Although both have had food handling and hygiene training they have not received additional cooking training. It is necessary for the Head Cook to be given catering training which to ensure she has the skills and competencies to perform her role fully. Rosemount DS0000028819.V290820.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 & 18 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. There is a complaints policy in place that is known to residents, relatives and staff. This describes the system for managing and dealing with complaints, which is being followed. The residents are protected from abuse by staff training, recruitment and selection and effective documentation. 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. There has been six complaints received since 01.01.06. The records of these were detailed including the response to the complainants and any action for improvement taken in response to the issues raised. Four of these are completed and two are still in the process of being investigated. The Manager records all expressions of concern so she can use the information in the companies quality assurance system. Four of the residents who were interviewed during the visit understood how to make a complaint, and could identify the way this would be dealt with. Three relatives who was visiting the home was aware of the complaints procedure but had not needed to use it and the questionnaire responses supported this. Rosemount DS0000028819.V290820.R01.S.doc Version 5.2 Page 14 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. Rosemount DS0000028819.V290820.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The bedrooms are all single occupancy and are decorated and equipped in a homely and personalised way. The home is generally clean and well decorated, and there is an ongoing programme of redecoration. Cleaning schedules are not in place for the kitchen. These would demonstrate how the cleaning is being undertaken and by whom as part of the quality assurance process. EVIDENCE: A tour of the premises was conducted with the Manager and alone and it was noted that the communal room are clean and well decorated. Bedrooms are personalised and are decorated in line with the wishes and choices of the resident. There are a few bedrooms which require replacement of the carpet, and the manager has a list of these with priority given to those in greatest Rosemount DS0000028819.V290820.R01.S.doc Version 5.2 Page 16 need. The Manager has plans to further improve the environment generally as part of the redecoration programme. The home was clean and odour free on all visits. The Manager acknowledges that the positioning of the laundry near the entrance of the building does cause occasional problems with odour. She is attempting to use methods of reducing this. 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 is temporally using open topped bins while awaiting foot operated ones. 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. Feedback from the questionnaires returned suggested that the bedroom areas are not always deep cleaned to the necessary standard. Although this was not evident on the visits it is recommended that the Manager undertake an audit of the bedroom cleaning to ensure that it is not a problem. The kitchen area was clean and tidy, however there was no cleaning schedule in place to demonstrate the way in which this is being achieved. This was organised and in place by the last visit. This will allow the Manager to ensure that she can audit this area fully as part of her quality assurance process. Rosemount DS0000028819.V290820.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home has an effective recruitment and selection system, which ensures that residents are cared for by competent staff and are in safe hands, including Criminal Record Bureau checks and use of the Protection of Vulnerable Adults List. The training programme is up to date for all staff and a significant amount of training is being given to the staff in health and safety, statutory and clinical areas of practice. EVIDENCE: Four staff records were examined and 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. The manager confirmed that she has ensured that the staff are up to date with moving and handling, first aid, and fire training. They also are offered a number of other training opportunities including pressure area care; continence training and catheter care 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 programme is up to date Rosemount DS0000028819.V290820.R01.S.doc Version 5.2 Page 18 except for the updates of the fire training which is usually provided six monthly for day staff and three monthly for night staff. One of the returned relative questionnaires suggested that there were insufficient staff. The staffing rota does not support this, however it may be the result of individual perceptions of the required staffing levels or the way the staff are delegated. It may also relate to the dependency of the current residents in the home and it is therefore recommended that the Manager undertake an audit into the dependency levels and the impact on staffing requirements. Rosemount DS0000028819.V290820.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Mrs. Huntingdon is the Registered Manager for the home. The company has policies and procedures in place to ensure that the home is managed effectively taking into account the needs and wishes of the residents and there is evidence that she is working in line with these. Resident’s personal allowances are being managed effectively. The Manager is ensuring that the home is protecting the residents through good health and safety practices and staff training. Only fire training updates are not fully up to date. Rosemount DS0000028819.V290820.R01.S.doc Version 5.2 Page 20 EVIDENCE: 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. However the updates for all staff are not up to date. There is a system in place to review health and safety in the home involving the staff, for which records are available. 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. 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. There is a small float available for the staff to access on behalf of the residents. Rosemount DS0000028819.V290820.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Rosemount DS0000028819.V290820.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP12 Regulation 16 (2) (m) (n) Requirement The residents must have more opportunities to be involved in varied and individualised social activities, which must be recorded in detail. The cook must be provided with training to ensure she has the skills and competencies to fulfil her role. All staff must receive firetraining updates in line with the company policies. Timescale for action 01/12/06 2. OP15 18 01/03/07 3. OP38 23 (4) 01/10/06 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 OP27 OP26 Good Practice Recommendations It is recommended the Manager undertake a staffing audit to determine the impact the current level of dependency of the residents is having on the staffing requirement. It is recommended the Manager introduce an audit of the bedroom cleaning to ensure the standard is not being allowed to fall. Rosemount DS0000028819.V290820.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rosemount DS0000028819.V290820.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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!