Inspection on 11/06/07 for Rosemount Residential Care Home

This inspection was carried out on 11th 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 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 Residential Care Home 21/07/09

Rosemount Residential Care Home 09/02/09

Rosemount Residential Care Home 09/01/08

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Rosemount Residential Care Home 48 Old Exeter Street Chudleigh Newton Abbot Devon TQ13 0JX Lead Inspector Fiona Cartlidge Unannounced Inspection 11th June 2007 10:55 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 Residential Care Home DS0000067202.V338606.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 Residential Care Home DS0000067202.V338606.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosemount Residential Care Home Address 48 Old Exeter Street Chudleigh Newton Abbot Devon TQ13 0JX 01626 853416 01626 852398 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) Mariarod Care Homes UK Ltd Ms Rosemarie Anne Noon Care Home 20 Category(ies) of Dementia (20), Old age, not falling within any registration, with number other category (20), Physical disability over 65 of places years of age (20) Rosemount Residential Care Home DS0000067202.V338606.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18/10/06 Brief Description of the Service: Rosemount is a 400-year old building set within a heritage area, near the centre of Chudleigh. It is privately owned and aims to provide long-term residential care for older people. The home is registered to care for a maximum of twenty older people of either gender who are physically and mentally frail or have dementia. The home does not intend to provide a service for people whose mental health issues cause them to display anti-social behaviour or aggression. The home does not provide an intermediate rehabilitation care service. It is not registered to provide nursing care. Due to the age and structure of the building residents are required to have a certain degree of mobility although one of the two staircases benefits from a chair lift for access to the first floor bedrooms. The home has twelve single bedrooms and four shared rooms, some of which have en-suite facilities. There is a large sitting/dining room, and in good weather residents can benefit from a level paved seating area on the ground floor. Information provided to the commission by the provider in October 2006 was that the fees at Rosemount range from £287 to £363, with supplementary costs for hairdressing, chiropodist, papers, toiletries, taxis and some entertainment. Rosemount Residential Care Home DS0000067202.V338606.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit took place over 5 hours and was unannounced. We conducted a full tour of the home. Two hours were spent particularly observing the care given to two service users and any the activities undertaken. After which staff were spoken with and comparisons to care records were made. Two service users had their care needs studied in detail - their records were examined and both service users were spoken with in depth about the care and services they receive. Six other Service users were spoken with during the visit, 3 visitors, 2 members of staff and the registered providers. Personnel records of 3 members of staff and policies and procedures were also inspected. What the service does well: What has improved since the last inspection? The registered persons have owned this home for one year, when they purchased the home there were a number of standards that were not being met. There was evidence at this inspection (one year later) that a considerable amount of work has been undertaken to meet standards. It was noted though that generally outcomes for people who use this service are satisfactory people looked well cared for, the atmosphere was calm and friendly and people told us things have improved under the new ownership. The provider explained and showed us the considerable improvements that have been made to the exterior of the property to provide access for Rosemount Residential Care Home DS0000067202.V338606.R01.S.doc Version 5.2 Page 6 emergency vehicles and resident transport and a comfortable seating area for residents in fine weather. Internally a tour of the premises showed: a new call system has been fitted allowing for residents to summon assistance wherever they are in the home. Four bedrooms have been redecorated and refurbished. A macerator has been installed negating the use or storage of yellow bags for incineration and the possibility of foul odours. A staff-training programme has been introduced. The providers have made some considerable changes to the staff team an assistant manager has been provided with the role of managing the day-to-day care of residents, and members of staff who have been trained have responsibility for medication administration and management. A key worker system has been introduced which supports a ‘person centred’ approach to care. Care staff have received training on ‘the person centred theory of dementia’. Training has also been organised on the safeguarding of vulnerable adults. What they could do better: The system for administering medication is not completely safe this poses a risk to people who use this service the staff in the home must make sure that all prescribed medication including creams and ointments are accurately recorded when they are administered this will lessen the risk of over or under administration and provide a clear record to aid reviews. Hand washing facilities were seen available around the home with the exception of 1 WC, which had no hand basin. It was noted that soap bars where in use in shared rooms the soap bars were not in named receptacles this poses a risk that they may be shared increasing the risk of cross contamination. Recommendations have been made in this report to address these matters. None of the bedrooms had a lock nor were there any risk assessments to support the non-provision of locks therefore denying residents choice in relation to privacy dignity and security. A requirement has been made in this report to address this issue. Several areas of the home need to be redecorated and re-carpeted the provider has yet to compile a building and maintenance programme to show how and what improvements are going to be made. A recommendation has been made in this report for this to be done. The financial interests of the people using the service were not safeguarded. The current system of banking and recording finances was not individualised to each person using the service. A recommendation has been made in this report to rectify this situation. Records of fire and environmental risk assessments lacked detail. Safety systems had not been regularly checked. Failure to check fire safety equipment Rosemount Residential Care Home DS0000067202.V338606.R01.S.doc Version 5.2 Page 7 has the potential to place people who use this service at risk. A requirement has been made in this report to make sure this happens. Failure to train staff in health and safety issues such as moving and handling has the potential to put people at risk. A recommendation has been made to ensure all staff have the skills and knowledge to meet the needs of people who live in the home. 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 Residential Care Home DS0000067202.V338606.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 Residential Care Home DS0000067202.V338606.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): 1,3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service have sufficient information about the home in order to make an informed decision about whether the service is right for them. The personalised needs assessment means that people’s diverse needs are identified and planned for before they move to the home. EVIDENCE: Information about this home was available on request from the office. The Homes ‘handbook’ provides information about the services and facilities as well as its aims and objectives. The provider has told us that the handbook is given or sent to prospective residents and or their representatives. People are invited to visit the home to be shown around and meet staff and existing residents. Rosemount Residential Care Home DS0000067202.V338606.R01.S.doc Version 5.2 Page 10 A trial period is offered in order that people can be sure their needs can be met at this home. We spoke in detail to two recently admitted residents and one of their relatives. One told us they had chosen this home having looked at eight others, they had been impressed because it was family run and had a friendly and homely atmosphere; both the resident and the visitor said the home had exceeded their expectations. The other recently admitted resident confirmed they thought the home was ‘marvellous’. We looked at records held on behalf of two residents both contained copies of pre admission assessments undertaken by the registered provider. The information gleamed from this assessment allows a formal decision to be made about the homes ability to meet the individuals needs. The provider told us they had had to tell two prospective residents in the previous ten months that they did not think Rosemount would be the right home for them. Other records seen included copies of assessments carried out through care management arrangements and hospital/community health care teams where applicable. This home is not registered for and does not provide intermediate care. Rosemount Residential Care Home DS0000067202.V338606.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. People who use this service can be sure their health and personal care needs will be met. The system for administering medication is not completely safe this poses a risk to people who use this service. People are treated kindly and their right to privacy is upheld. EVIDENCE: Service users spoken with confirmed they receive a good level of care. Personal records held on behalf of 2 service users were examined in detail; there were documented assessments which provided information about personal skills, skin condition, moving and handling, safety - including risk of falls, nutritional needs and social needs. The information in the assessments had been used to form the plans of care and provided the basis from which the care was to be delivered. Rosemount Residential Care Home DS0000067202.V338606.R01.S.doc Version 5.2 Page 12 Records are written about all visits to the home by social or health care professionals, and all service users are registered with a General Practitioner. Records provided evidence that as well as visits from GPs, district and specialist nurses and chiropodists also visit. Records of outpatient appointments show that visits to community and hospital health resources are enabled. Since the last inspection to the home, improvements had been made in the storage and processes for the administration of medicines. However medication was not administered safely. The storage of medicines had improved by moving the medication to a more secure area and a new system of blister packed medicines, with new policy guidance had been introduced into the home. This had helped to bring a safer more consistent process of a administration into the home. Medication administration practice was poor as medications that had been prescribed for individuals were not recorded when they were administered. This relates to medicines given out and not signed for when administered and to the use of creams and lotions. This poses a risk, of either over or under administration, so that someone may receive to little or too much medication. This also makes it difficult for staff to monitor the medications effectiveness. Staff were seen and heard knocking on doors before entering bedrooms and were carrying out personal care for service users in private. Some staff observed in conversation with Service users were heard to be courteous and respectful, one, on one occasion, was patronising. Rosemount Residential Care Home DS0000067202.V338606.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 lifestyle experienced in the home meets the expectations of the people who use this service. People are encouraged and enabled to maintain contact with family, friends and representatives and the local community. Peoples rights to choice and control over their lives is respected and the food served in the home is appealing and provides a balanced diet. EVIDENCE: During the site visit, two hours were spent in the lounge/dining room observing residents and how staff interacted with them. This highlighted examples of excellent practice but also of very poor practice, which was explained to the Provider at the end of inspection. Some care given by staff was at the right speed and demonstrated genuine warmth and attention, and showing respect, whilst other interactions were based on tasks that were done quickly. The television in the lounge dining room was turned on, but there was no communication about whether this was the programme people wanted on, but Rosemount Residential Care Home DS0000067202.V338606.R01.S.doc Version 5.2 Page 14 it appeared rather that an assumption had been made that the residents liked the television on, none of the residents seemed distressed by the television being on. Other service users were seen spending time in their rooms, reading, listening to music, and watching television or seeing visitors. During a period of observation it was noted that staff addressed some of the people using the service, not by their names, but by terms of affection such as love or darling. It was not clear if this familiarity had been discussed and/or agreed between the member of staff and the person being spoken to. It is important to clarify how the person wishes to be addressed and to use the name they prefer as this helps to promote dignity, respect, independence and choice. Members of staff were observed engaging with the people using the service with humour, respect and concern, which they appeared to respond well to and enjoy Service users spoken with confirmed social activities are arranged, they spoke of regular musical entertainment. Residents told us that activities are advertised by word of mouth, with staff telling them what’s available; a notice board was seen in the hallway advertising past and forthcoming events. Records held about service users included some information about their social and economic histories. A more person centred approach to care allows the staff to know more about the people they care for such as their family and working history as well as their hobbies and interests. The feedback about food was very positive, all of the Service users spoken to said how good it was. A board advertising the choice available for lunch was situated in the lounge/dining room on the day of our visit people were able to chose from sausages and onions, lamb hotpot or chicken pie followed by peaches and creams or apple crumble. Meals-on-Wheels is provided from the home to about eight people living in the village. The food served at lunchtime looked and smelt appealing. Service users requiring assistance with their meals were mostly given this in an appropriate manner. During the period of observation, all Service users appeared to be enjoying their meal and were in a positive mood. The people living in the home said they were happy with the visiting arrangements. Visits were seen to take place socially in the lounge and privately in residents own accommodation. Visitors told us they feel welcomed into the home. Rosemount Residential Care Home DS0000067202.V338606.R01.S.doc Version 5.2 Page 15 Rosemount Residential Care Home DS0000067202.V338606.R01.S.doc Version 5.2 Page 16 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. Arrangements for protecting people who use this service and responding to their concerns are satisfactory. EVIDENCE: This service has a complaints procedure it is clearly written and easy to understand and was seen advertised in the guide about services as well as displayed in the hall way. Residents and visitors confirmed that they felt comfortable discussing issues with the staff and manager. The record of complaints had no entries and the provider confirmed they have had none. There have been no complaints referred to the Commission about this service. The complaints/concern book is currently kept in the office the provider has been advised to place this in the reception area so that people have access to it. Records seen show that the Staff have been made aware of and attend training on the recognition and reporting of incidents or allegations of abuse or neglect. The homes policy and procedures for safeguarding adults gives clear specific guidance but needs to be reviewed in the near future to ensure the contact Rosemount Residential Care Home DS0000067202.V338606.R01.S.doc Version 5.2 Page 17 details for external agencies are still correct. Residents told us they feel safe living in the home. Rosemount Residential Care Home DS0000067202.V338606.R01.S.doc Version 5.2 Page 18 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 adequate. This judgement has been made using available evidence including a visit to this service. Considerable improvements have been made to the environment since our last visit, however there is still work to be done to ensure pleasant and comfortable surroundings are available for all of the people who live and work in this home. EVIDENCE: On arrival at the home a large skip was seen adjacent to the entrance. The provider explained and showed us the considerable improvements that have been made to the exterior of the property to provide access for emergency vehicles and resident transport and a comfortable seating area for residents in fine weather. Rosemount Residential Care Home DS0000067202.V338606.R01.S.doc Version 5.2 Page 19 Internally a tour of the premises showed: a new call system has been fitted allowing for residents to summon assistance wherever they are in the home. Four bedrooms have been redecorated and refurbished. A macerator has been installed negating the use or storage of yellow bags for incineration. Hand washing facilities were seen available around the home with the exception of 1 WC, which had no hand basin. It was noted that soap bars where in use in shared rooms the soap bars were not in named receptacles this poses a risk that they may be shared increasing the risk of cross contamination. The laundry room floor has been replaced. An additional stair lift has been fitted but has yet to be commissioned. This will negate the current practise where one wheelchair bound resident is manually supported up and down the 2 steps that have to be negotiated each time they leave or access their bedroom. It was noted in another shared room that a step would need to be negotiated if the en suite were to be used. The residents in this room we were told were both immobile and therefore did not have the opportunity to use the en suite, instead they had no choice but to use commodes in the bedroom, screening was seen to be available. Residents told us they like their personal accommodation there was evidence that they have been supported and encouraged to bring personal possessions with them into the home. None of the bedrooms had a lock nor were there any risk assessments to support the non-provision of locks therefore denying residents choice in relation to privacy dignity and security. Some environmental and fire risk assessments were seen but these were not detailed and did not include specific risks to individuals. None of the radiators have covers some of these may not pose a risk because of there location and accessibility by residents others may pose a considerable risk, but this has yet to be assessed or action taken to minimise the risk where one is identified. A requirement has been made in this report to address this. Several areas of the home need to be redecorated and re-carpeted the provider has yet to compile a building and maintenance programme to show how and what improvements are going to be made. The environment was warm and odour free at the time of the visit, some areas needed cleaning for example carpets needed vacuuming, we were told that the cleaner had left and a replacement has yet to be found. Rosemount Residential Care Home DS0000067202.V338606.R01.S.doc Version 5.2 Page 20 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. There are usually sufficient numbers of staff to meet all of the needs of people living in this home and a staff-training programme has been introduced. The recruitment process offers a satisfactory level of protection to the people who use this service. EVIDENCE: Residents spoke highly of the staff team saying how kind and attentive they where. We observed some very good meaningful communication between the staff and residents but occasional task orientated approaches detracted from the good standards of care being provided for some residents at some times. On the day of our visit there where 3 care staff on duty in the morning, 2 in the afternoon and 3 in the evening with two at night for 17 residents. Two residents require the support of two staff to meet their personal needs this meant that if they needed care in the afternoon no one else could have their needs met at the same time. Two residents also wanted to be taken outside to smoke cigarettes on regular occasions leaving only one member of staff available for the other 15 clients. One member of staff told us they had been too busy to sign the medication administration records on the day of our visit Rosemount Residential Care Home DS0000067202.V338606.R01.S.doc Version 5.2 Page 21 as they had needed to spend time communicating with the hospital about a resident who had been admitted there. The providers have made some considerable changes to the staff team an assistant manager has been provided with the role of managing the day-to-day care of residents, and members of staff who have been trained have responsibility for medication administration and management. A key worker system has been introduced which supports a ‘person centred’ approach to care. Care staff have received training on ‘the person centred theory of dementia’. Training has also been organised on the safeguarding of vulnerable adults, notices confirmed this training was organised for all on the day following our visit. An induction programme has been introduced although the records of 2 newly appointed staff show this training has not been completed although they have been employed for over 5 months. Three Personnel files were examined, these records generally showed a commitment to safe recruitment practises, files contained detailed application forms, one file contained only 1 reference and the other 2 contained 2 written references. There was evidence of Criminal Record Bureaux checks, and each file held proof of the person’s identity. All of the files contained copies of terms and conditions of employment. Rosemount Residential Care Home DS0000067202.V338606.R01.S.doc Version 5.2 Page 22 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. The registered provider manages the home and she takes her responsibilities very seriously. The home is run in the best interests of the service users. Incomplete risk assessments mean that the health and safety of people living and working in the home are not consistently protected. EVIDENCE: The registered providers/manager cover shifts in the home they had both worked in the home the night before our visit and must be commended for Rosemount Residential Care Home DS0000067202.V338606.R01.S.doc Version 5.2 Page 23 assisting us in a professional manner with our inspection process after very little sleep. The registered manager had completed and returned a self-assessment document to the Commission before our visit to the home. We confirmed the information provided in this document during our visit. The registered persons have owned this home for one year, when they purchased the home there were a number of standards that were not being met. There was evidence at this inspection (one year later) that a considerable amount of work has been undertaken to meet standards it was also found that more work is required for this home to successfully meet all the key standards. It was noted though that generally outcomes for people who use this service are satisfactory people looked well cared for, the atmosphere was calm and friendly and people told us things have improved under the new ownership. Residents, visitors and staff told us that the management team were approachable and supportive. We examined templates of satisfaction questionnaires we have been told these are to be sent to relatives/visitors and residents where appropriate. Communication systems are informal because both partners work in the home they communicate regularly with the staff, residents and visitors. A more formal system of communication should be considered for example regular recorded meetings so that everyone has the opportunity of receiving the same information in a consistent manner and are given the opportunity to express their views. The financial interests of the people using the service were not safeguarded. The current system of banking and recording finances was not individualised to each person using the service. One account is held for several people and there are joint receipting for some bulk items and services such as chiropody and toiletries. This means it is difficult to audit, monitor and safeguard individuals finances. The manager of the home said that she was in the process of changing financial procedures in the home and was able to demonstrate that she had taken action to begin to change the current system. Records of fire and environmental risk assessments lacked detail. Safety systems are not regularly checked we looked at the fire log book this record showed emergency lights had last been checked in March as had the visual check on extinguishers weekly tests on the fire alarm were last recorded on 1st May and previously to that 16/03/07. Failure to check fire safety equipment has the potential to place people who use this service at risk. Failure to train staff in health and safety issues such as moving and handling has the potential to put people at risk. Rosemount Residential Care Home DS0000067202.V338606.R01.S.doc Version 5.2 Page 24 We found an unsecured container of an antibacterial scrub this poses a potential risk to people who have cognitive impairment of ingestion. Substances that could be hazardous to peoples health should be stored safely. Rosemount Residential Care Home DS0000067202.V338606.R01.S.doc Version 5.2 Page 25 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 X X 2 X 3 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 X X 2 Rosemount Residential Care Home DS0000067202.V338606.R01.S.doc Version 5.2 Page 26 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(2) Requirement The Registered Person must make arrangements for the handling and safe administration of medicines in the care home. This relates to the recording of the administration of non oral medication such as creams and lotions. 2. OP21 13(3)16(2 j)23(1a2j) The Registered Person must make suitable arrangements to prevent infection, toxic conditions and the spread of infection in the care home; This relates to the upstairs toilet with no hand washing facility. Previous timescale not met 31/12/06 The registered person must ensure robust recruitment processes to make sure that people employed at the home are suitable and to keep the people who live at the home safe. This relates to an absence of Rosemount Residential Care Home DS0000067202.V338606.R01.S.doc Version 5.2 Page 27 Timescale for action 01/08/07 01/09/07 3 OP29 19 01/09/07 4. OP38 13(4a,c) some of the documents listed in schedule 4 that must be kept in the care home. The Registered Person shall 30/09/07 ensure that(a) all parts of the home to which service users have access are so far as reasonably practical free from hazards to their safety; (c) Unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. This relates to the records of fire and environmental risk assessments lacking detail and safety systems are being regularly checked 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 OP14 OP19 Good Practice Recommendations The staff should clarify how the person using the service wishes to be addressed and to use the name they prefer. The Registered Person should continue with the proposed programme of renewal and refurbishment to the home, and supply a copy of this plan with dates to the Commission. The Registered Person should ensure that en-suite facilities in rooms accommodating service users using wheelchairs or other aids are accessible to them. The Registered Person should ensure that all bedrooms are DS0000067202.V338606.R01.S.doc Version 5.2 Page 28 3. OP21 4. OP24 Rosemount Residential Care Home fitted with locks suited to service users’ capabilities and accessible to staff in emergencies and that service users are provided with keys unless their written individual risk assessment suggests otherwise. 5. 6. 7. OP27 OP28 OP30 There should be sufficient members of staff to meet the assessed needs of people living at the home at all times. At least 50 of care staff should achieve a National Vocational Qualification at level 2 (or equivalent). Staff should complete the induction programmes that have been introduced to ensure they have the skills and knowledge to meet the needs of the people living in the home. All staff should have regular training and updates to ensure safe moving and handling practises are used at all times. The manager of the home should continue as planned with the changes to financial procedures in the home. 8. OP35 Rosemount Residential Care Home DS0000067202.V338606.R01.S.doc Version 5.2 Page 29 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. 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