CARE HOMES FOR OLDER PEOPLE
Rosemount Residential Care Home 48 Old Exeter Street Chudleigh Newton Abbot Devon TQ13 0JX Lead Inspector
Judy Hill Unannounced Inspection 11:00 9 & 10 January 2008
th th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rosemount Residential Care Home DS0000067202.V351232.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.V351232.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.V351232.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 11th June 2007 Brief Description of the Service: Rosemount Residential Home is registered to provide accommodation and care for a maximum of twenty people who are elderly and who may have dementia or physical disabilities. Rosemount is situated close to the centre of the Chudleigh and is a short walk from the shops and other local amenities. Information about the service is available from the home in a Home Handbook and copies of inspection reports can be obtained from the home or are available on the CSCI website. The current fees range from £285 to £374 a week and extra charges are made for the services of a professional Chiropodist and Hairdresser, toiletries (£9.87 a month), entertainment (£2 a week), newspapers, taxis and items of a personal nature. Rosemount Residential Care Home DS0000067202.V351232.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection carried out by one inspector on the 9th and 10th January 2008. The information contained in this report was gained in conversation with the registered owner/manager (Mrs Rosemarie Noon), the staff and the people who use the service and from surveys that had been completed by the service providers, staff and people who have a personal or professional relationship with the people who live at the home. Additional information was gained from an inspection of records, including individual plans of care (needs assessments, risk assessments, care plans and reviews) and staff records, including recruitment and training records and rotas. A physical inspection of the premises was carried out and direct and indirect observations were made about the service provided. What the service does well:
Individual needs assessments are carried before a new admission is made to the home to ensure that the service can offer the support required, although the home does still need to provide written confirmation of this to people considering using the service. The physical and mental health needs of the people who use the service are monitored and timely referrals are made to the professional health care services as and when necessary. Systems are in place to ensure that the medication administered by the staff is stored and handled safely. The people who live at Rosemount are encouraged to make choices, including when and where they receive visitors, what time the want to get up and go to bed and what they want to eat. Social activities within the home and occasional group outings are arranged. The quality and choice of the meals provided is excellent. Complaints are listened to, taken seriously and acted upon and policies and procedures are in place to protect the residents from the threat of abuse. The home is kept clean and fresh. Rosemount Residential Care Home DS0000067202.V351232.R01.S.doc Version 5.2 Page 6 Safe recruitment practices are used to ensure that unsuitable staff are not employed to work with the residents. What has improved since the last inspection? What they could do better:
To ensure that sufficient written information is available about the service a Statement of Purpose needs to be written up and made available on request and Service Users’ Guides need to be written up and given to all potential and existing residents. More attention needs to be given to ensuring the each of the residents and/or their representatives are fully involved in the development of care plans and individual risk assessments and in reviews. To preserve the dignity of the residents, all treatments provided including Chiropody, should be carried out in the privacy of their bedrooms. More could be done to enable the residents to take regular exercise and to maintain a presence in the community. The management is aware that further work is needed to modernise and upgrade the presentation of the home. The system of identifying the staffs training needs and the provision of induction, health and safety related and specialised training needs to be improved. The staffing levels need to be reviewed and the management need to demonstrate that enough staff are employed at all times to meet the assessed wishes and needs of the people who use the service. Rosemount Residential Care Home DS0000067202.V351232.R01.S.doc Version 5.2 Page 7 The quality assurance system needs to be developed so that a development plan, which takes into account feedback from the people who use the service and their representatives can be developed. A system of formal supervision needs to be initiated for the care staff. 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.V351232.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.V351232.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 Quality in this outcome area is adequate. Prospective residents needs are assessed before admission but the written information provided to prospective and current residents does not provide them with all of the information they need about the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service providers have not produced a Statement of Purpose or a Service Users’ Guide but do have a ‘Home Handbook’, which was inspected. This document contains information about the home and the service provided, but does not contain all of the required and recommended information. Mrs Noon said that she did not give a copy of the Home Handbook to the people who use the service but had given copies to their relatives. In a recent survey carried out by the home, some relatives said that they had not received this.
Rosemount Residential Care Home DS0000067202.V351232.R01.S.doc Version 5.2 Page 10 Written individual needs assessments had been carried out by the placement authorities and the home prior to the admission of new residents. These were seen to provide the information needed to form the basis of a plan of care. Mrs Noon said that she did not send written confirmation to prospective service users to confirm that the home would be able to meet their needs, but that she would not admit a new resident unless she was sure that their needs could be met. Mrs Noon said that prospective residents are always invited to visit the home before making a commitment to move in and that the first month following admission is regarded as a trial period to enable both parties to satisfy themselves that the home and service provided is suitable. Information about the trial period is included in the Homes Handbook. Rosemount Residential Care Home DS0000067202.V351232.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. Individuals are not always involved in decisions about their lives, and do not play an active role in planning the care and support they need. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Individual care plans are being drawn up for each of the people who use the service, however an inspection of the plan of care for two of the residents provided no evidence of direct involvement in this process by the people using the service. Although evidence was seen of general risk assessments, individual risk assessments and considered guidance for the staff on how to reduce individual risks while enabling people to maintain their independence and autonomy was not included. Rosemount Residential Care Home DS0000067202.V351232.R01.S.doc Version 5.2 Page 12 Daily records, which are intended to be used as part of the review process and to provide evidence of the service provided for individual residents, were seen. It was observed that these are not being completed daily, this was discussed with Mrs Noon who said that she had instructed the staff only to make an entry when something had happened that needed to be recorded. The Commission sent surveys were to the relatives of residents and people who are involved with the residents in a professional capacity. Some of the information received suggested that relatives are not always told about changes to the residents needs. This indicates that communication could be improved. The physical and mental wellbeing of the people who use the service is being monitored and timely referrals are being made to the professional healthcare services as and when necessary. It was observed that some of the people who have bedrooms on the first floor use walking frames and would not be able to negotiate the stairs, even with the aid of a stair lift, without assistance. As this places restrictions on the ability of some people to move freely around their home, individual risk assessments should be carried out, involving the individual concerned, their care managers, an occupational therapist and their families. An observation of the residents indicated that the staff are meeting their personal hygiene needs. It was noted that the service charges the people who use the service a fixed cost of £9.87 a month for toiletries. This is an institutional practice and the people living at the home should be helped to choose and buy the toiletries they need. A professional chiropodist visits the home on a regular basis and provides treatment in a quiet corner of the lounge. This practice was discussed with Mrs Noon who agreed that it would be more dignified for this to be carried out in the privacy of the resident’s bedrooms. No evidence was seen to indicate that the people who use the service are encouraged to take regular exercise and throughout the inspection it was observed that throughout the site visit most of the residents remained in seated in chairs in their bedrooms or in the lounge. The resident’s medication is kept in a locked cupboard and a suitable facility is provided for the storage of controlled drugs. The home uses a pharmacy controlled system which provides tablets in blister packs for safety and ease of use. The medication administration record sheets were spot checked and found to be clear and up to date. The deputy manager said that only staff who had received training were allowed to handle the residents medication and records were seen to confirm this. In the report of the last inspection a requirement was made to record the administration of creams and this is now
Rosemount Residential Care Home DS0000067202.V351232.R01.S.doc Version 5.2 Page 13 being done. An information file is kept with the medicines to provide information to the staff about the medicines being administered and possible side effects to look out for, this is recognised as good practice. Rosemount Residential Care Home DS0000067202.V351232.R01.S.doc Version 5.2 Page 14 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 adequate. The organised social, occupational and recreational activities are very good, but more could be done on an informal daily basis to keep the residents occupied both within their home and in the community. The quality and choice of the meals provided is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home recognises the need to ensure that activities are provided for the people who use the service and Mrs Noon has arranged for professional entertainers to visit the home three times a week to provide musical entertainment. Two of the people who use the service are taken out on a regular basis, one to Church and one to coffee mornings, but more could be done to ensure that all of the people who live at the home have the opportunity to go out on a regular
Rosemount Residential Care Home DS0000067202.V351232.R01.S.doc Version 5.2 Page 15 basis to enable them to exercise, enjoy a change of scenery and maintain a sense of presence in the community. Monthly group outings are arranged, weather permitting, and Mrs Noon said that the residents, weather permitting and that the residents are consulted about the venues. She said that the most recent outing had been in November and that all of the residents had enjoyed a drive on the moors followed by a cream tea in Teignmouth. During the site visit some of the residents were seen reading newspapers and doing word puzzles. A small number of residents had chosen to remain in their bedrooms but most were seated in the lounge. The television set was on in the lounge through out the site visit and very little activity and/or interaction between the residents was observed. It was observed that visitors were made welcome and the Homes Handbook states that visitors are welcome at any time. The home employs a professional chef who provides a choice of meals for the residents and dinners for people living in their own homes in the community. Special diets needs, including meals for people who are diabetic or need soft meals are catered for. Fresh ingredients are used to produce well-balanced and nutritious meals, puddings and cakes that are of an excellent standard and much appreciated by the residents. Rosemount Residential Care Home DS0000067202.V351232.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. Complaints will be taken listened to and acted upon and policies and procedures are in place to protect the people who use the service from the threat of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has a written complaints procedure and a summery of this was seen in the entrance hall and in the Homes Handbook. A box is kept in the reception area to enable the people using the service and visitors to the home to make complaints and compliments about the service. The staff who were interviewed were asked if they would know what to do if a resident made a complaint and all of them said that they would either deal with it directly or report it management. No complaints had been recorded in the complaints book and none have been referred to the Commission. The Annual Quality Assurance Assessment (AQAA) completed by Mrs Noon stated that the staff are trained in the Prevention of Abuse all Vulnerable Adults (Safeguarding). Interviews with staff and an inspection of staff records
Rosemount Residential Care Home DS0000067202.V351232.R01.S.doc Version 5.2 Page 17 showed that not all of the staff had attended formal training courses on safeguarding, although it is understood that courses are being planned (see Staffing). The AQAA identified that all of the policies and procedures relating to safeguarding the residents from abuse were kept and that they were updated in June 2006. All of the staff interviewed demonstrated that they knew how to access these policies and procedures. Rosemount Residential Care Home DS0000067202.V351232.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. Considerable improvements have been made to the Rosemount but there is still work to bring the presentation of the home up to a good standard for the people who live and work at there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Rosemount is a very old house and was in need of considerable refurbishment when Mrs Noon took over the business in May 2006. Records were seen to demonstrate that a considerable amount of refurbishing and redecoration work has been carried out and more work has been planned to improve the presentation of the home. Rosemount Residential Care Home DS0000067202.V351232.R01.S.doc Version 5.2 Page 19 Rosemount is an end of terraced house close to the centre of Chudleigh. The main entrance is to the side of the property and this leads out to a driveway that provides off street parking for four cars. Behind the driveway there is a small paved patio garden with chairs and tables for the residents use. A second outdoor area, pictured in the Home Handbook, is a roof terrace but the Mrs Noon said that was no longer being used for safety reasons (see Choice of Home). On the ground floor there is a very large through lounge/dining room. This room, which has recently been redecorated to a high standard, is the only communal room in the house. Evidence was seen that new carpets have been ordered for the ground floor rooms. The kitchen is next to the dining room and appears to be suitable for the needs of the home, although it was suggested to Mrs Noon that she may wish to consider buying a dishwasher. The laundry facilities are on the ground floor. These were seen to be satisfactory, but it was suggested and agreed that a lock needed to be fitted onto the door. There is a small staff office on the ground floor and a separate office, which is used by the manager on the second floor. The people who use the service may use staff office to make and receive telephone calls in private if they wish to do so. The bedrooms are on the first floor and the ground floor. There are two flights of stairs and stair lifts have been fitted to both. A handrail that had been removed from one flight of stairs when the stair lift was fitted was replaced during the inspection to enable the people to live at the home to use the stairs more safely if they prefer not to use a stairlift. Most of the bedrooms are single rooms and Mrs Noon said that the people who shared their bedrooms were happy to do so. The programme of upgrading the bedrooms was well underway and seven bedrooms had recently been redecorated and provided with new furniture. The residents may lock their bedroom doors if they choose to do so and the locks provided have an override system to enable the staff to gain entry in an emergency. The registered provider had changed the call bell system from a wall mounted system to personal alarms which the people who live at the home can wear around their necks if they choose to do so or keep close to them when they move around their home. Rosemount Residential Care Home DS0000067202.V351232.R01.S.doc Version 5.2 Page 20 CCTV cameras are used to monitor the driveway for security purposes but these do not intrude on the daily lives of the people living at the home. Rosemount Residential Care Home DS0000067202.V351232.R01.S.doc Version 5.2 Page 21 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. The staff are clearly very caring, but the staffing levels and the provision of staff training could be better. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Six members of staff were spoken with during the site visit and all of them showed a real commitment to providing a good service for the people who live at the home. A sample of staff recruitment records were inspected and these showed that safe practices are being used to employ new staff. Mrs Noon employs a weekday chef and a weekend cook, but does not employ housekeeping staff so the care staff combine their care duties with domestic work. Maintenance work is carried out and/or supervised by Mrs Noon’s partner. There is an assistant manager but no senior care staff to take charge when Mrs Noon and assistant manager are not on duty.
Rosemount Residential Care Home DS0000067202.V351232.R01.S.doc Version 5.2 Page 22 The rotas show that there are usually two care assistants/domestics on duty from 7am to 1pm, one from 8am to 4pm, one from 1pm to 5pm, one from 4pm to 9pm and one from 5pm to 9pm. This is in addition to the hours worked by Mrs Noon and her partner, which are not included on the staff rota unless they are covering a care shift. One waking night carer is employed from 9pm to 7am and one person is employed on a sleeping in basis. The Annual Quality Assurance Assessment completed by Mrs Noon identifies that the home is currently providing care for twenty people, that seven of the residents have dementia and that four people need two staff to help them with their care. In conversation with Mrs Noon she stated that only one of the people who used the service would be able to read and understand the Homes Handbook and that most of them would not be able to sign or initial their care plans. A general risk assessment was seen stating the none of the residents should use the stairs without staff assistance. All of the above indicates that the levels of need of the people using the service are high, but this is not reflected in the current staffing level. Further evidence that the care staffing levels need to be reviewed was found some of the surveys returned to the Commission may not be high enough to meet the needs of the people who use the service was found in some of the surveys, completed for the Commission, which highlighted a need for more staff time to be spent with the residents. Two of the staff have completed an NVQ in Care at Level 2 and at Level 3, a further two have completed Level 2 and two are working towards gaining their NVQ Qualification at Level 2. An induction programme has been introduced but an inspection of records showed that this was not being fully completed. Training records were seen to take into account the training received before and after staff have started working at the home, which is good practice, however a wall chart kept in the managers office to identify the staffs training needs and achievements did not include the dates that the training had been undertaken, which does need to be recorded as most training requires regular updates. It was also noted that there were gaps in the provision of required and recommended training and interviews with staff identified that some of their training needs had not yet been met. Rosemount Residential Care Home DS0000067202.V351232.R01.S.doc Version 5.2 Page 23 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, 36 & 38 Quality in this outcome area is adequate. The people who live at Rosemount benefit from the caring management and delivery of the service, although some of the administrative procedures need to be improved to enable the National Minimum Standards and Care Homes Regulations to be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mrs Rosemarie Noon is the registered owner of Rosemount and she is also the manager of the service. Mrs Noon has completed her National Vocational Qualification in Care at Level 4 and her Registered Managers Award. Mrs Noon is very experienced in the provision of care, having provided a care service in
Rosemount Residential Care Home DS0000067202.V351232.R01.S.doc Version 5.2 Page 24 her own home under the Adult Placement Scheme. Mrs Noon has clearly developed a good working relationship with her staff. This was made evidence during interviews with four members of staff, all of whom said that they find her supportive, caring and approachable. As with all service providers, Mrs Noon needs to ensure that she understands and is working towards providing a service that meets the National Minimum Standards and Care Homes Regulations and that she keeps up to date with changing expectations through on-going training and by accessing information from the CSCI Website. A quality assurance system is in the process of being developed and responses from surveys sent to the residents of relatives by the home were seen. This system could be further developed by gaining feedback from other people, including the people who live at the home, professional people who have contact with the people who live at the home and the staff. This information can then be used to develop an annual improvement plan. The home does not handle any money for the people who live at the home. People who need help to manage their finances are encouraged to seek help from their families or a professional representative and any out of pocket expenses will be paid for by the home and billed. An inspection of staff records showed that the care staff do not receive formal one to one supervision. This was confirmed by Mrs Noon and the staff interviewed. The staff spoken with did, however, say that the manager was very supportive and that they could discuss any issues that they wanted to raise on an informal basis through their daily contact with her. Records were seen to demonstrate that the servicing and maintenance of equipment is kept up to date and policies and procedures are in place, accessible to the staff and updated. Rosemount Residential Care Home DS0000067202.V351232.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 1 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 2 X 3 Rosemount Residential Care Home DS0000067202.V351232.R01.S.doc Version 5.2 Page 26 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 OP1 Regulation 4, 5 & Schedule 1 Requirement The registered person must produce a written Statement of Purpose and a written Service Users’ Guide. These documents must include all of the information listed in regulations 4 & 5 (including Schedule 1) of the Care Homes Regulations and should also include the information listed in Standard 1. Copies of both documents must be sent to the Commission and each of the people who use the service must be given a Service Users’ Guide. 2 OP3 14(1)d Following their initial needs assessment prospective new residents must be given written confirmation that the home will be able to meet their needs. The registered person must ensure that each resident and/or a representative, who could be a family member, is directly involved in developing and reviewing their plan of care. This should include a review of
DS0000067202.V351232.R01.S.doc Timescale for action 10/04/08 10/02/08 3 OP7 15(1) & 15(2) 10/04/08 Rosemount Residential Care Home Version 5.2 Page 27 their needs assessment, individual risk assessments and risk management plans and care plans. 4 OP8 13(7) & 17(1)(a) The registered person must arrange for multi-agency risk assessments to be carried out to assess the safety of individual residents with poor mobility using the stair lifts or stairs. This is because an inability to access communal indoor and outdoor areas is a form of restraint. 5 OP27 18 The registered person must review the care and ancillary staffing levels to ensure that they are high enough to meet the number and needs of the residents. The registered person must ensure that all of the staff receive the training they need to manager meet the needs of the people who live at the home. This should include induction training, health and safety related training and any specialised training needs identified the individual assessments and reviews of the residents needs. The registered person must develop her quality assurance programme to enable her to produce a development plan for the service, which incorporates the views of the people who use the service and their representatives. 10/02/08 10/04/08 6 OP30 18 10/07/08 7 OP33 24 10/07/08 Rosemount Residential Care Home DS0000067202.V351232.R01.S.doc Version 5.2 Page 28 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard OP7 OP8 OP8 OP8 OP10 Good Practice Recommendations Daily records should be recorded daily. Relatives should be informed of any changes to residents health and/or well-being. Residents should be given the help they need to choose and buy their own toiletries. The residents should be encouraged to take regular exercise. Any treatments, including Chiropody, provided for the residents should be carried out in the privacy of their bedrooms. More could be done to encourage the residents to engage in social and recreational activities within their home. Arrangements should be made to enable the residents to spend more time in the community. 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. At least 50 of care staff should achieve a National Vocational Qualification at level 2 (or equivalent). In her capacity as manager, the registered person should ensure that she has a good understanding of the National Minimum Standards and Care Homes Regulations and that she keeps up to date with changes through the provision of on-going training and the CSCI Website. The registered person should arrange for every member of her care staff to receive one to one supervision at least six
DS0000067202.V351232.R01.S.doc Version 5.2 Page 29 6 7 8 OP12 OP13 OP19 9 10 OP28 OP31 11 OP36 Rosemount Residential Care Home times a year. This should cover all aspects of care practice, the philosophy of care in the home and career development needs and training needs. Rosemount Residential Care Home DS0000067202.V351232.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Devon Area 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
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