Inspection on 03/05/05 for Rosetrees

This inspection was carried out on 3rd May 2005.

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

Other inspections for this house

Rosetrees 10/10/07

Rosetrees 18/04/06

Rosetrees 11/10/05

Rosetrees 03/11/04

Rosetrees 09/06/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE ROSETREES Asher Loftus Way Colney Hatch Lane London N11 3ND Lead Inspector Daniel Lim Announced 3 MAY 2005 @ 09:28 am 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 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. ROSETREES Version 1.10 Page 3 SERVICE INFORMATION Name of service Rosetrees Address Asher Loftus Way, Colney Hatch Lane, London N11 3ND Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8920 5150 020 8920 4171 Simon Morris for Jewish Care Mr Amos Samasuwo Care Home 57 Category(ies) of DE(E) Dementia over 65 registration, with number of places ROSETREES Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1 The room that is being changed to a hairdressing room will require to be inspected following the completion of the work. 2 The home removes one assisted bathroom from the ground floor to accommodate the storage and charging of hoists. 3 The home removes one assisted bathroom from the second floor to accommodate the storage and charging of hoists. 4 The home removes two assisted bathrooms from the first floor to:The home romoves two assisted bathrooms from the first floor to:a) Accommodate the storage and charging of hoists. b) The middle bathroom to be converted to a hairdressing salon. Date of last inspection 3 November 2004 Brief Description of the Service: Rosetrees is a large purpose-built care home registered to provide personal care for a maximum of fifty-seven older people with dementia. It was opened in 2001 and is run by Jewish Care. The stated aims of the home are ‘ to provide appropriate individual care for older members of the Jewish community who either choose or circumstances require them to live in residential care.’ The home is a large detached three storey building with fifty seven bedrooms. All bedrooms are for single occupancy and have en-suite facilities. There are two lifts serving all floors. There are toilets and assisted bathrooms on each of the three floors. The kitchen, office, reception and main lounge / diner are on the ground floor. Additional lounges and staff offices are located on the other two floors. There is a car park at the side of the building. The gardens are located at the front and side of the home. They are accessible to service users. The home is located in a private road off Colney Hatch Lane. It is located close to local shops, public transport and other community services along Friern Barnet Road. ROSETREES Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on 3 May 2005 and took one day to complete. The inspector found that effort had been made by the manager and his staff to comply with requirements made in the last inspection report and the quality of care provided was satisfactory. During this inspection, the inspector was accompanied by Mr Amos Samasuwo (manager). The inspector was able to interview six residents, a relative and a volunteer. The feedback received was generally positive and indicated that the needs of those interviewed had been met. In addition, completed questionnaires were received from 22 residents, 8 relatives and 8 healthcare professionals. The case records were examined. An inspection of the premises was carried out. Care staff were also interviewed. What the service does well: The premises were clean and hygienic. Staff were knowledgeable regarding their roles and responsibilities. They had been provided with essential training. There was evidence of regular consultation with residents and their relatives. The manager was able to provide examples of how residents could exercise choice and control in their lives (such as choice of meals, daily routine and items to have in bedrooms). Arrangements were in place to ensure that the healthcare needs of residents had been attended to. Residents were generally satisfied with the social activities provided. ROSETREES Version 1.10 Page 6 What has improved since the last inspection? What they could do better: The home needs an updated statement of purpose (which includes all items set out in Schedule 1of Regulation 4(1)(c). Residents must be provided with contracts / a statement of terms and conditions of tenancy containing the elements as set out in National Minimum Standard 2. The home had some residents with high needs. These residents must have their placements reviewed to determine if their care needs are met. Action needs to be taken to ensure that these residents are appropriately accommodated. Maintainence of the home and the equipment in bedrooms need to be reviewed. The bed of the resident identified in standard 23 must be lowered or replaced so that it is suitable for the resident concerned. The temperature of the room where medicines were stored was higher than 25C. This deficiency must be rectified. ROSETREES Version 1.10 Page 7 The registered provider must also improve ventilation in the main kitchen (located on the ground floor of Lady sarah Cohen House). Concerns were expressed by staff and relatives regarding staffing levels at the home. This would need to be investigated. Additional staff training is also needed in topics identified. The staff records did not contain all items stated in schedule 4 (Regulation 17(2)). These must be obtained and made available for inspection. To ensure that fire safety arrangements are adequate, the registered person must request a fire safety inspection of the premises by the fire authorities (LFEPA). The registered person must also review the use of the lost property cupboard with residents and relatives. This is because of dissatisfaction voiced by a relative. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. ROSETREES Version 1.10 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 Standards Statutory Requirements Identified During the Inspection ROSETREES Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1-5 The manager and his staff had a good understanding of the needs of residents and were able to ensure that their needs were met. Six residents, one relative and a volunteer who were interviewed were generally happy with the care and services provided. The inspector was however, uncertain if the care needs of some residents with high care needs had been met at the home. EVIDENCE: The inspector interviewed six residents, one relative and a volunteer. The feedback received indicated that on the whole, the needs of residents had been met. This was also confirmed in the completed questionnaires received from residents, relatives and professionals involved in the care of residents. Six case records examined were generally well maintained and contained the required assessments and plans of care. ROSETREES Version 1.10 Page 10 The inspector observed the physical condition of residents. Residents were noted to be clean and appropriately dressed. Two contracts were examined. These were not sufficiently comprehensive as the obligation of residents and bedrooms to be occupied were not stated. This information must be provided. The inspector noted that several of the residents had high needs and he was unable to determine if their placement was appropriate. A requirement is therefore made for the placement of these residents to be reviewed to determine if their care needs are met and plan any action that needs to be taken to ensure that they are accommodated appropriately. The statement of purpose was not sufficiently comprehensive as it did not contain all items specified in schedule 1 of Regulation 4(1)(c) (such as the range of needs and criteria for admission). This statement must be updated. ROSETREES Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 - 11 Arrangements were in place to ensure that the needs of most of the residents are met. Residents who were interviewed indicated that they had been treated with respect and dignity and their personal and healthcare needs had been met. The inspector however, noted that medication had not been stored at the recommended temperature range. EVIDENCE: Feedback from residents indicated that they had been treated with respect and dignity. The sample of six case records examined were up to date and plans of care had been reviewed regularly. Records of medical and healthcare treatment were available. Staff interviewed were knowledgeable regarding the care to be provided to residents. ROSETREES Version 1.10 Page 12 The medication administration charts examined had been appropriately signed. The temperature of the treatment room and medication fridge had been monitored daily and there were occasions when the room temperature was above 25 C. A requirement is made for this to be rectified. All residents interviewed stated that they had been given their medication. The inspector was uncertain if the needs of residents with high needs had been met as staff stated that there had been difficulties caring for them. This is commented upon in the sections dealing with Standards 1-6 and 27-30. Requirements have already been made under those standards. ROSETREES Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12-15 The daily life and routines of residents were well organised and the social, cultural and religious needs of residents had on the whole been met. Some dissatisfaction had been expressed by residents regarding the provision of meals. These had already been responded to by the manager. EVIDENCE: The inspector met the home’s activities organiser and saw the home’s programme of weekly social and therapeutic activities. The case records examined contained details of activities that residents had engaged in. Residents who were interviewed and who returned completed questionnaires indicated that they were generally satisfied with the activities provided. The kitchen and arrangements for the provision of meals were examined and certain deficiencies were noted. ROSETREES Version 1.10 Page 14 The ventilation in the kitchen was poor and staff complained that it was too hot. A requirement is made for this to be attended to. There was documented evidence of consultation meetings with residents and the manager was able to provide examples of how residents could exercise choice and control in their lives (such choice of meals, daily routine and items to have in bedrooms). Residents said they had been visited by their families. ROSETREES Version 1.10 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16-18 The rights of residents had been protected and complaints had been taken seriously. Arrangements were in place to ensure that residents are treated with respect and dignity and protected from abuse. EVIDENCE: The complaints record was examined. Complaints recorded had been promptly responded to. Staff were interviewed and found to be knowledgeable regarding adult protection. The staff records examined indicated that staff had been provided with training in adult protection. Six residents who were interviewed stated that they had been well treated. However, two individuals present informed the inspector that a staff member had been rude towards residents. This was discussed with the manager who provided the inspector with evidence that appropriate action had been taken against this staff member in accordance with the home’s disciplinary procedure. The induction programme examined indicated that staff had been instructed to treat residents with respect and dignity. ROSETREES Version 1.10 Page 16 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 standard(s) 19 -26 The home was clean and well furnished. The washing and toilet facilities were adequate. Residents interviewed stated that they were generally happy with the accommodation provided. Some of the standards were not fully met as the inspector noted that there were some deficiencies which needed to be attended to. EVIDENCE: The home had a record of maintenance done and there was documented evidence that the equipment and utilities of the home had been inspected. The premises inspected were found to be clean and hygienic. No offensive odours were detected. ROSETREES Version 1.10 Page 17 The inspector however, noted that some light bulbs (in light clusters on the ceiling) were not working. The manager agreed that they would be replaced. Some window restrictors were too narrow and did not allow sufficient ventilation. The manager agreed to have them adjusted. One resident stated that his bed was too high. This was brought to the attention of the manager who agreed that he would make arrangements for the problem to be rectified. The laundry was inspected. Linen and clothing which had been laundered were found to be clean. Staff interviewed were aware that soiled linen and clothing had to be washed at the required high temperatures of over 68C for at least 10 minutes. Laundry staff complained that there had been an instance when staff had not placed soiled laundry in special plastic bags provided. This was discussed with the manager. He provided evidence that staff had been instructed to follow the correct procedures. ROSETREES Version 1.10 Page 18 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 - 30 Staff were knowledgeable regarding their roles and responsibilities. However, some of the standards were not fully met as the inspector noted that there were deficiencies in the recruitment procedure and he was unsure if the staffing levels and deployment of staff were adequate. EVIDENCE: The random sample of staff records examined, indicated that most of the staff were recruited with care and the required recruitment procedures had been followed. However, it was noted that the records of one staff member did not contain all the required documentation (ie. CRB disclosure). The manager explained that the staff member had been transferred from another home belonging to the same organisation and agreed to obtain the required information. The records of another staff member did not provide clear evidence that she was allowed to work in this country. The manager is therefore required to clarify the employment status of this member of staff. The identity of both staff members have been disclosed to the manager. The staff records examined indicated that staff had been provided with essential training and were knowledgeable regarding their role and responsibilities. The inspector however, identified a need for staff to be provided with training in the care of residents with challenging behaviour and ROSETREES Version 1.10 Page 19 in infection control. Staff who were interviewed stated that some residents had challenging behaviour and they would like training in this area. The inspector was uncertain if the staffing arrangements were adequate and a further requirement is made for an investigation to be carried out as to why there had been concerns expressed regarding staffing levels by relatives and staff interviewed. Staff were of the opinion that the home had several residents with high needs and that these residents should be transferred to a care home providing nursing care as they had experienced difficulties caring for them. This was discussed with the manager who agreed to look into the matter and provide the inspector with a report. ROSETREES Version 1.10 Page 20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31-38 Staff and residents interviewed were of the opinion that the home was generally well managed. The manager was knowledgeable regarding his role and responsibilities. Arrangements were in place to ensure the health and safety of residents and staff. The inspector however, noted that a fire safety inspection by the LFEPA is needed and there is a need to review the use of the lost property cupboard. EVIDENCE: When interviewed, the manager was found to be knowledgeable and residents expressed confidence in his abilities. The inspector however, noted that a relative was dissatisfied that suggestions made by him regarding having a lost property cupboard had not been promptly ROSETREES Version 1.10 Page 21 responded to. This was discussed with the manager and a requirement is made for him to review the issue with residents and their relatives. The inspector noted that appropriate action had been taken to safeguard staff and residents. Window restrictors were in place. A trip hazard in bedrooms which was identified, had been rectified. There was documented evidence that appropriate action had been taken against staff who did not follow the home’s drug administration procedures. Weekly fire alarm checks, fire drills and fire training had been documented. The home had been inspected by the fire authorities (LFEPA) in July 2004, but no report had yet been received. Due to the lapse of time, the registered person must therefore request for a fire safety inspection of the premises by the fire authorities (LFEPA)) to be carried out and forward a copy of the report when received, together with details of any action to be taken in response to requirements made. The home’s record of accidents was examined. The records were well maintained. ROSETREES Version 1.10 Page 22 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 2 3 2 3 x 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 3 15 2 COMPLAINTS AND PROTECTION 3 3 3 3 2 2 3 4 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 2 3 3 3 3 2 ROSETREES Version 1.10 Page 23 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 4(1) Requirement The registered person must have a statement of purpose (which includes all items set out in Regulation 4(1)(c) Schedule 1). The registered person must provide residents with contracts / a statement of terms and conditions of tenancy containing the elements as set out in National Minimum Standard 2. The registered person must review the care of the residents with high needs with the purchasing authorities to determine if the placements are appropriate. The registered person must ensure that staff are provided with training in the following areas : a) care of residents who have challenging behaviour b)infection control The registered person must ensure that medication in the home is stored in an area or areas where the temperature can be maintained at 25°C or below. The registered provider must improve ventilation in the kitchen. Version 1.10 Timescale for action 3/8/05 2. 2 5 3/8/05 3. 3 12(1), 14(2) 3/8/05 4. 30 18 (1) (c) (i) 3/8/05 5. 9 13(2) 4/6/05 6. 15 23(2)(c) 3/8/05 ROSETREES Page 24 7. 23 16(2)(c) 8. 9. 24 27 23(2)(p) 18(1)(a) 10. 29 19 11. 29 19 12. 33 12 13. 38 23(4) The registered person must arrange for the bed of the resident identified in standard 23 to be lowered and replaced. The registered person must arrange for adequate ventilation in residents bedrooms. The registered person must investigate concerns expressed by relatives and staff regarding staffing levels and the roles of care staff at the home and undertake any actions identified out of the investigation so as to ensure it has sufficient staff to meet the needs of residents throughout the day and night. A report of actions undertaken following this investigation must be forwarded to the inspector. The registered person must ensure that staff records contain all documentation outlined in Schedule 2 of the Care Home Regulations 2001.Written confirmation must be provided that the staff member identified in standard 29 has received a satisfactory CRB disclosure. The registered person must clarify the employment status of the staff member identified in standard 29 with the personnel department of the organisation. The registered person must review the use of the lost property cupboard with residents and relatives. The registered person must request a fire safety inspection of the premises by the fire authorities (LFEPA). 3/6/05 13/6/05 1/8/05 4/6/05 1/8/05 30/7/05 3/7/05 ROSETREES Version 1.10 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations ROSETREES Version 1.10 Page 26 Commission for Social Care Inspection Solar House 1st Floor, 282 Chase Road Southgate London N14 6HA 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 ROSETREES Version 1.10 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!