Inspection on 14/11/07 for Rosevilla Residential Home

This inspection was carried out on 14th November 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Rosevilla Residential Home 31/05/06

Rosevilla Residential Home 19/01/06

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

CARE HOMES FOR OLDER PEOPLE Rosevilla Residential Home Penkford Lane Collins Green Burtonwood, Warrington Cheshire WA5 4EE Lead Inspector June Shimmin Unannounced Inspection 14 November 2007 10:15 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 Rosevilla Residential Home DS0000066238.V339682.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. Rosevilla Residential Home DS0000066238.V339682.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosevilla Residential Home Address Penkford Lane Collins Green Burtonwood, Warrington Cheshire WA5 4EE 01925 228637 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) Rosevilla Residential Home Limited Peter Nesarajah Care Home 31 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (31), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (4) Rosevilla Residential Home DS0000066238.V339682.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home is registered for a maximum of 31 service users in the category DE(E) (Dementia over the age of 65) Up to 4 service users in the category MD(E) (Mental disorder, excluding learning disability or dementia, over the age of 65) may be accommodated within the maximum number of 31 Up to 5 service users in the category DE (Dementia under the age of 65) may be accommodated within the maximum number of 31 31 May 2006 Date of last inspection Brief Description of the Service: Rosevilla is a 31 bedded care home providing personal care only for people with dementia. It can also provide care for a smaller number of older people with mental health problems. The home is in Collins Green, on the outskirts of the village of Burtonwood and is not far from Warrington. Accommodation is provided on both floors of the home. There are 15 first floor bedrooms and 16 bedrooms on the ground floor. Three bedrooms have en suite facilities. There are two lounges and two dining rooms. Specialist equipment is provided for people with varying degrees of disability. There is a passenger lift. Part of the top floor is used as living accommodation for the owners who live on site. Rosevilla has well maintained gardens. There is adequate car parking. The home has an adapted minibus, which is used to transport people living in the home and staff. Weekly fees for living at the home range from £369 to £450. Rosevilla Residential Home DS0000066238.V339682.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on the 14 November 2007 and lasted six hours. A short, focussed inspection has been carried out at this home since the last main inspection. This thematic inspection looked at the quality of care people with dementia experience when living in care homes, focussing on ‘dignity’ as an important part of people’s quality of life. Because people with dementia are not always able to tell us about their experiences, we used a formal way to observe people in the thematic inspection to help us understand. We call this the Short Observational Framework for Inspection (SOFI). This involved us observing 5 people who live in the home for 2 hours and recording their experiences at regular intervals. This included their state of well being, and how they interacted with staff members, other people who use services, and the environment. The visits were just one part of the inspection. Other information received about the home was also looked at. Before this visit the home manager had completed a questionnaire to provide up to date information about Rosevilla. CSCI questionnaires were also given and sent to people living in the home, families, and health and social care professionals such as social workers and doctors to find out their views. During the visit various records and the premises were looked at. A number of people who live at the home were spoken with and they gave their views about Rosevilla. What the service does well: Rosevilla is a well managed home and the registered manager is fully qualified for the role he performs. Effective mechanisms are in place to monitor the quality of care provided so that people know they are receiving a good service. Staff working at the home are highly regarded by people living in the home, relatives and professionals. A doctor commented, “conscientious staff show high level of empathy and concern for residents’ well being,” and a relative, “caring/food/hygiene is excellent at the home.” A senior carer carries out an assessment of people’s needs before they move into the home to make sure that their needs can be met there. Rosevilla Residential Home DS0000066238.V339682.R01.S.doc Version 5.2 Page 6 People are given information about the home and its facilities to help them decide if this is a suitable home. Medication is well managed so that people receive their medication safely. The standard of catering is good so that people are well nourished. The religious beliefs of all people in the home are taken into account and catered for so that people’s spiritual needs are met. Complaints are dealt with promptly and action taken to protect people from possible abuse. Rosevilla is well maintained so people live in clean, comfortable and pleasant living surroundings. Staffing levels are adequate and staff are given support and encouragement to undertake appropriate training so they can provide quality care for the people who live in the home. Recruitment practices are thorough so that people know that sufficient checks have been carried out. What has improved since the last inspection? The manager has been registered with the Commission for Social Care Inspection demonstrating that he is a suitable and appropriately qualified person to manage the home. References are obtained from the employee’s previous employer demonstrating that the employee is a suitable person to work in the home. All staff take part in a fire drill at least twice a year so that they know what to do in the event of a fire. More than 50 of care staff have achieved NVQ2 in care so that people are cared for by skilled and knowledgeable staff. There has been some improvement in the standard of care planning so that care plans describe the actions to be taken to meet the needs of people in the home. An appropriately trained second person works in the kitchen on the days when the full time cook is not working so the standard of the catering is maintained. There is always a senior carer on duty at night to administer any necessary medication and to take charge of the shift. Rosevilla Residential Home DS0000066238.V339682.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Rosevilla Residential Home DS0000066238.V339682.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 Rosevilla Residential Home DS0000066238.V339682.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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An assessment of people’s needs is carried out before they move into the home to make sure their needs can be met there. EVIDENCE: The initial assessments of two people who had recently moved into the home were seen. These contained some information about their likes and dislikes, choices and preferences but needed more detail. For instance, the interests of one person included listening to the radio but did not state what programmes the person preferred. The person later said that he enjoyed listening to Radio 4 but this was not detailed and maybe not known by care staff. Some family history was provided as were details about the person’s social care needs. The senior carer said that the manager was hoping to introduce the concept of life histories for each person living there and that carers were going to put together a “memory box” for each person. This demonstrates that the home is Rosevilla Residential Home DS0000066238.V339682.R01.S.doc Version 5.2 Page 10 progressing towards the provision of person-centred care that is individualised to each person and acknowledges the person’s unique life history. Rosevilla does not provide intermediate care so standard 6 does not apply. Rosevilla Residential Home DS0000066238.V339682.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Most health and personal care needs are described in care plans so that people receive the care they need. Medication is well managed but some care practices indicate that the dignity of people may not always be maintained. EVIDENCE: The care plans for two people who live at the home were looked at. The content of the care plans has improved so that more care needs are identified and the care plans describe more accurately how those care needs should be met. However, several care needs, which had been identified during the assessment process, were not included in the care plans. These needs related to nutrition, diabetes and communication amongst others. There were appropriate risk assessments so that staff would know what to do to reduce the risk to which people were exposed. One care plan had been evaluated so that staff could assess whether care provided had been effective. There was no evidence that people were involved in drawing up or discussing Rosevilla Residential Home DS0000066238.V339682.R01.S.doc Version 5.2 Page 12 their care plans so that they may not be fully aware of or involved in the care that was provided for them. In many cases this may be difficult if people do not understand about care plans but it should be possible for several people living in the home to do this. In cases where the person cannot understand about care plans it should be possible for their next of kin to be involved so that they are aware of the care to be provided and whether it is working. Records also indicated that people were referred to a number of health care professionals such as doctors, district nurses and audiologists to make sure their health care needs were met. Medication records and storage facilities were seen. These were of a good standard and showed that people receive their prescribed medication in a safe and effective manner. Staff generally demonstrated good person centred skills towards people living in the home but several staff behaved in a way that indicated that the dignity of people was not always respected. Rosevilla Residential Home DS0000066238.V339682.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 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The limited provision of social and leisure activities means that some people are at risk of not being stimulated and becoming socially isolated. The standard of catering is good. EVIDENCE: There was little documented in care plans about the individual social care needs of people. A tick list system was being used, which indicated that the main source of stimulation was visitors, television and music tapes. The senior carer said that she and another staff member also do manicures. Nobody is currently employed at the home to organise activities. Care staff said that people were given a choice of films to watch. However, it was noticed that a DVD was playing during the lunch period and that when people came back to the lounge they would have missed at least half an hour of the running time of the film. The registered manager said that a new person centred method of promoting activities was to be introduced in the new year, with the addition of gardening and cookery to be added to those activities currently available. Rosevilla Residential Home DS0000066238.V339682.R01.S.doc Version 5.2 Page 14 Care staff said that bedroom doors were locked during the day but that if people wanted to go back to their room for a rest or a change of environment they could. However, this could also indicate that people were not given choice and were dependent on the staff member’s interpretation of the person’s wishes. A relative commented, “allow my mother to be in her room when and if she wants to be there.” People’s choices about their daily lives were not referred to in their care plans. Staff at the home try to meet the spiritual needs of people. The religion of people who move into the home is recorded and services take place on regularly. A relative commented, “they have different clergy going into the home to do services for the different faiths”. People said that the standard of catering in the home was good. One person commented about a lack of choice of hot food in the evening and sometimes being hungry. A relative said, “well fed and nourished.” Rosevilla Residential Home DS0000066238.V339682.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People know that their complaints will be listened to and acted upon. Appropriate adult protection procedures are in place so that people are protected from harm. EVIDENCE: Information provided by the manager before the inspection indicated that the home has received no complaints in the last twelve months. The complaints procedure is displayed in the bedroom of every person so that they or their representative are aware of the procedure. The manager and a staff member employed by the adjoining domestic care agency are trainers in the protection of vulnerable adults. The manager said that all staff had undertaken training in this subject in the last year. Appropriate action is taken when an allegation of abuse is made so that people in the home know they will be protected. Rosevilla Residential Home DS0000066238.V339682.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Rosevilla is well maintained so that people live in safe, comfortable and pleasant surroundings. EVIDENCE: The manager said that a number of improvements are to be made to the environment to enhance the living environment. These include plans to paint corridor walls white with yellow handrails. People living in the home would also be able to put up paintings or photographs that were meaningful to them. Toilet and bathroom doors are to be painted red to help people to identify them. Bathrooms are to be updated so that they are more welcoming and easy to use for staff. A project is to go ahead in conjunction with a landscape gardener to develop a further garden area at the front of the home. Rosevilla Residential Home DS0000066238.V339682.R01.S.doc Version 5.2 Page 17 The home has adequate storage facilities and a variety of aids and adaptations to assist people with any degree of disability. During a tour of the building no odours were noticed and effective measures are in place to control the possible spread of infection in the home. There are enough communal rooms so that people have a choice of living areas to sit in and there is wheelchair access to the gardens at the front and rear of the home. At the rear there are enclosed garden areas so that people can go outside with minimal supervision. A relative commented, “take the residents outside the home into the garden (not just in summer) to get some fresh air. If they are well wrapped up it would do them good to walk round the gardens any time of the year”. Rosevilla Residential Home DS0000066238.V339682.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are good and the recruitment process is thorough to make sure that staff are suitable to work with the people who live in the home. Staff have received relevant training so that people are receiving care from staff with sufficient knowledge and skills. EVIDENCE: Staffing levels during the visit appeared to be adequate and staff had time to sit and chat with people who live in the home. A relative commented, “most of the staff seem to be very experienced and caring”. A carer said that some care staff have occasionally been helping out with cleaning and laundry duties at the weekend when there have been staff shortages. The manager should review the use of care staff who carry out other duties so that there are always enough care hours available to make sure that people’s needs are met. Recruitment records were seen for two staff. All relevant documentation was in place and neither staff member had started work until a full security check had been received from the Criminal Records Bureau. Induction records were also seen and these demonstrated that staff had been assessed in various topics. The home does joint training with the domiciliary care agency, which is run from the same premises so that training costs can be Rosevilla Residential Home DS0000066238.V339682.R01.S.doc Version 5.2 Page 19 shared and are therefore efficient and cost effective. This also means that staff do not have to wait a long time to undergo training. Training in dementia care is being organised with the local Alzheimer’s Society so that staff receive specialist training and have more knowledge about how to meet the needs of people with dementia. The manager said that this training would be mandatory for staff working in the home. More than 50 of staff have achieved NVQ 2 in care and remaining care staff are working towards this award so that all staff will have the knowledge and skills to perform their role. The manager said that the home is in the process of applying to become recognised as a centre providing NVQ training, which means that the home will not have to depend on outside organisations to provide this training. Rosevilla Residential Home DS0000066238.V339682.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Rosevilla is well managed and has effective mechanisms in place to monitor the quality of care at the home so that people know they are being well cared for. EVIDENCE: Rosevilla is a family owned business and all family members retain an interest and involvement in the running of the home. Since the last inspection the manager has become registered with the CSCI. He is a first level Registered Mental Health nurse and has an honours degree in Health Studies. He is hoping to commence a masters degree in dementia care in the new year, to increase his knowledge and skills. He also attends conferences on dementia to improve his expertise in this subject and to learn about ways in which care for Rosevilla Residential Home DS0000066238.V339682.R01.S.doc Version 5.2 Page 21 people with dementia can be improved. A care manager helps with the running of the home and takes the lead for care issues. The care manager is also to undertake a short course in dementia care mapping next year and will therefore increase her understanding of the management of dementia. Information provided before the inspection stated that people are actively encouraged to control their own money. The manager said that audits are carried out to find out whether the home is well run. Recent audits include one for medication and another to find out whether staff are satisfied with the way the home is run. A letter has been sent to people living in the home or their representative to ask whether they would like Sky television to be introduced so that they have more choice of television programmes. Information provided before the inspection indicated that a questionnaire had been sent to people in the home and their relatives to find out what they thought about the care provided. Information received before the inspection indicated that installations and equipment in the home are serviced and maintained regularly. Records relating to fire safety were seen and indicated that home staff carry out regular checks on fire alarms and emergency lighting. Records of fire safety training and fire drills also indicated that most staff have undergone training in the last year. Several staff have not done a refresher training course in fire safety during the last year. The registered manager also confirmed that there is not always a person trained in first aid on duty so that staff may not know what to do in an emergency. Rosevilla Residential Home DS0000066238.V339682.R01.S.doc Version 5.2 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. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 10 11 3 X X X X X X 3 STAFFING Standard No Score 27 28 29 30 3 2 X 3 4 3 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Rosevilla Residential Home DS0000066238.V339682.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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 OP7 OP7 Good Practice Recommendations Care plans should be provided for all identified needs so that people receive appropriate care. People living in the home or their next of kin/representative should be involved in the care planning and review process so that they know what care they will receive and are able to discuss this with staff. Care staff should undertake training in person centred care so that they understand ways in which the dignity of the person should be respected. There should be a range of activities provided at the home so that people’s individual needs are met and so that they are not at risk of social isolation and lack of stimulation. Care plans should demonstrate the ways in which people are offered choice in their daily lives. All staff should undertake an annual refresher course in fire safety. There should be someone trained in first aid on duty at all times. DS0000066238.V339682.R01.S.doc Version 5.2 Page 24 3 4 5 6 7 OP10 OP12 OP14 OP38 OP38 Rosevilla Residential Home Rosevilla Residential Home DS0000066238.V339682.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rosevilla Residential Home DS0000066238.V339682.R01.S.doc Version 5.2 Page 26 - 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!