Inspection on 19/01/06 for Rosevilla Residential Home

This inspection was carried out on 19th January 2006.

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

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

Other inspections for this house

Rosevilla Residential Home 14/11/07

Rosevilla Residential Home 31/05/06

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 19th January 2006 09:45 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.V276189.R01.S.doc Version 5.1 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.V276189.R01.S.doc Version 5.1 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 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.V276189.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 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 The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Staffing must be provided to meet the dependency needs of service users at all times and will comply with any guidance which may be issued through the Commission for Social Care Inspection 9th June, 2005 3. 4. 5. Date of last inspection Brief Description of the Service: Rosevilla is a 31 bedded care home providing personal care only for older service users with dementia. It can also care for a smaller number of older and younger service users with mental health illness. 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. There are 15 first floor bedrooms and 16 bedrooms on the ground floor. Three bedrooms have en suite facilities. There are three lounges, two dining rooms and a conservatory that is currently used as a smoking area for service users. Specialist equipment is provided for service users 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 extensive, safe and well maintained gardens. There is adequate car parking. The home has an adapted minibus which is used to transport service users and staff. Rosevilla Residential Home DS0000066238.V276189.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection on 19 January 2006, took place over 5 and a half hours. Five residents, two homeowners and four staff were spoken with. A partial tour of the home was undertaken. Care records for three residents were looked at, together with accident, fire and medication records. What the service does well: What has improved since the last inspection? The owners have installed double glazing to windows throughout the home. New flooring has been laid in two bathrooms. New signs have been put on toilet doors to assist residents. Carpets have been replaced in corridors and shared living areas. The hairdressing room has been extended. There are new interior fire doors. The standard of care planning has slightly improved. Care staff have undertaken training in care planning. Medication administration records are fully completed. Rosevilla Residential Home DS0000066238.V276189.R01.S.doc Version 5.1 Page 6 Four senior staff have done a fire instructor`s course so that they can carry out fire drills. Most staff have taken part in a fire drill in the last six months. The new accident form allows more information to be recorded. 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. Rosevilla Residential Home DS0000066238.V276189.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rosevilla Residential Home DS0000066238.V276189.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 The information about Rosevilla needs to be updated so that service users and their families are fully aware of the facilities available. New service users are assessed prior to admission to ensure that the home can meet their needs. Information about the social, cultural and family history of service users is not sufficiently detailed. EVIDENCE: The owner has indicated in the pre-inspection questionnaire (PIQ) that the information leaflets (Statement of Purpose and Service User Guide) have been reviewed. The new format is based on an example provided by an outside care consultancy firm and has not yet been adapted to Rosevilla`s needs. Rosevilla Residential Home DS0000066238.V276189.R01.S.doc Version 5.1 Page 9 The assessment of a service user recently admitted to Rosevilla was examined. The content of the assessment was quite good and looked at the physical and mental health needs of service users. There was however limited information documented about the service user`s current and previous social, family and cultural interests. This information helps carers provide care, which is personcentred and suited to the individual needs of service users. Social workers or health professionals may also provide written assessments. Rosevilla Residential Home DS0000066238.V276189.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9 Further work needs to be carried out to ensure that care plans are more indepth and describe in full the service users` care needs. Advice and support is sought promptly from health care professionals. Medication is generally well managed. EVIDENCE: Three care plans were looked at, one for a new service user and two for service users living at Rosevilla for some time. There has been some improvement in the content of the care plans since the last inspection. The owners have arranged care planning training for staff. The first care plan did not describe the care that the service user needed in relation to nutrition, social activities and sleep. The weight of the service user was not recorded on admission to act as a baseline for care. The service user`s care needs had not been reviewed since admission to the home in November 2005. Daily progress records were informative. An identified risk had not been documented. Rosevilla Residential Home DS0000066238.V276189.R01.S.doc Version 5.1 Page 11 There was no care plan for communication and behaviour for the second service user where these had been identified as care needs. Also a new care need in relation to the prevention of pressure sores had been identified in the progress records but not recorded as a care need. The risk assessment for the prevention of pressure sores had not been reviewed since October 2005. This service user had gained 3 kilograms in one month but there had been no further weight record since October 2005. The assessment stated “does not like to be sat doing nothing”, yet there was no care plan describing the social care needs of this service user. The third care plan indicated that the service user had lost nearly five and a half kilograms in weight in a period of sixteen months. The risk assessment about the prevention of pressure sores was inaccurate and did not reflect the increased risk to the service user. The care plan for the prevention of pressure sores only referred to leg ulcers and did not describe what actions would be taken to reduce the risk of developing pressure sores. Care planning documentation demonstrated that the care home works closely with a number of health care professionals and refers any issues promptly. The recording of the administration of medication was good. Medication is generally well managed at Rosevilla. However, the receipt of medication is not recorded on the medication administration record. Rosevilla Residential Home DS0000066238.V276189.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14 and 15 The individual social care needs at Rosevilla are not met. Care staff provide group activities which are enjoyed by some service users. There is little choice and variety in relation to food. The standard of catering is poor. EVIDENCE: In the morning a number of service users were seen enjoying a sing-a-long with staff in one lounge. However, it was noticeable that about half the service users were asleep despite the music being played quite loud. One service user commented that the music was too loud and the volume was turned down. The PIQ does not specify what activities are provided at Rosevilla. Staff said that they played games such as dominoes and cards. Another staff member commented, “most of them do not want to do anything.” This staff member also did not know much about the life history of at least one service user who had been living at the home for some time. There was little recorded on individual care plans about the social care needs of service users and how these needs were being met. Rosevilla has pleasant gardens which are safe and well maintained. The owner said that an activity room is to be developed. Rosevilla Residential Home DS0000066238.V276189.R01.S.doc Version 5.1 Page 13 The records about food provided at the home show that there is little choice. If a service user complains about a meal then an alternative is offered. During the inspection lunch was served. For at least three service users this was toast and jam followed by tea and biscuits. A member of staff said that one service user would be having toast for breakfast and lunch followed by poached eggs on toast for the evening meal. The other service users were having corned beef or cheese `toasties` followed by tea and biscuits. The cook said that the evening meal is served at 3 45pm. This was to be tinned stewing steak with potatoes and vegetables. The dessert was tapioca pudding. The alternative was not indicated. Although one service user was satisfied with the standard of food several others were not, “every day cheese.” Supper is provided between 7 and 8pm and consists of teacakes, cakes or biscuits. Rosevilla Residential Home DS0000066238.V276189.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Staff are knowledgeable about the actions to take in the case of alleged abuse. EVIDENCE: The trainee manager has undertaken a course in adult protection and is passing this information on to other staff. About half the staff at Rosevilla have been through the one day training course. Staff spoken to knew what action to take if they suspected a service user had been abused. Rosevilla has policies and procedures about adult protection. Rosevilla Residential Home DS0000066238.V276189.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 25 and 26 Rosevilla offers service users a comfortable, domestic and safe living environment. The owners are continuously improving the environment for service users. The home is kept clean and tidy. EVIDENCE: A partial tour of the home indicated that high standards of hygiene and cleanliness are maintained. No odours were detected. Further environmental improvements have been carried out since the last inspection. These include: double glazing throughout the home, new carpets to corridors and shared living areas, new floors to two bathrooms and new signs on the doors of toilets to help service users identify the location of toilets. There is adequate provision of shared living accommodation. Rosevilla Residential Home DS0000066238.V276189.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 28 Staffing levels are adequate for the size of the home. The owners place great importance on the value of training and staff are given opportunities to undertake training. EVIDENCE: Staffing levels remain the same as at the previous inspection. These are adequate in terms of numbers and skills. Rosevilla uses no agency staff which means that service users do not have to get used to unfamiliar faces. The owners are commended for having nearly achieved 50 of care staff with NVQ level 2 in care. The PIQ indicates that staff are supported to undertake a number of training courses held at the home or externally. All staff have training files with copies of certificates achieved. Rosevilla Residential Home DS0000066238.V276189.R01.S.doc Version 5.1 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Rosevilla is well managed. The owners are accessible and approachable. Mechanisms are in place to check whether the home delivers a quality service. The monies of service users are safeguarded. Rosevilla is safe and well maintained. EVIDENCE: The owners of Rosevilla live at the home and are available at all times, if needed. Staff described the owners as being approachable and willing to listen. The registered manager has not yet achieved NVQ level 4 in management. However, a trainee manager is working towards this award. The owners hold monthly staff meetings to keep staff up to date with any changes and to hear their views about the running of the home. The PIQ stated that the families or representatives of service users handle all monies. Rosevilla Residential Home DS0000066238.V276189.R01.S.doc Version 5.1 Page 18 Equipment and installations at Rosevilla are serviced on a regular basis. A contractor was servicing portable electrical appliances during the inspection. Accident records were looked at and found to be satisfactory. The format of the accident record has been reviewed allowing more information to be recorded. Four senior members of staff have done a fire instructor`s course which enables them to conduct fire drills. Most staff have taken part in a fire drill and fire training update within the last six months. The fire risk assessment was written in October 2004 and should be reviewed annually. Other fire maintenance records were accurate and up to date. Seven staff have a current first aid certificate. Three new starters have not yet taken part in a fire drill or done moving and handling training. Rosevilla Residential Home DS0000066238.V276189.R01.S.doc Version 5.1 Page 19 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 2 X 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 2 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 3 3 3 X X 3 3 STAFFING Standard No Score 27 3 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Rosevilla Residential Home DS0000066238.V276189.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement Timescale for action 19/04/06 2 OP12 16 3 OP14 17 (2) Schedule 4 Care plans must address all identified care needs. (Previous timescales of 25/12/2004 and 9/8/2005 not met) Care plans must adequately describe the actions to be taken by staff to meet the care needs of service users. (Previous timescales of 25/12/04 and 9/8/05 not met) Care plans must be reviewed and amended to meet the changing care needs of service users. (Previous timescales of 25/12/04 and 9/8/05 not met) The registered person must 19/04/06 provide a range of leisure and social activities which is individualised to each service user and which meets their needs. The registered person must 19/04/06 ensure that a choice of food is available at all meals and that records are kept of meals served to all service users. Rosevilla Residential Home DS0000066238.V276189.R01.S.doc Version 5.1 Page 21 4 OP15 16 (i) The registered person must provide, in adequate quantities, suitable, wholesome and nutritious food which is varied. 19/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 6 7 8 Refer to Standard OP1 OP3 OP7 OP15 OP15 OP31 OP38 OP38 Good Practice Recommendations The registered person should ensure that the template for the statement of purpose and service user guide is adapted to Rosevilla`s needs. The registered person should document the social, cultural and family history of service users on admission and this should be incorporated in the care plan. The weight of service users should be recorded on admission, kept under review, and action taken to address any weight loss. The registered person should seek advice from a dietician about the content and variety of food provided. The registered person should review mealtimes, especially the timing of the evening meal. The registered manager should complete the NVQ level 4 in management as soon as possible. The fire risk assessment should be reviewed. All new employees should undertake a fire drill and moving and handling training. Rosevilla Residential Home DS0000066238.V276189.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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. 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