Inspection on 19/02/08 for Rosewell Country Home

This inspection was carried out on 19th February 2008.

CSCI found this care home to be providing an Good service.

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

Rosewell Country Home 28/05/10

Rosewell Country Home 24/05/07

Rosewell Country Home 23/05/06

Rosewell Country Home 15/11/05

Rosewell Country Home 13/07/05

Rosewell Country Home 10/03/05

Rosewell Country Home 23/09/04

Rosewell Country Home 11/03/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Rosewell Country Home Church Hill High Littleton Bath & N E Somerset BS39 6HF Lead Inspector Kathy Marshalsea Unannounced Inspection 19th February 2008 10:00 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 Rosewell Country Home DS0000044632.V354957.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. Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosewell Country Home Address Church Hill High Littleton Bath & N E Somerset BS39 6HF 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) 01761 472062 01761 479124 rw2europeancare@aol.com www.europeancare.net European Care (UK) Limited Ms Gillian Galloway Care Home 94 Category(ies) of Old age, not falling within any other category registration, with number (94), Physical disability (6) of places Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. 6 Beds may be for young physically disabled persons age 18-50 years. Staffing Notice dated 18/04/2001 applies. Manager must be a RN on parts 1 of 12 of the NMC register. May accommodate up to 60 persons aged 50 years and over requiring nursing care, in the Main House. May allocate up to 34 persons aged 65 years and over requiring Personal Care only, in the Farm House May accommodate up to 40 persons aged 65 years and over requiring personal care only, in the Main House. May accommodate one named individual requiring nursing care in the `Farmhouse` until such time as her nursing needs increase to the point that the `Farmhouse` is unsuitable to meet those needs, or she chooses to move 24th May 2007 Date of last inspection Brief Description of the Service: Rosewell Country Home is an extended farmhouse situated in the village of High Littleton. The accommodation consists of an open style conservatory entrance area, which links the Farmhouse and Main house. The conservatory area provides a focal point for the home, housing the main reception, hairdressing salon, manager’s office, service user seating, a piano and a small bistro. The accommodation in the farmhouse consists of single and double en-suite rooms (WC & hand basin) with 3 stair lifts and is registered for social care (residential) service users. Not all rooms in the Farmhouse have level access from the stair lifts The main house provides accommodation over three floors. There is lift access to all floors and each floor has a separate communal lounge and dining facility. Bedrooms vary in size, most are en-suite (WC & hand basin) and there are assisted bathrooms and shower rooms on each floor. Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 5 The home is registered for a maximum occupancy of 94 but the usual operational maximum is lower than this because few of the 12 double-sized rooms are in shared use at any one time. The home offers respite care subject to bed availability. Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. This was an unannounced inspection visit and formed the home’s key (main) inspection. Before the visit took place survey forms had been sent to the home for people living in the home, their relatives and health care professionals to complete. The information in these forms is used to help us decide upon the quality of life experienced by those who live in the home. The visit took one day and was spent talking with people, reading records and observing the way staff interacted with people in their care. The manager and residential supervisor were present for this visit and had the immediate feedback about our findings. It was a very positive visit and this is reflected by the small amount of requirements and recommendations made. What the service does well: Those people living in and visiting the service said the following: “ Very satisfactory”, I am quite satisfied with the service, good company“,” I am very happy living at Rosewell”, I am quite happy here”,” I am quite satisfied”,” my relative has benefited greatly from the company of other residents and staff. I visit regularly and they always seen cheerful and content. There is ample food and it is well presented and my relative has no concerns”. “ On the whole I am very happy and all the staff are lovely”. Roswell continues to offer a comfortable homely and relaxed home to live in. There is a stable management team who work well together to ensure that there are high standards of care. The people who live in and visit the service are consulted regularly about how the home is run, so that they can influence any decisions that are made. There is a careful selection process for recruiting staff to make sure that they are suitable to work with vulnerable people. New staff have a comprehensive induction so that they are confident and competent. The manager recognises importance of staff training so supports people to keep themselves up-to-date. Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 7 All but one of the staff observed during the inspection visit treated the people in their care with great respect. The staffing levels are adjusted to meet the dependency levels of the people living in the home. In order for people to be able to pursue their interests and hobbies two activities organisers are employed. Other staff also work hard to make sure the people are supported to do something interesting for them. People we met told us about the friendships that they have formed since living at their home; this was very evident during our visit. The manager make sure that any concerns complaints or allegations of abuse are dealt with promptly, and in a way that protects people living in the home. What has improved since the last inspection? What they could do better: In order for staff to have the details of how to meet each person’s needs the care plans should be clearly written. The plans need to include personal and social care needs too. Some staff would benefit from some more dementia training with this being reinforced at supervision sessions. Staff would also benefit from having training in mental health conditions. Night staff need to have more regular fire safety training to make sure that they would be competent if there was a fire. The annual testing of the electrical equipment in the home needs to be done to make sure that all appliances are safe. Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 8 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. Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 9 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 Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 10 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): 3,4 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. No one moves into the home without having his or her needs assessed and can be assured that these will be met. The care of people with dementia is not always based on current good practice or relevant specialist clinical guidance. EVIDENCE: The home continues to do a comprehensive pre-admission assessment for each person who may be moving into the home. The manager and residential supervisor usually do the visits together; this enables them to make a joint decision about whether they can meet the persons needs. Information on the survey forms received from people living in the home were positive about this process. 14 people said that they received enough information about the home Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 11 before moving in to make a decision about whether it was the right place for them, some people said on the forms that their families had helped to make a decision, and one person knew all about the home as they have lived in the area. On the homes annual quality assurance assessment form the manager stated that they offer prospective service users/relatives various options to make them feel welcome. This could be a days trial free of charge, spending a holiday week with them so they could familiarise themselves with staff and the environment to see if it was right for them before they make a final decision, and also inform people about their website. The manager stated and staff confirmed that she informs them about anyone new who is moving into the home, and any difficulties they may experience. At the last visit it was noted that several people who suffer from dementia were living in the home. It had been a requirement that staff should receive training in the condition of dementia to enhance their understanding of the effects this condition can have upon individuals. At this visit we met one person who suffered from dementia. The staff working with that person obviously knew them very well, and had information about their previous life, interests and hobbies. This is commended as they were using some of this information to provide the person with interesting things to do. The staff had also recognised this person’s affection for a doll. Unfortunately when the staff were interacting with the person and a doll they were laughing at the persons response to the doll and to them. This was discussed with the manager who was going to make sure that this persons attachment to the doll was dealt with in a more sensitive way. Care plans for people who live in the residential section of the home have included in their care plan a section for their well-being and orientation. These were completed in a very helpful way so that staff would know how to promote a persons well-being and how to help them be orientated. This is not included in the care plans on the nursing section. In files we saw there was information for staff (which had been downloaded from the Internet) about the condition of dementia and in some instances the condition of depression. This gives very useful background information that could then be used in the care plans to help staff minimise the effects of dementia is having upon each person. In one instance one person was being seen by the psychiatrist and was on medication to reduce the effects of dementia. This had not been included in their care plan. In another care plan for a persons dementia staff were able to describe strategies that they use for when the person can be verbally aggressive, this was not included in the care plan. Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 12 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 good. This judgement has been made using available evidence including a visit to this service. Not all care plans on the nursing wing set out the person’s personal and social care needs, and some do not include their mental health problems. The care plans on the residential wing are of a high standard and include the “whole” person. People living in the home are supported to access health care services and the majority of staff treat them with respect. EVIDENCE: In order to check whether the care needs of people were being met with looked at various records relating to this, as well as meeting the people themselves so that we could talk to them, and also the staff caring for them. Two of these people lived in the residential section and three in the nursing section. Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 13 The care plans in the residential section were comprehensive and covered every area of a persons needs, which included all of their health, personal, social and spiritual needs. The plans gave the staff very good detail in order that they could help to support the person. Both plans were up-to-date and were being reviewed as the persons needs changed. One plan covered a very difficult topic as a person had expressed their wishes about dying, this was written about very sensitively and had been signed by both the person themselves and their relative. All of the instructions given in the care plan, for example for people to be weighed very regularly, had also been done as instructed, and any medication they were on including any precautions staff needed to be aware of. The care plans in the nursing section of the home did not offer the details of people as a whole and varied in their quality. One person who had been living in the home since 2003 had nothing in their social care assessment about their hobbies or past interests, and their social activities log of what has happened for them was completely blank. Instructions for care staff were of a very poor quality, not only in terms of the way English have been used, but also in terms of what the problem/need was. All of the plans for this person gave very confusing information. Despite the fact that this persons spouse had died there was no mention of this in their care plan. The risk assessments are also of poor quality and again gave very vague instructions to staff. The second plan was a much better quality both in the way English had been used, but also in the detail that was given to staff to meet this persons needs. The review of the care plan contained regular updates as well as things that had happened in between the updates. It was possible to track the actions that have been taken as a result of new health care problems and to see that these had been resolved. It was obvious from talking with staff and the activities organiser that a lot of effort was being made to provide this person with meaningful occupation. Unfortunately this had not been recorded in the care plan, but was in the activities organiser notes, it would be useful for staff to liaise with the activities organiser and for the care plan to show what is happening. One risk assessment for this person, which had been relevant on admission, was now much less of a risk and needed to be reviewed to show this. The sideeffects of medication needs to be recorded in the care plan as one of these can have serious side effects which staff need to observe. The most recent social services review for this person and mental health review by the community psychiatric nurse and psychiatrist showed how pleased they were with this persons progress since moving into the home. There was information present in the file, which have been downloaded from the Internet, about this persons mental health condition. Following discussion with staff a plan also needs to be included about the way this person expresses their sexuality. Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 14 As mentioned previously risk assessments are done for some health care problems such as the risk of developing a pressure sore, having a fall, and any problems the person has with their mobility. On the residential section these had been reviewed appropriately, using information to see whether the risk been increased, decreased or stayed the same. This had not been done as well in the nursing section where some information was not being used; this had been the same at the last inspection visit. The commissions pharmacy inspector assessed the way that medicines are administered, stored and dispensed in the home. During this inspection visit we noted very warm, respectful and professional interactions between staff and people living in the home. Two care staff in particular was seen to be extremely helpful, polite, and obviously had a warm relationship with the people they were talking with. One member of the domestic staff was heard to be telling off one of the people living in the home for moving a chair around in the main hall. They persisted in trying to persuade them not to do that and did not question why they might prefer a different chair to sit in. Fortunately the residential supervisor noticed that this was happening and intervened to help the person to get a suitable chair. We were later informed that the supervisor spoke to the member of staff about their attitude. Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 15 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): 12,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in the home can expect to be supported to have some type of meaningful occupation. A varied diet is provided which is suited to individual needs. EVIDENCE: At the time of this visit there were two activities organisers who were working at the home part-time. On one day each week they work together. One of them has recently achieved a qualification with the National Open College Network, which has given her the title of a Creative Activity Therapy person. This was done with Somerset County Council and included how to plan activities, reminiscences learning and dementia care. The home recognised that having one activities assistant in the size of home was not enough, which is why a second person was employed. Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 16 We spoke with one of them during our visit who was very a positive about their role and how well they work together as a team. They have benefited from the knowledge that the other has attained doing this course. There are various planned activities such as flexi-exercise, which we saw during our visit, which seemed to be very popular. The organisers make sure that they ask every person if they would like to join in activities, even if they have refused to before. They also move around the various sections of the home to provide activities for people who may prefer to stay in the area they live in. The time also includes one-to-one time with people who preferred to or need to be in their rooms. We were given an example of one person who is now very frail and so are often stays in bed. We are told about her interests and the organisers are able to provide some sensory stimulation such as hand massages, and share this persons love of music. Their programme of activities also includes outside entertainers who come into the home and every four to six weeks a karaoke evening is held which is very popular and well attended. The organisers are also working hard to obtain life histories of each person as they move into the home, as well as those existing ones. This complements the knowledge they have in an effort to support the person to continue with their previous interests and hobbies. We were given examples of two people for whom traditional activities are of no interest and how they have worked towards helping these people by promoting their abilities and interests. This is commended. Since last visit the standard of hygiene in the kitchen has improved and when recently inspected by the environmental health department the home had met the high standards, and were presented with a food hygiene award. There is a weekly cleaning programme in place for the kitchen, risk assessments have been identified and put in place. There is a varied diet which is offered over a four-week period and is changed twice a year, winter and summer, in consultation with the people who live in the home. People we spoke with said that everyone is given a choice of meals and alternatives are given when required. Snacks are available at any time and special diets are catered for including cultural preferences. Evidence was seen of people being given a high or low calorie diet, and in some instances small frequent meals. Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints and allegations of abuse are taken seriously and investigated in accordance with the home’s own policies. EVIDENCE: The manager at home has been found at previous visits to take all concerns, complaints and allegations of abuse seriously and act upon them promptly. A complaints file is kept updated and shows that complaints are responded to in the time span detailed in the homes own complaints procedure. We looked at the response for a complaint received which replied in detail to each element of the complaint. This was resolved to the complainant satisfaction. We also discussed two recent allegations of possible abuse. One of these involved some missing money and the other the conduct of a person working in the home. The management team dealt with both incidents very promptly, and all of the relevant agencies were informed, for example Social Services, the Police and the Commission for Social Care Inspection. Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 18 All staff are trained in the subject of abuse, which is started on their induction, and then after that they receive regular updates. The home uses a DVD about the subject, when staff have seen this they complete a questionnaire. The home has so far chosen not to access the free social services training about the subject of abuse. We discussed that this might be quite useful, particular the senior staff. Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 19 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 good. This judgement has been made using available evidence including a visit to this service. Roswell is a safe and well-maintained home. The replacement of the ventilation in the bathrooms has not yet been done. EVIDENCE: Rosewell continues to provide a relaxed and homely environment which is light and airy. People have a choice of several communal areas to spend their days if they wish. Some of the bedrooms were quite personalised and included small items of furniture. The home has a rolling decorating program, replacement of carpets and some furniture when applicable. There were three negative comments on survey forms about the cleanliness in the home. The manager stated that this had been due to a shortage of staff Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 20 and sometimes domestic staff, who could also work in the care side, had been utilised for care instead of cleaning duties. This situation is now resolved. During our visit the standard of cleanliness was very satisfactory. At our last visit we noticed the poor ventilation in some parts of the home, including the bathrooms. The manager stated that they have put an application in to the company to have new baths and this will mean the ventilation in the bathrooms is included. Till this is done in the current ventilation is not sufficient. Rosewell Country Home DS0000044632.V354957.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 good. This judgement has been made using available evidence including a visit to this service. People living in the home have their needs met by the numbers and skill mix of the staff. They are supported and protected by staff who are carefully recruited and trained. EVIDENCE: Responses to questions on the survey forms about the staff in the home were generally very positive. To the question “do you receive the care and support you need” 14 people said always, 8 usually and one sometimes. To the question “ do the staff listen and act upon what you say” 17 said yes. Comments with these questions included staff always come when help is needed”,”when the staff are busy I have to wait sometimes”, “staff always come when I ring the bell, unless they are seen to another resident”, “I sometimes need to wait but not for long.” Everything I have asked for happens quite promptly. With reference to my relatives health and well-being, I feel they are very well cared for. They have an open door policy and whenever we visit there always details of events that are on for the residents. The staff work hard to involve and make the care rounded-body and soul and mind. The home have a league of friends who make us feel part of the home Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 22 and have input in making life better for all. We received a phone call whenever anything happens and updates. They cannot be faulted in what they do and cannot be spoken more highly of. Those staff we have spoken to have had a lot of experience and training on many levels. I feel I can talk to the staff at the home they are excellent, the level of care is very good, they treat the residents as individuals, they know their names, their needs, what they like and dislike, encourage them to take part in activities and make friends. Many of the staff working the home have been enrolled on the National Vocation Qualification.As well as care staff, domestics, the receptionist and kitchen staff are all doing these courses related to their line of work. The manager encourages registered nurses to attend courses so that they maintain their professional qualification, and keep themselves up-to-date with good practice. Some of these areas were seen to be identified during the staff supervision sessions. Staff are encouraged to share information when theyve attended a training course, for example someone recently attended a course on nutrition and copied the information from that course for the other nurses. The training records for staff met during the inspection showed that in 2006 there was a huge amount of training given to staff. Since then the home do not use this training provider so the manager has to try and access training for staff. In 2007 some sessions staff have attended have been swallowing problems in care homes, mobility in care homes, communication in the care home. These sessions were all attended by between 12 and 15 staff. Staff have been kept up-to-date with mandatory training such as food hygiene, moving and handling, fire safety, infection control, and first aid. This home has showed a consistent high standard of safe recruitment practice. All of the necessary checks are done before the person starts working at the home to make sure that they are suitable to work with vulnerable adults. The employment process also makes sure that they uphold equal opportunities and equality and diversity. The manager monitors the dependency levels of people living in the home to make sure the enough staff on duty to meet their care needs. She was able to give an example of one floor where the dependency levels altered so staffing levels had been increased on that floor. At the time of our visit there were 75 people living in the home. Two registered nurses are on duty 24 hours a day, during the morning there are 14 care assistants on duty, during the afternoon 11 to 12, and at night six. Due to the fact that there are some staff vacancies the home are still having to use agency staff regularly. The manager stated there are very happy with the agency they were using, as they were efficient and reliable. The agency also sends through confirmation of their staffs status in relation to them being suitable to work with vulnerable adults and what qualifications the person has. Rosewell Country Home DS0000044632.V354957.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): 31,32,36,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is qualified, competent and experienced to run the home. All benefit from her inclusive and open management style. The home is run in the best interests of the people living there. EVIDENCE: Mrs Galloway is still the registered manager of the home and has been since the home opened. She is supported in her role by the residential supervisor and clinical nurse leader. One member of staff said that the manager respects staff and is not asked to do anything she wouldnt do herself. She also comes out into the floor to make Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 24 sure that things are happening as it should be. We were also told Mrs Galloway listens to the staff, for example if they feel the dependency levels in the home have changed, which she then responds to. Mrs Galloway is very responsive to the inspection process and sees it as an opportunity to have a full audit of the home to make sure that good standards are maintained in every area of life in the home. She makes sure that shes kept herself up-to-date by doing long distance learning courses, such as the one she is doing on dementia care and medication, and by reading nursing journals. Mrs Galloway leads her team with a calm and quiet confidence and maintains very high standards. She works well with the rest of the management team and trained nurses to provide an inclusive and open management style. The home has a monthly meeting for everyone living in the home, which is led by the activities organisers, at the last one in 20 people attended plus some relatives. Some of the topics included minor concerns such as people wanting lids on their water jugs, someone wanted a brighter light and people commented how pleased they were with the recent redecoration. These concerns are passed straight to the manager after the meeting who has made sure everything has been done as requested. The home does an annual quality assurance survey of their own which makes sure that everyone is included in how the home is run. The manager also holds regular staff meetings in which the agenda is posted so that staff can add on any items they wish to discuss. The home also continues to have its quarterly meetings with different doctors visiting the home. Minutes of all these meetings are made available for those who werent able to attend the meetings. Some supervision records were checked to make sure that staff receive regular, useful sessions. Four peoples records were checked and showed that staff are seen reasonably regularly, and that mostly the content was detailed enough to show any career development, areas of weaknesses and strengths. It was also possible to see the outcome by one person had been subject to a disciplinary meeting. Fire records were checked to make sure that the safety checks were being done as often as they should be, and that the staff were being trained regularly in fire safety. The records showed that the safety checks of equipment and alarms had been done as often as is recommended by the local Fire Authority, and the drills are also held regularly. The records for two of the night staff showed that they had not had any fire safety training since April 2007, it is recommended that they have three monthly updates. The manager was confident that she could organise some training for them as soon as possible. Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 25 Maintenance records show health and safety is taken seriously as other regular checks are done, such as making sure the hot water outlets do not have scalding water. All of the other safety checks and servicing of equipment had all been done in 2007, apart from the annual safety check on electrical equipment. Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 26 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 2 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 2 3 X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X X 3 X 3 Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 27 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 The registered person shall ensure that care plans detail the health, personal and social care needs of each service user. Repeated requirement The registered person shall ensure that ventilation is provided in all parts of the home which are used by service users. Repeated requirement Timescale for action 30/06/08 2. OP25 23(2)(p) 30/06/08 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. Refer to Standard OP4 OP38 OP38 Good Practice Recommendations Staff would benefit from further Dementia and Mental Health training. The night staff need to receive more regular updates in Fire training The annual PAT testing needs to be done. DS0000044632.V354957.R01.S.doc Version 5.2 Page 28 Rosewell Country Home Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection South West Regional Office 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Rosewell Country Home DS0000044632.V354957.R01.S.doc Version 5.2 Page 30 - 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. 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