CARE HOMES FOR OLDER PEOPLE
Rosewell Country Home Church Hill High Littleton Bath & N E Somerset BS39 6HF Lead Inspector
Kathy Marshalsea Key Unannounced Inspection 07:00 24th May 2007 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.V336218.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.V336218.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 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.V336218.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 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. Date of last inspection 23rd May 2006 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. 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.V336218.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced early morning visit done as part of the home’s key inspection. Two inspectors conducted the visit due to the size of the home. The decision to go early morning was made after two separate concerns had been raised with the Commission for Social Care Inspection about aspects of the care during night duty. Most of the allegations were unfounded but it was of concern that some people who live in the home and need help to have their drinks are not being helped as they should be. Some of the night staff are not receiving regular supervision so may not being fully supported to do their job. Most of the findings of this visit were very positive but there were three areas of immediate concern, which needed attention within 48 hours of the visit. These are described under “What they could do better”. To help the inspector form judgements about the home, survey forms had been sent to the home for people who live in the home, their relatives and any health care professionals to complete. These were then sent directly to the Commission for Social Care Inspection. Some of the negative comments were checked during the inspection and the positive comments will be found in the report. What the service does well:
Rosewell offers opportunities for people who live in the home to influence the way the home is run. Staff also meet regularly so that they are kept informed and can discuss things that concern them. Staff spoken with during the inspection spoke warmly about the manager and how approachable she is. The staff recognise when they cannot meet a person’s needs. This is done either at the pre-admission assessment time or during the initial assessment period and then actions taken to find a more appropriate care home. Staff try their best to make sure that each person is treated with dignity and respect. Some staff make sure that activities are a normal feature of their floor and so people who live on that floor benefit from a more interesting day. Rosewell Country Home DS0000044632.V336218.R01.S.doc Version 5.2 Page 6 Most people who live in the home were positive about the meals provided for them. They confirmed that they are asked what they would like to eat. The manager has responded to allegations of abuse by contacting the relevant authorities and making sure that the well-being of the people who live in the home is her priority. The Manager makes sure that the numbers and skill mix of staff are able to meet the needs of people who live in the home. The home has a high percentage of staff who have completed their National Vocational Qualification in care. The recruitment process makes sure that safety checks are carried out so that unsuitable staff are not employed. Quotes from survey forms included the following comments: “ I feel the home is very caring, clean and positive who generally communicate well with relatives and friends”. “ I am very pleased with the service and care provided”. “ They generally look after the residents to a very high standard”. “Rosewell is a very welcoming home to both residents and families. The reception area is a great asset to the home. Staff are always kind and friendly to residents”. “The staff are usually cheerful and caring if sometimes pressed” “Roswell staff are part of the family they make you so welcome. It is the happiest we have seen my relative in years. No amount of thanks will repay the staff. Claire the activities lady is so good at her job; she entertains the residents so well. They do everything well”. “ Overall the care my relative receives is excellent”. “ We feel secure and trust the staff who always let us know if there are any problems”. What has improved since the last inspection?
Rosewell Country Home DS0000044632.V336218.R01.S.doc Version 5.2 Page 7 There is now evidence that the people who live in the nursing section are consulted about their care plan or if that is not possible then their relatives. Records seen during the visit showed that people who live in the home have their weight regularly monitored to ensure that they are not loosing weight. It is now possible to see how a complaint has been responded to and if the complainant is satisfied with the investigation and actions taken. The social care assessment is completed shortly after any admission so that a biography of a person’s life is present. Radiator covers have been fitted throughout the home safeguarding people who live in the home from the possibility of being scalded. What they could do better:
The following three Immediate Requirements were made: 1) The staff need to behave differently so that when a person has an accident/fall/incident actions recorded to reduce any risks to each person are checked to make sure that those actions are effective enough and so risks are minimised as much as possible. 2) The staff need to make sure that when a person is admitted to the home a care plan is developed. If there is no Social Services care plan then this becomes more urgent. Any risks identified need to be recorded so that staff have the details of how to meet people’s needs. 3) The staff working in the kitchen must make sure that a good standard of hygiene is kept at all times. Cleaning must be effective and adhere to the cleaning schedules. Staff need to show a better understanding about how the condition of dementia may affect a person. Records showed little recognition of these effects and in some instances negative and unhelpful information was read. Care plans read during the visit did not detail people who live in the home’s health, personal and social care needs. The plans were reviewed often but did not show all of the things that had been happening to people such as multiple falls. Staff who ask for safety checks to be done in the care plan must make sure that all staff know about this.
Rosewell Country Home DS0000044632.V336218.R01.S.doc Version 5.2 Page 8 Staff need to make sure that any person who is at risk of being socially isolated has that recorded and that every effort is made to prevent that isolation. The home needs to be better equipped to deal with the hot weather. Ventilation is poor and this includes some bathrooms which then can’t be used when it is very hot. All staff should have the opportunity to have regular supervision sessions with their supervisor whether they work during the day or night. This should enable them to discuss their practice and any career developments. Fluid charts need to be fully completed and totalled every 24 hours to gauge if an adequate amount of fluid intake is being taken. 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.V336218.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.V336218.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 good. This judgement has been made using available evidence including a visit to this service. The home assesses each person who may be coming to live at the home so that they make sure that they can meet each person’s needs. Staff need to be better trained to understand the condition of dementia. EVIDENCE: It has been found at previous inspection visits that the home gathers as much information about a prospective person needing to move into the home, including visiting them wherever they are, before deciding whether they can meet their needs. During our visit we discovered two people who had recently come to live in the home who were not suitable for the home’s categories of care. This had already been recognised during the normal trial period and meetings held with the funding agencies to inform them of their decision not to offer a permanent placement.
Rosewell Country Home DS0000044632.V336218.R01.S.doc Version 5.2 Page 11 It was seen during this visit that a significant amount of people who live in the home suffered from dementia. Some of these people were case tracked by the inspectors. It was obvious from reading their records that staff did not always understand the process of this condition and the different ways it can affect people’s behaviour. Ways of dealing consistently with some of these issues was not described in the care plans and when it was mentioned in daily notes negative and subjective comments were used such as “wandering” and a “silent person”. Rosewell Country Home DS0000044632.V336218.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): 7,8,10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The personal and social care needs of the people who live in the home are not written about in the care plans, but most health care needs are. Staff do not use all of the available information when checking the plans for any changes so that risks such as falls are not fully planned for. EVIDENCE: The inspectors chose eight people who live in the home to case track, which involved looking at their care plans and all the other documents related to their care needs. They also met the staff looking after those people and where possible the people themselves. It was disappointing that in all cases the care plans did not meet the required minimum standard. Two did not have a care plan at all and both had very significant needs which would need to be planned for. The other plans contained some health care needs such as how they needed help to get up and walk about. Very little mention was made of the person’s remaining abilities to
Rosewell Country Home DS0000044632.V336218.R01.S.doc Version 5.2 Page 13 make sure that staff encouraged those. There were no plans for any social needs despite there being a social care assessment. One person was at great risk of being socially isolated as they chose to stay in their room. This had not been accounted for. Psychological needs even in those who had a recognised mental health diagnosis were also not detailed. It was of concern that when staff were checking the care plans monthly they were not using information in other records, for example the accident records. At least two people who live in the home had a significant number of recent falls which had not been mentioned in the review, leading to an inadequate review of the risk. The manager expressed her concern at the above and had asked the trained staff to make sure that they reviewed the records of people after they had falls. She also was surprised that care plans had not been written for the new people Other health care assessments were present and had been checked and reviewed regularly. These included things like nutrition, continence, moving and handling, the risk of falls and the risk of developing a pressure sore. It was seen that where fluid charts were being used there were often unaccounted for gaps, and the charts were not being totalled every 24 hours to make sure that each person was receiving the correct amount of fluids. Both inspectors noticed that there was a mutual relationship of respect and warmth between the staff and people who live in the home. A quote from a survey form stated,” Staff are always kind and friendly towards the people who live in the home”. Rosewell Country Home DS0000044632.V336218.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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 benefit from having meaningful activities organised for them by the activities organiser. Some care staff make sure that they also provide some form of social activity. While the meals are good the kitchen was not clean and may pose a health & safety risk. EVIDENCE: Many of the survey forms received by the Commission for Social Care Inspection commented positively about the Activities organiser. One of these comments was “ Claire always encourages my relative to join in or watch the activities. She does so much with everyone.” It was noticed during our visit that she spent time on each floor as well as in the main conservatory area doing various activities with each group. It was also obvious that on some floors staff make a lot of effort to continue this theme by doing activities themselves. Those we spoke with verified this. Most comments about meals on the survey forms were positive but one person said that meals were not always hot when they reached the rooms, and food is
Rosewell Country Home DS0000044632.V336218.R01.S.doc Version 5.2 Page 15 not of a very good standard. Everyone we spoke with during our visit said they enjoyed the meals and were given choices of what they eat. Snacks are available after the evening meal is served. People who live in the home also said they usually have fresh fruit in the lounges. One inspector went to check upon hygiene standards and records in the kitchen after lunch. Various health & safety checks are made apart from risk assessments for hot surfaces. The standard of cleanliness in the kitchen was poor and remained so when it was checked a couple of hours later. As this could pose a health & safety risk an immediate requirement notice was served so that the kitchen received a deep clean within 48 hours of the inspection visit. Rosewell Country Home DS0000044632.V336218.R01.S.doc Version 5.2 Page 16 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 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 properly investigated. EVIDENCE: The home has had seven complaints so far this year. These include three allegations of abuse or neglect. The manager carefully investigated complaints about care and a clear letter sent to the complainant. They are asked whether they are satisfied with the outcome of that investigation and any actions taken. In some instances the complainant had replied and expressed their satisfaction with the home’s response. On all survey forms received people who live in the home and relatives stated that they know how to complain if they wish to. Allegations of abuse were dealt with differently and according to the home’s policy for abuse and local procedures. The appropriate agencies were notified immediately and actions taken to protect the people who live in the home from any possible harm. None of the allegations were substantiated. Staff receive regular training in the prevention and awareness of abuse. We discussed the use of door alarms which are used to alert staff when someone has left their bedroom when there is a risk of them falling. It was agreed that this method of detection needs to be assessed and reviewed after
Rosewell Country Home DS0000044632.V336218.R01.S.doc Version 5.2 Page 17 that. Consent is obtained for the use of bed rails in the likelihood of someone falling out of bed. Rosewell Country Home DS0000044632.V336218.R01.S.doc Version 5.2 Page 18 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has not been kept consistently clean due to a shortage of cleaning staff. There is insufficient ventilation in the home, especially in the bathrooms and conservatory area. Otherwise the house is comfortable and provides a good standard of accommodation. EVIDENCE: There were some negative comments in some survey forms about the cleanliness of the house and about having no ventilation in the main bathrooms making it unusable when the weather is very hot. During a tour of the building many bedrooms were checked and the level of cleanliness was acceptable. The manager said that they had been using some of the cleaning staff, who can also work as care assistants, as part of the care numbers if they have been short staffed. This has left the cleaning staff with less staff recently.
Rosewell Country Home DS0000044632.V336218.R01.S.doc Version 5.2 Page 19 The manager hopes this problem will be resolved by the beginning of June 2007. As regards the use of the bathrooms the manager agreed that they were unable to use some for a period of 3 weeks last summer. She had discussed this with the company’s representative who asked her to look into the air conditioning which is supposed to be in the bathrooms. There are plans to buy new more heat reflective blinds in the main hall and conservatory area. It was noticed that despite the visit starting early morning (7am) and it not being hot outside then, the house itself was very stuffy and airless. Very few windows were open and the heat was quite uncomfortable. Several people who live in the home also commented that they were rather hot. Fans have been bought for each bedroom but not in use during the visit although it became quite a hot day. Fans were being used in the conservatory area. Staff must remember to ask each person in their rooms and in the communal areas if they are comfortable with the temperature. The manager said that she is waiting to get approval to replace some carpets throughout the home. It was noted that the programme of covering the radiators has been completed reducing any risk from scalding from those surfaces. Some of the guttering which is difficult to access is filled with debris and needs to be attended to. The manager is trying to find a company that is able to do this. Rosewell Country Home DS0000044632.V336218.R01.S.doc Version 5.2 Page 20 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. Staff are supported to do their job by receiving regular training. Recruitment processes protect the people who live in the home from unsuitable staff being employed. EVIDENCE: One of the concerns raised about night duty was regarding staffing numbers and how the work is allocated. The inspectors checked the home for numbers and skill mixes of staff when they arrived at 7am, and how the workload is organised. There were 2 trained nurses on duty and 6 care assistants. At the time of the visit there were 48 nursing and 28 residential people living in the home. On checking each floor it was seen that most people were in bed and it was possible to verify with those already up that this was their choice. Staff spoken with on each floor stated that they were able to do their work in a satisfactory way apart from the top floor. Due to there being less people on that floor, and the dependency levels being lower than other floors, only one member of staff stays on the floor, and has assistance from one of the trained nurses when necessary. This may lead there to be times when staff manage themselves while they wait for assistance. This needs to be kept monitored by the nurse in charge on night duty and the manager. The inspectors noticed that when call
Rosewell Country Home DS0000044632.V336218.R01.S.doc Version 5.2 Page 21 bells rang they were answered promptly and that staff had the time to write their records. The home has a shortage of permanent care assistants at the moment. The manager has recruited locally and is waiting for the checks to come thorough so that these new staff can begin working. There is a full complement of trained nurses. A senior carer is also allocated on each floor and where possible on each shift. The trained staff act as named nurses for a group of people who live in the home and are responsible for keeping their records up to date including the care plans. Due to the shortage of care assistants the keyworker system for them has not been fully effective. Although the home is registered to have the overseas nurses adaptation programme in the home there was no one doing that course at the time of the inspection. The National Training Vocational programme continues and 24 staff have completed their National Training Vocational training. This includes all carers being enrolled on the course and the kitchen staff, the receptionists are doing a front of house course and the cleaners are doing housekeeping. Recruitment records were checked and continue to meet the required safety checks. The manager was informed about a revised regulation, which will mean that a full employment history has to be obtained for prospective employees. New staff undergo a probationary period and a structured induction programme to ensure their competency. Staff from overseas are given English lessons if needed. Individual training records were checked for various members of staff. These showed that courses done by staff in 2006 included: Effective written communication, Fire safety, Care in the UK, Moving and Handling, Health & Safety, Fire safety, Principles of care, The role of the carer, Palliative care, Infection control, Abuse, and a two day dementia course. Records for trained nurses showed that they are keeping themselves up to date in their practices according to the Nursing, Midwifery Council guidelines. Most of the mandatory training has been done this year, and also communications training was done on how to assist people who live in the home with their meals. There are sessions planned on falls and another communications course. The manager plans the following: In house training – European Care have enrolled on the internet SILI where you can download individual and group training courses. She also has some Rosewell Country Home DS0000044632.V336218.R01.S.doc Version 5.2 Page 22 workbooks and a training DVD from the opticians on eye conditions and looking after glasses etc. Rosewell Country Home DS0000044632.V336218.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): 31,32,33,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has a clear sense of direction and leadership, which she communicates well to staff and people who live in the home. People who live in the home are able to influence the way the home is run. EVIDENCE: Mrs Galloway continues as the registered manager of the home and has been since the home opened. There is a clinical nurse leader who is responsible for organising the nursing staff and care. There is also a residential supervisor who organises the staff and care of the residential people who live in the home. The organisation employ a Programme manager who is responsible for overseeing the home and visits the home twice a month. During this visit they complete a
Rosewell Country Home DS0000044632.V336218.R01.S.doc Version 5.2 Page 24 report which is also sent to the Commission for Social Care Inspection’s local office. All of the management team were very helpful during the inspection visit and continue to inform us about incidents affecting the well-being of the people who live in the home. Staff spoken with during the inspection visit said that they find Mrs Galloway approachable and helpful. It was obvious that she knows the people who live in the home well and has a warm relationship with them. The residential supervisor Jeannie Scrivens also has a very clear sense of direction and leadership, and with Mrs Galloway has the rights of the people who live in the home at the heart of her management style. Various meetings are held for different disciplines of staff but the home has resumed its quarterly meetings with the different doctors serving the home. There are regular meetings for those people who live in the home; they have themselves requested that these are held monthly where possible. The manager chairs the trained nurse meetings, last held in April 2007. These are to be held every 4-6 weeks. Various topics are discussed and at the recent meeting the new care plan format was discussed and they looked at some issues with overseas staff not always speaking English. Copies of the minutes are given/sent to staff unable to attend. Care staff meetings are also held. The records of supervision sessions were checked. Four day staff and one night staff’s records were checked. It was noted that the night staff’s records showed that they had not received the recommended six sessions in 2006 and only one so far in 2007.The day staff had all received more regular sessions during 2006.All staff need to receive regular supervision sessions, it is recommended that they have six times a year. Rosewell Country Home DS0000044632.V336218.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 2 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 X 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 2 2 3 3 3 2 2 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 3 3 X X 2 X 3 Rosewell Country Home DS0000044632.V336218.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP8 Regulation 13(4(© Requirement The registered person shall ensure that following an accident/fall/incident by a service user the care plan and relevant risk assessments are checked for their effectiveness. The registered person shall ensure that care plans are developed after an admission to the home. The registered person shall ensure that the kitchen has a deep clean and then is kept to that standard. The registered person shall ensure that care plans detail the health, personal and social care needs of each service user. The registered person shall ensure that ventilation is provided in all parts of the home which are used by service users. The registered person shall ensure that all staff receive formal supervision regularly. The registered person shall ensure that all staff receive training in Dementia. Timescale for action 25/05/07 2. OP7 15 24/05/07 3. OP15 16(2)(j) 26/05/07 4 OP7 15 31/08/07 5 OP25 23(2)(p) 30/06/07 6 7 OP36 OP4 18(2) 14(d) 31/07/07 31/08/07 Rosewell Country Home DS0000044632.V336218.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP12 Good Practice Recommendations Staff must make sure that those people at risk of social isolation have opportunities to have social stimulation according to their needs, preferences and capabilities. Particular consideration should be given to those people with dementia and other cognitive and sensory impairments Fluid charts should be kept up to date and totalled at the end of each 24 hour period to make sure sufficient intake/output is being maintained. Risk assessment for hot surfaces in the kitchen Record and then regularly assess the appropriateness of using the door alarms. It is recommended that staff receive formal supervision sessions six times a year. 2 3 4 5 OP8 OP15 OP18 OP36 Rosewell Country Home DS0000044632.V336218.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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