Inspection on 11/01/06 for Rosewood

This inspection was carried out on 11th January 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rosewood 24/04/07

Rosewood 08/05/06

Rosewood 15/08/05

Rosewood 03/11/04

Rosewood 06/05/04

Rosewood 17/12/03

Rosewood 29/05/03

Rosewood 25/07/02

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

CARE HOME ADULTS 18-65 Rosewood Church Lane Grangetown Middlesbrough TS6 6TP Lead Inspector Neil McKenzie Unannounced Inspection 11th January 2006 09:30 Rosewood DS0000000112.V267480.R01.S.doc Version 5.1 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 Rosewood DS0000000112.V267480.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 Adults 18-65. 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. Rosewood DS0000000112.V267480.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Rosewood Address Church Lane Grangetown Middlesbrough TS6 6TP 01642 463306 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) The Bridgings Limited Miss Theresa Paula Massey Care Home 8 Category(ies) of Learning disability (8), Physical disability (8) registration, with number of places Rosewood DS0000000112.V267480.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 8 residents with Learning Disability and Physical Disability Date of last inspection 15th August 2005 Brief Description of the Service: Rosewood, Bridgings Limited, is a care home for 8 service users with a learning disability, some of whom have associated physical disabilities. The home is a detached bungalow, set in its own grounds and is on one level, which is suited to the needs of highly physically dependent people. Each service user has their own room, which is personalised according to taste and preference and which is equipped to meet the needs of each individual. There is land surrounding the property, which can be used for outdoor activity when weather permits. The home has its own transport which has been adapted for the use of service users with a physical disability. Rosewood DS0000000112.V267480.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was done by one inspector who arrived at the home without letting the staff and residents know he was going to visit that day. The inspector spoke to the previous inspector before the visit. The inspector started the day by being shown around the home by the manager. During the inspection the inspector spoke to one resident and one care staff member and the deputy manager. There were no visitors during the inspection. The inspector looked at maintenance, health and safety records and documentation that included resident and staff files, finance and medication policy and procedures. The inspector observed and noted how staff and residents interacted with each other. The inspection took four hours. The inspector was made very welcome. What the service does well: What has improved since the last inspection? There have been some ongoing environmental improvements, with rooms including the kitchen and sitting room being redecorated. This has included tiling in the shower room and the edging in the bathroom being replaced and the concrete area outside the kitchen door being improved. Rosewood DS0000000112.V267480.R01.S.doc Version 5.1 Page 6 Action has also taken place to ensure that hoist slings over 2 years old have been replaced. 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. Rosewood DS0000000112.V267480.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rosewood DS0000000112.V267480.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The assessment procedure ensured that only those needs could be met would be admitted to the home. EVIDENCE: Examination of care plans and conversation with the manager and staff demonstrated the practice of care management assessments to determine the homes ability to meet the needs of prospective residents. There was also evidence of care management assessment plans that have been reviewed. These reviews involve residents, family members and other professionals. Currently two residents do not have an allocated social worker although pending reviews to be held in March have a named contact from the Care Panel to attend. Rosewood DS0000000112.V267480.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 69 There is a consistent care planning process in place that ensures that residents’ needs are identified and met. In addition to the care plans there are personalised health action plans that are pictorial and easy to understand to the individual. Risk assessments should be improved to include changing life style and ability of residents’ and evidence of resident and or family agreement. EVIDENCE: Three care plans were randomly chosen and were well organised and provided detailed picture of the resident and of his/her changing needs and aspirations. For example, one resident with challenging behaviours is beginning to plan towards attending a day service. As confirmed by the manager another resident, ‘is now able to toilet himself and no longer uses a commode’. Rosewood DS0000000112.V267480.R01.S.doc Version 5.1 Page 10 In addition to the care plans were individual health action plans that reflect the health care needs of residents. Considerable effort has been made to ensure that these plans are friendly and easy to understand for the individual. Much use is made of photographs and pictures. Risk assessments were in place but do need to be updated to demonstrate the changing risk management strategies developed to reflect changing life-style and ability levels of residents’. Where possible they should include resident and or family agreement. Rosewood DS0000000112.V267480.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Non of these standards were looked at during this inspection. EVIDENCE: Rosewood DS0000000112.V267480.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 The medication systems are in the main robust.l EVIDENCE: Medication records were examined and the systems were managed effectively. During discussion with staff they were able to describe their roles and confirm that only senior staff administer medication. The manager commented that all residents had recently completed individual medication reviews by either their GP or Consultant Psychiatrist. In October 2005 the home was visited by the Chief Pharmacist who conducted a review and recommended the practice of using a separate recording book for the administration of the drug phenobarbitone. The manager was able to show me the new method of recording. In August 2005 the deputy manager and another staff member received certificated training in the ‘safe handling of medication’. Rosewood DS0000000112.V267480.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 23 The resident spoken to was confident that if he had any worries that these would be dealt with and robust procedures were in place to protect residents from abuse. EVIDENCE: One resident said that he was confident if he had any worries that they would be dealt with. As he said, ‘ I would tell someone who knows what to do’. There have been no complaints since the last inspection. Procedures are in place to protect residents from abuse. Staff confirmed that they were in the process of completing a ‘no secrets’ module and the manager of the home said that she had recently completed a two-day course on the protection of vulnerable adults. As one staff member said, ‘If I had concerns I would contact my manager and CSCI’. A random sample of residents’ personal allowances and records were examined and there were no discrepancies with the balance stated on the transaction sheet and the actual amount contained in the individual money envelope. Rosewood DS0000000112.V267480.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The home has improved the environment for residents since the last inspection but appears to have been slow to action some of the requirements in respect of environmental issues with regard to maintenance. EVIDENCE: The inspector had a tour of the home and concentrated on the environmental requirements from the last inspection. Since the last inspection a number of the requirements have been rectified. For example, tiling and edging made good in the shower and bathroom, the concrete improved outside the kitchen door, the carpet in the corridor leading from the dining room made safe, and the kitchen decorated. In addition the sitting room has been decorated, new furniture purchased and the manager confirmed that new carpets have been ordered for the dining room, lounge and sitting room. However, the flooring in the kitchen had not been replaced and this remained a tripping hazard that called for an immediate requirement to be given to the home. The office still has one chair which is exposing its filling. Rosewood DS0000000112.V267480.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Non of these standards were looked at during this inspection. EVIDENCE: Rosewood DS0000000112.V267480.R01.S.doc Version 5.1 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 42 Residents’ living in the home benefit from the opportunity to share their views and wishes to staff and have up to date health and safety practices. Some of the mandatory training with respect to moving and handling and fire awareness requires updating. Safety and comfort needs to be improved by the utility/laundry room being locked when not used by staff as there is unregulated water temperatures and for the staff room fire door not to be wedged open. EVIDENCE: Resident and staff believed they were valued as individuals and had a voice in the home, which was responded to. The view of the resident was that he had been given opportunity to choose the colour of his room and to say how he spends his time. He had recently started a computer course at college and the home had brought him a computer for Christmas. During the visit a computer table arrived for his room and staff were helping him to put it together. Rosewood DS0000000112.V267480.R01.S.doc Version 5.1 Page 17 There was also a carer survey that had very positive comments about the home and staff and the way they involve residents in the daily activities of the home. Details of health and safety were made available through the inspection and these were found up to date and or were in the process of being updated. The hoist slings that were over two years old had been replaced although there were no records at the home to support this. Inspector requested for this to be forwarded to him. Some of the mandatory training required updating with respect to ‘moving and handling’ and fire awareness. During the tour it was noted that the staff room fire door was wedged open and this practice must stop. The utility room was unlocked and should be made safe by the practice of locking the door when not being used. Rosewood DS0000000112.V267480.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X X X 3 X X 2 X Rosewood DS0000000112.V267480.R01.S.doc Version 5.1 Page 19 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 YA24 Regulation 23(2)(b) Requirement The carpet in the dining room is marked, despite staff having said that they have tried to remove stains. The look of this room must be improved by the whole of the floor area being covered in matching carpet. This requirement is outstanding from the last inspection held on 15/08/05 There is a join in the flooring just inside the door which has lifted and which is a tripping hazard and must be made safe. This requirement is outstanding from the last inspection held on 15/08/05 The boxed-in area behind the bath taps is in poor condition - it has a cracked surface and must be made good. The requirement is outstanding from the last inspection held on the 15/08/05 The appearance of the above bathroom must be improved by boxing-in of the open-shelved storage area. This requirement is outstanding from the last inspection held on the 18/08/05 In the office there is only one DS0000000112.V267480.R01.S.doc Timescale for action 28/02/06 2. YA24 23(2)(b) 18/01/06 3. YA24 23(2)(b) 28/02/06 4. YA24 23(2)(b) 28/02/06 5. Rosewood YA24 23(2)(b) Version 5.1 Page 20 6. 7. YA42 YA42 23(4) (B) 23(2)(A) chair, and this is exposing its filling. Additional seating of an acceptable quality should be provided for the manager and staff. This requirement is outstanding from the last inspection held on the 18/08/05 The home must not use wedges to open fire doors. The laundry room must be locked when not used by staff 28/02/06 11/01/06 11/01/06 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. Refer to Standard YA9 YA42 Good Practice Recommendations Risk assessments should be developed to include family and or resident agreement Fire awareness training should be updated for staff Rosewood DS0000000112.V267480.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rosewood DS0000000112.V267480.R01.S.doc Version 5.1 Page 22 - 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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