Inspection on 12/05/05 for Rosewood

This inspection was carried out on 12th May 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

Rosewood 11/05/07

Rosewood 10/08/05

Rosewood 16/11/04

Rosewood 20/05/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Sutton Lodge Nursing Home

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

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

CARE HOME ADULTS 18-65 Rosewood Farmfield Drive Charlwood Surrey RH6 0BG Lead Inspector Mrs Sue McBriarty Announced 12 May 2005 th 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 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 Stationary 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 H58_s33902_Rosewood_v218717_120505_stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Rosewood Address Farmfield Drive Charlwood Surrey RH6 0BG 01883 383838 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Peter Kinsey Mrs Rosemary Simpson Care Home 8 Category(ies) of LD - Learning Disability (8) registration, with number of places PD - Physical Disability (8) SI - Sensory Impairment (8) Rosewood H58_s33902_Rosewood_v218717_120505_stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 3. There will be a registered nurse of level one or above and three health care assistants on the day shift. 5. The registered manager must be in addition to staff for at least two shifts per week, in order to carry out the responsible under the care standards act 2000 1. The age range of the people that may be accomodated will be 18-55 years 2. The home may admit one named person who is over the age of 55 years 4. There will be one registered nurse of level one or above and one health care assistant on the night shift Date of last inspection 16th November 2004 Brief Description of the Service: Rosewood is owned and managed by Surrey Oaklands NHS Trust and is registered to accommodate eight service users with learning disabilities and nursing needs. In addition the eight service users may have needs in relation to physical disability and or sensory impairment. The property has been purpose built and is appropriate for those who have needs associated with physical and sensory impairments. The home has a semi rural location but is in close proximity to several local towns. The communal areas of the home provide a large lounge, sun lounge, kitchen, utility room and a sensory room. A large garden surrounds the home which has been designed for wheelchair users in mind. Rosewood H58_s33902_Rosewood_v218717_120505_stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, the first for 2005 – 2006. Previous inspection reports are available from CSCI on request. This home prefers to call the people living there residents and this is reflected in this report. During the inspection seven residents were seen and four staff were seen excluding the manager. The residents had complex needs and were not able to offer their views on the service provided. A tour of the home took place and documents including care plans and risk assessments were sampled. The manager had completed a pre-inspection report; comment cards had been completed by family or other professionals and sent to CSCI. What the service does well: What has improved since the last inspection? 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 H58_s33902_Rosewood_v218717_120505_stage4.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection Rosewood H58_s33902_Rosewood_v218717_120505_stage4.doc Version 1.30 Page 7 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 standard(s) 1, 2, 3, 4, 5 Information is available to prospective residents, their families and professionals to assist in making a decision as to whether to move into the home. EVIDENCE: The pre-inspection report documented that the statement of purpose had been updated since the last inspection and contained all the information required to assist people in making a decision as to whether the home was able to meet their needs. Those residents files sampled had a written contract one had not been signed. It was recommended that where any person has no representative to sign on their behalf that either an advocate or care manager be asked to sign. Rosewood H58_s33902_Rosewood_v218717_120505_stage4.doc Version 1.30 Page 8 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 standard(s) 6, 7, 8, 9, 10 No progress had been made since the last inspection to document reviews of care plans and risk assessments. EVIDENCE: The home was in the process of changing the care plan systems however care plans and risk assessments were in place. The manager and staff were able to describe in full the residents needs and stated that their needs were also discussed during each shift hand over. This is the third inspection that has required that documents relating to service users needs are reviewed and a record made of the review. The care plans evidenced that a six monthly review takes place with Social Services and documented minutes were available on the resident’s files. This process does not take the place of the homes own review of their resident’s information. The residents were not able to take part in the assessment process due to their complex needs. Records are held appropriately and staff had access to the documents. Rosewood H58_s33902_Rosewood_v218717_120505_stage4.doc Version 1.30 Page 9 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 standard(s) 11, 12, 13, 14, 15, 16, 17 The residents had complex needs and activities were provided that took this into account. Sample menus were provided with the pre-inspection report and the menus were varied and nutritious. EVIDENCE: The current residents have complex needs and were reliant on staff and family members making decisions on their behalf. Staff members were observed talking to service users in a respectful and warm manner. The responses from the residents offered eye contact, smiles and some sounds. Comment cards received from relatives and other professionals were complimentary about the service. The responses confirmed that they could see their family in privacy and that staff members respected that privacy. The preparation and presentation of food was observed and the lunch sampled. Fresh ingredients were used. The cook was spoken to during the inspection and observed talking in a friendly manner to the residents. The residents use Rosewood H58_s33902_Rosewood_v218717_120505_stage4.doc Version 1.30 Page 10 the dining area to eat and due to the extent of their disabilities and the use of specialist wheelchairs they do not use the dining table. Limited day service provision was provided to each resident, two hours weekly. Any other activity had to be with the support of the staff team. Activities included access to hydrotherapy, music therapy and the homes own sensory room. One of the bubble tubes was out of order at the time of this inspection and given the importance of this room to the residents it is strongly recommended that it be repaired. The residents were being supported to book a holiday this year although no details were available at the time of this inspection. Rosewood H58_s33902_Rosewood_v218717_120505_stage4.doc Version 1.30 Page 11 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 standard(s) 18, 19, 20 Personal care needs were being met in the way preferred by service users. Detailed health action plans were in place. Policies and procedures were in place to support those who may be ill or dying. EVIDENCE: The care plans sampled evidenced that staff were aware of the resident’s preferences with regard to their personal care needs being met. There were detailed accounts of how residents might respond if their needs were not met in the manner of their own choice. As noted previously staff are required to record the review dates of care plans for each of the residents. The care plans included the health needs of the residents and how they were to be met. All the comment cards received by the CSCI from other professionals and family members noted that they are kept informed and consulted on the needs of the residents. Medication was kept in a suitable locked location and records for the administration, receipt and handling of medication were seen to be adequate. The pre-inspection reports evidenced the provision of policies and procedures for the ageing and death of a resident. Rosewood H58_s33902_Rosewood_v218717_120505_stage4.doc Version 1.30 Page 12 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 standard(s) 22, 23 A complaint procedure is in place. The residents are protected by the provision of adult protection procedures and staff training. EVIDENCE: The pre-inspection report evidenced that policies and procedures were in place to deal with complaints and adult protection referrals. The comment cards received confirmed the information provided in the preinspection report that no complaints had been received by the home over the last twelve months. One adult protection issue had been dealt with by the organisation. Fourteen of the staff team had received training in the protection of vulnerable adults. There had been difficulties in gaining places on the Surrey County Council Protection of Vulnerable Adults training course. It has been recommended that Surrey Oaklands NHS Trust consider alternative options in order to ensure the full staff team receive training. Rosewood H58_s33902_Rosewood_v218717_120505_stage4.doc Version 1.30 Page 13 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 standard(s) 24, 25, 26, 27, 28, 29, 30 The home was clean, well presented and homely. The toilet and bathroom facilities were adequate for the needs of the service users. EVIDENCE: The communal areas were bright, clean and airy. The large windows and patio doors enabled residents to watch the local wildlife that entered the home’s garden. The wide corridors enabled people who use wheelchairs to comfortably access all areas of the home. The toilets and bathrooms had appropriate equipment to assist the residents. Each of the resident’s rooms had been personalised and were colourful, bright and contained specialist beds where they were needed. Rosewood H58_s33902_Rosewood_v218717_120505_stage4.doc Version 1.30 Page 14 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 35 The organisation had policies and procedures in place for the recruitment and selection of staff. Full training records were provided with the pre-inspection report. All staff received appropriate training. Further progress is required with regard to qualifying training for care staff. EVIDENCE: The Trust has policies and procedures in place for the recruitment and selection of staff. Six of the staff team were qualified nurses; thirteen were care staff and one ancillary staff member. Only one member of the care staff team had a NVQ Level 2 qualification. It is required that the home provides the CSCI with their plan to improve the care staff qualification level to 50 . The home had four staff on duty each morning and afternoon and two at night. At the time of the inspection the ancillary staff member was working part time The role of this staff member was as cook and cleaner. As care staff had to take on the duties of this person when he was not present it is recommended that a staff review takes place to see if additional hours are required. The manager maintains a record of training undertaken by each member of staff a copy of which was included in the pre-inspection report. The skill mix with qualified nursing staff and care staff was adequate to the needs of the residents. Rosewood H58_s33902_Rosewood_v218717_120505_stage4.doc Version 1.30 Page 15 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38, 40, 41, 42, The home had an open and inclusive approach where staff and service users were listened to. Staff training information was recorded in full. Further progress is required with regard to maintaining service user records. Action is also required with regard to some parts of the home and garden. EVIDENCE: The relationship between the staff and the manager was positive and staff were observed talking in an open and inclusive way to each other and their manager. The pre-inspection report notes that appropriate checks had been made on all parts of the home in order to ensure the safety of staff and residents. Policies and procedures are in place to maintain the health and safety of staff and residents. It is required that the residents rooms be provided with liquid soap and a paper towel dispenser. None of the resident’s rooms had paper towels available Rosewood H58_s33902_Rosewood_v218717_120505_stage4.doc Version 1.30 Page 16 and provision would reduce the risk of cross infection. In addition these items must be provided in all areas where staff are handling food and/or assisting residents with personal care. The garden paving requires attention due to moss and weed growth. The area would become a slip hazard during wet and or frosty weather. The majority of the current residents were wheelchair users however one person was able to walk and staff also use the area. Some parts of the paving are beginning to subside and provide a trip hazard to anyone walking in the garden. The area must be repaired, cleaned and kept clean and free from hazards. The external patio doors require redecorating and parts of the outer walls require cleaning down. The walls are marked and have cobwebs on them. The patio doors have faded and the wood is harsh to the touch. An area by the sun lounge patio doors needs to be made good from a previous repair. A recommendation has been made to make good this aspect of the home. The home is seeking to extend its current registration categories and it was recommended that the manager undertake a full risk assessment of all areas of the home with this in mind. Rosewood H58_s33902_Rosewood_v218717_120505_stage4.doc Version 1.30 Page 17 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 2 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 2 3 3 3 Standard No 31 32 33 34 35 36 Score x 2 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Rosewood Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x 3 x 3 2 2 x Version 1.30 H58_s33902_Rosewood_v218717_120505_stage4.doc Page 18 YES Are there any outstanding requirements from the last inspection? 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 5 Regulation 15(1)(2)( a)(b)(c) (d) 15(1)(b) (c) Requirement The registered person must ensure that, where appropriate, service users or their representatives sign and agree the care plan. The registered person must ensure that service users care plans are reviewed regularly and the date of review recorded. (carried forward from two previous inspections, timescale of 31st December 2004 not met) The registered person must ensure that service users risk assessments are reviewed regularly and the date of review recorded. The registered person must ensure that all members of staff receive training in the local authorities protection of adults procedures. The registered person must provide CSCI with a copy of their plan to ensure that 50 of the care staff team receive their NVQ Level 2 qualification. The registered person must ensure that liquid soap and paper towels are provided in each service user room, Timescale for action 31st July 2005 2. 6 30th June 2005 this matter must be complied with. 30th June 2005 3. 9 13(4)(c ) 4. 23 13(6) 31st July 2005 5. 32 18(1)(a) (c )(ii) 30th June 2005 6. 42 13(3)(4) (c ) 30th June 2005 Rosewood H58_s33902_Rosewood_v218717_120505_stage4.doc Version 1.30 Page 19 bathrooms and kitchen. 7. 42 13(4)(a) (c ) 23(2)(b) The registered person must ensure that the paved areas of the garden are free from weeds and moss growth. The area above the patio door in the sun lounge to be made good. 30th June 2005 31st July 2005 8. 42 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 14 Good Practice Recommendations It is recommended that the bubble tube in the sensory room be repaired. The current residents needs are such that the full use of the room is important to them and it is noticeable that it is not functioing. It is recommended that the hours for ancillary staff be reviewed. This to enable the care staff to focus on the needs of the residents over an increased number of hours each week. It is recommended that the manager undertake a full risk assessment of all parts of the home based on any future addition of service user category. it is recommended that the external areas to the home are cleaned and the patio doors painted. 2. 33 3. 4. 42 42 Rosewood H58_s33902_Rosewood_v218717_120505_stage4.doc Version 1.30 Page 20 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 H58_s33902_Rosewood_v218717_120505_stage4.doc Version 1.30 Page 21 - 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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