Inspection on 15/08/05 for Rosewood

This inspection was carried out on 15th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 24/04/07

Rosewood 08/05/06

Rosewood 11/01/06

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 Christine Moon Unannounced 15 August 2005 09:30 am 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 B51-B01 S112 Rosewood V244345 150805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Rosewood Address Church Lane Grangetown Middlesbrough TS6 6TP 01642 463306 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) The Bridgings Limited Miss Theresa P Massey Care home only 8 Category(ies) of LD - Learning Disability (8) registration, with number PD - Physical Disability (8) of places Rosewood B51-B01 S112 Rosewood V244345 150805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd November 2004 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 B51-B01 S112 Rosewood V244345 150805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Inspection, which was Unannounced, took place over one day and lasted almost 4 hours. During this time, the internal environment of the home was assessed and time was spent talking with the manager and staff, and in observing and spending time with service users. A second Inspection will be held later to complete the 2005/2006 statutory inspections, and time will then be spent looking at systems of internal management of the home, including care planning. What the service does well: What has improved since the last inspection? Staff morale, as demonstrated by a greatly reduced sickness record, markedly improved. The atmosphere within the home is more friendly open, and both residents and staff were seen to be relaxed and happy. manager is working hard to access as much training as possible in order staff and service users benefit from increased levels of competence. has and The that Rosewood B51-B01 S112 Rosewood V244345 150805 Stage 4.doc Version 1.40 Page 6 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 B51-B01 S112 Rosewood V244345 150805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Rosewood B51-B01 S112 Rosewood V244345 150805 Stage 4.doc Version 1.40 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 standard(s) These Standards were not assessed at this Inspection. EVIDENCE: Rosewood B51-B01 S112 Rosewood V244345 150805 Stage 4.doc Version 1.40 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 standard(s) 7 and 8 With the support of staff, service users are able to make decisions about their lives, and are consulted on all aspects of life in the home wherever possible. EVIDENCE: The manager said, and staff confirmed, that all service users who are able, are given choice as to how they will spend their day, for example residents can get up when they choose to, and are able to decide on what they would like to do during the day. This choice extends to all aspects of daily living, including visiting friends and relatives, social activities and holidays. Consultation with service users takes place on a daily basis, mostly informally, which is best suited to the needs of those living there. All care staff working at the home have a thorough knowledge of likes and dislikes of their residents, and are able to utilise this in order to try to ensure service users are supported to both live the lives they choose to, and participate in all aspects of life within the home. Rosewood B51-B01 S112 Rosewood V244345 150805 Stage 4.doc Version 1.40 Page 10 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 and 17 In addition to opportunities for personal development, service users are able to take part in many and varied activities, some within the local community. Staff at Rosewood positively encourage contact with friends and family. Rights and responsibilities are respected and recognised by staff, and support is offered if needed. Careful consideration is given to ensuring residents have both an enjoyable and healthy diet. EVIDENCE: Discussion with both the manager and care staff confirmed that, as far as is possible, all service users have opportunities for personal development. An example of this is to be seen in how hard the manager and staff worked to try to find a college course for one resident. Despite at first not succeeding, continued searching resulted in a suitable college course being identified, to the delight of the service user. Rosewood B51-B01 S112 Rosewood V244345 150805 Stage 4.doc Version 1.40 Page 11 Activities available for residents are many and varied, some enjoy dancing, all are said to enjoy meals out and parties held for birthdays and other special occasions. Within the local area, trips to the cinema are popular and on the day of the Inspection, most residents were out on a trip to Redcar, which included lunch. Other day outings popular are trips to Whitby and Scarborough. In addition, the manager and staff keep a look out for suitable leisure experiences locally, and some residents enjoyed attending the Riverside Festival recently held in Stockton. In respect of holidays, two residents have recently been to the Centreparc near Penrith, two to Skegness and two are going abroad, supported by two members of staff, in September of this year. The manager and staff at Rosewood positively encourage and support regular contact with friends and family, and this takes place for those service users who are still in touch with families. In addition to visits to family and friends, staff support residents to further keep in touch by letters or telephone calls. Where appropriate, those living at Rosewood are encouraged and supported to have input into daily life within the home. One service user enjoys baking, and others enjoy helping with kitchen tasks, with the support of staff. The manager said that all food provided is carefully considered in order to try to ensure that service users enjoy a healthy diet. Fresh fruit and vegetables are available on a daily basis, and for the traditional Sunday lunch, fresh meat is bought for the meal to try to ensure better quality. In addition, residents are said to enjoy ‘takeaways’, on an occasional basis. If residents have specific likes, for example one service user loves Lurpak butter and this is provided for him. A dietician is involved in menu preparation for one of the service users. Rosewood B51-B01 S112 Rosewood V244345 150805 Stage 4.doc Version 1.40 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 standard(s) 18 and 19 Care staff provide personal support in the way preferred by service users, and work alongside other professionals to try to ensure all care needs are met. EVIDENCE: Being a small home, care staff at Rosewood have detailed knowledge of the personal care needs of those living there, and always provide intimate personal care in the way preferred by service users, and in a way which is discreet, taking account of the need to ensure privacy is maintained. The manager and staff work hard to try to ensure that all physical and emotional health needs are met – where needed advice is sought from professionals based within the Learning Disability team at nearby Flatts Lane. Currently a Community Psychiatric Nurse is working alongside staff at the home in order to try to better understand and meet the emotional needs of one resident. Rosewood B51-B01 S112 Rosewood V244345 150805 Stage 4.doc Version 1.40 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 standard(s) These Standards were not assessed at this Inspection. EVIDENCE: Rosewood B51-B01 S112 Rosewood V244345 150805 Stage 4.doc Version 1.40 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 standard(s) 24,25,26,27,28,29 and 30 The home is clean and hygienic. needs and lifestyles. Service users’ personal rooms suit their Both the decorative state and maintenance of the home are below that expected for those living in the home. EVIDENCE: Rosewood has a dedicated cleaner five days a week, and on the day of the Inspection the home was seen to be clean, tidy and hygienic. Supportive equipment is in place for those requiring it and the Arjo bath lift had been serviced on 28th July 2005. The manager and staff have worked hard to ensure that service users’ bedrooms suit their needs and lifestyles, and all rooms were seen to be comfortable and appropriate. The manager has plans to redecorate some of the rooms and service users will be asked to contribute in choosing colour schemes. Rosewood B51-B01 S112 Rosewood V244345 150805 Stage 4.doc Version 1.40 Page 15 There were areas of the home which were seen to be in need of attention, and these are as follows: 1. 2. 3. The concreted area outside the kitchen door is rough, could constitute a tripping hazard and is in need of being made good. The carpet in the corridor leading from the dining room to the sitting room is not flush with the floor, and could be a tripping hazard. The floor in the shower room along this corridor looks grubby, tiles are stained with what might be adhesive and the floor generally needs upgrading. The carpet in the dining room is marked, despite staff having said that they have tried to remove stains. The look of this room would be improved by the whole of the floor area being covered in matching carpet. The kitchen floor is in poor condition, despite being cleaned twice daily. There is a join in the flooring just inside the door which has lifted and which is a tripping hazard. The look of the kitchen would be improved by upgrading the floor covering. The metal plate racks on the wall above the sink detract from the overall appearance of the room. The wallpaper in the kitchen, which is said to be seven years old, looks dated and detracts from the appearance of the room. The floor remains stained in the bottom bathroom, and the edge of this flooring is marked with white splashes. The boxed-in area behind the bath taps is in poor condition – it has a cracked surface and edging strip. 9. 10. The appearance of this bathroom would be improved by the boxing-in of the open-shelved storage area. The sitting room is in a poor decorative state, and the carpet, which is of a quality which gives the room a very ‘basic’ feel, is stained. Curtains need attention in this room, as on the day of the Inspection, one was not securely fixed. In the office, there is one chair only, and this is exposing its filling. Additional seating of an acceptable quality should be provided for the manager and staff. B51-B01 S112 Rosewood V244345 150805 Stage 4.doc Version 1.40 Page 16 4. 5. 6. 7. 8. 11. Rosewood 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) 31,32,33,35 and 36 Staff at Rosewood are appropriately qualified and competent, work as an effective team and are well-supported by a manager who ‘leads from the front’. Training is accessed in order to ensure that staff are trained to meet individual service user need. EVIDENCE: The recently appointed Registered Manager of the home ‘leads from the front’ and as such staff are clear about their roles and responsibilities. The staff team, which has remained fairly consistent, appear dedicated to their service users and demonstrated a thorough knowledge of overall care needs. Three are qualified to NVQ2 in care, one to NVQ3, and two members of staff are progressing to NVQ3. One senior member of staff is progressing to NVQ Level 4 and expects to start this in September 2005. Induction training is being undertaken for a recently employed staff member. The manager said that she is keen for staff to undertake training in Safe Handling of Medication and is currently researching a suitable course. Rosewood B51-B01 S112 Rosewood V244345 150805 Stage 4.doc Version 1.40 Page 17 Discussion with the manager and staff confirmed that there is a strong staff team, and staff are said to ‘do above and beyond’ what is expected of them in their work. Those members of staff spoken with said they were happy in their work, and demonstrated a high level of commitment and loyalty to their residents. Formal Supervision of staff is undertaken by the manager, who also has an ‘open door’ policy which enables staff to both benefit from guidance and input into the home’s care practices. During the night, there is one ‘waking’ member of staff on duty, and one member of staff who is on ‘sleepover’ duty within the home. Rosewood B51-B01 S112 Rosewood V244345 150805 Stage 4.doc Version 1.40 Page 18 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) 37,38, and 43 Rosewood is well run, with an ethos and management style which puts all service users at the centre of care delivery. The management of the home is both competent and accountable. EVIDENCE: Observation on the day of the Inspection along with discussion with both the manager and staff, confirmed that the home is well run by a qualified and competent manager who provides staff with a sound role model and guidance. She is a registered general nurse, and has recently completed NVQ4 in Management, along with the Assessor’s Award A1. The ethos of the home is one which places service users at the centre of all care provided, and staff are conscientious in trying to ensure that all needs, that is physical, emotional and social, are fully met. Rosewood B51-B01 S112 Rosewood V244345 150805 Stage 4.doc Version 1.40 Page 19 There is no doubt that the home is run in the best interests of residents, and interactions observed between staff and residents on the day of the Inspection were seen to be positive and supportive. The knowledge and experience of individual service users demonstrated by staff is commendable, as is the caring way support is provided. The registered manager, who is relatively new, has been seen to approach her duties in a conscientious manner, and has been quick to seek advice from outside sources when necessary. Rosewood B51-B01 S112 Rosewood V244345 150805 Stage 4.doc Version 1.40 Page 20 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 N/A N/A N/A N/A N/A Standard No 22 23 ENVIRONMENT Score N/A N/A INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 3 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 3 2 2 3 3 Standard No 11 12 13 14 15 16 17 4 4 3 4 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 N/A 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Rosewood Score 4 4 N/A N/A Standard No 37 38 39 40 41 42 43 Score 3 3 N/A N/A N/A 3 3 B51-B01 S112 Rosewood V244345 150805 Stage 4.doc Version 1.40 Page 21 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 24 Regulation 23(2)(b) Requirement The concreted area outside the kitchen door is rough, could constitute a tripping hazard and is in need of being made good The carpet in the corridor leading from the dining room to the sitting room is not flush with the floor, and could be a tripping hazard The floor in the shower room along the above corridor looks grubby, tiles are stained with what might be adhesive and the floor generally needs upgrading The carpet in the dining room is marked, despite staff having said that they have tried to remove stains. The look of this room would be improved by the whole of the floor area being covered in matching carpet The kitchen floor covering is in poor condition, despite being cleaned twice daily. There is a join in the flooring just inside the door which has lifted and which is a tripping hazard. The look of the kitchen would be improved by upgrading the floor covering The metal plate racks on the wall above the sink detract from the Timescale for action Immediate 2. 24 23(2)(b) Immediate 3. 24 23(2)(b) By 10th October 2005 By 10th October 2005 4. 24 23(2)(b) 5. 24 23(2)(b) By 10th October 2005 6. 24 23(2)(b) By 10th October Page 22 Rosewood B51-B01 S112 Rosewood V244345 150805 Stage 4.doc Version 1.40 7. 24 23(2)(b) 8. 24 23(2)(b) 9. 24 23(2)(b) 10. 24 23(2)(b) 11. 24 23(2)(b) overall appearance of the room, and an alternative should be found The wallpaper in the kitche, which is said to be 7 years old, looks dated and detracts from the appearance of the room The floor remains stained in the bottom bathroom, and the edge of this flooring is marked with white sphases. In addition, the boxed-in area behind the bath taps is in poor condition - it has a cracked surface and edging strip The appearance of the above bathroom would be improved by boxing-in of the open-shelved storage area The sitting room is in a poor decorative state, and the carpet, which is of a quality which gives the room a very basic feel, is stained. Curtains need attention in this room, as on the day of the Inspection, one was not securely fixed In the office there is only one chair, and this is exposing its filling. Additional seating of an acceptable quality should be provided for the manager and staff 2005 By 10th October 2005 By 10th October 2005 By 10th October 2005 By 10th October 2005 By 10th October 2005 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 Good Practice Recommendations Rosewood B51-B01 S112 Rosewood V244345 150805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Unit B, 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 B51-B01 S112 Rosewood V244345 150805 Stage 4.doc Version 1.40 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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