Inspection on 24/04/07 for Rosewood

This inspection was carried out on 24th April 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Rosewood 08/05/06

Rosewood 11/01/06

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 Jane Bassett Key Unannounced Inspection 24th April 2007 09:30 Rosewood DS0000000112.V336566.R01.S.doc Version 5.2 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.V336566.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 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.V336566.R01.S.doc Version 5.2 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.V336566.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 8 residents with Learning Disability and Physical Disability Date of last inspection 8th May 2006 Brief Description of the Service: Rosewood, Bridgings Limited, is a care home for 8 service users with a learning disability, some of who 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. The home currently charges fees from £462.96 to £1054.70 per week. Rosewood DS0000000112.V336566.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection report includes information obtained from a pre inspection questionnaire. An unannounced visit to the home was carried out. During the visit, which lasted five hours the inspector walked around the building and looked at documentation including staff records and residents files. The inspector spoke to two residents, three staff members, and the manager. Whilst it was difficult for the inspector to obtain the views of the residents all appeared settled and comfortable in their surroundings. What the service does well: What has improved since the last inspection? Risk assessment documentation, including use of bedrails and lap straps has been developed to be more personalised to individual needs. The home has recently introduced competency checks in relation to the administration of medication. The home has developed a system for recording complaints should they receive any. The recording of resident’s personal monies has been developed to include two signatures and a regular audit. Work has been carried out to remove open storage shelves in one of the bathrooms, however this has left a number of small holes in the wall and wallpaper. A number of redecorated. resident’s bedrooms and the main corridor have been Rosewood DS0000000112.V336566.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Rosewood DS0000000112.V336566.R01.S.doc Version 5.2 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.V336566.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Outcomes for standard 2 were looked at. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who may use the service and their representatives have the information needed to choose a home which will meet their needs. EVIDENCE: During the inspection the file of a resident recently admitted to the home was examined. This was found to contain an assessment of need carried out prior to admission. The assessment included information from the person’s social worker, learning disabilities services and previous placement. The manager told the inspector that staff from the home had visited the resident prior to the move, and gathered information about their needs and preferences. The resident and family also had the opportunity to visit Rosewood before making a decision. Rosewood DS0000000112.V336566.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Outcomes for standards 6, 7, 8, & 9 were looked at. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Where possible individuals are involved in decisions about their lives, and play a role in planning the care and support they receive. EVIDENCE: During the inspection three residents files were examined. These were found to be well organised. Files were found to contain an action plan detailing care needs, including health, emotional, social, leisure and educational needs. Records also included details of what residents can do for themselves, their likes and dislikes, any risks and how these are to be met. Rosewood DS0000000112.V336566.R01.S.doc Version 5.2 Page 10 Information recorded in risk assessments has been developed and is now personalised to individual need. Risks assessments in relation to the use of bedrails and lap straps have been developed as required at the previous inspection. There was clear evidence that risk had been discussed and agreed with either the resident or their relative were appropriate. Action plans are reviewed on a regular basis. The inspector was told plans of care are to be developed to be more accessible to residents and will include a pictorial record of care needs and actions to take. Staff who spoke to the inspector had a good knowledge of individual residents needs, preferences, choices and how these are met. The home has a key worker system that promotes individual care of residents. Whilst it was difficult to obtain residents views the inspector observed a friendly and respectful rapport and good interaction between residents and staff. Staff were seen to offer residents choice and support independence. One resident who spoke to the inspector told her ‘ its good living here’. Rosewood DS0000000112.V336566.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Outcomes for standards 12, 13, 15, 16, & 17 were looked at. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use services are able to make choices about their lifestyle. Social, educational, and recreational activities and relationships meet individual’s expectations. EVIDENCE: Discussion with both the manager and staff confirmed that as far as possible the residents have opportunities for personal development, for example one resident attends college, others are on day placements within the local community. Activities at the home are varied and include meals out, trips and, outings to places such as Redcar etc. Rosewood DS0000000112.V336566.R01.S.doc Version 5.2 Page 12 A number of residents have been on holidays supported by the staff. Contact between residents and their family and friends is supported and encouraged by the staff. One resident who spoke to the inspector said he/she was happy at the home and had friends here. Comments received included ‘ its good living here’ and ‘ I can pick where to go on trips’. Resident’s rooms were seen to be personalised to taste reflecting individual’s interests and preferences. Staff spoke of encouraging choice, one commented ‘its their home they should choose’. The inspector was told the menus were varied and the home provides a healthy diet. Special dietary needs are addressed. Residents are involved in the choice of menus. Resident’s likes and dislikes are discussed and recorded. Fresh fruit and vegetables are used within the meals. In addition, residents enjoy the occasional takeaway or meal out. Rosewood DS0000000112.V336566.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Outcomes for standards 18, 19, 20, & 21 were looked at. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Staff were able to demonstrate through response to questions and observed interaction that they promote residents independence, whilst respecting peoples preferences and dignity. Both the manager and staff told the inspector that support is sought from other professionals as required, for example the challenging behaviour team, GP’s and district nurses. An audit of medication found no concerns with the ordering, storage and administration of medication. The manager told the inspector that all staff who administer medication have received the appropriate training. Rosewood DS0000000112.V336566.R01.S.doc Version 5.2 Page 14 The home has recently introduced competency checks in relation to the administration of medication. The home has a copy of the BNF, which is a reference document regarding medication, however this was found to be out of date. The manager and staff spoke to the inspector of the actions they took and the support given to the other residents during the illness and death of a resident who had been at the home a number of years. Staff described how they remained at the hospital to support and comfort the individual during the final hours. Both staff and residents had involvement in planning the funeral to ensure that it was personalised, and residents were supported and enabled to attend. Rosewood DS0000000112.V336566.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Outcomes for standards 22 & 23 were looked at. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can express their concerns and have access to a complaints procedure, are protected from abuse and have their rights protected. EVIDENCE: The home has a policy and procedure in relation to complaints, this has been developed to include details of authorities funding resident’s care, and has made provision to record any complaints received as required at the previous inspection. The inspector was told the home has not received any complaints since the previous inspection. One resident who spent time with the inspector confirmed they could speak to the manager or staff if they had any concerns. Staff who spoke to the inspector confirmed they have received training in relation to prevention of abuse and reporting concerns. All demonstrated through response to questions a commitment to protecting residents safety and wellbeing and actions they would take if a concern were raised. Staff members spoke of having access to advocacy services if required. Rosewood DS0000000112.V336566.R01.S.doc Version 5.2 Page 16 An audit of residents personal monies held by the home evidenced the system has been made safer and includes retention of appropriate receipts, two signatures and a monthly check. A random sample of personal allowances found there were no discrepancies with the balance stated on the record sheet and the actual amount in the individual money envelope. Rosewood DS0000000112.V336566.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Outcomes for standards 24 & 30 were looked at. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The environment of the home is generally well maintained, comfortable and safe. EVIDENCE: The inspector walked around the home and looked in a number of resident’s bedrooms and communal areas. The home was found to be clean, tidy and odour free. It was seen that the open storage shelves have been replaced by a smaller cupboard in one bathroom. However this has left a number of small holes in the wall and wallpaper. A number of redecorated. Rosewood resident’s bedrooms and the main corridor have been DS0000000112.V336566.R01.S.doc Version 5.2 Page 18 Whilst the home offers a comfortable and ‘ homely’ environment it would benefit from an ongoing planned programme of refurbishment. The manager told the inspector that further bedrooms and bathrooms are to be decorated. It was seen that one bathroom contained a hoist. The manager told the inspector that this was not used and was being stored there. Rosewood DS0000000112.V336566.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Outcomes for standards 32, 34, & 35 were looked at. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient number to support the people who use the service, and support the smooth running of the home. EVIDENCE: During the inspection the file of one staff member recently recruited was examined. This was found to contain the appropriate documentation in relation to recruitment including the details of the CRB as required at the previous inspection. However dates in the file indicated that the staff member had commenced work prior to receipt of a CRB. The manager told the inspector that they had not been involved in personal care and had taken part in induction training only. Other staff records seen contained evidence of training in relation to fire safety, food hygiene, safe handling of medication, first aid, challenging behaviour and ‘no secrets’ guidance. Rosewood DS0000000112.V336566.R01.S.doc Version 5.2 Page 20 The manager told the inspector 95 of care staff have achieved NVQ at level 2 or above. Staff confirmed there were sufficient staff on duty to meet residents needs, supervision takes place on a regular basis, communication is good and information is passed on at handovers and staff meetings. Rosewood DS0000000112.V336566.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Outcomes for standards 37, 39, & 42 were looked at. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect, and is developing quality assurance systems. EVIDENCE: The manager and staff were all able to demonstrate a commitment to the residents who are valued as individuals. Discussion with staff confirmed that the home is well run and place the residents at the centre of all the care provided. Staff who spoke to the inspector said the manager of the home was open and approachable. Rosewood DS0000000112.V336566.R01.S.doc Version 5.2 Page 22 The home has developed an annual survey that is more resident friendly. Advocates have been asked to help the residents complete this. The manager told the inspector it is planned to analyse and publish the results of the survey. Regulation 26 visits take place on a monthly basis and reports were available. Accidents were seen to be recorded appropriately. The manager carries out regular audits in relation to residents personal monies held by the home, accidents, and care planning documentation. Information in the pre inspection questionnaire indicated that the home and equipment are maintained as required, and fire alarms are tested weekly. The manager told the inspector that temperatures of hot water for bathing are checked and recorded each time in resident’s records. Rosewood DS0000000112.V336566.R01.S.doc Version 5.2 Page 23 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 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 2 X X 3 x Rosewood DS0000000112.V336566.R01.S.doc Version 5.2 Page 24 No 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. Standard Regulation Requirement Timescale for action 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 YA20 YA24 Good Practice Recommendations The home should obtain a more up to date BNF. Redecoration and refurbishment should continue to improve the environment for the comfort and benefit of residents, including the bathroom where shelving has been removed. More suitable storage space should be found for unused equipment, such as hoists. This should not be stored in bathrooms. The date that staff commence providing personal care should be recorded to confirm that this is not prior to reciept of satisfactory CRB. The annual survey should be developed further, and results published in a format that is usable by residents and relatives. 3. 4 5 YA24 YA34 YA39 Rosewood DS0000000112.V336566.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rosewood DS0000000112.V336566.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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