Inspection on 11/10/05 for Rosewood Care Home

This inspection was carried out on 11th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 Care Home 31/07/07

Rosewood Care Home 19/07/06

Rosewood Care Home 19/04/05

Rosewood Care Home 07/12/04

Rosewood Care Home 14/09/04

Rosewood Care Home 30/01/04

Similar services:

St Vincents

The Cotswold Home

Winton House

Newbeech House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Rosewood Care Home 131a Swift Road Woolston Southampton Hampshire SO19 9ES Lead Inspector Chris Johnson Unannounced Inspection 11th October 2005 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rosewood Care Home DS0000011616.V260390.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rosewood Care Home DS0000011616.V260390.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Rosewood Care Home Address 131a Swift Road Woolston Southampton Hampshire SO19 9ES 023 8068 5224 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) Mycare Homes Limited Care Home 12 Category(ies) of Old age, not falling within any other category registration, with number (12) of places Rosewood Care Home DS0000011616.V260390.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th April 2005 Brief Description of the Service: Rosewood care home provides care for twelve older people who need some assistance with personal care needs. The home is located in Woolston not far from the local shops and within a short distance from Weston Shore. All rooms for service users are on the ground floor. The staff sleeping in room is located on the first floor. Service users have access to a large lounge/diner and all service users have single rooms with shared WC facilities between rooms. The home is set back from the main road and offers a rear garden for service users. Rosewood Care Home DS0000011616.V260390.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second inspection carried out for the year April 2005/06. This inspection was unannounced and took place over six hours. The purpose of this visit was to carry out an inspection of the home and follow up on requirements made at the last inspection. Both reports should be read for an overview of how the home is meeting the standards. The findings of this report are based on a number of different sources of evidence including; a tour of the premises that included looking at service user’s bedrooms. Staff and care records were inspected; several staff were spoken to and observed in their interactions with residents. A group discussion was held with eight residents and residents were also spoken with individually. As a result of this inspection several immediate requirements were made and a letter of serious concern was sent to the provider. The provider was also invited to attend a meeting with the Commission for Social Care Inspection to discuss the issues outstanding from previous inspections that had not been addressed. What the service does well: What has improved since the last inspection? What they could do better: There had been no improvement or action taken to comply with three of the four requirements made in the last inspection report. This matter is of significant concern to the Commission, as the requirements referred specifically to ensuring that residents were safeguarded against poor recruitment practices. The home needs to take action to comply with the Rosewood Care Home DS0000011616.V260390.R01.S.doc Version 5.0 Page 6 requirements of the Care Standards Act 2000, associated regulations and the National Minimum Standards. Residents would appear to be less satisfied with some aspects of life in the home than they were at the previous inspection. Residents said that they would like the opportunity to take part in more activities and get out of the home more frequently. They said that activities were important to them as they “provided a distraction and helped pass the time”. Residents also said that they were not happy with the standard of some of the food. In the absence of a manager, there would not appear to be anyone with the authority at present to address these concerns or to make sure that legislation is complied with. Some staff work long shifts and a lot of hours. This can potentially put residents at risk. 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 Care Home DS0000011616.V260390.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rosewood Care Home DS0000011616.V260390.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 EVIDENCE: Rosewood does not provide intermediate care. Standards 3,4 and 5 were assessed at the last inspection and on that occasion found to be satisfactory. Rosewood Care Home DS0000011616.V260390.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Standards 7,8,9 and 10 were assessed at the last inspection and on that occasion found to be satisfactory. Rosewood Care Home DS0000011616.V260390.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,14 and 15 Residents are less satisfied with the food and opportunities to engage in activities than they were at the last inspection. EVIDENCE: The home does provide activities and this was looked at during the last inspection. However, during a group discussion, residents said that there were not enough activities or things to do. All residents said that they would like the opportunity to go out and about more frequently. Most residents require the support of a care worker to go out of the home and are therefore reliant on them. At present there is very little opportunity for this to happen. Staff were in agreement that they would like the opportunity to go out with residents more often. Residents said that they did enjoy the planned activities that were provided such as bingo, however sometimes they were not provided as planned and no explanation was given. Several residents with partial sight require assistance to take part in activities such as bingo. However there is not always sufficient staff to provide this level of support. This can mean that some residents are excluded from activities or the activity does not go ahead as planned. Minutes of a residents meeting held in August demonstrated that residents are consulted about the type of activities that they would like and staff do make an Rosewood Care Home DS0000011616.V260390.R01.S.doc Version 5.0 Page 11 effort to provide different forms of entertainment and activities. However resources do create an obstacle to fulfilling their wishes. From looking at several residents’ bedrooms and individual discussions with residents it was evident that they can pursue their own interest and hobbies and choose how they spend their time. Residents were generally unhappy with the standard of the main midday meal. They reported that quantities of food were sufficient but the quality and standard was not. Residents said that they particularly disliked the way that vegetables were “not cooked properly”. Some said that they had raised this issue at residents meetings but there had not been any improvement. Comments received included, “Staff are not trained cooks, but they do their best”. The staff member cooking lunch on the day of the inspection had not cooked previously and had not been trained in food hygiene neither had two other staff members spoken with whom both cook on a regular basis. This was a cause of concern. Residents are given a wide choice of teatime meal. All were in agreement that staff try to provide them with their individual choices at teatime. A senior manager within the organisation has control over the food and all other budgets and decides on the quantity of food to be ordered. The home does not hold a petty cash float to replace items that may run out during the week. This matter is of concern as residents said that there is a tendency for certain items to run out and this does limit their choice. The menu for the main midday meal is the same as at least one other home within the Mycare group. This would suggest that menus are not based on individual preferences. Rosewood Care Home DS0000011616.V260390.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18 Residents feel free to express their concerns and their opinions regarding life in the home. There is a need however to ensure that everyone is aware of their right to make a complaint and how to go about it. EVIDENCE: There had not been any complaints made about the home since the last inspection. None of the residents spoken with were aware of the actual procedure although all said that they would speak to the acting manager should they have any concerns. There is a need to regularly remind residents of the procedure. Although it had been discussed at a meeting some months previously there had since than been several new residents move into the home. A complaints procedure is displayed within the home informing service users of their right to complain and how they can go about this. However it needs to be more prominently displayed. Residents were also unaware of the existence of questionnaires sent by The Commission for Social Care Inspection asking them their views on life at the home. These were on a notice board although as with the complaints procedure that were not prominent and residents did not seem to have any knowledge of their existence. All residents spoken with said that they felt safe and well looked after in the home. Information regarding advocacy services was available and residents said that they were given the opportunity to take part in elections. Staff spoken with were aware of adult protection and reporting procedures. Residents did say that they thought that it was good that they felt comfortable Rosewood Care Home DS0000011616.V260390.R01.S.doc Version 5.0 Page 13 and able to express their opinions to the inspector and that this was due to the fact that environment and ethos of the home enabled them to do this. Rosewood Care Home DS0000011616.V260390.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23,24 and 26 The home is clean, comfortable and homely. EVIDENCE: On the day of the inspection the home was clean, tidy, warm and well maintained throughout. A cleaner is employed to work at the home six days a week and it was evident that standards of hygiene are maintained. The home provides a comfortable and homely environment. Residents were all in agreement that they felt at “home” and were happy with their surroundings. Bedrooms contain sufficient furnishings and residents had been able to personalise them with their own belongings. Several rooms were seen and the inspector was satisfied that action had been taken to address the requirement made at the last inspection to provide all residents with appropriate bedding. Rosewood Care Home DS0000011616.V260390.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 The staff team are caring and reliable. However the procedures for the recruitment of staff are poor and do not provide the safeguards to offer protection to people living in the home. Health and safety is at times jeopardized by the excessively long hours that staff work. Staff do not receive sufficient training in food hygiene practices. EVIDENCE: The home maintains a reasonably consistent staff team. All residents spoken with said that they felt safe with the staff and that they were all good and caring. They did however report that there were sometimes language difficulties with some staff employed from overseas. Residents said that they could not always make them understand what they wanted. The inspector spoke with staff employed from overseas during the inspection and of those spoken with all demonstrated a good and thorough understanding of the English language. Recruitment records were very poor. Records in respect of four members of staff employed to work at the home since the last inspection were checked. There was nothing at all to indicate that three of the four had been through any recruitment procedure. Criminal Records Bureau checks had not been obtained for any of them neither had a check against the Protection of Vulnerable Adults list been made. References were not on file, nor were evidence that they had completed an application form, been through any recruitment procedure or that they held a valid work permit. Rosewood Care Home DS0000011616.V260390.R01.S.doc Version 5.0 Page 16 Records for the fourth member of staff showed that the person had commenced work at the home without a Criminal Records Bureau or Protection of Vulnerable Adults check having been carried out. This was despite the fact that a requirement had been made at the last inspection that staff must not commence work at the home until all satisfactory checks had been completed. No effort had been made to obtain up to date checks on a fifth member of staff despite their records being identified at the last inspection as being lacking. The home relies on existing and staff from another home within the Mycare organisation to cover sickness and leave. The rota for the week of the inspection showed that several staff were scheduled to work around 70 hours. This was inclusive of overtime hours to cover leave and is not necessarily the norm. It is however something that must be monitored to ensure the health and safety of all. Staff at times work excessively long hours. One staff member was scheduled to work a 21-hour shift as part of their normal weekly duties. These are extremely long hours to work consecutively and present a risk to the health and safety of the home, the staff and the residents in their care. Staff do receive regular training such as induction training, training in the safe handling of medication and manual handling. Staff were aware of and had access to the homes’ policies and procedures. Staff involved in food preparation are not however appropriately trained in food hygiene practices. Rosewood Care Home DS0000011616.V260390.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,37 The absence of a manager results in some practices that do not safeguard the welfare of service users. The home is failing to comply with requirements and fulfil all responsibilities and legal requirements as defined by the Care Standards Act. EVIDENCE: The home has not had a registered manager for a long time. This has been highlighted and commented on in three previous reports dated September 2004, December 2004 and April 2005. Requirements were made in December and April that the home must appoint a manager and an application must be submitted to the Commission for Social Care Inspection for registration. These have not been complied with. The current arrangement is that a manager from one of the other homes within the Mycare organisation visits on a regular basis, as does the Area director. The home is lacking in the leadership of a full time, permanent manager. Although a member of staff does oversee the dayRosewood Care Home DS0000011616.V260390.R01.S.doc Version 5.0 Page 18 to-day running of the home a full time manager is needed to ensure that all responsibilities such as correct recruitment procedures are followed, to take action to resolve the requirements made at the last inspection and to fulfil all responsibilities and legal requirements as defined by the Care Standards Act. Residents would appear to be less satisfied with some aspects of life in the home than they were at the previous inspection. There would not appear to be anyone with the authority at present to address these concerns and residents did comment that they were unaware of who the owner of the home was. The standard of record keeping with the exception of staff records was satisfactory and staff are aware of the homes’ policies and procedures. Rosewood Care Home DS0000011616.V260390.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 3 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 3 18 3 x x x x 3 3 x 3 STAFFING Standard No Score 27 2 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 1 2 x x x 1 x Rosewood Care Home DS0000011616.V260390.R01.S.doc Version 5.0 Page 20 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 OP15 Regulation 13 (3) Requirement All staff involved in food preparation must be trained in food hygiene, and be competent to cook. You must ensure that there are adequate food supplies at all times. All food must be properly prepared and cooked. The complaints procedure must be explained and made accessible to service users and or their representatives. You are required to ensure that staff working in excess of the hours as detailed in the European Working Time Directive are fit for duty having had adequate rest periods. All staff records are to be kept in the home. Staff must not commence work at the home, or continue to work at the home until all satisfactory checks have been made. Staff may only work in the home in line with the provisions of The DS0000011616.V260390.R01.S.doc Timescale for action 31/12/05 2 3 4 OP15 OP15 OP16 16 (2) (i) 16 (2) 22 12/10/05 12/10/05 29/11/05 5 OP27 12 (1) 11/11/05 6 OP37OP29 17(2) Schedule 4 (6) 19 31/10/05 7 OP29 12/10/05 Rosewood Care Home Version 5.0 Page 21 8 OP31 8 Care Standards Act 2000 (Establishments and Agencies) (Miscellaneous Amendments) Regulations 2004. (Previous timescale of 20/4/05 not met) The home must appoint a manager and an application must be submitted to the Commission for Social Care Inspection for registration. (Previous timescales of 7/2/05 and 1/10/05 not met) 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP12 Good Practice Recommendations That a review of the current activities available to Service users is carried out in consultation with them. That more outings / opportunities for Service users to get out into the community are created. Consideration should be given to employing a cook. That a petty cash budget is held in the home so that money is available to replace food items and other items as necessary. 2 3 OP15 OP34OP15 Rosewood Care Home DS0000011616.V260390.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Care Home DS0000011616.V260390.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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