Inspection on 21/03/06 for Rosewood Court

This inspection was carried out on 21st March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Court 30/01/07

Rosewood Court 10/05/06

Rosewood Court 18/11/05

Rosewood Court 27/04/05

Rosewood Court 07/09/04

Rosewood Court 22/04/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Rosewood Court Shakespeare Close Butler Street East Bradford BD3 9AR Lead Inspector Nadia Jejna Unannounced Inspection 21st March 2006 13:30 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 Court DS0000034033.V287127.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 Court DS0000034033.V287127.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Rosewood Court Address Shakespeare Close Butler Street East Bradford BD3 9AR 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) 01274 308308 01274 308307 Southern Cross Healthcare (Kent) Ltd Care Home 80 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (41), Old age, not falling within any other of places category (40), Physical disability (1) Rosewood Court DS0000034033.V287127.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That the category of PD be used for the service user named in the application signed on 5 October 2004 The place for DE is for the named service user only. One of the DE(E) places is specifically for the person named in the variation application dated 17.2.06 18th November 2005 Date of last inspection Brief Description of the Service: Rosewood Court provides care to older people diagnosed as needing residential and nursing care including older people diagnosed with dementia. The home was purpose built as a care home. The size and layout meets current minimum standards. All rooms are single and provided with an en-suite toilet and washbasin. The home is situated close to Bradford city centre and is well served with public transport from both Leeds and Bradford. There is level access into the home and two passenger lifts to the first floor. The building is split into four units, each catering for up to twenty people providing a total of eighty beds. Each unit has a designated speciality as follows, residential (Aspen Unit), residential dementia care (Rowan Unit), general nursing (Willow Unit) and dementia nursing (Cedar Unit). There are two enclosed garden areas. Rosewood Court DS0000034033.V287127.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Over an inspection year from April until March, care homes have a minimum of two inspections a year; these may be announced or unannounced. This is the third inspection of the year; the last inspection was in November 2005. This showed that the home had made some progress towards meeting the requirements and recommendations made at previous inspections. In order to get an overall picture of the service the last two inspection reports should be looked at alongside this one. The purpose of this inspection was to monitor the home’s progress since the last unannounced inspection. Time was spent looking at whether the fourteen requirements remaining after the last visit had been addressed. The inspectors spent time on the two dementia units and looked at care plans and other records as well as speaking to the management team, staff, residents and visitors on these units. Comment cards/questionnaires had been left after the last inspection for residents and visitors so that they could share their views of the home with the CSCI. One resident and nine relatives survey cards had been received at the time of writing this report. This inspection was unannounced and was carried out by two inspectors. The visit started at 13:30 and ended at 17:15. A second visit was made by one inspector to provide feedback to the acting manager. The people who live in the home prefer the term residents, and this is the term that will be used throughout this report. What the service does well: What has improved since the last inspection? A start has been made on redecorating the reception area and the communal areas of the general residential unit. New cleaning products are being used which has eliminated odours caused by products being used at the time of the last inspection. Rosewood Court DS0000034033.V287127.R01.S.doc Version 5.1 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 Court DS0000034033.V287127.R01.S.doc Version 5.1 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 Court DS0000034033.V287127.R01.S.doc Version 5.1 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): 4 Residents’ needs are not being met because staff have not received appropriate training. EVIDENCE: The home is registered to provide care with nursing to older people with dementia, however staff on the dementia units do not have an understanding of dementia or how it affects people because they have not had appropriate training. Therefore they are unable to meet the needs of these residents. One of the visitors to the residential dementia unit said that the staff were kind but did not understand their relative’s condition as they often heard them use phrases such as ‘remember what we said….’. They also said that their relative had been left with a cup of tea when they had been unable to manage a cup for some time and could not have a drink without help. Rosewood Court DS0000034033.V287127.R01.S.doc Version 5.1 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): 7, 8 and 10. Residents are at risk of their health, physical, social and psychological care needs not being identified and appropriately dealt with. The dignity and self-esteem of residents is not respected by staff. EVIDENCE: Five care plans for residents on the dementia units were looked at. It was clear that the plans were not individual or person centred. Plans about helping residents with personal care, hygiene needs and continence care could relate to any resident. Not all assessed, identified needs had appropriate care plans in place. Examples were given to the acting manager during feedback. They included: a) Care plans for residents who were at risk of losing weight did not say that they needed enriched nourishing meals, what snacks they should be offered in between meals or what their individual likes and dislikes where. There was no evidence to show that referral to the dietician had been requested. b) The care plans did not identify what type of dementia residents had, how it affected them or how staff could help them to lead as normal a life as Rosewood Court DS0000034033.V287127.R01.S.doc Version 5.1 Page 10 possible. The plans seen dealt with dementia in a generalised way and as something that affected memory and the ability to carry out everyday tasks rather than an illness that affects individuals differently. c) One resident had chronic head pains but there was no care plan in place. d) Another resident had a pressure sore and was being seen by the district nurses and was being nursed on a specialist air mattress. The care plan did not mention this at all or what action staff were to take looking after the resident’s pressure areas. Two of the plans seen contained social/personal histories. But the information in them had not been used when writing the care plans. Appropriate risk assessments and care plans were in place for a resident at risk of falling. These showed that the resident did not sleep at night and liked to walk around the unit. At these times they needed 1 to 1 attention from staff. This had been identified at the last inspection and a requirement made that staffing levels be reviewed. Staff said that requests had been made to head office for increased staffing at night but they had been turned down. The resident therefore is still at risk of falling. The requirement about making sure that staffing levels are appropriate to the physical, social and psychological needs and numbers of residents living in the home has been carried forward. Staff said that the manual hoist for moving residents and the manual seated weighing scales were not suitable for people with dementia as they were wary of the equipment and it took too long to use it effectively. Many of the residents on the dementia units looked as if their hair had not been brushed/combed, some had dirty fingernails, others still had food on their faces from lunch (served two hours earlier) and a resident who had a problem with excessive saliva production was given a hard blue hand towel to use rather than paper handkerchief’s. Rosewood Court DS0000034033.V287127.R01.S.doc Version 5.1 Page 11 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 and 15 Activities provided meet resident’s expectations in the general care unit, but there is a risk that the needs of people with dementia will be overlooked. There is a risk that the nutritional needs of residents with dementia will not be met unless there is increased provision of nourishing meals, drinks and snacks. EVIDENCE: Two activity organisers have been employed. Between them they work forty hours a week to provide social and recreational activities for all the residents at the home. They have not had any training to help them fulfil this role, even though they are also expected to provide a programme of activities for people with dementia. One of the organisers said that there had been a theatre trip the previous week and that various group activity sessions such as sing alongs, bingo and quizzes are planned. They also gave some good examples of one to one activities that they did intuitively for some of the residents. These included hand massage, reading and discussing newspapers or magazines and using flash cards and word association. Activity plans for each unit were displayed on notice boards. The organisers spend half of the day on different units and said that staff on the other units should make sure that the planned sessions take place. The planned sing a long session on the residential dementia unit did not take place. Music was Rosewood Court DS0000034033.V287127.R01.S.doc Version 5.1 Page 12 played while staff sat with the residents who looked bored and disinterested. There was no interaction between the staff and residents. It was clear that residents on the dementia units are not provided with appropriate social and leisure activities. The care plans seen on the dementia units did not identify what individuals preferred social activities were. The information in the life histories, when done, was not used to plan appropriate activities for individuals. The acting manager said that a new head chef is due to start work at the home in the next few weeks. Advice was given that they should have training about maintaining nutrition in the elderly, particularly those with dementia. The assistant cook said that snacks and drinks are available on request but staff do not ask for them. The kitchen used to provide finger foods for people on the dementia units but stopped because it was being returned unused. It was clear that there was no provision of frequent nourishing snacks or drinks on the dementia units. The acting manager said that the organisation was looking at providing kitchenettes on these units. Rosewood Court DS0000034033.V287127.R01.S.doc Version 5.1 Page 13 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 Records show that complaints are taken seriously. The responses seen show that responses do not always address all issues raised and it is concerning that a there are repeated complaints about poor care and staff attitudes. EVIDENCE: A complaints procedure is in place. This is displayed in the reception area as well as being included as part of the Service User Guide. Of the nine relatives/visitors survey cards returned six said that they were not aware of this procedure. The complaints register showed that there have been nine complaints since 26th January 2006. Five of these were from relatives with concerns about care issues and staff attitudes towards their relatives. Some of the complaints had been reported to the CSCI. These were referred to the provider to investigate. It was clear from the responses sent to the complainants and to the CSCI that not all areas of concerns were addressed. Steps must be taken to make sure that all concerns and complaints are appropriately investigated and that action is taken to address shortfalls in care delivery and practice. This is of particular importance regarding concerns of staff attitudes towards residents. Rosewood Court DS0000034033.V287127.R01.S.doc Version 5.1 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): 19 and 26. Some work on the environment has taken place, but further refurbishment is required in order to make sure it is more appropriate for the residents living in the different units. The system of laundering soiled linen creates the opportunity for cross infection. EVIDENCE: The acting manager said that plans were in place for a major programme of redecoration and refurbishment. Work has started on the reception area and the residential unit communal areas. It was disappointing that the redecoration of one of the dementia units last year had not taken into account good practice for the decorating and furnishing of dementia units or the use of clear sign posting. The previous manager had promised that this would be the case. The communal areas of the dementia units were not homely. They were clinical and felt like waiting rooms. The Rosewood Court DS0000034033.V287127.R01.S.doc Version 5.1 Page 15 acting manager said that the plans for the dementia units would make sure that the environments were made more suitable for people with dementia. A requirement was first made at the inspection in April 2005 that plans be put in place to improve the laundry facilities by 31st March 2006. The area is small for the size of the home and the amount of laundry generated, it does not allow for the adequate separation of clean and dirty linen and there is inadequate storage space for laundered items. This increases the risk of cross infection. The manager was advised to contact the infection control nurse for advice on how to reduce the risk of cross infection. The positioning of the dryers also presents a moving and handling risk to staff when using them. There was no information in the home to show if any progress had been made with the proposed changes to the laundry. Staff said that there was only one carpet cleaner for the whole building. They also said that there were no domestic staff on duty at weekends. This meant that care staff were expected to carry out cleaning tasks and if they did not have time it would be left until Monday morning. The domestic staff said they have not seen the infection control policies and procedures and have not received this training. Rosewood Court DS0000034033.V287127.R01.S.doc Version 5.1 Page 16 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 and 30 Staffing levels do not guarantee that the needs of residents can be met. Staff have not received appropriate training and there is a risk that resident’s needs will not be met. EVIDENCE: Following the inspections in April and October 2005, a requirement was made that the staffing levels must be reviewed taking into account the needs and dependency levels of the residents. This has not been done. Staff said that staffing levels had remained the same. It was clear that the needs of residents vary on each unit and that the standard staff allocation was not always appropriate. The implications of insufficient staff allocated to one of the dementia units has already been discussed in the health and personal care section where one of the resident’s care plans clearly showed that they needed 1 to 1 attention, especially at night, to reduce the risk of falls. The provider must review staffing levels in each of the units and make sure that they take into account not only the physical and health needs of residents but also their social and psychological needs and dependencies. Relative survey forms said that they thought there were not always enough staff on duty. A large proportion of the staff on the dementia units are from overseas and speak English as a second language. Their comprehension of English is limited, in some cases, and this can cause difficulties for residents and their relatives. Rosewood Court DS0000034033.V287127.R01.S.doc Version 5.1 Page 17 This was confirmed in relatives survey forms returned. A requirement was made at the last inspection that staff must be able to communicate effectively with residents. This has not been met. The administrator has worked hard to update the training and development records and put together individual training and development files for all staff. The records seen showed that training provision has been poor. The main areas of training that have been given to staff are induction, moving and handling (but not all staff have been given the required annual update), fire safety and food hygiene. Very few staff have received training in health and safety, infection control, first aid, abuse/adult protection, dementia or person centred care. The staff team has been ill equipped to provide a good standard of care to residents, especially those with dementia. The records also showed that the domestic and ancillary staff have not been given training in health and safety related topics. The project manager said that plans are in place to provide staff with dementia training in April 2006. Rosewood Court DS0000034033.V287127.R01.S.doc Version 5.1 Page 18 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, 35 and 36. Residents’ financial interests are safeguarded. The home does not have a permanent manager and this has resulted in low staff morale and the home not being run in the best interests of the residents. EVIDENCE: There is no manager at the home. The organisation has put a project manager in to oversee things until a suitable person is recruited to manage the home. The project manager had only been there for a few weeks and was still getting to know the home, the residents, staff and carrying out internal audits. There were no records available to show if a quality assurance survey of residents’ and visitor’s views of the home had been carried out. The deputy manager said that a residents and relatives meeting had last been held in December 2005. Rosewood Court DS0000034033.V287127.R01.S.doc Version 5.1 Page 19 The feedback from staff was that they felt dissatisfied and unsupported. They said that requests had been made and turned down for training, specialist equipment and to increase staffing levels on the dementia units. It was not made clear who the requests were made to. The administrator acts as appointee for one resident and holds money in safe keeping for them and a number of other residents in the home. Receipts are issued for all transactions and appropriate computerised records kept. Staff records seen showed that formal supervision was not being given to staff at regular intervals. It was also clear that not all of the staff providing supervision had received appropriate training to help them to do so. The handy man carries out weekly safety checks and inspections of bedrails, nurse call systems, window restrictors, hot water temperatures and wheelchairs. Records are kept. He also carries out weekly fire safety systems checks. Accident records are kept and the CSCI is made aware of all incidents as required by Regulation 37. The project manager said that all required maintenance and safety checks of all appliances, equipment and installations are done at least annually by appropriately qualified personnel. Rosewood Court DS0000034033.V287127.R01.S.doc Version 5.1 Page 20 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 1 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 X 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X X X X X 2 STAFFING Standard No Score 27 1 28 X 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 1 1 X 3 2 X 3 Rosewood Court DS0000034033.V287127.R01.S.doc Version 5.1 Page 21 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 OP4 Regulation 14 Requirement Steps must be taken to make sure that the home can meet the assessed needs of all service users admitted to the home. Relevant training must be provided for staff to ensure this. The registered person must make sure that the care plans clearly show how all assessed health, personal and social care needs will be met. These must evidence all actions taken and provide an accurate picture of the service user’s medical, physical and social well-being. Staff must be trained in writing care plans and appropriate systems put in place to ensure this. (Timescales of 30.11.05 and 30/04/06 have not been met.) The registered person must make sure that where residents are identified as at risk of falling, losing weight or from developing pressure sores appropriate advice is sought and actions taken. Records must be kept. The registered provider must DS0000034033.V287127.R01.S.doc Timescale for action 31/05/06 2. OP7 15 30/04/06 3. OP8 14, 15 31/05/06 4 OP8OP22 13 and 23 30/07/06 Page 22 Rosewood Court Version 5.1 5 OP10 12 6 OP12 16 7 OP15 16 8 OP16 22 make sure arrangements are in place to provide safe systems for moving and handling residents. These must take into account individual residents physical and psychological needs. Steps must be taken to make sure that the dignity and selfesteem of residents is respected and maintained. A regular programme of activities must be put in place, which takes into account the needs, preferences and abilities of residents, especially those with dementia. Appropriate support and training must be given to staff who facilitate activities. The registered person must take appropriate steps to make sure that residents receive a nourishing diet appropriate to their individual needs and preferences. The registered person must make sure that: a) All residents and their representatives are aware of the complaints procedure. b) Complaints received must be thoroughly investigated and responded to. Appropriate action must be taken to make sure that identified issues are dealt with. The registered person must make sure that all staff receive training around abuse and adult protection. They must be aware of all available systems for reporting abuse. (This standard was not assessed on this occasion. The timescale has not been altered.) The registered person must make sure that the external DS0000034033.V287127.R01.S.doc 30/06/06 30/06/06 30/06/06 30/06/06 9 OP18 18 30/06/06 10 OP19 23 31/05/06 Page 23 Rosewood Court Version 5.1 11 OP19 23 12 OP26 13, 16 grounds are suitable for, and safe for use by, service users and that they are appropriately maintained. The gardens must be landscaped and furniture provided. (The timescale of 31/03/06 has not been met.) The communal rooms situated 31/05/06 on the ground floor must be upgraded in respect of furniture and decoration. (The timescale of 31/03/06 has been extended.) The laundry facilities must be 31/05/06 improved in order to provide more room and clear separation of soiled and clean laundry. The registered person must contact the infection control nurse for advice on maintaining best practice until this work has been completed. (The timescale of 31/03/06 has not been met.) The registered person must make sure that there is adequate provision of cleaning equipment available in the home. 31/05/06 The registered person must make sure that there are enough suitably qualified, competent and experienced people working at the home to meet the needs of the residents. There must be suitable provision of ancillary staff so that care assistants are not taken away from caring for residents to carry out cleaning duties. A full review must be undertaken of the staffing levels provided on each unit. The resident’s physical, medical, social and psychological needs must underpin this assessment. The CSCI must be informed of the 13 OP27 18 Rosewood Court DS0000034033.V287127.R01.S.doc Version 5.1 Page 24 14 OP29 19 15 OP30 18 outcome and action taken. (The timescales of 31/10/05 and 31/01/06 have not been met.) The registered person must make sure that gaps in employment are explored and records are kept. (This standard was not assessed on this inspection. The timescale has been extended.) The registered person must make sure that people working in the home receive training appropriate to the work they do and suitable assistance, including time off, for obtaining further appropriate qualifications. This must include the Sector Skills Council training targets with regard to induction and foundation training, health and safety related topics as well as suitable updates on pressure area and wound care and administration of medicines for nurses. The specialist needs of service users must also be taken into account especially with regard to dementia care and dealing with challenging behaviour. The registered person must make sure that all staff can communicate effectively with residents. (The timescale of 31/03/06 made originally in the report for April 2005 and carried forward in the report October 2005 has not been met.) The registered provider must take steps to recruit and employ a suitably qualified and experienced person to manage the home. The registered provider must DS0000034033.V287127.R01.S.doc 31/05/06 30/06/06 16 OP31 9 30/06/06 17 OP32 12 30/07/06 Rosewood Court Version 5.1 Page 25 make sure that good personal and professional relationships are maintained between them, staff and residents. 18 OP33 10, 12 and 24 Quality assurance and monitoring systems must be put in place that also seeks the views of service users and other stakeholders. 30/07/06 19 OP36 18 Identified requirements on inspection reports must be met within the agreed timescales. The registered person must 30/07/06 make sure that the programme of providing formal supervision to staff is continued and that it is provided at least six times a year. Staff providing supervision should receive appropriate training to enable them to do so. (This standard was not assessed on this occasion. The timescale of 30/04/06 has been extended.) 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 OP9 Good Practice Recommendations The registered person should make sure that the homes policies around dealing with medication are revised to reflect the changes in disposing of medicines for the nursing units. Policies should be in place to make sure that medication administration records are completed. The registered person should review the dining arrangements in the residential units in order to make sure that meal times are a pleasant experience for all. The registered person should make sure that at least 50 of the care staff are qualified to NVQ level 2 by December DS0000034033.V287127.R01.S.doc Version 5.1 Page 26 2. 3. OP15 OP28 Rosewood Court 2006. (This standard was not assessed on this occasion. The recommendation has been carried forward.) Rosewood Court DS0000034033.V287127.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Court DS0000034033.V287127.R01.S.doc Version 5.1 Page 28 - 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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