Inspection on 03/05/06 for Rosewood House Care Home

This inspection was carried out on 3rd May 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 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 House Care Home 21/05/08

Rosewood House Care Home 10/12/07

Rosewood House Care Home 31/01/07

Rosewood House Care Home 23/11/04

Rosewood House Care Home 17/08/04

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

CARE HOMES FOR OLDER PEOPLE Rosewood House Care Home 84a Main Road Radcliffe on Trent Nottingham NG12 2BQ Lead Inspector Steve Keeling Unannounced Inspection 3rd May 2006 09:00 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 House Care Home DS0000008796.V292737.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 House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Rosewood House Care Home Address 84a Main Road Radcliffe on Trent Nottingham NG12 2BQ 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) 0115 9334717 0115 9332510 Mr Mukesh Seetul Mrs Valerie Oliver Care Home 17 Category(ies) of Dementia - over 65 years of age (17) registration, with number of places Rosewood House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users shall be within category DE/E, 1 Named service user shall be within category DE 13th April 2006 Date of last inspection Brief Description of the Service: Rosewood House is an adapted and extended property sitting in the heart of a residential area of the village of Radcliffe on Trent. The home is registered to provide residential care for up to 17 service users who have Dementia and particular needs associated with their diagnosis. The accommodation spans two floors and there is a vertical lift to facilitate access between these floors for service users. Gardens are to the side and rear of the property and there is a car park to the front. The village of Radcliffe on Trent is a couple of minutes away by car and provides a range of facilities including shops, churches, restaurants, pubs and public transport. Currently the fees charged at the home for social service funded residential care is £277. Privately funded residential care is currently £319. Rosewood House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over a 5 hour period and involved one inspector. The main method of inspection was case note tracking, this is a method of selecting residents within the home and discussing with them their expectations and experiences of living within the home environment. The case tracking method also analyses the records of the service users to ascertain if the residents identified needs are being addressed appropriately within the care home setting and that their safety and well being is being maintained. On this occasion two residents notes were case tracked. Also as part of the case tracking process a staff member within the home was informally interviewed to further evidence the quality of care afforded to the residents. It was evident that the care staff on duty at the time of the inspection are committed to providing a high standard of care for the residents. All staff members within the unit were very helpful and cooperative thus ensuring that the inspection process progressed in a professional and efficient manner. The report indicates comments from the residents and visitors to the home on the day of the inspection to glean further information as to the quality of care afforded to the residents. What the service does well: The staff at the home have created a warm, friendly environment for the residents to enjoy and, on the whole the home appears welcoming and relaxed. Residents and visitors to the home felt that the staff at the home are polite, caring, respectful and promote the residents dignity at all times. Rosewood House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 6 Residents are encouraged to maintain contact with their families and friends and it was evident that the staff at the home are welcoming of visitors at all times. What has improved since the last inspection? What they could do better: It could not be established if staff at the home have received appropriate mandatory training opportunities. The social activities at the home are not sufficient to provide a stimulating environment for the residents. The majority of routine maintenance within the home could be evidenced although minor shortfalls were evident which could compromise the resident’s safety. The manager’s post is vacant at the home. Staff at the home do not receive appropriate formal supervision sessions Bimonthly. Residents or their relatives are not currently afforded the opportunity to express opinions and concerns within an open forum such as a residents meeting. Please contact the provider for advice of actions taken in response to this Rosewood House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rosewood House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 8 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 House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 9 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): 3, 6 Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Effective pre-admittance assessments are performed to ensure the residents identified needs can be met at the home. The home does not provide intermediate care services. EVIDENCE: The pre-admittance assessments within the two case tracked notes were detailed in identifying the specific needs of the service users to maintain optimum independence and health within the home. The documentation appertaining to the pre admittance assessment is clear, concise and well presented. Both case tracked assessments were signed and Rosewood House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 10 dated by the assessor and it was evident that the resident’s needs are reassessed on a monthly basis. Rosewood House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 11 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): 7.8.9.10 Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. The case tracking procedure revealed that the residents “holistic” needs are addressed through an individual care planning process. Residents are protected by the homes policies and procedures in relation to dealing with medication. Residents at the home are treated with respect and dignity and the resident’s privacy is maintained. EVIDENCE: The care plans examined at the time of the inspection were appropriate in addressing the identified holistic needs of the residents. Rosewood House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 12 The Residents needs are evaluated on a monthly basis so as to address any changes in their needs with an appropriate care plan. All care plans were signed and dated by the assessor. As far as practically possible residents or relatives were involved in the care planning process, which was evidenced by residents or their representatives signatures within the relevant documentation. At the time of the inspection no service users were responsible for the selfadministration on medicines. Lockable facilities were evidenced in the case tracked residents rooms to ensure safe storage, should self-administration of medicines be required. All residents spoken with stated that staff always respected their privacy and dignity and that all the staff within the home are good fun, helpful and considerate. Two visitors to the home also stated that the friendly atmosphere within the home is the norm rather than the exception. It was established that staff always knocked on the bedroom doors of residents before entering thus promoting the principles of privacy and dignity. Staff were witnessed addressing the residents in a very pleasant and respectful manner and it was evident that the residents were very comfortable and contented within the home environment. Rosewood House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 13 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, 13, 14, 15 Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. The provision of a stimulating environment for the residents is compromised. Residents have opportunities to access the local community and to maintain their links with family and friends. Routines are flexible and residents are given choices in their lifestyles. Resident’s benefit from a varied menu at the home, which is balanced and nutritionally balanced. EVIDENCE: The social activities coordinator has terminated her contract and the post remains vacant. Staff at the home interact with the residents and encourage the residents to participate in group activities such as sing songs, board games Rosewood House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 14 and encourage attendance when guest entertainers visit the home on a monthly basis. The resident would benefit from additional social activities to further promote a stimulating environment. One resident spoken with stated the “not much happens” and a second resident stated that she “reads most of the time or just watches the television”. A visitor to the home stated that she had not witnessed any social activities being performed in the home although she did praise the friendly and relaxed interactions between residents and staff at the home. The registered person is required to evidence that the residents’ social activities will not be compromised at the home in the absence of the social activities coordinator. It was evident that the home operates an “open door” policy in relation to visitations. Both case tracked residents and a visitor to the home stated that the staff at the home were always very friendly and respectful to visitors and went on to state that they were happy with the relaxed atmosphere within the home. The residents spoken with were very well presented, dressed in appropriate clothing for the season, and were wearing their own shoes or slippers. The residents spoken with stated that they always had their own clothing to wear and the laundry service is efficient, resulting in their items of clothing being retuned clean and well ironed. It was evident that, on the day of the inspection, the food in the home was wholesome, nutritionally appropriate and varied. The lunch provided on the day of the inspection consisted of meat and fresh vegetables. It was evidenced that residents always have a choice of meals and that daily menus are displayed within the dining area, for resident’s perusal. Rosewood House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 15 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. 18 Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. The residents and their relatives and friends are confident that their complaints are listened to, taken seriously and acted upon, thus protection the residents from abuse. EVIDENCE: The complaints procedure is displayed within the foyer of the home and is provided within the home information pack when residents are admitted to the home. There have been no allegations of abuse since the last inspection and the Commission for Social Care Inspection has not received any complaints relating to the service provision at the home. It was established that the acting manager at the home is not investigating any complaints at this time; any complaints that are received are documented effectively together with resulting outcomes and actions. Both case tracked residents spoken with stated they felt safe within the home and have not had any reason to complain whatsoever, although should they Rosewood House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 16 have any concerns they would feel confidant in discussing theirs concerns with any members of staff at the home. Rosewood House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 17 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, 26 Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. The lounge area within the home is being used, inappropriately, for the storage of mobility aids resulting in a potential risk of injury to residents. The home, on the whole provides a clean and comfortable environment for residents. EVIDENCE: A partial tour of the premises was completed as part of this inspection process. The accommodation, on the whole, is well decorated, comfortably furnished and maintained to a good standard. The inspection process allowed for the examination of the “case tracked” residents bedrooms. It was evident that residents had many personal possessions in their bedrooms such as family pictures, ornaments, a television Rosewood House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 18 and radio thus promoting a homely environment, the radiators were enclosed and the windows have opening restrictors in place to promote the safety of the residents. It was evidenced that mobility aids were being stored within the lounge area. The resultant clutter presents a potential risk of injury for the service users and should be removed to ensure the safety of the residents. The dining room would benefit from redecoration, as the paintwork is currently shoddy and not aesthetically pleasing for the residents at the home. The registered person is required to demonstrate the actions to be taken to addresses the aforementioned shortfalls within the homes environment. Rosewood House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 19 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, 30 Quality in this outcome group is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Staffing levels at the home are appropriate in meeting the needs of the service users. The home utilises an appropriate recruitment policy, which is adhered to, thus ensuring residents are protected. It was not fully evident that staff employed at the home have received appropriate training to do their jobs effectively. EVIDENCE: On the day of the inspection 15 residents were accommodated at the home. Three carers were on duty throughout the morning and afternoon periods and two carers covered the night period. The staff recruitment files were not inspected during the inspection, as the Commission for Social Care Inspection has recently received evidence (13th February 2006) that all staff at the home has had Protection of Vulnerable Adults First (POVA First) checks and Criminal Record Bureau checks (CRB) Rosewood House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 20 together with two satisfactory references, thus protecting the vulnerable people in their care home. It could not be easily established that staff all at the home have received appropriate mandatory training in relation to Basic Food Hygiene, Basic First Aid, Moving and Handling, Prevention of Cross Infection, Abuse awareness and Health and Safety training to enable them to maintain their own and the service users’ health and safety. The registered person is required to evidence that staff at the home have received the aforementioned mandatory training with evidence of the National Vocational Qualifications (NVQ) status of care staff at the home together with any planned training events within the year 2006. Rosewood House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 21 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, 33, 35, 38. Quality in this outcome group is poor. This judgement has been made from evidence gathered both during and before the visit to this service. The home does not have a manager in post at this time. The resident’s consultation process is insufficient to ensure the home is run in the best interests of the residents. Residents are safeguarded from financial abuse. Minor shortfalls were evident in relation to routine maintenance at the home. EVIDENCE: Currently the manager’s post is vacant at the home, the owner with the support of an experienced senior carer is performing the manager’s role. Rosewood House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 22 It was established that an application would be made by the senior carer employed at the home to the Commission for Social Care Inspection for her to be assessed as fit for registration as the manager. It is a requirement that all staff at the home receive formal supervision sessions Bi- monthly to identify shortfalls in practise and allow staff the opportunity to speak about professional and other related issues. Currently this management element is not being performed effectively. A member of staff confirmed that she had only received one supervision session over the past year and the owner confirmed that formal staff supervision sessions are not taking place at this time. It was established that residents or their relatives are not currently afforded the opportunity to express opinions and concerns within an open forum such as a residents meeting. Residents meetings are intended to identify issues relating to the care provided to the residents at the home so that any issues of concern can be discussed and addressed effectively. Residents meetings could also provide a forum to discuss plans for the development of the home so as to include residents in this process. The owner of the home confirmed that the consultation process is somewhat lacking and intends to address the shortfall by creating a residents and relatives “tea afternoon” so as to provide a forum to discuss and document issues relating to the care provision at the home. The provider is not the financial appointee for any of the residents, people either have help from relatives to manage their finances or they do this themselves. Any expenditures incurred at the home is recorded and relatives are invoiced accordingly. None of the residents have deposited money at the home for safekeeping. The inspector was unable to establish that the home is maintained to a satisfactory standard in relation to Environmental Health visitations, the recording of water outlet temperatures, gas servicing and the hoist servicing within the home, which could place residents a risk. The registered person is required to provide evidence that demonstrates the actions to be taken to addresses the aforementioned shortfalls. Rosewood House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 23 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 1 X 3 1 X 2 Rosewood House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? No 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 OP19 Regulation 23 Requirement The registered provider shall ensure that the home is maintained effectively to ensure the health and safety of residents and staff at the home The registered provider shall ensure that all staff have received mandatory training. The registered provider shall ensure that feedback is actively sought from residents. The registered provider shall ensure that all staff receives formal supervision sessions. The registered provider shall ensure that all parts of the home to which the service users have access to are so far as reasonably practicable free from hazards to their safety. The registered provider shall ensure that at all times records are available for inspection in the care home by a person authorised by the Commission for Social Care Inspection to enter and inspect the home. Timescale for action 30/06/06 2 3 4 4 OP30 OP33 OP36 OP38 30 24 18 13 30/06/06 30/06/06 30/06/06 30/06/06 5 OP38 17 30/06/06 Rosewood House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 25 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. 3. Refer to Standard OP12 OP26 OP31 Good Practice Recommendations The registered provider should ensure that resident’s social activities are not compromised on occasions due to limited staffing levels. The registered provider should ensure that the home environment is clean, hygienic and aesthetically pleasing The registered provide should ensure that a suitably qualified manager is in post and that the individual applies for registration with the Commission for Social Care Inspection. Rosewood House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 House Care Home DS0000008796.V292737.R01.S.doc Version 5.1 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!