Inspection on 23/02/07 for Rosewood Lodge

This inspection was carried out on 23rd February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Rosewood Lodge 08/01/08

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Rosewood Lodge 9 Uphill Road North Weston Super Mare North Somerset BS23 4NE Lead Inspector Paul Grey Unannounced Inspection 09:00 23 February 2007 rd 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 Lodge DS0000067543.V318479.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 Lodge DS0000067543.V318479.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosewood Lodge Address 9 Uphill Road North Weston Super Mare North Somerset BS23 4NE 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) 01934 644266 Scosa Ltd Mrs Tina Eileen Fillingham Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Rosewood Lodge DS0000067543.V318479.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection New Service Brief Description of the Service: Rosewood Lodge is a 22 bedded care home caring for older people (65 and over) in Weston super mare. The home is located near the seafront of Weston and within walking distance of shops, the beach and a wide range of local amenities. Rosewood Lodge DS0000067543.V318479.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Rosewood Lodge is a new service and this was the first full inspection. The inspection was conducted by 1 regulation Inspector over 2 separate visits. Both inspections were conducted in the presence of the manager. During the inspection, the Inspector met the service user group, the staff team, a visiting health care professional and the family of one service user. The Inspector conducted a full tour of the premises, observed interactions between staff and people living at the home and reviewed the administration and documentation on the premises. The Inspector found a pleasant homely environment with content service user group and friendly staff team. Feedback from service users and relatives was positive, as were questionnaires returned to the CSCI. General administration at the home was adequate. The assessment of service users needs and care planning of service users needs was again adequate, just meeting national minimum standards. The Inspector has made a number of recommendations and one requirement regarding this. The Inspector would strongly recommend that the manager review the entire assessment of needs and care planning process at the home. What the service does well: What has improved since the last inspection? What they could do better: Rosewood Lodge DS0000067543.V318479.R01.S.doc Version 5.2 Page 6 The Inspector noted that approximately 33 of the staff team have achieved NVQ 2. The manager and provider need to address this and achieve a minimum level of 50 NVQ 2 trained staff. Whilst the standard of care delivered at the home is good, this is not reflected in the home’s documentation of care. The Inspector took some time and effort to assess the standard of care offered at the home as there was little information to be found in the assessment or care planning documents. Without the benefit of evidence from questionnaires, service user statements, relatives statements and an observation of care, the Inspector could not have concluded that the home meets service users needs based solely on its documentation. This theme continued through the homes general administration processes. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Rosewood Lodge DS0000067543.V318479.R01.S.doc Version 5.2 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 Lodge DS0000067543.V318479.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is adequate The admission of new service users is process driven but not particularly personalised to the individual. The admission process generates basic information about the individual’s needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector reviewed 5 Care records for people admitted to the home. These met standards but lacked detail and focused on physical needs. The home’s assessment gave little meaningful information about the service user’s psychological or social needs, or life prior to admission. Technically the documentation meets minimum standards but provides little more than the most basic information required to do so. The inspector spoke to 3 service users about their experience of moving into the home. The service users told Rosewood Lodge DS0000067543.V318479.R01.S.doc Version 5.2 Page 9 the inspector they had been invited to see the home prior to moving in and had found staff caring and keen to make them feel at home. The inspector noted that care planning had been based on the assessment process. The inspector spoke to one relative who was satisfied with the admission process and “could not fault” the home. Rosewood Lodge DS0000067543.V318479.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8,10 Quality in this outcome area is adequate There is evidence in the Care Plan of health care treatment and intervention, and a record of general health care information including weight monitoring, and nutritional information. There are some gaps in information but staff are able to give a verbal update. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector looked at 5 files. All contained up to date had care plans based on the home’s assessment process. However, the basic nature of the information obtained about the service user only allowed for a basic planning of needs. The manager was able to verbally outline how the service care the Rosewood Lodge DS0000067543.V318479.R01.S.doc Version 5.2 Page 11 home could meet more complex needs but this was not clear from the care plans which were lacking in detail. The inspector noted that one service user with more complex psychological needs was having their needs met by the staff team. However this had not been assessed or care planned adequately. Only after some investigation and discussing the care of this individual was the inspector able to find verbal evidence that the service could meet the needs of this individual. More complex social needs, are not addressed in any depth by the service. The inspector recommends the home investigate an alternative format to assess and document service users needs. See Recommendations. The Inspector case tracked the needs of three service users. One of these was terminally ill and being supported by the community nursing team. The inspector found evidence of an assessment of needs for this service user, and evidence that these needs were met. The inspector did not speak with the service user but spoke with family. Feedback from the family was very positive about both the staff team and care delivered to their relative. Both other files sampled contained an evidence of an assessment of needs and outlined how this was to be met The inspector found some evidence of nutritional assessment but these was briefly documented and offered little meaningful information. Medication procedures were not formally assessed at this inspection. The inspector spoke with 11 service users. The inspector was told by all service users that the staff team are ‘very kind’ and were ‘very patient’. The service users felt staff treated them with respect and dignity. During the inspection the inspector noted personal care was provided discretely and with an awareness of the service user’s needs for privacy and dignity. Staff on duty spoke with the inspector and demonstrated an awareness of good practice. Rosewood Lodge DS0000067543.V318479.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15 Quality in this outcome area is good The routines of the home are planned around the resident’s needs and wishes. The home encourages residents to take control of their life and be actively involved in the running of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector observed how staff responded to Service users. Staff made sure that each service user was spoken to at regular intervals and nobody, including those who were quiet was ignored. Service users were offered choices and invited to take part in conversation and group activities. During the inspection there was a “community” atmosphere, with staff and residents interacting freely (including the manager). Relative feedback commented on the ‘family feel’ of the service. Rosewood Lodge DS0000067543.V318479.R01.S.doc Version 5.2 Page 13 Relatives and service users commented on the free access of visiting. Visiting is generally restricted to normal social hours. However if this presents a problem, or if service users are unwell the service allows 24 hour visiting. Service users are welcome to invite visitors to their rooms or sit with them in one of the large communal areas. The inspector reviewed the menu at the home. The home has a regular rotating menu that can be altered to meet the needs or preferences of the people living at the home. If required, specialist cultural or religious meals can be provided to service users. The inspector observed 2 meals over the course of the 2 inspections. Both were relaxed and pleasant occasions where service users ate in pleasant atmosphere. Service users and one relative spoke highly of the food which was described as very good and ‘in abundant quantities’. Rosewood Lodge DS0000067543.V318479.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is adequate Rosewood Lodge has a complaints procedure that meets the National Minimum Standards and Regulations. The complaints procedure is available within the Home. Service users and relatives state that they are satisfied with the service provision, and feel safe and supported. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector reviewed the home’s complaints procedure. The complaints procedure was simple and clearly outlined staff action in the event of a complaint. The inspector also noted a poster on the communal board advising service users how to complain if they were unhappy. The inspector asked 3 service users if they knew how to complain. All told the inspector they would speak with the manager if they were unhappy with any aspect of care. There were no complaints at the time of inspection. The home has a Protection of Vulnerable adults policy and procedures to protect service users from abuse. At the time of inspection there had been no allegations of abuse. The manager was able to outline the procedures to follow in the event of actual abuse, or suspected abuse. Rosewood Lodge DS0000067543.V318479.R01.S.doc Version 5.2 Page 15 Rosewood Lodge DS0000067543.V318479.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. The home has a well-maintained environment, which is a very pleasant, safe place to live. The home is well lit, clean and tidy and smells fresh. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Inspector conducted a tour of the premises. During this time the Inspector visited most bedrooms, inspected the communal and staff areas of the property, then reviewed the grounds outside of the property. Rosewood Lodge is a pleasant, well maintained building. The property is safe, and attractive throughout. The Inspector noted evidence of regular maintenance and a schedule of repairs to the property. Rosewood Lodge DS0000067543.V318479.R01.S.doc Version 5.2 Page 17 During the inspection, the premises were clean, bright and fresh smelling. The inspector noted no offensive odours in the building. Service users informed the inspector that the building was constantly clean and pleasant to live in. The home has laundry facilities located away from food preparation areas suitable to meet the needs of the service user group. Rosewood Lodge DS0000067543.V318479.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28, 29 Quality in this outcome area is adequate Service users have confidence in the staff team that care for them. Rosewood Lodge recognises the importance of training, but there are still some areas which need addressing such as the number of staff that have achieved NVQ 2. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Inspector reviewed the number of staff available to support service users. At the time of inspection, the manager was on duty supported by 3 carers and a staff member dedicated to the preparation of food. During the inspection process, the Inspector saw staff chatting with service users and going about their daily routine. Service users felt that sufficient staff were available to meet their needs. Feedback from service user questionnaires and one relative indicated that sufficient staff available to meet the service users daily requirements. The Inspector reviewed the homes staff rota and noted that there were staff in sufficient numbers to meet service users needs. Rosewood Lodge DS0000067543.V318479.R01.S.doc Version 5.2 Page 19 At the time of writing, 5 staff members have completed NVQ level 2 of a staff team of 15. This does not meet national minimum standards. The Inspector reviewed the homes recruitment procedures. Four staff files were sampled at random. Files sampled contained 2 references, a criminal record bureau check, a protection of vulnerable adults check and a statement of terms and conditions for the staff. Rosewood Lodge DS0000067543.V318479.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 36, 38 Quality in this outcome area is adequate The manager has the necessary experience to run the Home, is aware of and works to the basic processes set out in the NMS. The home has developed a health and safety policy that generally meets health and safety requirements and legislation. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Rosewood Lodge has a competent and experienced registered manager. Mrs Fillingham holds an NVQ level 4 in care management and has completed a number of courses including medication handling, infection control, manual Rosewood Lodge DS0000067543.V318479.R01.S.doc Version 5.2 Page 21 handling assessors course, food hygiene and palliative care. The Inspector noted evidence that the manager periodically updates knowledge through training courses. There are clear lines of accountability in the home with the staff team being aware of their role and responsibility. The manager has a clear job description outlining her duties and responsibilities. The Inspector reviewed the home’s quality assurance and quality monitoring systems. Feedback from both service users and relatives about the general standard of care at the home is good. However, the Inspector was interested in how the home measured it’s performance. The manager was able to provide the Inspector with completed questionnaires sent to relatives, external professionals and the service users living at the home. The Inspector reviewed the questionnaires and noted positive feedback from all concerned. The home has a policy regarding the implementation of quality assurance but this remains in its infancy and needs further development by the manager. This was discussed with the manager during the inspection process. This is subject to a recommendation to be found at the end of the report. The inspector reviewed staff support, in particular the amount of supervision that was provided to the staff team. The inspector noted evidence of regular supervision by the manager. Two members of staff indicated that they had received regular supervision in addition to frequent informal chats with the manager around aspects of care. Staff felt this was a satisfactory arrangement. The inspector noted documentation of supervision was available on inspection although not always signed by the staff member. This was subject to a recommendation. The manager was able to demonstrate how the service promotes a safe environment in the home. Staff have received statutory training in moving and handling of people, on going fire safety training for the staff team and first aid training. During the inspection of the premises the inspector noted hazardous substances were appropriately stored and the boiler and electrical appliances were subject to regular maintenance and servicing. Staff could outline infection control and Control of Hazardous substances procedures for the premises. Rosewood Lodge DS0000067543.V318479.R01.S.doc Version 5.2 Page 22 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 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x x 3 x 3 Rosewood Lodge DS0000067543.V318479.R01.S.doc Version 5.2 Page 23 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 OP28 Regulation 19 5 b Requirement The inspector requires the manager/provider ensure staff training is provided to a level of NVQ2 for a minimum of 50 of the staff team. Timescale for action 30/09/07 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 OP3 Good Practice Recommendations The inspector recommends the manager review the home’s assessment documentation. The current format is brief, institutional and contains little space for meaningful documentation or person centred planning. The inspector recommends the manager review the homes care planning format. Currently, the format used is institutional, contains insufficient space for meaningful documentation and does not address the service user’s holistic needs. The inspector recommends the manager review the quality assurance procedures at the home. In particular the DS0000067543.V318479.R01.S.doc Version 5.2 Page 24 2 OP7 3. OP33 Rosewood Lodge 4. OP36 inspector recommends the manager scrutinise and clarify how the service will identify and implement change based on service user feedback. The inspector recommends the manager review the documentation of supervision and obtain a staff signature and record of areas discussed. Rosewood Lodge DS0000067543.V318479.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rosewood Lodge DS0000067543.V318479.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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!