Inspection on 03/01/06 for Rosewood Lodge

This inspection was carried out on 3rd January 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Rosewood Lodge 03/09/08

Rosewood Lodge 23/08/07

Rosewood Lodge 08/08/06

Rosewood Lodge 27/06/05

Rosewood Lodge 28/12/04

Rosewood Lodge 05/07/04

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The Grove Waltham

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Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Rosewood Lodge 4 Southfield Hessle East Yorkshire HU13 0EX Lead Inspector Pam Dimishky Unannounced Inspection 3rd January 2006 09:30 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 Lodge DS0000037734.V263012.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 Lodge DS0000037734.V263012.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Rosewood Lodge Address 4 Southfield Hessle East Yorkshire HU13 0EX 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) 01482 641106 01482 627929 Tvikkie@aol.com Jagata Nanda Kumar Adikaram Miss Victoria Maria Taylor Care Home 21 Category(ies) of Dementia - over 65 years of age (21), Old age, registration, with number not falling within any other category (21) of places Rosewood Lodge DS0000037734.V263012.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th June 2005 Brief Description of the Service: Rosewood Lodge is a large traditional property in a residential area of Hessle. The care home is privately owned and is registered for 21 older people aged over 65 years of age, some of whom may have dementia. The home will also take people for respite care within this category. The property has an extension that includes bedrooms with an en suite facility, a shower room and a conservatory which is used as a lounge. There is a patio and large garden which are easily accessed from the conservatory and there is a small car park. A further lounge and a dining room are situated in the main body of the building. Individual accommodation is provided in 18 single rooms and 1 double room (one double room is now only used as a single). Seven bedrooms on the first floor are accessed either by the staircase or stair lift. The home is close to the railway station and a short walk from the centre of Hessle where there are shops, cafes, banks and a library. Rosewood Lodge DS0000037734.V263012.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over 6 hours (including preparation time). The inspection process included a review of documentation and a tour of the building. The inspector spent some time with the residents and spoke in particular to 11, some of whom were in the lounge and some in their own room. The manager was not present at this inspection and two senior carers provided information and assisted the inspector. What the service does well: What has improved since the last inspection? The proprietor continues to make ongoing improvements to the environment and staff training is very much in evidence covering areas appropriate to meeting residents’ needs and mandatory training. Rosewood Lodge DS0000037734.V263012.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 Lodge DS0000037734.V263012.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 Lodge DS0000037734.V263012.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): 1 and 3 Prospective residents have the information they need to make a decision as to whether to come into the home. The admission procedure includes a proper assessment being made of residents moving into the service to ensure the home can meet their needs. EVIDENCE: Information about the home in the form of a welcome pack, is given to all prospective residents or their relatives. The information includes the statement of purpose, service user guide, complaints procedure, residents’ questionnaire, copy contract and the last inspection report; a copy is always available in the reception area and copies were also seen in some residents bedrooms. The manager is to discuss with the proprietor a variation to the registration to reduce the number of beds as one room, previously an undersized double, is now only used for single use. For residents placed through social services, the home obtains a copy of care management’s care plan and needs assessment prior to coming into the home. From this information the manager makes a decision as to whether the home can meet the identified needs. Privately funded residents have their needs Rosewood Lodge DS0000037734.V263012.R01.S.doc Version 5.1 Page 9 assessed by the manager before coming into the home; this includes information obtained from other involved professionals. The registered person confirms in writing the home can meet the individual needs of residents as required by regulation. Rosewood Lodge DS0000037734.V263012.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 9 All residents have a care plan ensuring their assessed needs are being met. However, these have not previously been routinely reviewed monthly by the manager and updated as needs have changed. The systems for the administration of medication are good with clear arrangements being in place to ensure resident’s medication needs are met. EVIDENCE: Four care plans were examined and found to cover most areas of need and includes samples of areas to be written up in the daily care notes. However, the manager was advised at the last inspection that oral health and foot-care must be included and these were not seen in the care plans examined. The manager stated she is currently reviewing care plans and updating them, but they have not been reviewed monthly and when needs have changed. A care assistant had also written an inappropriate entry in the daily record for one resident. The home has access to specialist health care including the district nurse, community psychiatric nurse, and chiropodist who are currently providing support in meeting residents’ needs. Rosewood Lodge DS0000037734.V263012.R01.S.doc Version 5.1 Page 11 Medications, storage and records were checked for four residents and seen to be in order although Lactulose and eye drops for two residents were found in the kitchen. Rosewood Lodge DS0000037734.V263012.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 15 Daily life and social activities generally meet the expectations and choice of residents living in the home but spiritual needs must be given consideration. There is a choice of meals which are nutritious and offer a varied diet for residents. EVIDENCE: Residents said there was very little to do in the home and a number said they would like staff to find the time to talk to them more; another said “the vicar used to call but hasn’t been for some time”. The home is now keeping a record of all activities in the home and the residents who participate. There is clear evidence that particularly during the month of December a number of activities took place both in and outside the home ie Memory Lane reminiscence session, Christmas decoration making, carol service, sing-a-long to Christmas songs, Scattergories, lunch at Darleys hotel, Christmas party, quiz, nail care and a hoops game; a member of staff was playing Scattergories with residents during the course of the morning of the inspection. All residents said they had a lovely Christmas day lunch and everyone commented how good the food is and that they are offered choices for both lunch and tea. A menu book is kept of meals offered and what has been chosen by individual residents. On the day of the inspection lunch consisted of chicken and Rosewood Lodge DS0000037734.V263012.R01.S.doc Version 5.1 Page 13 mushroom pie and vegetables or minced beef and vegetables followed by a dessert. Rosewood Lodge DS0000037734.V263012.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The home has a satisfactory complaints process with some evidence that residents feel that their views are listened to and acted upon. Staff are all trained to protect residents from abuse. EVIDENCE: The home’s complaints procedure is displayed in the reception area and is included in the welcome pack, which was seen to be kept in some residents rooms. A record is kept of concerns brought to the attention of the manager, four since the last inspection, and were noted to have been satisfactorily resolved with the complainants. The manager was advised with regard to one complaint which involved inappropriate behaviour by two members of staff, one of whom is no longer working in the home. All staff have received abuse awareness training for the protection of vulnerable adults. Rosewood Lodge DS0000037734.V263012.R01.S.doc Version 5.1 Page 15 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 The standard of the environment within this home is generally good providing residents with an attractive and homely place to live. However, more care must be taken in resolving the offensive odour in three bedrooms. EVIDENCE: The location and layout of the home is suitable for its stated purpose and is accessible and well maintained. The home is set in a large garden which is kept tidy and attractive with trees and shrubs. The proprietor continues to make progress in the maintenance, redecoration and refurbishment programme for the home; substantial repair and maintenance of the roof, guttering and some windows having recently been completed. Hot water temperatures are being checked weekly and before bathing and using the shower. The shower room had a collection of toiletries, razors, hairbrush etc which has the potential for communal use. The manager was advised that to prevent the spread of infection, each resident should have their own brought with them for use in the bathroom or shower room. Despite the best efforts of staff three bedrooms, where the residents choose to self-care, had an offensive Rosewood Lodge DS0000037734.V263012.R01.S.doc Version 5.1 Page 16 odour. The kitchen is adequately equipped with cooker, food preparation areas, refrigeration and freezer units. Daily records are kept, and were up to date, for the temperature of the refrigerators and freezers. Some work surfaces and the cooker hood would benefit from a deep clean. A food store in the corridor needs attention to the bottom shelf to prevent infestation by vermin. Rosewood Lodge DS0000037734.V263012.R01.S.doc Version 5.1 Page 17 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 29 Staff are well trained and therefore competent to do their jobs. EVIDENCE: The home employs sixteen care staff, one cook and one cleaner. Currently sixteen residents are cared for by three care staff on the early shift, and two on the late and night shifts. Two senior members of staff on duty confirmed the staffing levels are adequate at the present time due to the low dependency needs of the majority of residents. The manager has returned to working fulltime and the provider and his wife spend up to eight hours a day in the home; all assist with the day to day running of the home and the manager also works extra hours when needed, eg covering shifts and absence of the cook. The home has a good record for training staff and ensuring they continue with updating training. All staff are currently taking a qualification through Hull College in infection control and all staff are trained in first aid. Personal records were not available for inspection as the manager was not present. However, she confirmed the following day, in a telephone conversation, that two new members of staff have commenced working in the home since the last inspection, both of whom have had a Criminal Records Bureau (CRB) check and two references obtained. Induction training commences as soon as new members start working in the home whilst awaiting the results of the CRB check. The manager has NVQIV in care and management and the statement of purpose states all new members of staff must train to achieve NVQ level 2 Rosewood Lodge DS0000037734.V263012.R01.S.doc Version 5.1 Page 18 within two years of employment and are then encouraged to obtain NVQ level 3. Rosewood Lodge DS0000037734.V263012.R01.S.doc Version 5.1 Page 19 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): 37 and 38 The home is being managed properly and support is also given by the provider and his wife ensuring there is leadership, guidance and direction to staff. This generally results in practices that promote and safeguard the health, safety and welfare of the people using the service. However, three window opening restrictors need attention and some safety certificates were not available at the time of this inspection which may result in residents being put at risk. EVIDENCE: The manager and his wife spend up to eight hours a day in the home working alongside staff. Monthly reports are provided to the Commission which include consultation with residents and staff, inspection of the premises and records. Death notifications to the Commission, which were outstanding at the time of the previous inspection, are now being forwarded without delay as required. A health and safety notice is displayed in the reception area and the employers public liability certificate is current to March 2006. Hot water temperatures are Rosewood Lodge DS0000037734.V263012.R01.S.doc Version 5.1 Page 20 recorded as being checked monthly and the bathing policy is for the water to be checked before showering or bathing. The home has a fire risk assessment in place; fire extinguishers had been checked November 2005, a fire drill is recorded as taking place 18th July 2005 and the manager later confirmed a further fire safety lecture is being arranged as previously these have only taken place annually. The fire alarm and emergency lighting records indicated these had not been checked since 30th November 2005 and therefore were overdue. The home has a current gas safety certificate. There was no evidence of the stair lifts, mobile hoist and Oxford bath hoist having a six monthly thorough examination although routine servicing is recorded. Window opening restrictors had been removed in rooms 14, 15 and 17 on the first floor. Rosewood Lodge DS0000037734.V263012.R01.S.doc Version 5.1 Page 21 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 2 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 x 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 3 x x x x x x 1 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x 3 1 Rosewood Lodge DS0000037734.V263012.R01.S.doc Version 5.1 Page 22 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. Standard Regulation Requirement Timescale for action 15/02/06 1 OP1 4 & Sch 4 2 3 4 5 6 7 8 OP7 OP7 OP9 OP12 OP18 OP26 OP26 15 17 13 12,16 13 16 16 9 OP38 13 The registered person must apply to the Commission to vary the registration to reflect a reduction in the number of beds. The manager must review care plans monthly and when needs change Daily records must be appropriate to the individual care provided Ensure that all medications are stored safely Ensure residents spiritual needs are met Ensure staff are aware of the implications of inappropriate language in caring for residents The care home must be kept free of offensive odours After consultation with the environmental health officer make suitable arrangements for maintaining satisfactory hygiene in the kitchen Ensure all parts of the home so far as practicable are free from hazards to residents safety eg fire alarm and emergency DS0000037734.V263012.R01.S.doc 28/02/06 03/01/06 03/01/06 28/02/06 28/02/06 03/01/06 31/01/06 31/01/06 Rosewood Lodge Version 5.1 Page 23 lighting must be checked weekly, provide evidence to the Commission the stair lifts, mobile hoist and bath hoist have had a six monthly thorough examination and ensure provision and maintenance of window restrictors based on the vulnerability of residents RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard 26 26 Good Practice Recommendations Ensure toiletries, razors, hairbrushes etc are for individual use To prevent the spread of infection , repair or replace the food store cupboard to prevent infestation of vermin Rosewood Lodge DS0000037734.V263012.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Lodge DS0000037734.V263012.R01.S.doc Version 5.1 Page 25 - 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!