Inspection on 08/08/06 for Rosewood Lodge

This inspection was carried out on 8th August 2006.

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 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 03/01/06

Rosewood Lodge 27/06/05

Rosewood Lodge 28/12/04

Rosewood Lodge 05/07/04

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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 Key Unannounced Inspection 8th August 2006 09:10 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.V305524.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 DS0000037734.V305524.R01.S.doc Version 5.2 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 20 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (20) of places Rosewood Lodge DS0000037734.V305524.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd January 2006 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 20 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. 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. The home’s current scale of charges is £328.80 per week. Rosewood Lodge DS0000037734.V305524.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a period of 6.25 hours. All the key standards were inspected, the inspector looked around all of the building and a number of records were examined. Residents were observed both directly and indirectly. Four residents were particularly spoken with along with others, two relatives, two members of staff and the manager. Eighteen comment cards were returned from residents, six from relatives, ten from staff, three from care managers and two from health service professionals. Apart from one anonymous card from a relative, the majority of questions asked about the home were answered positively. What the service does well: What has improved since the last inspection? All the requirements and recommendations made at the last inspection have been implemented. The vicar now attends monthly and provides communion and a small service to meet residents spiritual needs. Daily records of the care provided have improved and the manager is now reviewing care plans monthly or when needs change. Following consultation with the environmental health officer the hygiene standards in the kitchen are much improved; new worktops and cupboard doors have also been fitted. Rosewood Lodge DS0000037734.V305524.R01.S.doc Version 5.2 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.V305524.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 DS0000037734.V305524.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. The assessment procedure for prospective service users is good and ensures individual needs can be met by the home. EVIDENCE: Since the last inspection the provider has reduced the number of beds registered, as a room previously used for shared occupancy, has been changed for single use only. A new registration certificate, displayed in the entrance, has been issued reflecting the reduction in beds. 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 usually visits prospective residents in their own home or hospital to make an assessment of their care needs. If this is not possible information Rosewood Lodge DS0000037734.V305524.R01.S.doc Version 5.2 Page 9 is obtained over the telephone eg from the hospital who will also e-mail a care plan, from relatives, social services and other involved professionals. One resident, placed earlier in the year, was found to have needs which could not be met by the home and therefore arrangements were made for this resident to be placed in a more suitable home. The manager stated she had not been given the full picture when agreeing to the placement, and is confident the home’s admission and assessment procedure is adequate. One new resident was unable to remember any information she was given about the home or the assessment procedure. However, the manager stated the arrangements were all made with the daughter-in-law. The registered person confirms in writing the home can meet the individual needs of residents as required by regulation. Rosewood Lodge DS0000037734.V305524.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. All residents have a care plan ensuring staff have the information to ensure assessed needs can be met. The systems for the administration of medication are good ensuring residents medication needs are met. Personal support in this home is provided in such a way as to promote and protect residents’ privacy and dignity. EVIDENCE: Examination of four care plans found all areas of need being covered, and the manager has included examples for writing up daily care notes of how needs are being met. Advice given at the last inspection for oral health and foot-care to be included in the care plan, has been put into effect. The staff on each shift make a daily record of the care provided to meet the care plan. Key workers are recording the time spent with residents on an individual basis eg time spent with one resident who enjoys horse racing, in choosing a horse to place a bet. The home has arrangements in place for health service professional support ie general practitioner, district nurse, community psychiatric nurse, occupational therapist, dietician, dentist, optician, Rosewood Lodge DS0000037734.V305524.R01.S.doc Version 5.2 Page 11 physiotherapist and chiropodist. Residents who are hearing impaired are taken to the audiology department at Hull Royal Infirmary as needed. One resident has a pressure sore which is responding to treatment the district nurse is providing three times a week; the resident has been supplied with a special mattress to encourage healing and prevent further sores developing. Two comment cards were returned from general practitioners giving positive responses about the home. Medication records and storage were examined for four residents and found to be in order. Advice given by the supplying pharmacist at a recent visit is being followed and a photograph of the resident is to be included with the administration record. The home has a policy and procedure for the administration, recording and storage of medications. Residents spoke well of the home and the care received. Rosewood Lodge DS0000037734.V305524.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Residents are able to take advantage of activities provided by the home and are able to participate in community and family life; family and friends are able to visit the home and maintain telephone contact which enriches their lives. The meals in this home are good offering both choice and variety and catering for special dietary needs. EVIDENCE: Activities are now being held in the home every morning and afternoon and includes Scattergories, walking stick hockey, bingo, card games and dominoes. A quiz and bingo was being held during the morning of the inspection; residents were asked if they wanted to participate and a prize of a small carton of fruit juice or sweets was being offered to the winner of each round of bingo. Skittles was played during the afternoon. One resident said he likes horse racing and occasionally chooses a horse for which staff then place the bet on his behalf; he then watches the results of the race on television. Another resident said she very much enjoys going to a day centre three times a week. The manager has obtained a copy of “Activities for Today” from Secondary Health and Social Care Resources for ideas of new activities for the home. Since the last inspection arrangements have been made for a local church Rosewood Lodge DS0000037734.V305524.R01.S.doc Version 5.2 Page 13 minister to give communion and a short service every first Thursday in the month which is proving very successful with the residents. The manager is in the process of setting up a magazine about events taking place in the home. Visitors are welcome any reasonable time and two relatives were spoken with during the course of the inspection. One resident’s son from London was visiting and said he is “very happy with the home and the care provided and wishes Mum had moved in sooner”. He also said staff always keep him informed. Information about forthcoming trips out of the home were displayed on the visitors lounge door. These included Sewerby Hall and gardens, Goole Waterways Museum and a pub lunch and drinks. From comments made to the inspector and from the questionnaires completed by the residents, it is evident the meals being offered by the home are enjoyed. On the day of inspection residents were observed apparently enjoying a lunch of French onion soup, boiled ham and pineapple or pork casserole, carrots, peas and potatoes followed by lemon roly-poly and custard. Tea was a choice of fish pie and croquettes or turkey salad followed by raspberry ripple ice-cream. Residents are invited to eat either in the dining room or their own room. Staff made several attempts of using gentle persuasion to eat for one resident who seems to have lost her appetite although does appear to enjoy buns and biscuits. The inspector was informed her food intake is being monitored and the manager is to consult with the general practitioner. A bowl of fresh fruit was placed in the lounge and drinks were seen to be available at regular intervals; the inspector was informed extra drinks had been offered during the hot weather. Rosewood Lodge DS0000037734.V305524.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. The home has a satisfactory complaints process with some evidence that residents feel that their views are listened to and acted upon. Vulnerable adults policies, procedures and staff training ensure that residents are protected from abuse. EVIDENCE: The home’s complaints procedure is included in the service user guide which is kept in every resident’s room; a copy is also displayed in the entrance for visitors to see. Two complaints have been recorded since the last inspection and these have been thoroughly investigated and action taken. Concerns raised in one of the comment cards completed by a relative were discussed with the inspector prior to the inspection. However, the relative also contacted the manager who had taken action to rectify the issues raised. The manager stated she had notified the outcome to the relative who is now happy with the results. The home has a policy and procedure for the prevention of abuse and all staff receive awareness training for the protection of vulnerable adults. Rosewood Lodge DS0000037734.V305524.R01.S.doc Version 5.2 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 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. The standard of the environment within this home is good providing residents with an attractive and homely place to live. However, more effort must be made in addressing the offensive odour in one resident’s room. 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 meeting the maintenance, redecoration and refurbishment programme for the home. Since the last inspection new carpet has been installed in the reception, dining room and lounge, new settees in the reception, dining room chairs have been replaced and the lounge and dining room have been redecorated. The kitchen has had new work-tops and cupboard doors and following a visit from the environmental health officer the cook is now keeping a daily record of kitchen management activities including Rosewood Lodge DS0000037734.V305524.R01.S.doc Version 5.2 Page 16 refrigerator and freezer temperatures. Advice should be sought from the environmental health officer as to whether attention is needed to prevent vermin entering the store cupboard, used mainly for the storage of tinned foods, located in the corridor outside the kitchen. One resident’s room with an offensive odour continues to prove challenging to the home. (The inspector was informed following the inspection that external agencies have been contacted for advice in addressing the problems). Problems had been identified recently with the stair-lift, which was replaced the following day without too much inconvenience to the residents. Rosewood Lodge DS0000037734.V305524.R01.S.doc Version 5.2 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): 27,28,29 and 30 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Sufficient staff are deployed at all times to meet the needs of the residents. Current recruitment practice ensures residents are supported and protected. The staff are well trained and therefore competent to do their jobs. EVIDENCE: Staff rotas indicate there are sufficient staff on duty at all times to meet current residents needs ie three early, two late, two at night plus seven days a week an extra three hours help is employed between the hours of 5.00 and 8.00pm. The majority of resident comment cards returned to the Commission stated there is always sufficient staff on duty although two out of the five relatives returning their cards, said there is not always sufficient staff on duty. All the staff questionnaires returned were happy with the level of staffing. Staff interviewed spoke highly of the home and the benefits of night and day staff working as a team. A training programme ensures staff have the skills to do the job and staff turnover is low. Supervision takes place approximately six times a year and appraisals twice a year. All staff are trained in first aid and all are taking a qualification in infection control. Three residents have diabetes which is diet controlled so staff have been scheduled to attend Withernsea Hospital during September for a course on diabetes. New staff commence induction training whilst awaiting the results of their Criminal Records Bureau check and all new staff must train to achieve NVQ level II and are then encouraged to take level III. Records checked for three new members of staff indicated the home’s recruitment practice is good. In each of these files is a Rosewood Lodge DS0000037734.V305524.R01.S.doc Version 5.2 Page 18 signed copy of the General Social Care Councils code of practice and copies of training certificates achieved. Rosewood Lodge DS0000037734.V305524.R01.S.doc Version 5.2 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): 31,33,35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. With the exception of shortfalls identified in this section of this report, management of the home is good and the provider and his wife also give support. Good systems are in place to ensure residents, or their representatives, views are listened to and affect the services provided. EVIDENCE: The manager is qualified to NVQ level IV in care and management and is supported by the provider and his wife who also work alongside staff; the Commission receives a report every month from the provider as required by legislation. The inspector was shown the annual service report the home prepares for the local authority in order to retain the quality development scheme awarded to the home. A letter was also seen from the local authority congratulating the home on its high standards. Consultation with staff and Rosewood Lodge DS0000037734.V305524.R01.S.doc Version 5.2 Page 20 residents is via team meetings, which previously have been held every three to four months, and residents meetings which are held quarterly, although the manager is now changing team meetings to every two months. All residents pensions now go directly to their own bank accounts which are held by the family or the resident’s representative; the provider invoices the family for any additional charges. The pre-inspection questionnaire completed by the home indicates regular maintenance checks for equipment is taking place, although the annual gas safety certificate has been delayed due to work which is being completed to meet changes in gas safety regulations. Records indicate fire alarm tests and emergency lighting is checked weekly and staff receive in house fire training twice a year completing a questionnaire to confirm their knowledge of fire procedures. Accident records were examined and seen to be adequately recorded. However, one month’s records were missing at the time of the inspection and, due to a misunderstanding on the manager’s behalf, six accidents had not been forwarded to the Commission. (Following the inspection the manager telephoned the inspector to say the missing records had been found and outstanding accident notifications were being forwarded to the Commission. These have now been received). An emergency care practitioner from a local Primary Care Trust provides support to the home for minor illness, injuries and falls. Rosewood Lodge DS0000037734.V305524.R01.S.doc Version 5.2 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 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 1 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 1 Rosewood Lodge DS0000037734.V305524.R01.S.doc Version 5.2 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. 1 Standard OP26 Regulation 16 Requirement The care home must be kept free from offensive odours. (This requirement relates to one bedroom and is outstanding from the previous inspection) Provide the Commission with a copy of the current gas safety certificate The registered provider must notify the Commission without delay of any death, illness or other event Timescale for action 08/08/06 2 3 OP38 OP38 13 37 15/09/06 08/08/06 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 OP26 Good Practice Recommendations Advice should be sought from the environmental health officer as to whether the cupboard, located outside the kitchen and used for storing tinned foods, is adequate in its present state Rosewood Lodge DS0000037734.V305524.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hessle Area Office First Floor 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.V305524.R01.S.doc Version 5.2 Page 24 - 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!