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Inspection on 19/07/07 for Rosewood Lodge & Brook House

Also see our care home review for Rosewood Lodge & Brook House for more information

This inspection was carried out on 19th July 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides care and support to up to 20 service users who have a mental health need. The home is split into two separate dwellings each accommodating 10 service users. Both properties provide a homely environment for service users. Service users have their own bedroom, which they are encouraged to personalise. Service users have a key to their rooms and lockable space. Service users confirmed that they liked living at the home and `felt safe`. Service users were positive about the staff and the support they received. Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 6Very positive comments were received from service users regarding the provision of activities available both within the home and within the local community. The home employs an activities co-ordinator 5 days a week and service users who are funded for additional activities, receive regular input from access workers. The home is effectively managed by two experienced registered managers. A registered manager is based in each house. Service users and staff were positive about the managers and informed the inspector that they found them very supportive and approachable. No service user moves to the home unless their needs have been fully assessed by one of the managers. Prospective service users are encouraged to spend time at the home to ensure that they are happy that the home can meet their needs and aspirations. Service users benefit from an appropriate skill mix of staff and numbers of staff on duty are appropriate to meet the needs of service users. Service users are able to choose who assists them with personal support ie: attending appointments, assistance with personal care etc. The home`s care planning systems are good and service users are involved in this process. The home follows robust staff recruitment procedures which reduce the risk of harm or abuse to service users.

What has improved since the last inspection?

What the care home could do better:

No requirements were raised at this inspection. When asked, service users could not think of anything that the home could do betterIn pre-inspection information completed by the home, the home plans to make the following improvements; - the involvement of service users in the staff recruitment process - To produce a newsletter for family, friends and significant others - To produce appropriate documents in easy read/picture format for service users

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Rosewood Lodge & Brook House 11-13 Friarn Street Bridgwater Somerset TA6 3LH Lead Inspector Kathy McCluskey Unannounced Inspection 19th July 2007 09:30 Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 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 & Brook House DS0000069127.V338224.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 and Care Homes for Adults 18 – 65*. 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 & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosewood Lodge & Brook House Address 11-13 Friarn Street Bridgwater Somerset TA6 3LH 01278 457676 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) Rosewood & Brook House Ltd Mrs Tina Amanda Waterman Deborah Jane Smith Care Home 20 Category(ies) of Learning disability (20), Mental disorder, registration, with number excluding learning disability or dementia (20), of places Mental Disorder, excluding learning disability or dementia - over 65 years of age (20) Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 20 persons in categories MD, MD(E) and LD including a maximum of two persons with a concurrent physical disability. NA Date of last inspection Brief Description of the Service: Rosewood and Brook House are registered with the Commission for Social Care Inspection to provide personal care for up to 20 service users who have a mental disorder (age 18 – over 65yrs) or a learning disability age 18-65yrs. The home is not registered to provide nursing care. Rosewood and Brook House consist of two separate Georgian terraced properties which are located in a quiet street in the centre of Bridgwater. Each house accommodates 10 service users. All bedrooms are for single occupancy and accommodation is located over four floors. The home has not been adapted to meet the needs of service users with mobility difficulties/physical needs. Both houses have pleasant large gardens. The registered provider is Rosewood & Brook House Ltd. The responsible individual is Mr Biswanand Oozageer. The registered managers are Mrs Tina Waterman and Mrs Deborah Smith. The homes current weekly fee range is between £500 & £1200. Fees are determined on the assessed needs of the individual. Extra charges are met by service users for personal items, toiletries, chiropody. Further details regarding fees and extra charges should be obtained from the home. Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of this inspection visit was to inspect relevant key standards under the Commission’s ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are; - excellent, good, adequate and poor. This was the home’s first inspection since the Commission registered the new provider in February 2007. This unannounced key inspection was conducted over one day (6hrs) by CSCI regulation inspector Kathy McCluskey. Both registered mangers were present though out the inspection and the inspector was given unrestricted access to the home and records. At the time of this inspection 18 service users were living at the home this consisted of 9 living in Rosewood and 9 in Brook House. The inspector was able to meet with approximately 9 service users and 3 staff. Comments were positive and have been incorporated within the report. As part of this key inspection, comment cards were sent to GP’s and healthcare professionals. To date, no concerns have been raised with the Commission. The inspector would like to thank service users, staff and the management team for their time and cooperation with the inspection process. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. What the service does well: The home provides care and support to up to 20 service users who have a mental health need. The home is split into two separate dwellings each accommodating 10 service users. Both properties provide a homely environment for service users. Service users have their own bedroom, which they are encouraged to personalise. Service users have a key to their rooms and lockable space. Service users confirmed that they liked living at the home and ‘felt safe’. Service users were positive about the staff and the support they received. Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 6 Very positive comments were received from service users regarding the provision of activities available both within the home and within the local community. The home employs an activities co-ordinator 5 days a week and service users who are funded for additional activities, receive regular input from access workers. The home is effectively managed by two experienced registered managers. A registered manager is based in each house. Service users and staff were positive about the managers and informed the inspector that they found them very supportive and approachable. No service user moves to the home unless their needs have been fully assessed by one of the managers. Prospective service users are encouraged to spend time at the home to ensure that they are happy that the home can meet their needs and aspirations. Service users benefit from an appropriate skill mix of staff and numbers of staff on duty are appropriate to meet the needs of service users. Service users are able to choose who assists them with personal support ie: attending appointments, assistance with personal care etc. The home’s care planning systems are good and service users are involved in this process. The home follows robust staff recruitment procedures which reduce the risk of harm or abuse to service users. What has improved since the last inspection? What they could do better: No requirements were raised at this inspection. When asked, service users could not think of anything that the home could do better. Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 7 In pre-inspection information completed by the home, the home plans to make the following improvements; - the involvement of service users in the staff recruitment process - To produce a newsletter for family, friends and significant others - To produce appropriate documents in easy read/picture format for service users 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 & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home ensures that prospective service users have the information they need to enable them to make an informed choice about moving to the home. The needs and aspirations are fully assessed by the home prior to a placement being offered. Prospective service users are given the opportunity to ‘test drive’ the home. EVIDENCE: Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 10 The home submitted a Statement of Purpose and Service User Guide to the Commission as part of its registration process. These documents provide information about the home and services offered. The Statement of Purpose and Service User Guide are made available to service users and prospective service users. Copies are also available at the home. The home ensures that prospective service users’ health & social needs are fully assessed prior to a placement being offered. A pre-admission assessment and assessments from other healthcare professionals were seen in the care records of the most recent service user to the home. One of the home’s registered managers carries out the pre-admission assessment. As appropriate, prospective service users are offered visits to the home. This gives the service user the opportunity to ‘test drive’ the home and enables all parties to establish whether the home can meet the assessed needs and aspirations of the service user. Pre-inspection information supplied by the home indicates that as appropriate, significant others are also invited to visit the home. The inspector was able to see detailed records relating to the outcome of visits, for the most recent service user. The inspector was informed that these records provided useful information which can be used at review meetings prior to a placement being offered. Service users are issued with appropriate contracts/statement of terms and conditions. Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14 and 33 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 & 10 Quality in this outcome are is Good. This judgement has been made using available evidence including a visit to this service. The home’s care planning systems are good and service users are fully involved in this process. Service users are supported to take informed risks as part of their plan of care. Any restrictions are fully identified and agreed. Service users are supported to by fully involved in the day to day running of the home. EVIDENCE: Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 12 Two service user care plans were examined in detail at this inspection. The inspector was able to see that individual’s assessed needs had been clearly set out in the plan of care. Any restrictions on the service user had been clearly identified and agreed. The inspector was able to see that the service user had been fully involved in the care planning process. Each service user is allocated a key worker who will meet with the service user at least monthly and go through the individuals plan of care. Any changes to the care needs or risk assessments are documented and agreed with the service user. Evidence of this was seen in the two care plans examined. Service users spoken with at this inspection confirmed that they received regular meetings with their key worker and that they were involved in the care planning process. Service users confirmed that they were able to choose how and where to spend their day. As previously mentioned, any restrictions on this are clearly identified in the plan of care. The home a policy for staff on action to be taken where a service user goes missing. Individual care plans contain an up to date photograph of the service user and other appropriate information which can be used to identify an individual. The home supports service users to be fully involved in the day to day running of the home. Service users confirmed that they have regular meetings where their views are encouraged. The minutes of the most recent meeting were seen by the inspector. Menus were discussed and service users had raised suggestions regarding in-house activities. Meetings are currently held every other month. The last meeting was on 17/05/07 and a poster was on display for service users advising the date of the next meeting in July. Service users encouraged to be fully involved in day to day life in the home. During this inspection, service users were observed assisting with kitchen duties and tidying up after lunch. The inspector was able to see that a rota had been agreed by service users. Two service users informed the inspector that they had enjoyed designing and planting the garden. The home provided the Commission with pre-inspection information which confirms that service users and staff are aware of the issues around confidentiality and the correct storage of information. At the time of this inspection, all records pertaining to service users were noted to be stored in accordance with the Data Protection Act 1998. Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 13 Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. 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. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome are is Good This judgement has been made using available evidence including a visit to this service. Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 15 The home supports service users to develop and maintain independent living skills. Service users have access to a wide range of leisure activities. The home’s arrangements for ensuring that service users are offered a healthy diet are very good. EVIDENCE: On the day of this inspection the inspector observed service users ‘going about their daily business’. The atmosphere was relaxed. Two service users had returned from a visit into town, many service users were seen chatting in the garden. Service users moved freely around the home. The inspector spent time in the garden talking to five service users. All confirmed that there was ‘lots to do’ and that they enjoyed life at the home. Some comments made were; ‘I feel settled here and there is lots to do’, ‘There are lots of activities and I like going out’, ‘I can do pretty much what I like’. One service user was keen to tell the inspector about the weekly trips out that have been organised by the home. The inspector was able to view records relating to the weekly trips. Places visited were varied and interesting. The home maintains records relating to all trips and gains written feedback from service users following each outing. The home also documents who attended and the outcome for each service user. This is felt to be positive. As part of their agreed plan of care, service users are supported to participate in the local community. One service user told the inspector that they enjoyed working in a local shop 2 hours each week. On the afternoon of this inspection, one service user was being supported to catch the bus to Burnham-on-Sea. The home employs an activities co-ordinator 9-5 Monday to Friday. This member of staff supports service users to access the local community and arranges in house activities and trips out. The majority of service user are funded for activities and are allocated access workers. One service user is regularly supported to visit their allotment. Another service user was looking forward to a forthcoming activities holiday with their access worker in Wales. Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 16 Service users spoken with were very positive about the opportunities open to them an of the support they received. The home supports service users to maintain links with family and friends. Evidence to support this was gained from service users, staff and preinspection information provided by the home. Service users confirmed that they have keys to their bedrooms and that staff seek their permission before entering. Service users were observed moving freely around the home and utilising all areas. Service users were very clear on the restrictions on smoking at the home. As previously mentioned in this report, service users are fully involved in daily routines at the home. A weekly rota is agreed with service users. All meals are cooked freshly at the home. Service users are involved in the development of the menu. The inspector was informed that once a menu had been agreed, this was then forwarded to a local dietician for their comments. This is felt to be positive. Service users are involved in food shopping and cooking. Each house has a well-equipped kitchen and dining room. The inspector was able to see evidence that all staff had received appropriate training in food hygiene. Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 17 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) Service users retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicines. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 (Adults 18-65) 8, 9 & 10 (Older People) Quality in this outcome are is Good. This judgement has been made using available evidence including a visit to this service. Service users are treated with respect and their privacy is respected. Service users have access to a wide range of healthcare professionals and staff support service users as required/requested. The home follows the correct procedures for the management and administration of service users medication. Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 18 EVIDENCE: Service users spoken with at this inspection informed the inspector that they were able to make choices about what time they get up or go to bed. No concerns were raised by service users about the support they received from staff. During the inspection staff were observed interacting and communicating with service users in a kind and respectful manner. All service users are registered with appropriate healthcare professionals. Detailed records relating to contact with healthcare professionals are maintained in individual care plans. Service users are supported to maintain independence in accessing services though staff support service users to attend appointments as required/requested. The home has a sufficient mix of male/female staff to enable service users to choose who supports them. Some service users are supported to manage their prescribed medication in line with their agreed plan of care and risk assessment. This is monitored regularly by staff and lockable facilities are made available in service user bedrooms as appropriate. The home currently uses the monitored dosage system (MDS) with pre-printed medication administration records. Regular audits are carried out by the home’s managers to ensure that staff follow the correct procedures for the management and administration of service user medication. All medicines are securely stored. All staff involved in the administration of service user medication have received appropriate and up to date training. Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 (Adults 18-65) 16, 18 & 35 (older people) Quality in this outcome are is Good. This judgement has been made using available evidence including a visit to this service. The home has satisfactory complaints procedures in place and service users fell confident in raising concerns. The home has systems in place to reduce the risk of harm or abuse to service users. EVIDENCE: The home has a complaints procedure which is displayed in each house. The contact details of the Commission are identified. The registered managers confirmed that they have not received any complaints since the last inspection. No concerns have been raised directly with the Commission. Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 20 Service users spoken with at this inspection did not raise any concerns with the inspector. Service users confirmed that they would raise concerns if they had any. No concerns were raised by staff spoken with, and all confirmed that they were aware of the whistle blowing policy and action to be taken should they suspect any form of abuse. The home has procedures in place to reduce the risk of harm or abuse to service users. Those examined at this inspection included; the management of aggression, acceptance of gifts and bullying. The home needs to ensure that it has a clear Abuse policy for staff which identifies the types of abuse and action to be taken by staff. Action detailed needs to be in line with the revised Safeguarding Adults policy (May 2007). The inspector informed the registered manager at the time of this inspection, how to obtain a copy of this policy. The management of aggression policy was found to be satisfactory though needs to be updated to ensure it prompts staff to refer to an individual service users care plan where an assessed need has been identified. Staff spoken with were aware of the home’s ‘whistle blowing’ policy and staff were aware of how concerns should be reported. Staff recruitment procedures are robust and include criminal record checks (CRB) and vulnerable adult checks (POVA). As agreed in the plan of care, staff support service users to manage their personal monies. Records examined at this inspection had been appropriately completed and receipts maintained. Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28 & 30 (Adults 18-65) Quality in this outcome are is Good This judgement has been made using available evidence including a visit to this service. Service users live in a comfortable homely environment with a range of communal areas and pleasant gardens. All bedrooms are for single occupancy and service users are able to personalise their rooms. The home takes appropriate steps to reduce the risk of the spread of infection Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 22 EVIDENCE: Brook House & Rosewood consist of two mid-terraced houses next door to each other. They are located in a quiet street in the centre of Bridgwater. Both have large gardens which are well maintained. Accommodation in both houses is arranged over four floors. Stairs provide access to the upper and lower floors. The home does not have any specialised equipment to aid service users with mobility or other physical disabilities. The home clearly states that it is unable to cater for service users with these needs. Rosewood does have two ground floor bedrooms and the Commission has imposed a condition of registration that these rooms can be used for a maximum of two service users with a concurrent physical disability. All bedrooms are for single occupancy. Each house has 10 bedrooms. All have been fitted with a lock and service users are given a key to their room. Bedrooms are also fitted with lockable space to enable service users to store private items/medicines etc. Bathrooms and toilets are domestic in style. In Brook House there are two bathrooms, located on the first and second floor. Toilets are available on each floor. A staff toilet is located in the basement. One bedroom has an en-suite shower facility. All bedrooms have the provision of a wash hand basin. Rosewood has no communal bathing facilities as all bedrooms have en-suite shower facilities. Rosewood has four communal toilets and one staff toilet. All areas of the home (both houses) are comfortably furnished. Furnishings are domestic in style and promote a homely atmosphere. Service users are involved in choosing décor for the home and are able to personalise their bedrooms. Each house has appropriate laundry facilities. Appropriate systems are in place to reduce the risk of the spread of infection which include the provision of liquid soap and paper hand towels in appropriate areas. Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 and 36 (Adults 18-65) 27, 28, 29 & 30 (Older People) Quality in this outcome are is Good This judgement has been made using available evidence including a visit to this service. Service users benefit from a staff team who have been appropriately trained. Staffing levels are appropriate to meet the needs of service users. The home follows robust staff recruitment procedures which reduce the risk of harm or abuse to service users. Staff are appropriately supervised. Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 24 EVIDENCE: Staff are issued with job descriptions which clearly identify their roles and responsibilities. Staff spoken with at this inspection confirmed that they were clear about their own and others’ responsibilities. Staff also confirmed that they felt they had received the training needed to enable them to meet service users needs. Staff are issued with a copy of the General Social Care Council (GSCC) code of conduct. All staff receive appropriate mandatory training which includes moving and handling, health & safety, food hygiene and fire safety. Staff have also received first aid training, training in the management and administration of medication, diabetes, the management of aggression and the Mental capacity Act. Both managers agreed that further training in mental health issues needs to be accessed for staff. A recommendation has been raised and this will be followed up at the next inspection. The home is also registered for service users with a learning disability and the inspector noted that staff had not been trained in this area. This was discussed with the managers at the time and the inspector was informed that the home would not admit a service user if the staff did not have the skills and experience to meet their needs. The managers confirmed that the home would only accept service users whose primary needs were mental health. This is identified in the home’s Statement of Purpose. The managers provided the Commission with pre-inspection information which identified that of the 17 care staff employed, 2 had achieved a minimum of an NVQ level 2 in care. This equates to 12 which falls short of the 50 recommended in the National Minimum Standards. At the time of the inspection, the inspector was informed that 10 staff are currently working towards this award and that the home is in the process of registering for the Investor in People Award. Staffing levels at the home appear adequate to the needs of service users. No concerns were raised by service users or staff at this inspection. The inspector was informed that the home is currently staffed as follows; Brook House – 3 care staff during the morning and 2 in the afternoon evening. Nights are covered by 2 waking care staff. The registered manager based at Brook House is Debbie Smith who works Monday to Friday in addition to the care staff hours. Rosewood – 2 care staff throughout the day. Nights are covered by 1 waking care staff. The registered manager based at Rosewood is Tina Waterman who works weekdays (excl Wednesday) in addition to the care staff hours. Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 25 The home employs an activities co-ordinator who works 9-5 Monday to Friday. Access workers are employed in numbers to meet the assessed social needs of service users. The home has an appropriate on-call system in place. A maintenance person is also employed. The home follows robust staff recruitment procedures. Two staff files were examined and both contained all required information including enhanced criminal record checks (CRB) and protection of vulnerable adults checks (POVA). All newly appointed staff follow a detailed 12 week induction programme which follows the Skills for Care Common Induction Standards. The inspector was informed that during the induction programme staff are met with on a weekly basis and progress is discussed. The inspector was able to see evidence that all staff receive regular supervision sessions. Detailed records were seen in the staff files examined. Any training needs or requests had been recorded. All staff have a training plan to address needs and to ensure that mandatory training is kept up to date. Annual appraisals are conducted for each member of staff. Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 26 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 41 and 42 Quality in this outcome are is Good. This judgement has been made using available evidence including a visit to this service. The home is effectively managed by two experienced registered managers. Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 27 Service users benefit from an open and inclusive style of management where their views are encouraged. The home has an effective quality assurance programme in place which seek the views of service users any other stakeholders. Appropriate systems are in place to ensure the health & safety of persons at the home. EVIDENCE: The home benefits from two registered managers, one based in each house. Tina Waterman is based at Rosewood and has worked at the home for 13yrs under the previous owner. She has been a registered manager for 11 years and has an RMN nursing qualification. Debbie Smith is based at Brook House and has worked at the home for 11yrs. Under the previous owner Debbie was deputy manager for the last 3 yrs. The Commission approved an application for Debbie to become registered manager when the home was registered in February 2007. Both Tina and Debbie have completed appropriate mandatory training and are currently working towards the Registered Manager Award. Both managers work closely together in a consistent manner and both promote an open and inclusive style of management. Staff and service users were positive about both managers and all confirmed that they were very approachable. Regular meetings are held for staff and service users with minutes maintained. The views of service users and staff are sought. Both managers ensure that the home maintains an effective quality assurance programme. The views of relatives and healthcare professionals are sought formally, on an annual basis. A selection of completed questionnaires were examined at this inspection and comments were positive. As previously mentioned in this report, the views of service users are sought more frequently through meetings, key worker contact, regular reviews and through activity questionnaires. The home is currently working though detailed quality questionnaires with service users. Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 28 As required in the Care Homes Regulations 2001, the responsible individual conducts monthly unannounced visits to the home. Written reports were not available in the home at the time of this inspection, though the registered managers advised the inspector that these had been received the day after the inspection. Assurances were given that further reports would be maintained at the home. Records seen at this inspection were found to be securely stored in accordance with the Data Protection Act 1998. At the time of this inspection the home appeared to be taking appropriate steps to ensure the health & safety of persons at the home. This was ascertained by a tour of the premises, discussions with service users and staff and on examination of the following records; Fire Safety – Each home maintains its own records relating to weekly inhouse tests on the home’s fire alarm systems and monthly checks on emergency lighting. Weekly in-house checks are also made on fire extinguishers and torches. Records examined were found to be up to date. Annual servicing by external contractors was also found to be up to date. This was conducted in both houses on 26/02/07. Staff receive regular fire safety training. This last took place in May and July of this year. Six monthly fire drills are carried out where service users are involved. This was last recorded as 29/06/07. The home has a fire risk assessment in place. Electrical Safety – Both houses have an electrical hardwiring certificate dated 30/09/05. It has been recommended that the home contacts the contractor as the certificate recommended the next service in ‘one year’. The inspector could not ascertain the reasons for this from the information on the report. Portable electrical items are checked annually with records maintained. Gas Safety – Each house has an up to date Landlords Gas Safety Certificate dated 23/04/07. Accidents/First Aid – The home maintains appropriate accidents relating to service users and visitors to the home. Records were examined at this inspection and the number of accidents were unremarkable. Accidents are analysed by the registered manager and the inspector was able to see that appropriate action had been taken regarding a trait noted with one service user. Staff at the home have received training in first aid and the registered manager confirmed that there is a first aider on every shift. The inspector recommended that the nominated first aider is clearly identified on the staff duty rota. Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 29 Individual Risk management – as previously mentioned in this report, as appropriate detailed risk assessments are completed for service users to address a specific need. Risk assessments seen demonstrated the involvement of service users and, as appropriate healthcare professionals. Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 30 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 N/A 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT Standard No Score 37 3 38 3 39 3 40 x 41 3 42 3 43 x 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Rosewood Lodge & Brook House Score 3 3 3 x DS0000069127.V338224.R01.S.doc Version 5.2 Page 31 NA Are there any outstanding requirements from the last inspection? 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 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. 4. Refer to Standard YA23 YA32 YA32 YA42 Good Practice Recommendations The registered person should ensure that a specific abuse policy is developed for staff and that the home obtains a copy of Somerset’s revised policy on Safeguarding Adults. The registered person should access appropriate training for staff in relevant mental health issues. The registered person should ensure that at least 50 of the care staff team achieve a minimum of an NVQ level 2 in care. The registered person should seek advice regarding the reinspection of the home’s electrical hardwiring. Rosewood Lodge & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection Taunton Local Office 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 & Brook House DS0000069127.V338224.R01.S.doc Version 5.2 Page 33 - 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. 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