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Inspection on 16/05/05 for Rosewood Residential Care Home

Also see our care home review for Rosewood Residential Care Home for more information

This inspection was carried out on 16th May 2005.

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 is decorated and furnished to a high standard the living room, dining room areas are very spacious and the overall impression is homely, comfortable, clean, bright and airy. There are good care plans in place and detailed records kept to ensure the well being of the people living at the home. The staff have received training to help them do their jobs and the Manager has an open and supportive approach to running the home. The Inspectors saw that the medication in the home is administered according to the homes policies and procedures and is in line with good practice.

What has improved since the last inspection?

Care Plans are in the process of being updated and those that have been done provided a good level of detail of service users daily routines and clear guidance to staff on how to support service users. The new extension provides 6 en-suite rooms that have been decorated and refurnished to a high standard.

CARE HOMES FOR OLDER PEOPLE Rosewood Residential Care Home Cobham Terrace Bean Road Greenhithe Kent DA9 9JB Lead Inspector Fiona Holdaway Unannounced 16 May 2005 10:00 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 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 Residential Care Home H56-H06 S23994 Rosewood V227192 160505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Rosewood Residential Care Home Address Cobham Terrace Bean Road Greenhithe Kent DA9 9JB 01322 385880 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Charing Cross Investments Limited Mrs Kathleen Powell CRH Care Home 43 Category(ies) of Dementia - over 65 (43) registration, with number of places Rosewood Residential Care Home H56-H06 S23994 Rosewood V227192 160505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20 October 2004 Brief Description of the Service: Rosewood provides residential care for up to 43 older people who have been diagnosed with dementia. There is a smaller unit situated on the first floor for more highly dependent service users. An extension of 6 bedrooms and additional day space has recently been completed and registered. The home has a shaft lift between the ground and first floors. The home is situated in a residential area of Greenhithe, Blue water shopping complex is approximately 1/2 mile away. The home is close to public transport and local facilities. Rosewood Residential Care Home H56-H06 S23994 Rosewood V227192 160505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced Inspection was carried out by Regulation Inspector Fiona Holdaway. A tour of the home took place and the Inspector met with service users and staff, the Manager was present in the home throughout the Inspection, care records, policy documents and staff files were inspected. There have been no complaints received by CSCI about this home. What the service does well: What has improved since the last inspection? 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 Residential Care Home H56-H06 S23994 Rosewood V227192 160505 Stage 4.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection Rosewood Residential Care Home H56-H06 S23994 Rosewood V227192 160505 Stage 4.doc Version 1.30 Page 7 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 standard(s) 1,2,3,4,5 Prospective service users and their relatives have the information they need to make a choice about the home. Service users and their relatives are encouraged to visit the home before the person moves in. The needs of service users are assessed prior to admission. Each service user has a contract with the home stating the terms and conditions of their residency. EVIDENCE: The home has an information pack for prospective service users which contains all the relevant information about the home. The service users guide was in the process of being updated and was nearly completed. Service users needs are assessed prior to being offered a place at the home to ensure that the home is able to meet the needs of the individual and the first month of stay is a trial period for both parties. The manager stated she undertakes the assessment of prospective service users within their current environment and with the involvement of relatives as appropriate. Rosewood Residential Care Home H56-H06 S23994 Rosewood V227192 160505 Stage 4.doc Version 1.30 Page 8 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 standard(s) 7,8,9,10 Service users personal, social and health care is provided according to service users needs and wishes. Service users are protected by the homes medication policies, procedures and good practice. Service users are treated with respect and their privacy is maintained at all times. EVIDENCE: Each service users care plans are in sufficient detail to provide clear guidance to staff on the actions to be taken to meet all aspects of their health and welfare needs. Care records included risk assessments, moving and handling assessments, nutrition assessments, healthcare appointments and the outcomes. Guidance for staff on managing behaviour specific to the individual service user with dementia was in place. Staff were observed to respect service users and the daily records provided information about how service users were and how they had spent their day. Privacy screens were provided in all double rooms and all rooms, toilets and bathrooms were lockable. Staff were knowledgeable about medication procedures and the homes medication records were properly kept. Rosewood Residential Care Home H56-H06 S23994 Rosewood V227192 160505 Stage 4.doc Version 1.30 Page 9 Rosewood Residential Care Home H56-H06 S23994 Rosewood V227192 160505 Stage 4.doc Version 1.30 Page 10 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 standard(s) 12,13,15 Service users have access to a range of activities in the home. They are encouraged to make choices about all aspects of their daily routine. Service users are supported to maintain contact with family, friends and the wider community. The meals in the home are good offering both choice and variety and catering for special dietary requirements. EVIDENCE: The home employs an activities person 5 days per week from 10am until 3pm, including some weekends. The manager stated that activities vary and include games, bingo, reminiscence groups, gentle exercise games etc and sometimes reading and talking about the daily newspaper or just sitting with one person and spending some time talking with them. There are large print books and videos available. Care plans recorded the details of service users hobbies and interests and how they liked to spend their time. Menu records were seen and these showed that a balanced and varied diet is offered. Service users are asked to make a choice from 2 main meals on offer, and photographs of the meals are used to help service users with dementia that may find it difficult to make a choice, or to remember it. A service user had been provided with adapted cutlery and a cup suitable for her needs. Rosewood Residential Care Home H56-H06 S23994 Rosewood V227192 160505 Stage 4.doc Version 1.30 Page 11 Rosewood Residential Care Home H56-H06 S23994 Rosewood V227192 160505 Stage 4.doc Version 1.30 Page 12 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 standard(s) 16,18 Service users and their relatives are provided with a copy of the complaints procedure. The homes policies and procedures protect service users from potential abuse. EVIDENCE: The home has a clear complaints procedure that meets the requirements of the regulations. The complaints procedure was displayed within the home and a copy is provided as part of the contract to every service user and their relatives, it is also included in the Service User Guide and Statement of Purpose. The home had not received any complaints but had received a number of cards of thanks and complimentary letters. The homes adult protection policies were viewed and included a ‘whistleblowing’ policy for staff. Training in adult protection was planned for 15 staff. Rosewood Residential Care Home H56-H06 S23994 Rosewood V227192 160505 Stage 4.doc Version 1.30 Page 13 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 standard(s) 19,20,21,22,24,25,26 Service users live in a safe, well-maintained and clean environment. The standard of décor, furnishing and fittings are high providing a homely and pleasant living environment. EVIDENCE: The home has a large lounge / dining area on the ground floor and a smaller separate dining room on the first floor. On the day of the inspection the home was found to be bright, airy, warm and well lit. The home has sufficient toilet and assisted bathroom facilities for the number of service users. It was found that there was a high standard of cleanliness throughout the home, and with one exception there were no undue odours. There are handrails situated around the home, a passenger lift and an emergency call system in all rooms. Some service users rooms have en-suite facilities and where these are not included a suitable bathroom is located nearby. Service users rooms were personalised with ornaments and pictures and some of their own small items of furniture and some service users had chosen their own décor. Double rooms had adequate screening. Rosewood Residential Care Home H56-H06 S23994 Rosewood V227192 160505 Stage 4.doc Version 1.30 Page 14 Rosewood Residential Care Home H56-H06 S23994 Rosewood V227192 160505 Stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,30 The numbers of staff employed are sufficient to provide the level of care required. The Manager ensures that the staff team continually develop their knowledge and skills providing a competent and skilled workforce. EVIDENCE: Staff rotas were examined and evidenced consistent planning. All staff (other than the qualified nurses) are working towards NVQ’s. The training records showed that staff had received training in a range of subjects and a variety of courses were planned in for the coming year. Care staff and some domestic staff have received some Dementia Awareness training from the Dementia Liaison Nurse. The Inspector discussed with the manager the need for further accredited training in Dementia Care. Training in diabetes is also needed. Rosewood Residential Care Home H56-H06 S23994 Rosewood V227192 160505 Stage 4.doc Version 1.30 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33 and 36, The atmosphere of the home is friendly and welcoming. The manager is open and approachable to service users and staff, she offers clear guidance and support to staff and runs the home in the best interests of service users. EVIDENCE: The Manager demonstrated through discussion, a clear understanding of the needs of the service users and any current issues. The manager makes sure that all staff receive appropriate training and has sought training and information from professionals such as a nutritionist and the dementia nurse. The Manager has achieved The Registered Managers Award and has an NVQ level 4 in care. Evidence was sent that staff receive formal supervision and an annual appraisal of their work. Rosewood Residential Care Home H56-H06 S23994 Rosewood V227192 160505 Stage 4.doc Version 1.30 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 x 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 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 x 3 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x 3 3 3 x x 3 x x Rosewood Residential Care Home H56-H06 S23994 Rosewood V227192 160505 Stage 4.doc Version 1.30 Page 18 no 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. 1. Standard 30 Regulation 18 Requirement Staffing 18. - (1) The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users (c) ensure that the persons employed by the registered person to work at the care home receive – (i) training appropriate to the work they are to perform; and (ii) suitable assistance, including time off, for the purpose of obtaining further qualifications appropriate to such work. All staff working with service users with a diagnosis of Dementia to have accredited training in Dementia Care. Training in Diabetes is also required. Timescale for action Action Plan RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Rosewood Residential Care Home H56-H06 S23994 Rosewood V227192 160505 Stage 4.doc Version 1.30 Page 19 No. 1. Refer to Standard Good Practice Recommendations Rosewood Residential Care Home H56-H06 S23994 Rosewood V227192 160505 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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 Residential Care Home H56-H06 S23994 Rosewood V227192 160505 Stage 4.doc Version 1.30 Page 21 - 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!