Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 23/08/06 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 23rd 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 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

Rosewood provides individual person centred care, which is focused on personal choice and preferences and tailored to meet the service users needs and providing a good quality service. The care plans and daily recording are very informative and comprehensive. Rosewood offers a good range of activities and has various lounges for service users to spend their time. The home is well run and managed with an open approach in working with external agencies. Rosewood is very clean and tidy yet lived in.

What has improved since the last inspection?

The care plans and daily recordings have been expanded and improved upon. Staff training has been increased with a staff training matrix being devised based upon mandatory training and specialised training developed through individual staff appraisals and the aims and objectives of the home. Staff are more diligent in completing the medication sheets.

What the care home could do better:

There are a few improvements still to be made to the home such as a chair needed for the new shower room and indicators on toilet doors. The care plans need to be developed further to provide individual guidance on support and direction for staff to follow in managing some potential difficult behaviours. The PRN (when required) medication needs to be firmed up to provide more precise detail in written form and a means to establish when medication is required. The home would benefit from having an assessment made as to equipment for service users for who have limited mobility and require assistance with standing.

CARE HOMES FOR OLDER PEOPLE Rosewood Residential Care Home Cobham Terrace, Bean Road Greenhithe Kent DA9 9JB Lead Inspector Maria Tucker Key Unannounced Inspection 23rd August 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rosewood Residential Care Home DS0000023994.V301385.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 Residential Care Home DS0000023994.V301385.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosewood Residential Care Home Address Cobham Terrace, Bean Road Greenhithe Kent DA9 9JB 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) 01322 385880 Charing Cross Investments Limited Mrs Kathleen Powell Care Home 43 Category(ies) of Dementia - over 65 years of age (43) registration, with number of places Rosewood Residential Care Home DS0000023994.V301385.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th October 2005 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. The current fee levels range from £390.00 to £538.00 per week Rosewood Residential Care Home DS0000023994.V301385.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection. The visit lasted from 10.00am until 14.45pm. The visit was spent talking directly with two service users, 2 care staff, the deputy manager, and the manager via telephone. Some judgements about quality of life and choices were taken from direct conversation with service users followed by discussion with care staff and evidencing from records held at the home. A partial tour of part of the premises was undertaken. The pre inspection questionnaire has been received. Comment cards have been received comments included: From service users: • Happy with all of care. Activities “can’t remember her coming, I do play cards with ladies”. Everyone is nice. • Little meals sometimes sandwiches. • No complaints. • The home is beautiful. • The food and entertainment is excellent. • There are activities I choose not to join in. • I like to have a cigarette and I am supported staff in the area. From relatives / visitors • I am always informed after event i.e. chiropody medication changes. • Generally very pleased with the very good level of care. • I am very impressed with the quality of care at Rosewood. My (service user) is very happy and they make sure that her needs are met. • I may have been told about complaints procedure but never needed it. • The manager and staff are always accessible and provide the care needed. • We are very pleased with the care. Staff are very kind and very nice to us when we visit and we know they are fond of (service user). From placement officers • Clients and relatives are happy with the care provided staff interact well with clients and are always friendly and welcoming. From health professionals • I feel this home is run in the most professional manner and I’m pleased to attend a home of this standard. • I only visit on request made by GP my opinions are based on my impressions. (Satisfied, works well in partnership with home) Rosewood Residential Care Home DS0000023994.V301385.R01.S.doc Version 5.2 Page 6 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 DS0000023994.V301385.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 Residential Care Home DS0000023994.V301385.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): 2, 3, 4, 5 Quality on this outcome area is good this judgement has been made using available evidence including a visit to the service. Service users can feel confident that they will be admitted to the home following a comprehensive assessment and that their assessed needs would be met. EVIDENCE: Initial assessments are conducted by the home prior to being offered a place. Copies of these were seen to be in service users files. Further assessments are sought as part of this process from health and social care professional’s copies are retained on file and form part of the overall care plan. It was discussed that for good practice the care plan drawn up from the initial assessments should be forwarded to the service user and / or representative for them to sign in agreement. Relatives spoken with detailed how they were invited to visit the home and had made a positive choice with the service user to move into Rosewood. Staff discussed how the initial assessment was updated when a service user moved into the home as often their needs changed with the change of care and environment. A relative spoke of how since being at the home their Rosewood Residential Care Home DS0000023994.V301385.R01.S.doc Version 5.2 Page 9 relative had made great improvements and that the home had supported them to settle. Stating their relative is “happy here” has “settled” as at first they chose to spend most of their time in their room but with encouragement and support has made friends and is now the “life and sole of the home”. The home does not provide intermediate care. Copies of contracts were seen to be kept in the manager’s office. The manager conducts a further assessment when service users are admitted to hospital to ensure that the home can continue to meet their needs evidencing good practice. Rosewood Residential Care Home DS0000023994.V301385.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, 10, 11 Quality on this outcome area is good, this judgement has been made using available evidence including a visit to the service. Service users can feel confident that their health and welfare will be promoted and that they will be facilitated to a lifestyle, which suits their individual needs and preferences. EVIDENCE: The care plans seen were very comprehensive and informative. They contained relevant details to enable staff to provide care from a person centred perspective on an individual basis. Good recordings in the daily notes included care given with times and details of how and what the service user did during the day. To assist staff with supporting service users on a 24 hour period the home have begun to record individual daily routines an example of excellent recording for this was seen in a care plan it stated “(service users name) is not a morning person and doesn’t like to be rushed, and will grasp the carers hand or arms if you attempt to move (service users name). It is better to sit and talk to (the service users name) for a while so that they have time to wake up”. Staff were familiar with service users likes and dislikes and were seen to be adhering to these offering choice and opportunity to exercise preferences. Rosewood Residential Care Home DS0000023994.V301385.R01.S.doc Version 5.2 Page 11 Examples of this were service users whose assessment indicated that they preferred to sleep in until later were having a ‘lie in’. Another service user who smoked was asked if they wanted a cigarette and staff supported them to do so. It was discussed that the care plans could be enhanced with specific instructions and guidance on how to support and manage some difficult and aggressive behaviours this would enable a consistent approach to be adopted. It is acknowledged that from observations and discussions with staff they were familiar and able to manager behaviours appropriately although these had not been formally written as part of the care plan. It was discussed that evidence that (if possible) service users and relatives and as appropriate others agree with the care plans these should be signed accordingly. The deputy manager agreed to include a section for signatures in the care plan formats. A relative spoke of how they had formal review held to discuss the care plans and were part of this process. Service users health and welfare is promoted through regular and routine medical and health appointments, which are recorded in the care plans. A service user whose needs have changed has been re assessed and was currently awaiting a nursing home placement to be found. Monitoring of general health such as nutrition, weight and moving and handling is conducted as well as any specialist support i.e. for diabetics. Advice is sought when required and hospital and medical appointments made and followed through. During the inspection staff were heard to receive a telephone call from a local hospital to arrange an appointment. From discussions with staff they were familiar with medical needs and current health related conditions. Relatives are kept informed of health needs as evidenced in a comment made by a relative in the comment card received “I am always informed after event i.e. chiropody medication changes”. A relative spoke of how staff had a good understanding into dementia another stated that, “staff have a good knowledge of dementia”. The home has stringent policies and procedures for dealing with medication. Controlled mediation is stored separately within a metal locked facility. Staff were observed to be supporting service users with taking medication and from discussions held with the inspector evidenced they had a good insight into what medication was prescribed for and particular preferences or difficulties service users may have with medication. Currently no service user administers their own medication. Staff were clear that they would support service users in administering their own medication although due to the cognitive impairment associated with dementia did not feel at present there was anyone who would be safely able to do this or understand the implications and dangers associated with the medication they may be taking. Medication was seen to be stored appropriately as was the recording in the mar sheets. It was agreed that the home need to firm up on their PRN medication as currently the mar sheets detail as directed. This was discussed in depth and again staff were very familiar with what medication had been prescribed for and detailed how individual service users indicated the need for i.e. painkillers. Rosewood Residential Care Home DS0000023994.V301385.R01.S.doc Version 5.2 Page 12 The home will devise a method to establish and record parameters for what; when; why and dosage of PRN (when required) medication to be given. Service users were heard to be called by their preferred name and staff were seen to be respectful and courteous towards service users at all times. A relative spoke of how another service user had been wearing an item of their relative’s clothing and that this had been raised with the manager and resolved. It was noted that the staff minutes had recorded that staff must ensure that the right cloths are put away for the individual service user as things had been found on occasions not to be in the right place. Recorded in the staff minutes was that “carers must not put socks onto ladies feet when they are wearing a skirt” the deputy manager explained that this was for dignity reasons as it was felt that the service users would not have liked this if in the past and that it was undignified. It was noted that a service user had refused to have their photograph taken for identification purposes when administering medication and staff had adhered to their wishes. The care plans recorded service users wishes in the event of death. A clear instruction was seen detailing staff actions to follow in the event of this occurring. This procedure was noted to be respectful, clear and an informative policy providing guidance to staff, which enables this process to be managed in a professional and dignified manor. During the inspection staff were notified by the hospital of such an event. They were seen to be personally affected, yet professional, sensitive and supportive in the manner in which they received this information, informed other staff and in speaking with a relative and health professional. Rosewood Residential Care Home DS0000023994.V301385.R01.S.doc Version 5.2 Page 13 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, 15 Quality on this outcome area is excellent this judgement has been made using available evidence including a visit to the service. Service users can expect an active life as they wish either opting in or out of activities on offer. There is a vast range of meals provided. EVIDENCE: The home employs an activity coordinator who supports the service users in their leisure and recreation time. Service users were busy during the inspection knitting, reading papers and engaging with staff who were supporting them with puzzles or activities. Some service users spoken with described what they wanted to do and what they had done. One service user in their room had a budgie and delighted in talking with the inspector about the pleasure they had from this. Comments received in the comment cards from service users was positive and included Happy with all of care. Activities “can’t remember her coming, I do play cards with ladies”. Everyone is nice. Another comment made stated “The food and entertainment is excellent” and “There are activities I choose not to join in”. A relative told the inspector that they joined in the singing with their relative who enjoys singing along when this activity takes place. Relatives were seen coming and going visiting service users either in the lounge areas or in the garden. Rosewood Residential Care Home DS0000023994.V301385.R01.S.doc Version 5.2 Page 14 Service users were seen to wander freely around the home and were able to spend their time either in the lounges or their room as they chose. Some service users were still in bed on the arrival of the inspector, as they preferred to have a lie in. Staff were familiar with service users preferences their likes and dislikes. One staff explained that a service user who enjoyed reading the paper also enjoyed the occasional game of drafts. The home had plenty of equipment such as games and books and music and televisions. There are lounges downstairs and a quieter lounge upstairs so that service users can choose where they want to be according to what they wanted to do. Service users spoken with expressed that they liked it at the home this was reinforced by relatives who detailed how their relative was happy and settled at Rosewood. Activities in the home are designed to engage service users who have dementia in that they are stimulating and individual for service users particular needs and tastes. Trips out are arranged as is entertainment bought into the home such as a singer. The pre inspection questionnaire list a range of activities that take place including celebrations of events and birthdays; music and trips to the theatre; shopping trips and general outings to the park and to feed the ducks. The lunchtime meal was appetising and presented well. Staff were supporting service users to enable them to actively take part in assisting feeding by over hand support and guidance. The mealtime was busy yet service users were unhurried and appeared to be relaxed in the congenial dinning room setting and mealtime routine. The food was fresh cooked balanced and wholesome. Service users spoke of how they had a choice of meals. Comments received in the comment card Comment from placement officers were positive an example of such included “Clients and relatives are happy with the care provided, staff interact well with clients and are always friendly and welcoming”. Rosewood Residential Care Home DS0000023994.V301385.R01.S.doc Version 5.2 Page 15 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, 18 Quality on this outcome area is good this judgement has been made using available evidence including a visit to the service. Service users can feel confident that the home has good systems in place to protect them from potential abuse or harm. That they or their relatives are able to make a complaint and that this would be treated and managed appropriately. EVIDENCE: There have been no complaints made. Service users spoken with did not have any concerns and were seen to be happy and relaxed. A comment received from a service user in the feedback questionnaires re complaints stated, “I would tell staff and they would sort it out”. Staff were proactive in seeking the views of the service users to ensure that everything was all right and their needs were being met. Relatives expressed that they had no complaints and were complementary of the home and the care provided as evidenced from a comment made in a comment card received by the CSCI stating “I may have been told about complaints procedure but never needed it”. From discussions and observations staff were conscientious and sensitive in their manor and approach towards service users and relatives. There has been one adult protection alert raised that has been managed by the social services with the full co-operation of the home, this has been resolved with a good outcome for the service user in question. Evidencing the home’s commitment to providing a high quality service that protects service users health safety and welfare. Rosewood Residential Care Home DS0000023994.V301385.R01.S.doc Version 5.2 Page 16 The home has stringent recording and safe keeping of service users personal spending. This was inspected and good practice was noted to be adhered to. Relatives during the inspection had bought money in for spending receipts were given and money placed in personal pouches. CRB checks are carried out on staff. Staff had been made aware of POVA and the new documentation relating to adult protection from the local authority. Rosewood Residential Care Home DS0000023994.V301385.R01.S.doc Version 5.2 Page 17 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, 20, 21, 22, 23, 24, 25, 26 Quality on this outcome area is good this judgement has been made using available evidence including a visit to the service. The home is clean, tidy and provides a comfortable, spacious, safe environment for service users to live in. EVIDENCE: The home has designated staff for cleaning and laundry. The kitchen staff have designated times for cleaning kitchen areas and equipment. Overall the home was found to be in a good general state of repair and decorated to a high standard with good quality furniture and fixtures. There were no offensive odours and the home was exceptionally clean and tidy yet lived in. There were a few things that needed to be done this included a radiator cover in room 21; the shower chair replaced with one that can be easily cleaned and designed for use in a walk in shower facility; indicators and locks fitted to the toilets that do not have them. The grounds looked very pleasant and well kept providing a safe a nice environment for service users to enjoy. Rosewood Residential Care Home DS0000023994.V301385.R01.S.doc Version 5.2 Page 18 There are 3 lounge areas downstairs and a separate lounge upstairs so that service users can have a change of scene and environment. The home has a sluice room. There was noted to be grab rails and other aids scattered around the home. It was discussed that the home would benefit from seeking advice on other equipment such as a standing hoist which may be useful to support service users who need a little bit of extra support. Assisted baths are available and the new walk in shower has proved to be popular. All of the private rooms were individual with plenty of personal effects. One room noted to be pink that had a male resident occupying it was down for redecoration. Lockable facilities were noted in service users rooms although the bedroom doors were not lockable. This was discussed and the deputy manager explained that a recent audit undertaken had established that service users did not currently choose to have locks fitted but they would be provided should they be requested. Screening was provided in shared rooms. The pre inspection questionnaire received by the CSCI listed maintenance and associated records these were spot checked during the inspection. Rosewood Residential Care Home DS0000023994.V301385.R01.S.doc Version 5.2 Page 19 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, 30 Quality on this outcome area is good this judgement has been made using available evidence including a visit to the service. Competent staff who received regular training and are recruited through a stringent procedure meets Service users needs. EVIDENCE: The staffing numbers according to the rota consist of 7 care staff am and 6 care staff pm. There is a senior on each shift and the deputy or manager covering most days. There are extra staff for specific roles including kitchen assistant; cook; handy person; activity co-ordinator and 2 cleaners. There are 4 night staff. It was discussed that the rota format should be improved upon to include staffs designation and hours of duty. The pre inspection questionnaire received by the CSCI stated that there were no service users who were bed fast, that all needed assistance with dressing and undressing and 10 service users required assistance with meals and that 9 service users required 2 or more staff to undertake their care. It was not possible to calculate the staffing levels and number of hours required according to the department of health residential forum as this information was not complete in the pre inspection questionnaire. There was no evidence to suggest that there was not enough staff on duty. A staff spoken with expressed that during the morning it would be helpful to have an extra staff member, as it can get quite busy. From discussions this was thought to be due to general morning tasks of getting people up, administering medication and supporting with breakfast. Rosewood Residential Care Home DS0000023994.V301385.R01.S.doc Version 5.2 Page 20 Staff files inspected contained all items as required and evidenced that the home has stringent employment processes that they implement when recruiting new staff. Some staff have been recruited locally and an oversees recruitment agency is used to ensure a full complement of staffing. There is a training matrix for staff mandatory training and contained in staff files were copies of certificates. A regulation 26 report received conducted on 1st August 2006 stated that adult protection training had been conducted and that induction of new staff has started. Staff spoke of how helpful a recent moving and handling course was and that they had bought back and put into practice things learned. The pre inspection questionnaire states that 10 care staff have the NVQ level 2 or above and that the rest are “part way through or nearly finished”. According to the staffing list there are 22 staff excluding the deputy and manager, which would equate to 50 of staff either having or almost completing the NVQ level 2. The training plan for 2006 received as part of the pre inspection documentation listed a vast range of training including fire training; moving and handling; 3 day dementia training; dementia and challenging behaviour training; medication and first aid and food hygiene dates awaiting. POVA training has been rescheduled for August. From discussions with staff, relatives and general observations made during the inspection the staff on duty were familiar with the needs of this particular service user group with a good insight into the particular needs of service users with dementia. Rosewood Residential Care Home DS0000023994.V301385.R01.S.doc Version 5.2 Page 21 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, 32, 33, 35, 36, 37, 38 Quality on this outcome area is good this judgement has been made using available evidence including a visit to the service. The home is well run and managed effectively aiding in providing a good quality of life for the service users who live there and a good working environment. EVIDENCE: The manager is experienced and competent as evidenced by the systems management and practice of care in the home. Staff spoke highly of the manager stating “she is brilliant” describing the manager as the best the home has ever had and detailing vast improvements made since taking up her post. This is reiterated in the positive feedback from relatives and professions an example of which was made in a comment card received by the CSCI stating “The manager and staff are always accessible and provide the care needed” another example being “We are very pleased with the care. Staff are very kind and very nice to us when we visit and we know they are fond of (service Rosewood Residential Care Home DS0000023994.V301385.R01.S.doc Version 5.2 Page 22 user)”. From discussions with the manager she has an open approach to managing the home and welcomes any suggestions and advice that would improve the already good quality service provided. Throughout the inspection staff, service users and relatives were happy to discuss any issues raised and felt comfortable to do so. Staff reiterated the manager’s philosophy of honesty being the best policy evidencing an open ethos and approach to the running of the home. Comments received by health professionals were positive and included a comment that “I feel this home is ran in the most professional manner and I’m pleased to attend a home of this standard”. Service users meetings are held and notes made as seen in the office. An annual monitoring seeking views is made for quality assurance. The regulation 26 report received conducted on 1st August 2006 stated that the last quality audit form went through to head office and they are awaiting a response. Regular regulation 26 visits are made and reports forwarded to the CSCI these are noted to be very informative and open in the information contained and action taken. The business plan was not inspected although the deputy manager explained that they did have plans that considered items such as re decorating and improving the home generally. Staff files contained supervision notes these were not read for confidentiality reasons. Staff confirmed that regular supervision and appraisals take place. The accident recordings were inspected and contained minor accidents and injuries with appropriate action taken. Staff spoken with described the best thing about the home was the “people skills are very good” the care plans are good and the home is relaxed and enjoyable to work in. Another staff stated the best thing is that the service users have all they’re needs met. This was supported by a comment made by a relative that “I am very impressed with the quality of care at Rosewood. My (service user) is very happy and they make sure that her needs are met”. Rosewood Residential Care Home DS0000023994.V301385.R01.S.doc Version 5.2 Page 23 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 3 4 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 2 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 Rosewood Residential Care Home DS0000023994.V301385.R01.S.doc Version 5.2 Page 24 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 OP9 Regulation 13(2) Timescale for action The registered person shall make 30/11/06 arrangements for the recording, handling, safe keeping, safe administration and disposal of medicines received into the care home. In that the PRN medication procedures are firmed up as discussed in the text. Requirement 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 OP7 Good Practice Recommendations It is recommended that the care plans would benefit from detailing specific instructions and guidance on how to support and manage some difficult and aggressive behaviours. It is recommended that the minor improvements to the environment as identified in the text be addressed. It was discussed that the home would benefit from seeking advice on other equipment such as a standing hoist which DS0000023994.V301385.R01.S.doc Version 5.2 Page 25 2 3 OP19 OP22 Rosewood Residential Care Home 4 OP27 may be useful to support service users who need a little bit of extra support. It is recommended that the rota format be improved upon to include staffs designation and hours of duty. Rosewood Residential Care Home DS0000023994.V301385.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone 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 DS0000023994.V301385.R01.S.doc Version 5.2 Page 27 - 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!