Inspection on 04/10/05 for Rosewood Residential Care Home

This inspection was carried out on 4th October 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.

Other inspections for this house

Rosewood Residential Care Home 03/08/09

Rosewood Residential Care Home 01/12/08

Rosewood Residential Care Home 03/12/07

Rosewood Residential Care Home 23/08/06

Rosewood Residential Care Home 16/05/05

Rosewood Residential Care Home 20/10/04

Rosewood Residential Care Home 05/04/04

Rosewood Residential Care Home 14/11/03

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

CARE HOMES FOR OLDER PEOPLE Rosewood Residential Care Home Cobham Terrace, Bean Road Greenhithe Kent DA9 9JB Lead Inspector Sally Hall Unannounced Inspection 4th October 2005 10:00 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.V254056.R01.S.doc Version 5.0 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.V254056.R01.S.doc Version 5.0 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.V254056.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th May 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. Rosewood Residential Care Home DS0000023994.V254056.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced Inspection at Rosewood took place on 4th October 2005 at 10.00am. The Inspector agreed and explained the inspection process with the Head of Care and the senior carer. Time was spent reading documentation and records, including care plans and policies and procedures. A tour of premises was not undertaken during this visit. The focus of the inspection was to assess Rosewood in accordance with the National Minimum Standards for Older People. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. What the service does well: What has improved since the last inspection? What they could do better: The daily records need a little more detail, as staff are doing a lot for the service users but this is not always being recorded. The entries also need to show the time of the events and care that was provided rather than the time the staff write the report. Medication needs to be monitored closely and the Medication Record Sheets need to have the service users’ information fully completed. Rosewood Residential Care Home DS0000023994.V254056.R01.S.doc Version 5.0 Page 6 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.V254056.R01.S.doc Version 5.0 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.V254056.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4,5. 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. EVIDENCE: Service users and or their family are encouraged to visit the home before the assessment process begins. Service users are visited either at home or in hospital and their needs are assessed prior to being offered a place at the home. This is to ensure that the home is able to meet the needs of the individual, once admitted the assessment process continues. The staff at the home receive training to ensure they have the necessary skills and knowledge to meet the needs of the service users. The service user is offered a place only if the home can meet their needs. All service users that are admitted to the home do so on a 28-day trial basis, if this is successful then the service user is offered a permanent contract. Rosewood Residential Care Home DS0000023994.V254056.R01.S.doc Version 5.0 Page 9 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, Service users’ personal, social and health care is provided according to service users’ needs and wishes. Service users are protected by the home’s medication policies, procedures and good practice, however at the time of the inspection, the information printed on the Medication Record Sheets by the chemist was incomplete and this needs to be addressed. EVIDENCE: Care records included risk assessments, moving and handling assessments, nutrition assessments, details of healthcare appointments and the outcomes. The service users’ care plans were 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. Guidance was in place for staff to manage specific behaviour for individual service users. The daily record, could be improved if it contained more detail, it was not possible to ascertain what personal care the service users had received. The times that events happened and care that was provided was not recorded; the staff are recording instead the time they wrote the report. Gaps were also found between entries in the daily records viewed. The staff were observed doing a lot for and with the service users but little of this work has been recorded. Rosewood Residential Care Home DS0000023994.V254056.R01.S.doc Version 5.0 Page 10 The home has a room it uses to store medication and the trolley used to transport medication around the home. The area was clean and provided adequate storage. Those Medication Record Sheets viewed did not contain all the required service user information; the senior carer did explain that the home has approached the pharmacy several times about this problem. The staff at the home need to ensure that if the pharmacy has not provided the information then staff need to record it. The audit of medication did show up some minor errors, and it was noted that some medication that came in to the home after the start of the month had not been signed in. The home does provide appropriate storage for controlled medication when required. Rosewood Residential Care Home DS0000023994.V254056.R01.S.doc Version 5.0 Page 11 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, 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 offer both choice and variety, however, the main meals of the day are timed close together. EVIDENCE: The home employs an activities person 6 days per week from 10am until 3pm, including some weekends. The records showed that activities vary and include games, bingo, reminiscence groups, gentle exercise games etc. The head of care also explained that sometimes the activity person read and then talked about the daily newspaper, or sat with one person spending some time chatting 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, however the daily record did not include details of the activities they had participated in. The staff explained how families are encouraged to visit and are offered refreshments on arrival. They said that some families take their relative out and occasionally a trip is arranged by the home; two theatre trips for Christmas time have been booked. The home also arranges for entertainers to come in the home. Posters seen displayed around the home showed that an Elvis impersonator was coming to sing for someone’s Rosewood Residential Care Home DS0000023994.V254056.R01.S.doc Version 5.0 Page 12 birthday the next day. 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 the senior carer said that photographs of the meals are used to help service users with dementia to make a choice. During the lunch time, it was observed that some staff were serving meals with out interacting with the service users, this approach was discussed with the Head of Care and the senior carer. The meals being served looked and smelt appetising. All service users spoken with said they enjoyed their meal. Rosewood Residential Care Home DS0000023994.V254056.R01.S.doc Version 5.0 Page 13 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 Service users and their relatives are provided with a copy of the complaints procedure. The management of the home protects the service users’ legal rights. The home’s 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 within the Service User Guide and Statement of Purpose. The home has not received any complaints since the last inspection but has received a number of cards of thanks and complimentary letters. The head of care explained that the home always applies for postal votes for it’s service users and families are asked to assist them in the completion of these if they need help. The home’s adult protection policies were viewed and included a ‘whistle-blowing’ policy for staff. The policy does need reviewing in light of the recent changes in protocols; the local authority has distributed the new document detailing these. The home could not find this new document and were advised to contact the local authority for a copy. Staff spoken to did not know about POVA and it implications, training in adult protection, which includes POVA is a requirement for all staff. Rosewood Residential Care Home DS0000023994.V254056.R01.S.doc Version 5.0 Page 14 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): The environment was not inspected during this visit. EVIDENCE: Rosewood Residential Care Home DS0000023994.V254056.R01.S.doc Version 5.0 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 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): 27,29 The numbers of staff employed are sufficient to provide the level of care required and the Provider is mindful that as the occupancy of the home increases so must the numbers of staff. The service users are protected by the home’s recruitment procedures. EVIDENCE: The head of care explained the staff cover provided in the home. There are two senior carers and five care staff on duty in the morning, with one senior care only in the afternoon. The home employs three domestic staff, a cook, kitchen assistant, laundry person and a maintenance man. The training records were not seen but in the staff supervision files there was evidence that staff have undertaken various training courses, these courses included Dementia Awareness training. It was recommended during the last inspection that staff undertook accredited dementia training, adult protection training, etc but this was not fully evidenced during this inspection. Occupation of the home’s extension has commenced. The head of care stated that the manager is currently recruiting staff, as she intends to increase the staffing levels to meet the increase in need. In the staff files sampled evidence was seen that new staff are asked to complete an application form, their interview is recorded, references are taken up and CRB checks are sent for. The staff are issued with a contract and have Rosewood Residential Care Home DS0000023994.V254056.R01.S.doc Version 5.0 Page 16 a probationary period. The files also contained the relevant ID and staff photograph. Rosewood Residential Care Home DS0000023994.V254056.R01.S.doc Version 5.0 Page 17 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): 32,33,35,36. The senior staff appeared open and approachable to service users and staff, the atmosphere of the home was friendly and welcoming. The home monitors the quality of the care it provides to service users. There are robust systems in place to ensure service users are protected from financial abuse. Staff are benefiting from formal supervision, however the required number of sessions will not be met by the end of the year. EVIDENCE: The head of care confirmed that people’s opinions about the care provision in the home are canvassed yearly. The home also has regular staff meetings; these are usually held on a monthly basis. The home also sends the families a newsletter to keep them abreast of what is going on in the home. The home has a procedure for the handling of service users’ personal money. The recorded account balances were audited with the service users personal money, which was kept safely in the home. These checks showed that the Rosewood Residential Care Home DS0000023994.V254056.R01.S.doc Version 5.0 Page 18 money held corresponded with those accounts sampled. All service users’ money is held separately and receipts are kept for all transactions. Staff supervision has started and all staff have formal supervision with the home manager. The formal supervision is not happening regularly enough to ensure it happens at least six times a year. The head of care confirmed that there is a plan to train senior staff to also do staff supervision. Given the numbers of staff employed this will help to ensure that all staff have the required supervisions each year. Rosewood Residential Care Home DS0000023994.V254056.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 X X X X X X X x STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x 3 3 x 3 2 x x Rosewood Residential Care Home DS0000023994.V254056.R01.S.doc Version 5.0 Page 20 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 12 13(2) Requirement The registered person ensures that there is a policy and staff adhere to the procedures for the receipt, recording, storage, handling administration and disposal of medicines, and service users are able to take responsibility for their own medication if they wish, within a risk management framework. Timescale for action 30/11/05 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 If the service users are not able to have a valid role in the formation of the care plan then families or an advocate(if they have one) should be encouraged to get involved. The daily record needs to show more detail and include the times of events and care provision The registered person ensures that staff supervision arrangements are put into practice for all staff to the required level. DS0000023994.V254056.R01.S.doc Version 5.0 Page 21 2 OP36 Rosewood Residential Care Home 3 OP18 Review the adult protection policy and procedure once you have received the new protocols from the local authority. Ensure all staff have the required training, this includes ancillary staff. Rosewood Residential Care Home DS0000023994.V254056.R01.S.doc Version 5.0 Page 22 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.V254056.R01.S.doc Version 5.0 Page 23 - 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. 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