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Inspection on 20/07/06 for Roseworth Lodge Nursing Home

Also see our care home review for Roseworth Lodge Nursing Home for more information

This inspection was carried out on 20th July 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

The Inspector evidenced a good rapport between the Residents` and their carers. One Resident informed the Inspector that he liked the home and that the staff were nice but it was not as good as being in his own home. He stated that the staff allowed him his independence, for example he could go into community whether it was to visit his friend in hospital or to meet friends in the pub, as long as he told them where he was going and approximately what time he would be back. Another Resident stated that she liked living at the home as it was lovely and the `girls were nice and helpful` and she especially liked having someone to take her and stay with her when she had to go to the hospital. A third Resident informed the Inspector that the home was a nice place to live and the girls looked after her well. She stated that her family visited her regularly and that she `enjoyed just sitting and watching the world go by`

What has improved since the last inspection?

The entrance to the home has been decorated. The dining room has been decorated and new furniture purchased. All of the corridors and lounges have been decorated and new lounge chairs have been purchased for two of the lounges. The main lounge on the ground floor has had a new carpet laid; five sets of bedroom furniture, a hoist and a stand aid have been purchased.

What the care home could do better:

Care documentation should continue to be improved to contain up to date information. Activities should commence as soon as possible for those Residents` who wish to participate. Training should be provided especially the protection of vulnerable adults and personnel files should contain the required information.

CARE HOMES FOR OLDER PEOPLE Roseworth Lodge Nursing Home Redhill Road Roseworth Stockton-on-Tees TS19 9BY Lead Inspector Julia Connor Key Unannounced Inspection 10:00 20th July 2006 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 Roseworth Lodge Nursing Home DS0000000197.V299467.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. Roseworth Lodge Nursing Home DS0000000197.V299467.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Roseworth Lodge Nursing Home Address Redhill Road Roseworth Stockton-on-Tees TS19 9BY 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) 01642 606497 01642 617878 www.fshc.co.uk Tamaris Healthcare (England) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Miss Kara Moses Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability over 65 years of age (0) of places Roseworth Lodge Nursing Home DS0000000197.V299467.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Five adults aged 55 years are able to be accommodated in the home. Date of last inspection 4th October 2005 Brief Description of the Service: Roseworth Lodge is a care home providing both nursing and personal care for older people. It is a two-storey purpose built home providing single accommodation for 48 Residents; the bedrooms are a minimum of 10 sq.m. There is a passenger lift giving access to the upper floor. There are two lounges (one of which is for Residents who smoke) and a large communal dining room on the ground floor. There are four lounges and a small dining room on the first floor. The home is close to local shops and amenities with a car park at the front of the home. Roseworth Lodge Nursing Home DS0000000197.V299467.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried on the 20th July, it commenced at 10.00 a.m. and concluded at 4.45 p.m. Three Residents’ and two members of staff were spoken to during the inspection. No relatives’ returned comment cards; three Residents’ returned their comment cards. The current fees structure is £345.00 to £360.00 a week depending on the level of care the Resident requires. What the service does well: What has improved since the last inspection? The entrance to the home has been decorated. The dining room has been decorated and new furniture purchased. All of the corridors and lounges have been decorated and new lounge chairs have been purchased for two of the lounges. The main lounge on the ground floor has had a new carpet laid; five sets of bedroom furniture, a hoist and a stand aid have been purchased. Roseworth Lodge Nursing Home DS0000000197.V299467.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Roseworth Lodge Nursing Home DS0000000197.V299467.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 Roseworth Lodge Nursing Home DS0000000197.V299467.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 and 3 Quality in this outcome area is GOOD. This judgement has been made using available evidence including a visit to this service. Residents’ have a written contract/statement of terms and conditions with the homes; and have their needs assessed prior to them being admitted to the home. EVIDENCE: The Inspector evidenced six of the written contract/statement of terms and conditions with the homes, which had been signed by the Residents’ next of kin. There was evidence in the Residents’ care documentation that they had been assessed either by the Social Worker or the discharging ward prior to moving into the home. The Manager carries out a pre admission assessment. Roseworth Lodge Nursing Home DS0000000197.V299467.R01.S.doc Version 5.2 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 and 10 Quality in this outcome area is ADEQUATE. This judgement has been made using available evidence including a visit to this service. The quality of the recording within the care documentation had improved but further work is required to meet the standard. Residents’ health care needs are met. No Resident currently administers their own medication. The home has a policy and procedure for medication. Residents’ feel they are treated with respect and their right to privacy acknowledged. Roseworth Lodge Nursing Home DS0000000197.V299467.R01.S.doc Version 5.2 Page 10 EVIDENCE: Three sets of care documents were audited and although they had improved from the last inspection in October 2005 further work was required so they reflected the changing needs of the Resident. Within one set of Resident’s documentation the admission assessment was not dated and did not give sufficient detail as to what care this Resident required. Another Resident’s risk assessment had not been updated to show that she was no longer at risk of falling from her wheelchair as she was being nursed in bed due to her deteriorating condition. On a positive note the majority of the care plans had been reviewed as stipulated and the quality of the information contained within the daily record had improved. Doctors, District Nurses, Chiropodists etc are requested to visit the Resident as and when necessary. There is a policy and procedure for the receipt, recording, storage, handling, administration and disposal of medicines. Four Seasons Healthcare Ltd has a contract with a Pharmacy to take away the homes unused medication. One Resident stated the ‘girls look after me well’ and always made sure that she visited the hairdresser. Another Resident stated that ‘the staff were nice and helped her when she needed it’ and went onto tell the Inspector how she had attended the hospital for an x-ray with a member of staff who had made sure that she understood what the staff had said to her. A third Resident stated that it was not as good as being at home but ‘the girls were very good’ and he was independent, doing everything for himself and always asked the girls if they needed him to do anything for them. Roseworth Lodge Nursing Home DS0000000197.V299467.R01.S.doc Version 5.2 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, 14 and 15. Quality in this outcome area is GOOD. This judgement has been made using available evidence including a visit to this service. The Residents’ recreational needs are not met therefore they do not receive any mental stimulation. Residents’ maintain contact with their family and friends and are encouraged to make decisions regarding their every day lives. The Residents’ are served a wholesome and appealing diet in pleasant surroundings. EVIDENCE: The Manager stated that she had recruited an activities person who would commence work as soon as her references and Criminal Records Bureau check were received. The staff that spoke to the Inspector stated that there was a game of Bingo a couple of times a week, which the Residents’ enjoyed. The three Residents’ who spoke to the Inspector stated that there was little to do, however one Resident stated that ‘she was happy to sit and watch the world go by’. Another Resident stated that she watched the Bingo but did not want to participate. One Resident informed the Inspector that there were no activities but he did not mind as he like to read and visit the pub where he met old friends. Roseworth Lodge Nursing Home DS0000000197.V299467.R01.S.doc Version 5.2 Page 12 There were visitors’ in the home on the day of the inspection and one Resident had been taken out for a few hours by her son. The Residents’ who spoke to the Inspector stated that their visitors’ were always made welcome. Residents’ informed the Inspector that they were encouraged to be as independent as they could be and to make decisions regarding their every day lives. One Resident informed the Inspector that he liked to visit his friend who was in hospital and all the staff asked of him was for him to let a member of staff know where he was going and approximately what time he would be back. The dining room has recently been decorated and Residents’ and staff stated that it was a nicer place in which to eat. All three of the Residents’ who spoke to the Inspector stated that the food was good and an alternative to what was being served was available. One Resident stated that she liked an egg sandwich for her breakfast but was always asked if she wanted something different. On the day of the inspection the meal served was steak and dumplings with potatoes, green beans and swede; with fresh fruit salad as a dessert. There was staff available to offer assistance to those Residents’ who required help. The atmosphere was pleasant and Residents’ were interacting with each other and the staff. There was a good stock of fresh and dried food. Roseworth Lodge Nursing Home DS0000000197.V299467.R01.S.doc Version 5.2 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 and 18 Quality in this outcome area is GOOD. This judgement has been made using available evidence including a visit to this service. Residents’ are confident that their complaints will be listened to, taken seriously and acted upon. There are polices and procedures in place to follow should abuse be reported. EVIDENCE: There is a complaints policy and procedure in place, which outlines the stages the complainant should take to make a formal or informal complaint. Complaints are recorded appropriately and are available for inspection. There have been four complaints in the last twelve months. The Residents’ who spoke to the Inspector were confident that should they make a complaint it would be taken seriously and acted upon. Policies and procedures are in place in relation to adult protection and prevention of abuse. The home has a copy of the Teeswide No Secrets Protection of Vulnerable Adults Guidance. There was no evidence that training had been given regarding the Protection of Vulnerable Adults, Roseworth Lodge Nursing Home DS0000000197.V299467.R01.S.doc Version 5.2 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): 19, 20, 22 and 26 Quality in this outcome area is GOOD. This judgement has been made using available evidence including a visit to this service. Residents’ live in a predominantly well-maintained environment, bedrooms meet their needs and specialist equipment is available. On the day of the inspection the home was clean, pleasant and hygienic. Residents’ have access to safe and comfortable outdoor communal facilities. EVIDENCE: A lot of decorating and renewal of furniture has taken place since the October 2005 inspection for example the front entrance and main dining room had been decorated and new dining room furniture purchased. All of the lounges had been decorated and two of the lounges had new lounge chairs. The main lounge on the ground floor had had a new carpet laid. their Roseworth Lodge Nursing Home DS0000000197.V299467.R01.S.doc Version 5.2 Page 15 The Inspector was informed that the redecoration programme had not finished, as there were still bedrooms that required new carpets or new flooring for the en-suites. The patio area had seating (with sun shades) for the Residents’ and families to use. However one Resident informed the Inspector she did not sit outside because it was too hot even in the shade and preferred to stay in her room where is it was cool. On the day of the inspection the home was clean and odour free. Roseworth Lodge Nursing Home DS0000000197.V299467.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is POOR. This judgement has been made using available evidence including a visit to this service. The duty rota indicated the appropriate number of staff where present in the home on the day of the inspection. Staff are being trained to NVQ level 2 which should ensure that they can meet the Residents’ needs. The Residents are not protected by the home’s recruitment practices and staff do not receive sufficient training to enable them to care for the Residents’. EVIDENCE: An audit of the duty rota showed that there was one qualified nurse and four care assistants’ on duty for the morning shift. One qualified nurse and three care assistants’ on duty for the evening shift and one qualified nurse and either two or three care assistants’ on duty on a night shift as stipulated on the Four Seasons Health Care Northern Staffing Grid. The Residents’ who spoke to the Inspector stated that they thought there was sufficient staff on duty but if they did have to wait it was due to the staff being so busy. The staff that spoke to the Inspector stated that there were times when they felt stretched, especially on the evening shift. The Manager recorded in the pre-inspection questionnaire that 66 of the care staff had an NVQ level 2 or 3 in care. Roseworth Lodge Nursing Home DS0000000197.V299467.R01.S.doc Version 5.2 Page 17 Six personnel files were audited. Only one file complied with the requirements stipulated in Schedule 2 of the Care Home Regulations 2001. The remaining five files had very little proof of the person’s identity for example a recent photograph. Six training files were audited and showed that only mandatory training had taken place for example fire and manual handling. One qualified nurse had attended the venepuncture course (the ability to take blood from a Resident) and a wound management training session. It would be beneficial for the care assistants to receive Resident specific training and the protection of vulnerable adults training. Roseworth Lodge Nursing Home DS0000000197.V299467.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is GOOD. This judgement has been made using available evidence including a visit to this service. The Manager is a registered general nurse with many years experience of working in the care home setting. There was evidence that quality assurance and quality monitoring takes place. The Residents’ personal finances are safeguarded and the required polices and procedures are in place, which should ensure that the health, safety and welfare of the Residents’ are promoted and protected. EVIDENCE: The Residents’ and staff spoke well of the Manager. Roseworth Lodge Nursing Home DS0000000197.V299467.R01.S.doc Version 5.2 Page 19 There is a quality assurance and quality monitoring system in place within the home. The audits cover the different departments within the home e.g. Residents care documentation, the kitchen and the environment. Regulation 26 visits are forwarded to the Commission for Social Care Inspection. The Residents’ combined monies are kept in an interest bearing account as per Four Seasons Health Care policy. The home has Health and Safety Policies and Procedures in place. The Manager recorded in the Pre-inspection questionnaire that equipment was maintained as required, for example the emergency lighting were serviced in April 2006 and the hoists’ were serviced in March 2006. Roseworth Lodge Nursing Home DS0000000197.V299467.R01.S.doc Version 5.2 Page 20 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Roseworth Lodge Nursing Home DS0000000197.V299467.R01.S.doc Version 5.2 Page 21 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 OP7OP7 Regulation 15 Requirement In order to demonstrate the home’s capacity to meet the assessed needs of the Service User, the registered person must ensure that there is sufficient information about the Resident in the nursing documentation. Care plans must be evaluated as stipulated. The registered person must not employ a person until the appropraite checks have taken place – proof of identity e.g. a recent photograph of the prospective staff member. The registered person must ensure that staff receive training appropriate to the work they perform. Timescale for action 30/09/06 2. OP29OP29 19 20/07/06 3. OP18OP18 OP30OP30 18 30/09/06 Roseworth Lodge Nursing Home DS0000000197.V299467.R01.S.doc Version 5.2 Page 22 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 Refer to Standard OP12OP12 OP22OP22 Good Practice Recommendations Activities should be provided on a regular basis to provide stimulation. All bathing facilities should be upgraded to meet Residents’ needs. Storage facilities to be reviewed and improved. Roseworth Lodge Nursing Home DS0000000197.V299467.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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. 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