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Inspection on 25/05/05 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 25th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

Many of the staff have worked at the home for many years and have a good knowledge of the Residents they care for.

What has improved since the last inspection?

Laminate flooring has been laid in the dining area on the ground floor.

What the care home could do better:

Improve the cleanliness of the Residents bedrooms and deep cleanse or replace carpets and en-suite flooring where necessary. The flooring in the visitor`s toilet also requires a deep clean or replacing if the deep clean is not sufficient. The quality and variety of food served to the Residents should be improved and Residents choices sought. Four Seasons Health Care should provide the Residents and families with an up To date statement of purpose and Service Users Guide as well as a statement of the terms and conditions of Roseworth Lodge.

CARE HOMES FOR OLDER PEOPLE Roseworth Lodge Nursing Home Redhill Road Roseworth Stockton-on-Tees TS19 9BY Lead Inspector Julia Connor Unannounced 25 May 2005 13:50 am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Roseworth Lodge Nursing Home B51-B01 S197 Roseworth Lodge V228302 250505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Roseworth Lodge Nursing Home Address Redhill Road Roseworth Stockton-on-Tees TS19 9BY 01642 606497 01642 617878 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Tamaris Healllthcare (England) Ltd (wholly owned subsidiary of Four Seasons Health Care) Miss Kara Moses Care Home with Nursing 48 Category(ies) of OP - Old age registration, with number PD(E) - Physical Disability - over 65 of places Roseworth Lodge Nursing Home B51-B01 S197 Roseworth Lodge V228302 250505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th November 2004 Brief Description of the Service: Roseworth Llodge 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 B51-B01 S197 Roseworth Lodge V228302 250505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over two days. The first visit commenced at 1.50 p.m. and concluded at 6.15 p.m. The second visit commenced at 10.00 a.m. and concluded at 1.50 p.m. The inspection took two days due to the Inspector investigating a complaint at the same time. Six Residents, one visitor and three members of staff were spoken to during the inspection. An Immediate Requirement was served during the second day of the inspection due to a health safety issue being identified regarding staffing levels. 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. Roseworth Lodge Nursing Home B51-B01 S197 Roseworth Lodge V228302 250505 Stage 4.doc Version 1.30 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Roseworth Lodge Nursing Home B51-B01 S197 Roseworth Lodge V228302 250505 Stage 4.doc Version 1.30 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 4. Residents do not have a statement of the terms and conditions of the home. Residents are not involved in the assessment of their needs. EVIDENCE: The company still does not have terms and conditions for the Residents and/or their families – this is a company wide issue. Out of the four Residents files checked three had not been signed by the Residents or their next of kin to show that they had been involved in the planning of their care. Roseworth Lodge Nursing Home B51-B01 S197 Roseworth Lodge V228302 250505 Stage 4.doc Version 1.30 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10. The qualities of the care plans are of a poor standard and did not demonstrate that the Residents changing needs and personal goals were being met. Resident’s health care needs are met. The Residents felt they were treated with respect. EVIDENCE: The care documentation audited did not contain the required information. Care plans were written once a need had been identified within the assessment process, however they were not evaluated on a regular basis and therefore did not reflect any changing needs that the Resident had. One Resident who had been admitted to the home in April this year had had no home assessment, care plans or risk assessments completed. The only documentation in place was the daily statement. The Resident had been given a pressure-relieving mattress despite no risk assessment for pressure sores having been completed. Roseworth Lodge Nursing Home B51-B01 S197 Roseworth Lodge V228302 250505 Stage 4.doc Version 1.30 Page 9 Doctors, District Nurses, Chiropodists etc are requested to visit the Resident as and when necessary. The Residents who spoke to the Inspector stated that the staff treated them with respect and dignity even though the staff always seemed so busy and tired at the end of their duty shift. Roseworth Lodge Nursing Home B51-B01 S197 Roseworth Lodge V228302 250505 Stage 4.doc Version 1.30 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15 Residents find their daily routine in the home matches their expectations. Social activities are not provided on a regular basis. Residents maintain contact with their family and friends. Residents do not receive a wholesome, appealing and well balanced diet. EVIDENCE: The Residents who spoke to the Inspector stated that they had choice in regards to the their daily living. However, four of the Residents informed the Inspector that the days can be long and boring as there was not much to do and they could only watch so much television; however, the female Residents said that there was the odd game of bingo, which they enjoyed. The Residents informed the Inspector that their family and friends were always made welcome and could visit at any time of the day and evening. One Resident informed the Inspector that her son often visits her before he goes to work (which is early) and the staff still make him welcome. Roseworth Lodge Nursing Home B51-B01 S197 Roseworth Lodge V228302 250505 Stage 4.doc Version 1.30 Page 11 The visitor who spoke to the Inspector stated that the she and her husband do not see as much of the staff as they did and she puts that down to them being too busy and/or tired and feels that it’s the result of the twelve hour shifts the staff now work. She stated that the staff used to pop into her husband and check him when he was in bed and have a chat with her but that no longer happens, as they are too busy. The Residents who spoke to the Inspector voiced their unhappiness in regards to the food. They stated that there were too many times during the week when spaghetti or beans was served at teatime. One Resident also stated that the quality of the meat was poor and that the portions served were too small. One Resident stated that if the Residents were only given a small tea and then two biscuits for supper at 8.00 p.m. it was a long time before breakfast again at 8.30 a.m. the next morning. He stated that you could ask the staff for something to eat but they were so busy he did not bother. All of the Residents stated that it depended on who gave you your morning and afternoon cup of tea whether you got a biscuit or not. When the Inspector asked if cakes or scones were ever served she was told no. On a positive note all of the Residents said that the breakfast was of a good standard. One Resident stated that she loved the mince and dumplings and Sunday lunches they were served. An audit of the kitchen showed that the Cook was not following the Companies four-week menu plan. There was documentation that showed that spaghetti or beans were served on a regular basis during the week. On the first day of the inspection there was a buffet tea, which the staff served to the Residents. Portion sizes varied for each Resident and the Inspector was told that this reflected the Residents appetite. On the second day of the inspection mince and dumplings were being served for lunch, which the Residents stated was nice. Roseworth Lodge Nursing Home B51-B01 S197 Roseworth Lodge V228302 250505 Stage 4.doc Version 1.30 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Procedures are in place for the protection of the Residents. The staff have a good knowledge of the action to take should they become aware of abuse within the home. EVIDENCE: Policies and procedures are in place in relation to adult protection and prevention of abuse. There is also a policy on whistle blowing and staff spoken to stated that they were aware of these policies and explained the action to take should they witness any form of abuse taking place within the home. The home has a copy of the Teeswide No Secrets Protection of Vulnerable Adults guidance. Roseworth Lodge Nursing Home B51-B01 S197 Roseworth Lodge V228302 250505 Stage 4.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 24 and 26 The Residents do not live in a well-maintained environment. The Residents bedrooms are not kept to an acceptable level of cleanliness, which causes many of them distress. EVIDENCE: There were bedrooms that required decorating and this was discussed with the Manager at the time of the inspection, who stated that the handyman had a decorating programme and that he was currently decorating the bedrooms. The Inspector evidenced one bedroom being decorated. Flooring in many of the en-suite facilities required a good clean or replacing. There were bedroom carpets that required a deep clean or replacing. The paint was peeling form the windowsill in bedroom 39. Roseworth Lodge Nursing Home B51-B01 S197 Roseworth Lodge V228302 250505 Stage 4.doc Version 1.30 Page 14 The Residents who spoke to the Inspector voiced their concern regarding the cleanliness of the home and in particular their bedrooms. One Resident stated that he thought the home was not as clean as it used to be because there were not as many cleaners as there had been. He stated that there was only one cleaner on during the day and none on an evening. The Manager confirmed that there was no cleaner on an evening. When the Inspector asked who cleaned the dining room after tea the response was either the care staff or it was left until the cleaner arrived for duty the next morning. The Manager was told that neither of the solutions was acceptable. The majority of the occupied bedrooms had dust on the furniture and/or the carpet needed hoovering. The unoccupied bedrooms were very dusty and looked as if they had not been cleaned for some time. The communal areas were clean and tidy. Residents had personalised their bedrooms to their own taste. Many Residents had taken in furniture from their homes as well as photographs of their loved ones. One Resident had a small fridge in her bedroom, which she kept drinks and yoghurts in. Roseworth Lodge Nursing Home B51-B01 S197 Roseworth Lodge V228302 250505 Stage 4.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29 There is insufficient staff on duty to meet the needs of the Residents. The Residents are not protected by the home’s recruitment practises. EVIDENCE: The Residents who spoke to the Inspector stated that they felt there was insufficient staff on duty. One Resident stated that there were times when she had waited for up to ten minutes for a member of staff to answer the alarm call. She went onto say that when a member of staff did respond to the alarm call they were pleasant and helpful and apologised for the time it had taken to respond to her request for attention. This Resident went onto say that in her opinion there was just far too much for the staff to do. Another Resident also spoke of his concern about the number of staff on duty. He stated that he felt that the shortage of staff meant that he was not receiving the care that he should. He went onto say that he thought the current twelve hours shifts were far to long and they made the staff tired which at times could make their attitude unacceptable. This Resident stated that happy staff made a happy home, which is not the case at present. Roseworth Lodge Nursing Home B51-B01 S197 Roseworth Lodge V228302 250505 Stage 4.doc Version 1.30 Page 16 A visitor who spoke to the Inspector also voiced her concern that there was insufficient staff on duty. She stated that when she sat with her husband in his bedroom several hours could go by without a member of staff entering the bedroom. This visitor put the current staffing problem down to the change of the shift times. She stated that when the staff started to work 8.00 a.m. to 8.00 p.m. they became very tired and everything had to be done early to make sure that the task was done; e.g. the Residents are taken down for their tea approximately half an hour before the meal is served. She went onto say that Residents only went to the toilet if they asked they did not get asked by the staff as they had done in the past. This visitor went onto say that she now worries about the care her husband receives when she is not there. The staff who were interviewed by the Inspector also stated that they felt there was insufficient staff on duty and that they queried if the Residents were actually receiving the care they should. One member of staff stated that there were sufficient staff but the shifts were busy. An audit of the staff rota covering four weeks showed that the home was not staffing to the guidelines set by Four Seasons Healthcare therefore an Immediate Requirement was served to the Manager. An immediate requirement is given when the Inspector had identified a health and safety issue within a home. An audit of four personnel files showed that the home was not following the correct procedure for the recruitment of staff. In one personnel file it was unclear whether the member of staff had had a Criminal Records Bureau (CRB) check. Another two files had only passport photographs, which were unclear. The fourth personnel file showed that the member of staff had had a CRB but the file did not contain proof of address, photograph or evidence that the Manager had seen a copy of the person’s birth certificate. Roseworth Lodge Nursing Home B51-B01 S197 Roseworth Lodge V228302 250505 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 and 37. The staff are not appropriately supervised. The Residents best interests are not safe guarded by the home’s record keeping. EVIDENCE: When the staff were asked if they received supervision they stated they did as the Manager and a member of staff where always available for help and advice; however they agreed that their was no formal supervision where their questions or concerns were documented. An audit of four personnel files showed that the staff did not receive formal supervision. Roseworth Lodge Nursing Home B51-B01 S197 Roseworth Lodge V228302 250505 Stage 4.doc Version 1.30 Page 18 The documentation relating to the Residents contained insufficient information and therefore did not reflect the changing need of the Residents (see standard 7 for further details). The personnel files did not contain the required information. Roseworth Lodge Nursing Home B51-B01 S197 Roseworth Lodge V228302 250505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 2 x 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 2 x x x x 2 x 1 STAFFING Standard No Score 27 2 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x x x x 2 2 x Roseworth Lodge Nursing Home B51-B01 S197 Roseworth Lodge V228302 250505 Stage 4.doc Version 1.30 Page 20 YES 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 2 Regulation 5 Requirement The registered person must provide the Resident with terms and conditions in respect of accommodation to be provided and the amount and method of payment of fees. 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 Service User in the nursing documentation. Also care plans must be formulated following the identification of a care need and evaluated appropriately. The registered person must ensure that food is provided in adequate quantities, be suitable, wholesome and nutritious and is varied and properly prepared and be available at such time as may reasonably be required by Service Users. The registered person must ensure for that for the benefit and comfort of the Service Users the premises be kept clean, hygienic and free from offensive odours. B51-B01 S197 Roseworth Lodge V228302 250505 Stage 4.doc Timescale for action 30th September 2005 2. 7 15 1st September 2005 3. 15 16 1st September 2005 4. 26 23 Immediate Roseworth Lodge Nursing Home Version 1.30 Page 21 5. 6. 27 29 18 19 7. 34 25 8. 37 17 The registered person must ensure that the required number of staff are on duty. The registered person must ensure that full information about staff members employed is obtained and recorded as identified in Schedules 2 and 4 of the Care Homes Regulations 2001. THIS IS OUTSTANDING SINCE THE NOVEMBER 2004 INSPECTION. The registered person must ensure that evidence of financial viability is availability for inspection. THIS IS OUTSTANDING SINCE THE NOVEMBER 2004 INSPECITON. The registered person must ensure that records kept within the home are up to date. Immediate 30TH August 2005 1st September 2005 30th August 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 12 22 36 Good Practice Recommendations Activities should be provided on a regular basis to provide stimulation. All bathing facilities should be upgraded to meet service users needs.Storage facilities to be reviewed and improved. Bathrooms should not be used as storerooms. The registered person should ensure all staff to receive supervision at least 6 times a year and this to be documented. Roseworth Lodge Nursing Home B51-B01 S197 Roseworth Lodge V228302 250505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Unit B, Advance House 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. Extracts may not be used or reproduced without the express permission of CSCI Roseworth Lodge Nursing Home B51-B01 S197 Roseworth Lodge V228302 250505 Stage 4.doc Version 1.30 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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