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Inspection on 03/07/08 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 3rd July 2008.

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 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

Roseworth Lodge is well managed and provides people that use the service with a good standard of care. Care plans are detailed, include evidence of personal choice and are updated on a regular basis. The home is purpose built, spacious, comfortable and well maintained. Furniture provided is of a good standard and the bedrooms of people that use the service are personalised, many having brought items of furniture and personal belongings from home. Comments made from people that use the service, relatives and surveys received included, "The staff are always there for you" and "The staff are very nice everyone takes care of you" and, "The home is good, the manager is approachable and they look after you well".

What has improved since the last inspection?

Numerous improvements have been made since the last inspection. The manager and staff at the home have worked extremely hard to improve the standard of care planning in the home environment. Files of people that use the services examined during the inspection were found to be well written. Care plans encouraged independence and detailed the level of assistance required from staff and what the person using the service could do independently. The manager ensures that a robust recruitment procedure is followed, gaps in employment are explored and two references are obtained, and where possible one being from the last employer. Training provided to staff has improved. A rolling programme of mandatory training is now available to staff. The number of staff qualified to NVQ Level 2 in care has increased to 54%. All but one of the requirements identified at the last inspection have been addressed.

CARE HOMES FOR OLDER PEOPLE Roseworth Lodge Nursing Home Redhill Road Roseworth Stockton-on-Tees TS19 9BY Lead Inspector Katherine Acheson Key Unannounced Inspection 3rd July 2008 10:10 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.V366407.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.V366407.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 roseworth.lodge@fshc.co.uk www.fshc.co.uk Tamaris Healthcare (England) Ltd Julia Foster 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.V366407.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Five adults aged 50 years are able to be accommodated in the home. The home is able to provide one place to a named resident under the age of 65 in the category for Mental Disorder (MD), should this person no longer require the service, CSCI must be notified. 18th July 2007 Date of last inspection Brief Description of the Service: Roseworth Lodge is registered to provide nursing and personal care to fortyeight older people. The home is a two-storey purpose built facility providing single room accommodation. 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 people who use the service and wish to 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. The home currently charges fees in the range £408 to £547 per week. Roseworth Lodge Nursing Home DS0000000197.V366407.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two stars. This means that people who use this service experience good quality outcomes. This announced key inspection was carried out on the 3rd July 2008 and lasted for just over seven hours. The reason for the inspection was to see how good a job the home does in meeting the National Minimum Standards set by the government for care homes. Numerous records including care plans, complaints and staff recruitment and training records were examined. The Inspector spoke at length to five people that use the service and in general to others. The Inspector also spoke to two relatives; two care staff, the handyman, the office administrator and the manager of the home. The Inspector walked around the home with the manager. Before the inspection ten surveys for people who use the service and ten surveys for relatives, carers and advocates were sent to the home for the manager to distribute accordingly. Surveys requested feedback on the service and staff provided. Also sent to the home were five surveys for staff. Surveys requested feedback on care given and the way the home is run. We received two surveys from people who use the service, four from relatives, carers and advocates and two surveys from staff. Comments received can be read within the report. The manager completed and returned an Annual Quality Assurance Assessment, (AQAA). The AQAA is the services self-assessment of how they think they are meeting national minimum standards. This information was received before the inspection and was used as part of the inspection process. The details of any issues identified at this inspection requiring action are to be found at the back of this report. Roseworth Lodge Nursing Home DS0000000197.V366407.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: Additional medication training and in-house assessment in line with best practice guidance must be provided to all staff involved in the administration of medicines. Having well trained competent staff helps to reduce the risk of medication errors. The manager must continue to monitor the temperature of the medication room to ensure that medication is kept at a temperature that is safe to use. Roseworth Lodge Nursing Home DS0000000197.V366407.R01.S.doc Version 5.2 Page 7 The homes complaint procedure needs to be updated to include all of the required information to help to ensure that complaints are dealt with promptly and appropriately. It was highlighted at the last inspection that two shower rooms in the home environment had stained flooring, dirty grouting to tiles and missing drain covers, which resulted in an unpleasant odour. Work to refurbish bathrooms and eliminate the odour had not commenced at the time of the inspection visit, however the Commission for Social Care Inspection has since been informed that work has commenced. The door leading to the lounge designated for those people that wish to smoke does not close properly and needs repair or replacing. The manager must achieve and NVQ level 4 in Management. 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. The summary of this inspection report can be made available in other formats on request. Roseworth Lodge Nursing Home DS0000000197.V366407.R01.S.doc Version 5.2 Page 8 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.V366407.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards assessed 3 and 6 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Assessments of people who are to use the service are carried out to ensure that the home can meet their needs. EVIDENCE: The manager said that before going into the home people who are to use the service are assessed by a social worker or health care professional. Staff at the home then carry out their own pre-admission assessment either visiting the person in their own home or at hospital to ensure that the needs can be met at Roseworth Lodge. If people are self-funding then an assessment is usually only carried out by experienced staff working at the home. Roseworth Lodge Nursing Home DS0000000197.V366407.R01.S.doc Version 5.2 Page 10 The manager said that Stockton Borough Council pay for and reserve a small number of beds in the home. She said that these beds are usually used to take emergency admissions and as such staff at the home can’t do a preadmission assessment. An assessment is carried out by a social worker and sent to the home before admission. Care plans of people using the service looked at during the visit contained appropriate assessments. Surveys received from people that use the service and relatives in general felt that they received enough information about the home to decide if it was the right place to come into. One person that uses the service who had just been admitted to the home said, “I didn’t get a visit from anyone from the home before I came in, but they were not given enough time. As soon as I did come in the manageress and her assistant came to see me they couldn’t have been more helpful”. The home does not provide intermediate care and as such standard 6 does not apply. Roseworth Lodge Nursing Home DS0000000197.V366407.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards assessed 7, 8, 9 and 10 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a good standard of care, people using the service are happy and care received is based on their individual needs. Procedures are in place to ensure good management of medication to ensure safety of people using the service. The home must ensure that all medicines are stored at the temperature recommended by the manufacturer so that they are safe to use. EVIDENCE: Three plans of care were looked at during this visit all of which contained detailed information about the person using the service and the help they needed. Care plans were individual to the person and contained evidence of personal choice. Care plans were signed by the person using the service and/or the family. Roseworth Lodge Nursing Home DS0000000197.V366407.R01.S.doc Version 5.2 Page 12 It is evident that since last inspection that the manager and staff have worked extremely hard to improve the standard of care plan documentation within the home. One plan of care detailed how independence could be encouraged and the person supported to wash and dress. Another plan of care detailed that a person preferred their bath just before bed and that they liked to use bubble bath. Another described in detail information on when the person needed medication to control pain. Care plans were well organised and easy to read. Care plans were updated on a monthly basis or more often if required. Files of people who use the service included healthcare visits and appointments. The records showed the regularity of visits for treatment from: doctors and district nurses, opticians, dentists and other healthcare specialists. People who use the service, relatives spoken to during the inspection by the Inspector, and surveys received said, “The staff couldn’t be more helpful” “The staff are very tolerant” “The staff are very good, they look after me very well. I am a lot better than when I came in” “Some staff are better than others” “ The home is top class all of the staff are very good” People who use the service confirmed that their dignity and privacy was respected. During the inspection arrangements for receiving, storing, administering, recording and disposing of medication were observed and examined. The ordering and returning of unused medication was good and records were well written. Nurses working at the home give out medication to people using the service. The manager said that some nurses working at the home have received medication training/updates, however some have not. The manager said that the provider has developed a system in which to supervise the practice of nurses to ensure they follow safe and best practice and that this is to be introduced over the coming weeks. During the visit a medication audit of a person that uses the service was carried out. Medication administration charts had been completed correctly Roseworth Lodge Nursing Home DS0000000197.V366407.R01.S.doc Version 5.2 Page 13 and the stock balance of medication belonging to the residents was correct, matching up with medication ordered, received, administered and remaining in the home. Appropriate codes were being used when medication was not being given for a particular reason. It was noted that on occasions the temperature of the medication room was too warm for the storage of medication. The manager said that she is monitoring this and if necessary will take appropriate action to address the situation. Roseworth Lodge Nursing Home DS0000000197.V366407.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards assessed 12, 13, 14 and 15 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appropriate and enjoyable activities do take place at the home and people are able to exercise choice and control. Visitors are encouraged and made to feel welcome at anytime. Food provided is enjoyed by people who use the service and provides them with a wholesome balanced diet. EVIDENCE: The home employs an activity co-ordinator to plan, arrange and take part in activities for people who use the service. The activity co-ordinator usually works Monday to Friday either 10:00am until 5:00 pm, however this can be flexible to fit in with functions or parties that the home is hosting. Activities taking place on a daily basis include, bingo, dominoes, gentle exercise, quizzes and regular visits to the local supermarket. Monthly visits are made to the home by a company called Motivation and Co who organise Roseworth Lodge Nursing Home DS0000000197.V366407.R01.S.doc Version 5.2 Page 15 games, activities and encourage reminiscence amongst people that use the service. Comments made in respect of activities and outings included, “The activities are good “ and, “There is enough going on for me. I do a lot of crosswords. I like to do exercises with staff, but I don’t like bingo”. The manager said that the home uses a local taxi company to transport people that use the service. She said that people that use the service have been on a recent trip into town to shop and have a coffee. People that use the service are supported to take responsible risks. One person places a bet on the horses on a daily basis and visits the local social club for a pint, whilst another walks to the shops each day to get the morning paper. Files of people who use the service sampled during the visit all contained a plan of care in respect of social activities, which included interests, likes and dislikes. Visits from relatives and friends are welcome at any time. Relatives are able to spend time and enjoy a meal at the home. One relative spoken to during the inspection said, “We are always made to feel welcome the staff fall over you to help”. The manager said that people that use the service are supported to practice their religion, Ministers from the local Church of England and Roman Catholic churches visit on a regular basis and one person goes out to church every Sunday with their family. The lunchtime of people who use the service was observed. The lunchtime menu of the day was lamb stew or braising steak with potatoes, carrots and cauliflower and for dessert there was cherry cheesecake, yoghurt or fruit. Tables were appropriately set. Lunchtime was relaxed with staff supporting and encouraging those people that needed help at mealtime. People who use the service and surveys received in general spoke positively about the food provided. Comments made included, “Today we had lamb casserole, the vegetables were nice, not over-cooked and the cherry cheesecake was lovely.” “I had braising steak, it was nice. We get enough food and always a choice.” “The food is smashing. The staff bend over backwards to make sure he/she gets what he/she likes.” Roseworth Lodge Nursing Home DS0000000197.V366407.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards assessed 16 and 18 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are confident that their complaints would be listened to, taken seriously and acted upon, however the complaint procedure needs to be updated to include all of the required information to help to ensure that complaints are dealt with promptly and appropriately. Adult protection procedures are in place, which helps to protect people that use the service from abuse. EVIDENCE: The home has a complaint procedure that is displayed in the main entrance of the home. The complaint procedure needs to be updated to include stages and timescales for action, who to contact including contact details of Social services. The home keeps a record of complaints, investigation undertaken and outcome. There have been seven complaints made in the last twelve months. Surveys received from people that use the service and people spoken to during the visit said that they know how to make a complaint and who to complain to. Roseworth Lodge Nursing Home DS0000000197.V366407.R01.S.doc Version 5.2 Page 17 The home has an adult protection policy that details action that staff should take if abuse is suspected. The manager said that staff receive adult protection training on a regular basis, staff spoken to during the visit confirmed that this was the case. The manager and staff spoken to during the visit were aware of action to take if abuse is suspected. There have been no adult protection referrals made in the last twelve months. Roseworth Lodge Nursing Home DS0000000197.V366407.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards assessed 19, and 26 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of the environment within this home is good providing the people who live there with and attractive, homely and comfortable place to live. Refurbishment of bathroom and shower areas will further enhance this. Safety could be compromised if the door leading to the lounge area for those people who wish to smoke is not repaired or replaced. EVIDENCE: Roseworth Lodge is a modern, purpose built facility that is registered to provide personal and nursing care to forty-eight older people. The home is located close to shops and amenities. The home is a two-storey building that provides single room accommodation. There is a passenger lift giving access to the upper floor. There are two lounges (one of which is for people that use Roseworth Lodge Nursing Home DS0000000197.V366407.R01.S.doc Version 5.2 Page 19 the service and wish to 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 Inspector walked around the home with the Manager. The home in general is well maintained. Lounge areas are pleasant and homely and furniture provided is of a good standard. Since last inspection one of the bathrooms on the ground floor of the home has been refurbished and a specialist bath that adjusts in height has been fitted. The Manager said that two other bathrooms are to be refurbished in the near future. It was pointed out at the last inspection that two shower rooms had stained flooring, dirty grouting to tiles and missing drain covers, which resulted in an unpleasant odour. Work to refurbish bathrooms and eliminate the odour had not commenced at the time of the inspection visit, however the Commission for Social Care Inspection has since been informed that work has commenced. It was also noted that the door leading to the lounge designated for those people that wish to smoke did not close properly and needed repair or replacing. The manager said that action had been taken to address the situation and work would be complete in two weeks. A number of bedrooms were visited, these were observed to be very personal, with people having their own furniture such as tables and chairs as well as more personal items. The manager said that there is a rolling programme in place for re-decoration of bedrooms. Since last inspection some bedroom furniture in the home has been replaced with the plan to replace more over the next twelve months. New bedding and pillows have also been purchased. The manager said that the home has a policy in respect of control of infection. Staff spoken to during the inspection said that there was always a plentiful supply of protective clothing. Appropriate laundry facilities are in place. On the day of the inspection the home was observed to be clean and odour free with the exception of the unpleasant odour coming from the shower rooms. Roseworth Lodge Nursing Home DS0000000197.V366407.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards assessed 27, 28, 29 and 30 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes recruitment procedure is robust which helps to ensure that people are protected. Staff are trained, skilled and in sufficient numbers to meet the needs of people living at the home. EVIDENCE: At the time of the inspection there were thirty-two people living at the home. The homes duty rota showed that between the hours of 8am and 8pm there are four or five care assistants on duty and three care assistants on night duty. There is also one trained nurse on duty during the day and night. In addition to this the manager of the home is supernumerary and works full time. People who use the service who were spoken to during the visit and all but one of the surveys received felt that there was sufficient staff on duty. The AQAA detailed that 54 of care staff working at the home have achieved a minimum qualification of NVQ level 2 in care. The homes recruitment procedure is robust. The files of three staff were looked at during the visit. Evidence was available to confirm that appropriate Roseworth Lodge Nursing Home DS0000000197.V366407.R01.S.doc Version 5.2 Page 21 POVA FIRST/Criminal Record Bureau checks are carried out on staff. It was observed that some staff start working at the home on receipt of a satisfactory POVA FIRST check and work supervised until the home receive a satisfactory Criminal Record Bureau check, this should be the exception rather than the rule. Files examined contained all of the required information including, proof of identity, photograph and two references. One file looked at during the visit was that of a trained nurse. Records were available to confirm that appropriate checks with the Nursing Midwifery Council were carried out to check that the nurse was eligible to practice before they started working at the home; however, the yearly check thereafter had not been carried out. The manager said that all new staff undertake induction that meets with the required standard. She said that induction is carried out over a twelve-week period. The Manager said that staff working at the home have had lots of training during the last year. Training mentioned included, moving and handling, fire, adult protection and emergency aid. One staff member spoken to during the visit said, “I have done lots of training this year and I have completed my NVQ level 2 in care” another said, “I have done all of my mandatory training and I have been on a training course on how best to care for people with Parkinson’s disease. I am going to do a course on caring for people with dementia”. Roseworth Lodge Nursing Home DS0000000197.V366407.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards assessed 31, 33, 35, 36 and 38 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home in is well run. Quality assurance monitoring systems are in place to ensure that the home is run in the best interest of people who use the service. EVIDENCE: The Manager is a Registered Nurse who has worked in the nursing and social care environment for many years. The Manager is currently working towards achieving her NVQ level 4 in Management, which she said that she hopes to achieve by December 2008. Roseworth Lodge Nursing Home DS0000000197.V366407.R01.S.doc Version 5.2 Page 23 The manager said that the home have quality assurance systems in place. Surveys are sent out to people that use the service and relatives on a yearly basis to see if they are happy with the home and care received. The Manager said that a letter is then sent out to people that use the service and relatives informing them of the results and outcome of the survey. The home operates an open door policy in which people that use the service, relatives and their representatives can speak to the manager of the home at anytime, this was evidenced on the day of the inspection. The manager said that she used to organise meetings for people that use the service and relatives, however, these were poorly attended. She said that a few weeks ago she informed everyone that she was to be available on a Saturday and that people that use the service and relatives could “drop in “ and see her at a time convenient for them. The Manager said that this worked very well and that four sets of relatives came to see her. Future “drop in” sessions are to be arranged. The home looks after small amounts of money belonging to some people who use the service. Appropriate records of transactions are kept, however money belonging to people that use the service is pooled into one bank account. Individual bank accounts for people using the service should be opened. Staff files examined during the visit contained evidence to confirm that had received supervision. A sample of health and safety records were examined and in general were found to be in order. Records were examined to confirm that the fire alarms and gas boilers had been serviced within the last year. The manager said that fire extinguishers had been serviced, however was unable to locate the certificate of service at the time of the visit. It was observed that fire extinguishers looked at during the visit had been marked to show that they had been serviced in January 2008. Records were available to confirm that a weekly test of the fire alarm system is carried out, however this did not always identify the area of the home checked. This was pointed out to the handyman at the time of the visit who said that he would take action to address. The handyman said that a weekly temperature check of showers and baths is carried out to ensure that they are within safe limits, however the handyman was unable to locate records of water temperature checks carried out after May 2008. Roseworth Lodge Nursing Home DS0000000197.V366407.R01.S.doc Version 5.2 Page 24 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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 3 X 2 Roseworth Lodge Nursing Home DS0000000197.V366407.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 OP19 Regulation 23 Requirement Work must be carried out to the flooring, tilling of the showers. Drain covers must be replaced and action taken in relation to the unpleasant odour in these rooms. Previous timescale for action of 1/10/07 not met Additional medication training and in-house assessment in line with best practice guidance must be provided to all staff involved in the administration of medicines. Having well trained competent staff helps to reduce the risk of medication errors. The Registered Person must ensure that the temperature of room in which medication is stored is monitored to ensure that medication is kept at the correct temperature and safe to use. The Registered Person must ensure that the complaints procedure is updated to include stages and timescales for action, DS0000000197.V366407.R01.S.doc Timescale for action 01/10/08 2. OP9 13(2) 18(1) 30/09/08 3. OP9 13 03/07/08 4. OP16 22 03/09/08 Roseworth Lodge Nursing Home Version 5.2 Page 26 who to contact including contact details of Social services to help to ensure that complaints are dealt with promptly and appropriately 5. OP19 23 The Registered Person must repair or replace the door leading to the lounge designated fro those people who wish to smoke to ensure safety The Manager must achieve an NVQ level 4 in Management 17/07/08 6. OP31 9 31/12/08 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 OP29 Good Practice Recommendations The Registered Person should carry out annual checks with the Nursing Midwifery Council to check that trained nurses are eligible to practice. Individual bank accounts should be obtained for people that use the service Records should be available in the home to confirm that water temperature checks of baths and showers are carried out on a weekly basis. 2. 3. OP35 OP38 Roseworth Lodge Nursing Home DS0000000197.V366407.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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