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Inspection on 04/10/05 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 4th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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. The Residents who spoke to the Inspector spoke well of the staff stating that they were `lovely`. One Resident stated that it had taken her a while to settle but the staff had made her feel welcome. The Inspector was told that the food was lovely and you could have what you wanted. Another Resident stated that she enjoyed the Bingo sessions that the home provided and also enjoyed completing her crossword puzzles.

What has improved since the last inspection?

The following has improved since the last inspection; the food served to the Residents` is now of an acceptable standard. The cleanliness of the occupied bedrooms has improved. The appropriate number of staff are now on duty and staff now receive regular supervision. Staff are now recruited appropriately.

What the care home could do better:

Residents should be provided with terms and conditions in respect of accommodation. Continue to improve care documentation. Ensure that all areas of the home are kept clean. Provide meaningful activities for Residents`. Up grade bathing facilities. Paint handrails and doorframes. Renew flooring in the en-suites identified. Decorate identified bathrooms.

CARE HOMES FOR OLDER PEOPLE Roseworth Lodge Nursing Home Redhill Road Roseworth Stockton-on-Tees TS19 9BY Lead Inspector Julia Connor Unannounced Inspection 4th October 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Roseworth Lodge Nursing Home DS0000000197.V255692.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Roseworth Lodge Nursing Home DS0000000197.V255692.R01.S.doc Version 5.0 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 Tamaris Healthcare (England) Ltd (wholly owned subsidiary of Four Seasons Health Care) 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.V255692.R01.S.doc Version 5.0 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 25th May 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.V255692.R01.S.doc Version 5.0 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 on the 4th October commenced at 9.30 a.m. and concluded at 1.00 p.m. The second visit on the 21st October commenced at 11.05 a.m. and concluded at 2.10 p.m. Four Residents, and two members of staff were spoken to during the inspection. 7 Residents returned the Service User Comment Cards and the wife of a Resident completed a comment card on his behalf. What the service does well: What has improved since the last inspection? The following has improved since the last inspection; the food served to the Residents’ is now of an acceptable standard. The cleanliness of the occupied bedrooms has improved. The appropriate number of staff are now on duty and staff now receive regular supervision. Staff are now recruited appropriately. Roseworth Lodge Nursing Home DS0000000197.V255692.R01.S.doc Version 5.0 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.V255692.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Roseworth Lodge Nursing Home DS0000000197.V255692.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3 Service Users’ do not have a statement of the terms and conditions of the home. Service Users’ do not move into the home without having had their needs assessed. EVIDENCE: While the terms and conditions for the Service Users’ and/or their families were in the home they had not been given out to the Service Users’ or their next of kin. There was evidence in the Service Users’ 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.V255692.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 9 The Service Users’ health, personal and social needs are recorded but these records do not contain sufficient information and are not always reviewed as stipulated, therefore they do not reflect the changing needs of the Service Users’. The Nurse in Charge administers medication to the Service Users’ as there are no Service Users’ who wish to self medicate. EVIDENCE: Three sets of care documents were audited and although they had improved from the last inspection in May they were still not adequate and did not reflect the changing needs of the Service Users’. One set of documentation stated that the Service User would be weighted monthly, this did not happen; the Service User had only been weighted twice since the beginning of the year. Care plans had not been reviewed as stipulated. Physical observations such as blood pressure and weight were not always recorded on admission therefore there was no base line for the staff to work from. The daily record did not contain sufficient information; ‘spent a pleasant day’ does not give an accurate account of how the Service User had been that day. Correction fluid had been used in one set of notes, this is not acceptable. Roseworth Lodge Nursing Home DS0000000197.V255692.R01.S.doc Version 5.0 Page 10 There is a policy and procedure for the receipt, recording, storage, handling, administration and disposal of medicines. The home carries out a three-month random audit of controlled medication. Four Seasons Healthcare Ltd has a contract with a Pharmacy to take away the homes unused medication. Roseworth Lodge Nursing Home DS0000000197.V255692.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 15 The Service Users’ recreational needs are not met therefore they get bored and find the days are long. The Service Users’ are served a wholesome and appealing diet in pleasant surrounds. EVIDENCE: There is no activity person currently in post. The staff holds a game of Bingo a couple of times a week, which the Service Users’ enjoy. The Service Users’ who spoke to the Inspector stated that there was little to do and that watching the television all day was boring. One Service User stated that she enjoyed doing her crossword puzzles. Another Service User stated that she enjoyed chatting to the staff but they were always so busy. Lunch on the first day of the inspection was shepherds pie with carrots and sprouts followed by rhubarb crumble and custard. Staff was available to offer assistance as necessary. The Service Users’ who spoke to the Inspector stated that the food was good. Three of the eight comments cards stated that the food was only good sometimes however, the other five comment cards recorded that the food was good. Roseworth Lodge Nursing Home DS0000000197.V255692.R01.S.doc Version 5.0 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 the following standard(s): 16 Service Users’ are confident that their complaints will be listened to, taken seriously and acted upon. EVIDENCE: There is a policy and procedure to follow should a visitor or member of staff wish to make a complaint. There have been four complaints in the last twelve months, two upheld and two partially upheld. The Service Users’ who spoke to the Inspector stated that they would speak to the ‘main woman’ if they had a complaint and were confident that she would do something about it. Six of the Service Users’ who returned the comment cards were aware of who to go to should they be unhappy with their care, one Service User ticked that s/he were unaware of who to speak to and the one Service User ticked that they were sometimes aware of who to speak to. Roseworth Lodge Nursing Home DS0000000197.V255692.R01.S.doc Version 5.0 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 the following standard(s): 19, 22 and 26 The Service Users’ live in a safe and predominately well maintained environment but certain areas require attention, either decorating or new floor covering. There is sufficient specialist equipment within the home. There are areas within the home that are not as clean as they should be, these give the home an air of neglect. EVIDENCE: Although all of the handrails can be used safely they do need painting, as do the bedroom doorframes. The en-suite floor covering in bedrooms 4, 11, 14, 16, 17, 19, 20, 24 and 40 need to be replaced. Bathroom one downstairs and bathroom four upstairs require decorating. There is sufficient specialist equipment within the home. The cleanliness of the unoccupied bedrooms was of a poor standard; for example there was a layer of dust on windowsills and bedroom carpets had not been hoovered. Roseworth Lodge Nursing Home DS0000000197.V255692.R01.S.doc Version 5.0 Page 14 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 There is sufficient staff on duty to meet the needs of the Service Users’. Staff have been trained to NVQ level 2 that should ensure that they can meet the Service Users’ needs. The Service Users’ are protected by the home’s recruitment practice. Staff receives training to be competent at their jobs EVIDENCE: An audit of three weeks duty rota showed that the home was staffing to the Four Seasons Healthcare Ltd Northern Staffing Grid. 68 of the staff has an NVQ Level 2 in care. Four personnel files were audited and contained the required information as stipulated in Schedule 2 of the Care Homes Regulations 2001. Mandatory training e.g. fire and manual handling has taken place. Training on the safe handling of medication has been delivered to the Nurses’ working at the home. Staff is currently receiving training on the protection of vulnerable adults. Following discussion with staff it became evident that Resident specific training would be beneficial for example diabetes or pressure area care. Roseworth Lodge Nursing Home DS0000000197.V255692.R01.S.doc Version 5.0 Page 15 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): 33, 34, 35, 36, 37 and 38 The Manager of the home carries out quality audits. Evidence of financial viability has been received by the Commission for Social Care Inspection. The Service Users’’ personal finances are safeguarded. The home has the required policies and procedures. The health, safety and welfare of Service Users’ are promoted and protected. EVIDENCE: The Four Seasons Healthcare audit was carried out. The Manager also carries out a regular audit on the care documentation, the kitchen, Service Users’ accidents, and medication. Financial viability has been received by the Commission for Social Care Inspection. Roseworth Lodge Nursing Home DS0000000197.V255692.R01.S.doc Version 5.0 Page 16 The Service Users’ combined monies are kept in an interest bearing account as per Four Seasons Healthcare policy. Supervision is taking place on a regular basis and this was confirmed by auditing the personnel files and in discussion with staff. The home has the required policies and procedures. The pre inspection questionnaire recorded that maintenance of equipment has taken place this year. Roseworth Lodge Nursing Home DS0000000197.V255692.R01.S.doc Version 5.0 Page 17 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 2 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 2 X X 3 X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 3 3 3 3 3 Roseworth Lodge Nursing Home DS0000000197.V255692.R01.S.doc Version 5.0 Page 18 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 OP2 Regulation 5 Requirement The registered person must provide the Residents’ 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 Resident in the nursing documentation. Care plans must be evaluated as stipulated. The registered person must ensure that the home is well maintained. The registered person must ensure for that for the benefit and comfort of the Service Users the premises be kept clean and hygienic. Timescale for action 01/12/05 2 OP7 15 01/12/05 3 4 OP19 OP26 23 23 01/03/06 Immediate Roseworth Lodge Nursing Home DS0000000197.V255692.R01.S.doc Version 5.0 Page 19 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 12 22 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.V255692.R01.S.doc Version 5.0 Page 20 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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