Inspection on 28/03/07 for Rosewyn House

This inspection was carried out on 28th March 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Rosewyn House 29/10/09

Rosewyn House 19/03/09

Rosewyn House 14/02/06

Rosewyn House 21/09/05

Rosewyn House 18/11/04

Rosewyn House 11/05/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Rosewyn House Alverton Terrace Truro Cornwall TR1 1JE Lead Inspector Ian Wright Unannounced Inspection 9:15 28 & 29 March 2007 th th 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 Rosewyn House DS0000009132.V332283.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. Rosewyn House DS0000009132.V332283.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosewyn House Address Alverton Terrace Truro Cornwall TR1 1JE 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) 01872 279107 rosewynhouse@gmail.com Mr William Percival Dawes Mr Gregory Brian Murrell Mrs Jennifer Eileen Spargo Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Rosewyn House DS0000009132.V332283.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th February 2006 Brief Description of the Service: Rosewyn House provides care for up to twenty elderly service users. The registered providers are Mr Dawes and Mr Murrell who are actively involved in the management of the home. Mrs Spargo is the registered manager. Rosewyn House, is situated in walking distance of the centre of Truro. Rosewyn is a large old house situated in pleasant grounds. The house has two floors with access to the first floor via either a staircase or lift. There is one double bedroom and eighteen single bedrooms. No bedrooms currently have en-suite facilities. There are suitable bathroom facilities. There is a large lounge and a large separate dining room. The home is pleasantly decorated throughout. There is also a block of supported living flats next door to the home, which are also managed by the registered persons. Some of the service users from here have their meals at the home. Although the flats are not registered for personal care, some move in to the care home as peoples’ needs change. A copy of the full inspection report is available from the manager, and it is suggested a copy is requested from them or CSCI if required. The range of fees at the time of the inspection is £300 to £380 per week. There are additional charges e.g. for hairdressing, chiropody, and newspapers etc. Rosewyn House DS0000009132.V332283.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place in fourteen and a half hours over two days. All of the key standards were inspected. The methodology used for this inspection was: • To case track four service users. This included, where possible, meeting and discussing with the service users their experiences, and inspecting their records. • Discussing with four staff their experiences working in the home. • Discussion with other service users and their representatives. • Observing care practices. • Discussing care practices with management. • Inspecting records and the care environment. Other evidence gathered since the previous inspection, such as notifications received from the home (e.g. regarding any incidents which occurred), was used to help form the judgements made in the report. What the service does well: What has improved since the last inspection? What they could do better: Although there is a programme of training, some staff do still need updates in some training required by law. A requirement has been issued regarding this matter. Two recommendations for good practice have been made regarding making some of the routines more flexible to meet individual needs. Rosewyn House DS0000009132.V332283.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Rosewyn House DS0000009132.V332283.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 Rosewyn House DS0000009132.V332283.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 Quality in this area is good. The judgement has been made using available evidence including a visit to the service. Service users are issued with a copy of terms and conditions of residency or a contract, so they are aware of their rights and responsibilities. The pre admission assessment procedure is satisfactory, and enables the registered persons to ascertain they can meet the needs of service users, before admission is arranged. EVIDENCE: A copy of the home’s statement of terms and conditions of residency / contract was inspected. An individualised copy of this document was on service user files. The registered provider assesses service users before they are admitted. The registered provider said service users or their relatives could visit the home before formal admission is arranged. Some service users remembered an assessment was completed before admission was arranged. Copies of assessments were available for inspection in service user files. Some of these could be a little more detailed, and the registered persons should ensure they are always dated. Rosewyn House DS0000009132.V332283.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this area is good. The judgement has been made using available evidence including a visit to the service. All service users have a care plan, and there is evidence that these are reviewed. This helps to ensure service users’ care needs are suitably met. Healthcare support seems appropriate so service users can be assured they will receive suitable support from medical practitioners. The operation of the medication system is to a good standard so service users can be assured their medication is looked after and administered appropriately. Issues regarding the diverse backgrounds of service users appear suitably addressed. Service users have said they feel they are treated with respect and dignity. EVIDENCE: There is a copy of a care plan in each service user file. Staff said care plans were accessible to them. Care plans are reviewed regularly. Some service users the inspector spoke to were aware they had a care plan. All service users however said care is delivered to a good standard, and staff did their best to meet their needs. Rosewyn House DS0000009132.V332283.R01.S.doc Version 5.2 Page 10 Service users said they were satisfied with the healthcare support they received. This includes visits from GP’s, district nurses, chiropodists, dentists and opticians. The registered provider has a satisfactory medication policy. Medication is administered via the monitored dosage system. The medication system was inspected and is managed to a good standard. Medication records kept are also managed to a good standard. Records show most staff have received formal training regarding the administration of medication, although a minority of staff do need to still receive or receive a refresher regarding this training. Some certificates for medication training were not present for some staff, although the manager said these staff had received the training. Service users said they felt staff worked with them in a manner, which respected their privacy and dignity. Service users were positive about their care. Service users said personal care was provided to a good standard. Service users said care was delivered in the way they wanted. The registered provider has a satisfactory policy regarding anti discrimination. There are currently no service users from ethnic minorities, although the manager said the home would be more than happy to accommodate service users from other cultures. The local population is predominantly Cornish, and from ‘White-UK’ background. Issues regarding sexuality, gender and disability seem to be suitably addressed. Rosewyn House DS0000009132.V332283.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this area is good. The judgement has been made using available evidence including a visit to the service. Routines and activities are generally to a good standard so service users can live a lifestyle that meets their needs. However a minority of service users said some routines could be more flexible. Appropriate arrangements appear to be in place regarding the management of service user monies. Visiting arrangements are flexible. Meals are provided to a good standard, so service users receive an appetising, wholesome and nutritious diet. EVIDENCE: Most service users said they could get up and go to bed when they wished and routines are flexible to suit their needs. However a minority of service users said they felt obliged to get up at 07:30 for breakfast although they would prefer to get up later. The manager said this should not happen. She said night staff should not be involved in getting people up unless there was a specific reason such as incontinence or a service user wished to get up early. Staff should show flexibility and enable service users to make a choice. The inspector said management should monitor this matter. However the majority of service users said they felt they had a choice when they could get up. All service users said they could go to bed when they wished. One service user said they did not agree with the practice that people who live in the home have to remain seated after meals, in the dining room, until the medication round has been completed. The person said this was the case even Rosewyn House DS0000009132.V332283.R01.S.doc Version 5.2 Page 12 when service users did not receive medication. The inspector did observe this practice at one of the lunch times. One service user became quite distressed as she wanted to go to the toilet. The manager said the practice did occur because there was sometimes an issue of ensuring service users had their medication, and an issue of service users colliding with staff when tea was being served. The practice is not usual in care homes for older people and needs reviewing. For example medication could be given when the sweet is served. Otherwise support provided to service users at mealtimes is good. The registered persons provide regular trips out in a minibus for service users. This provides an excellent opportunity for service users to remain part of the wider community. On the first day of the inspection some service users went out to the Roseland Peninsula for a drive, and this was very much enjoyed. This service is quite rare in care homes and is commended as excellent practice. Other activities arranged by staff include bingo and other games. One service user regularly goes to a club run by Age Concern. Another service user said she regularly goes to the theatre on her own, and also walks into town regularly. Some service users, the inspector spoke to, did not want to participate in some activities, but felt their right was respected. These service users said they were quite happy to organise their own time, for example spending time in the lounge with others or in their own bedrooms. Some service users receive library books. Religious ministers also visit the home. Some service users said they enjoyed sitting in the pleasant garden when the weather is good. Service users said they could receive visitors when they wished. The inspector spoke to several relatives and friends of service users who were all satisfied with the care given at the home. Service users all said they were encouraged to make choices and did not feel there were excessive or inappropriate restrictions placed upon them. The manager said staff look after some service user monies, and suitable records were inspected regarding this. Other monies were either maintained by the individual, individual solicitors or a service users relative. Currently only two of the bedroom doors are lockable, but the manager said service users could have a bedroom door lock if they wanted this facility. Service users said they felt their personal belongings were safe and secure in the home. Some service users said they had a lockable cash tin. Service users said they could bring in their own furnishings and personal belongings if they wished. Service users have their meals in the dining room, or in their bedrooms. The inspector shared lunch with service users on the first day of the inspection. The food provided was to a very good standard. Service users said if they did not like a particular dish an alternative was always provided. A choice of a hot and Rosewyn House DS0000009132.V332283.R01.S.doc Version 5.2 Page 13 cold evening tea is offered. Suitable records of menus and records of meals provided are maintained. Special diets (e.g. pureed meals) are provided if required. One service user said they would like to have more flexibility when they could make hot drinks. The inspector discussed this matter with the registered manager and it was agreed the person could have a kettle etc. in their bedroom. Rosewyn House DS0000009132.V332283.R01.S.doc Version 5.2 Page 14 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): 16, 18 Quality in this area is good. The judgement has been made using available evidence including a visit to the service. The registered provider has suitable procedures regarding complaints and adult protection. Subsequently service users can be assured there are appropriate procedures to deal with any concerns or bad practice. EVIDENCE: The registered provider has satisfactory procedures regarding complaints and adult protection. Staff and service users showed some awareness of the procedures, and were able to say whom they would approach if they had a complaint or were concerned about abuse. The Commission for Social Care Inspection has not received any complaints regarding this service. Some staff have received training regarding prevention of abuse and adult protection, delivered by the county council. It would be beneficial if more staff could attend this training if opportunities become available. Staff and service users all said they had not witnessed any bad or abusive practices. All staff have Criminal Record Bureau (CRB) check, and a Protection of Vulnerable Adults check (where applicable). One member of staff is still awaiting a CRB disclosure. Satisfactory supervision arrangements appear to be in place for this person. Rosewyn House DS0000009132.V332283.R01.S.doc Version 5.2 Page 15 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): 19, 26 Quality in this area is good. The judgement has been made using available evidence including a visit to the service. Rosewyn House provides a pleasant, homely, clean and well-maintained environment for service users to live and feel at home in. EVIDENCE: The building was inspected. The building appears to be well maintained, clean, pleasantly decorated and homely. There is a pleasant garden, which service users can use. There is a large lounge and a dining room. Both are homely and comfortable. Bedrooms are individualised and comfortable. A shaft lift is provided to assist service users to go upstairs. Decorations are to a high standard. Bathroom and shower facilities are to a suitable standard. Suitable kitchen and laundry facilities are provided. Cleaning staff are employed, and the home was clean and hygienic at the time of inspection. Rosewyn House DS0000009132.V332283.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this area is generally good although some improvement is required regarding staff training. The judgement has been made using available evidence including a visit to the service. Staffing levels are satisfactory so service users can be assured that a suitable number of staff are available. Recruitment records are satisfactory so service users can be assured suitable checks take place when staff are recruited. Staff training needs some improvement, as there are some gaps in training required by regulation. This improvement will assure service users that staff have suitable skills and knowledge to cater for their needs. The registered provider has a satisfactory approach to ensuring staff have a national vocational qualification in care. Equal opportunities issues regarding recruitment and work practices seem satisfactory. EVIDENCE: Suitable staffing is provided. Rotas show usually four staff are on duty between 0730 and 1400, and two staff between 1400 and 2100. Rotas show sometimes additional staffing is provided. One waking night staff, and one sleep in member of staff are on duty between 2100 and 0800. Auxiliary staff such as a cook and cleaning staff are employed. The registered provider has a suitable approach to providing National Vocational Qualifications (NVQ) for care staff. However currently only 33 have an NVQ (at least at level 2). The assistant manager said 4 other people have nearly completed the qualification. Rosewyn House DS0000009132.V332283.R01.S.doc Version 5.2 Page 17 Staff recruitment records are to a good standard. The registered persons have ensured current staff complete an application form. A Criminal Records Bureau check and Protection of Vulnerable Adults check (where applicable) are obtained. Two references have been obtained for staff. The inspector spoke to several staff regarding staff induction arrangements. Staff said they were shadowed on several initial shifts, and shown how to carry out their work. The induction checklist could be more comprehensive, and the registered manager said she is in the process of developing this. Staff training records were inspected. Records of staff training are adequate, but training does require some improvement in places so it meets regulatory requirements. For example staff must receive training in the following areas; first aid (there must be one first aider always on duty), fire and infection control training (for all staff). The registered provider’s approach to equal opportunities and anti discrimination is to a satisfactory standard. Rosewyn House DS0000009132.V332283.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this area is good. The judgement has been made using available evidence including a visit to the service. The registered persons are suitably experienced, skilled and qualified to manage the home. The registered persons has a satisfactory approach to quality assurance so service users can be assured there is a system to check the care they receive is of good quality. There are suitable arrangements for managing service user monies. The management of health and safety issues is to a good standard so service users can be assured they live in a safe environment. EVIDENCE: The registered persons have suitable experience, skill and knowledge to manage the home. The registered manager lives in a neighbouring property, and the registered providers visit the home most days during the working week. Rosewyn House DS0000009132.V332283.R01.S.doc Version 5.2 Page 19 The registered persons have a suitable quality assurance policy. The registered persons complete an annual survey of service users, their relatives and staff. The results of the survey for 2006 were positive. The manager said she was aware of the requirement to report any untoward incidents or deaths to the Commission for Social Care Inspection. The registered manager looks after monies for a minority of service users and suitable records are kept regarding this. The registered provider has a health and safety policy. Records kept of checks required by regulation are good. For example there are suitable records for the testing of fire equipment and moving and handling equipment. Health and safety risk assessments are satisfactory and there are suitable checks to assist with the prevention of Legionella. There are suitable records regarding the central heating system being serviced. The electrical hardwire circuit and portable electrical items have been tested. One service user said they were annoyed that their window could not be fully opened due to a window restrictor being fitted. The inspector discussed the matter with the registered manager. As the risk of intruders to the room and the risk of falling via the window was minimal, it was agreed to complete a risk assessment, signed by the service user, so the restrictor could be removed. The risk assessment should however be reviewed e.g. every 6 months or a year, in case the person’s needs change. Rosewyn House DS0000009132.V332283.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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Rosewyn House DS0000009132.V332283.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 OP30 Regulation 18 Requirement Staff must receive suitable training as required by regulation, and according to the needs of service users living in the home. Timescale for action 01/10/07 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 OP7 OP10 OP12 OP9 OP12 Good Practice Recommendations Management should monitor that service users do get a choice when service users get up and go to bed. Review arrangements for administering medication at mealtimes as detailed in the report. Rosewyn House DS0000009132.V332283.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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. Extracts may not be used or reproduced without the express permission of CSCI Rosewyn House DS0000009132.V332283.R01.S.doc Version 5.2 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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