Inspection on 27/06/07 for Rosset Holt Home

This inspection was carried out on 27th June 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

Rosset Holt Home 26/09/08

Rosset Holt Home 08/05/06

Rosset Holt Home 19/10/05

Rosset Holt Home 18/05/05

Rosset Holt Home 26/10/04

Rosset Holt Home 26/04/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Rosset Holt Home Pembury Road Tunbridge Wells Kent TN2 3RB Lead Inspector Eamonn Kelly Key Unannounced Inspection 27th June 2007 10:30 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 Rosset Holt Home DS0000023998.V340268.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. Rosset Holt Home DS0000023998.V340268.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosset Holt Home Address Pembury Road Tunbridge Wells Kent TN2 3RB 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) 01892 526077 01892 526077 Keychange Charity Mrs Marilyn Rose Luck Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Rosset Holt Home DS0000023998.V340268.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: According to its website www.keychange.org.uk Keychange Charity (formerly known as Christian Alliance) operates in two distinct areas of social need: providing homes for frail older people and supported accommodation for young and vulnerable homeless people. The website states that all its centres are run on Christian principles. The business has some 9 residential homes in England. Rosset Holt has bedroom accommodation on ground and first floors. Residents have the benefit of a passenger lift. Bedrooms are single occupancy but accommodation could be provided for people who wish to share a bedroom. Some rooms have en-suite facilities. Weekly fees are from £430-£450. Additional charges are made for hairdressing, chiropody, newspapers, personal telephone charges and personal spending. Rosset Holt Home DS0000023998.V340268.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on 27th June 2007. It consisted of meeting with residents, the assistant manager and members of staff. Support practices were observed and discussed with members of staff. A variety of records was seen during the visit principally those that supported the care of residents. The manager submitted a completed AQAA (annual quality assurance assessment) to the commission. This was helpful in the preparation of this report. Sixteen residents completed the commission’s survey prior to the inspection visit and their views have been used in the report. The report contains information about progress made since the previous inspection visit and about how further improvement is necessary for the welfare and comfort of residents. The manager has addressed the requirements contained in the previous inspection report and has given appropriate consideration to the recommendations. What the service does well: What has improved since the last inspection? What they could do better: Rosset Holt Home DS0000023998.V340268.R01.S.doc Version 5.2 Page 6 Residents should receive better support in remaining more mentally and physically active. The services of a skilled activities organiser would benefit residents and other staff. Residents who are increasingly frail or who have sensory impairments should receive more support to prevent isolation and loneliness. All members of staff should be encouraged to complete NVQ Level 2 in Care. Each should also over the following 12 months attend appropriate training in the topics regarded as mandatory for the continuing safety and comfort of residents. Because of the history of the home, for example, in dealing with medicines all members of staff with any responsibility for medicines should attend the “Safe Administration of Medicines” course. Likewise there should be a qualified first-aider on each shift and all staff must have received appropriate training in moving and handling and annual updates. This should include a substantial practical element including the use of hoists. 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. Rosset Holt Home DS0000023998.V340268.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 Rosset Holt Home DS0000023998.V340268.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): 1-6. Quality in this outcome area is good. This judgement was made using available evidence including a visit to the service. Prospective residents and their supporters receive good advice and support to enable them to make a decision about entering residential care with confidence. EVIDENCE: Prospective residents receive written information and other advice about services and facilities to help them make a decision about entering a care home. Some residents previously obtained knowledge of the home via respite care. All residents receive a detailed personal contract. Residents stated that they received good support and guidance at that critical time. Positive feedback was also received through the commission’s survey of residents’ views. Rosset Holt Home DS0000023998.V340268.R01.S.doc Version 5.2 Page 9 Prospective residents and their supporters are involved in the initial assessment procedure; GP’s and care managers are also involved in some instances. Visits to the home are arranged to help prospective residents and members of their families make a decision. Several residents said that they had a great deal of information about the home and its Christian values well in advance of when they decided to take up residence. Rosset Holt Home DS0000023998.V340268.R01.S.doc Version 5.2 Page 10 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): 7-11. Quality in this outcome area is good. This judgement was made using available evidence including a visit to the service. Residents receive good healthcare and personal support. EVIDENCE: Significant improvements have been made in the maintenance of care plan records. In the examples seen, care staff were able to demonstrate how the information recorded is useful in understanding the needs of residents and how these are being addressed. The examples of risk assessments seen also suggested that the dependency needs of residents are addressed and reviews of care are carried out. However, there is a continuing tendency for some residents to be isolated and possibly lonely in their bedrooms. This is referred to in more detail in the following section of this report. Rosset Holt Home DS0000023998.V340268.R01.S.doc Version 5.2 Page 11 Daily records maintained by staff have improved. This is of benefit to members of staff and residents not least in advising staff on incoming shifts about changes in resident’s condition or demeanour. The assistant manager outlined how better records are kept about incidents affecting residents including the effects of falls. Members of staff demonstrated a good understanding of and empathy with residents healthcare and personal needs. Profiles of residents discussed with members of staff and care plan records suggested that residents have good access to medical services including a nearby GP surgery. The home continues to have a good working relationship with specialist and local health care professionals in supporting residents with their health care needs. Considerable improvement has taken place in medicine administration. This had previously been a problem. The medicine room has very good storage facilities and MAR sheets are completed with care. All staff administering medicines have received basic training from a high street chemist. It would be appropriate for staff to receive more detailed training such as “Safe Administration of Medicines”. From observation and discussion with residents it was clear that staff treated residents with respect and promoted their privacy and dignity. Residents say that they highly value the home’s Christian values and ethos. Several referred to the spiritual and pastoral support they receive. Rosset Holt Home DS0000023998.V340268.R01.S.doc Version 5.2 Page 12 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): 12-15. Quality in this outcome area is adequate. This judgement was made using available evidence including a visit to the service. Residents are helped to lead relaxed and enjoyable lifestyles. They make many decisions about how to lead their lives but they would benefit from more activities particularly each afternoon. EVIDENCE: Bible studies and prayer meetings take place often. Residents decide whether or not to attend meetings and services. A notice board in the entrance hall includes details of forthcoming activities. Occasional outings are arranged. During the inspection visit, many residents were in their bedrooms in the morning while the remainder were in the lounge at bible study with a lay teacher. After lunch, four sat in the lounge (three asleep and one awake). The remainder went to their rooms. The premises became very quiet between 1.45-4.15pm. Rosset Holt Home DS0000023998.V340268.R01.S.doc Version 5.2 Page 13 The commission’s survey of resident’s views elicited some responses that suggested a significant lack of activities. The annual quality assurance assessment (AQAA) submitted to the commission indicated that this shortfall is acknowledged by the home. The AQAA says that an activities organiser would be employed if funding becomes available. The general advice is that a skilled activities organiser should be present for at least one hour per week per resident on the registration certificate (ie. 18 hours per week). Their direct impact would benefit residents on a day-to-day basis and members of staff would learn some techniques to use at other times. Many residents lead active and reflective lives. They have access to newspapers, books and other media. The previous inspection report suggested that more support was needed for residents with sensory loss and physical disabilities. On this occasion, the assistant manager found a resident (in a bedroom) who needed additional clothing because of a sudden change in the weather. A blind resident was somewhat isolated and alone. A resident was unhappy with the meal delivered and it was unclear whether the resident did not like the food or was a bit unwell. The previous report said that advice had been sought from specialists on how to care more actively for people of advanced age and/or who have sensory impairments and that such advice was put into practice. Improvements are still necessary. Residents say they enjoy receiving visitors. This they are able to do in comfortable surroundings. Over lunch, residents spoke highly of meals they receive. Lunch is transported in a heated cabinet and served in the hall/dining area. Residents say that members of staff know if they have allergies to certain foods, any diabetic conditions and are aware of their preferences. Residents say that they have their evening meal around 6.30pm and that there is generally a heated component to this meal. The annual quality assurance assessment (AQAA) stated that more work is being done to ensure that residents are able to choose from a menu for lunch and evening meals. Rosset Holt Home DS0000023998.V340268.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 outcome area is good. This judgement was made using available evidence including a visit to the service. Residents are protected and are in a safe environment. EVIDENCE: Residents say they know how to comment on aspects of services and that staff encourage them to express their views. Many responded to the commission via a questionnaire. This feedback was generally positive apart from reflections that better mental and physical stimulation would be appreciated. There is a complaints procedure. No significant complaints have been received since the previous inspection visit. All concerns expressed are taken seriously according to members of staff and the assistant manager. A record of complaints received and their outcomes is kept. Members of staff say that they know how to respond if they had concerns for resident’s safety, comfort or welfare. The assistant manager said that there would be a renewed effort to enable all staff to have a good understanding of adult protection procedures. Rosset Holt Home DS0000023998.V340268.R01.S.doc Version 5.2 Page 15 Rosset Holt Home DS0000023998.V340268.R01.S.doc Version 5.2 Page 16 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, 20, 24, 26. Quality in this outcome area is good. This judgement was made using available evidence including a visit to the service. The premises are suitable for use by frail older people. EVIDENCE: Resident’s bedrooms are personalised with occupants’ personal effects that generally reflected their individual tastes and interests. The sizes of bedroom vary considerably throughout the premises but residents say they are satisfied with all aspects of the premises. Some bedrooms have en-suite facilities. Residents were using the passenger lift without difficulty. Communal areas are comfortable. The garden is highly valued by residents. There are good parking facilities. Rosset Holt Home DS0000023998.V340268.R01.S.doc Version 5.2 Page 17 The premises are safe, tidy and well maintained. There is an ongoing programme of redecoration. The lounge carpet was being steam cleaned at the time of the inspection visit partly in preparation for the 100th birthday celebrations of a resident. The previous report indicated some concerns with hot water outlets that could lead to scalding. The assistant manager said that temperature limiters have been fitted and this aspect of safety is subject to recorded risk assessment. Covers are now fitted to all radiators for the safety of residents. Residents are well served by good laundry facilities. Improvements have been made as previously requested by the commission to the medicines room. Rosset Holt Home DS0000023998.V340268.R01.S.doc Version 5.2 Page 18 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): 27-30. Quality in this outcome area is adequate. This judgement was made using available evidence including a visit to the service. Residents are in the care of people who are hardworking and enthusiastic. They would benefit further if all members of staff were encouraged to complete all necessary training. EVIDENCE: Residents say they are satisfied with the support they receive from members of staff. There has been a stable staff group for several years. Nevertheless, agency staff fill a significant number of shifts. The annual quality assurance assessment (AQAA) states that efforts are being made to ensure that adequate numbers of staff are on duty and that training/staff personal development is being improved. Two members of staff (awake) are on duty at night. The previous assistant manager has retired and an administrator/assistant manager has been appointed. The assistant manager plans to undertake the registered manager’s award (RMA). Rosset Holt Home DS0000023998.V340268.R01.S.doc Version 5.2 Page 19 Staff files indicated that the required range of checks including CRB/POVA is carried out for new members of staff. The previous report requested increased concentration on staff training and development. Some members of staff have recently completed NVQ Level 2 in Care. The AQAA states that 8 of the home’s 14 permanent members of staff have achieved NVQ Level 2. Staff say that there has been an increase in fire safety training. Whilst this progress is significant, sufficient progress is not being made. Some members of staff met have not received training in essential “mandatory” topics. This is neither to their benefit or that of residents. The assistant manager stated that formal supervision is carried out for each member of staff. The objective is to enable staff to identify what they are doing well or not so well and to obtain appropriate development opportunities. Rosset Holt Home DS0000023998.V340268.R01.S.doc Version 5.2 Page 20 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 outcome area is good. This judgement was made using available evidence including a visit to the service. Residents have the benefit of living in premises that are well managed. EVIDENCE: The manager, Mrs Marilyn Luck, has extensive experience in the field of residential care and has achieved the RMA (registered manager’s award). The assistant manager has a good knowledge of resident’s care needs and these are being addressed. She is soon to undertake the RMA. A number of shortfalls in management processes are now being addressed as recommended in the previous inspection report. It is likely that, according to Rosset Holt Home DS0000023998.V340268.R01.S.doc Version 5.2 Page 21 the description of progress by the assistant manager, this rate of improvement will continue. A system of regular staff supervision is being implemented to ensure that the objectives of the home are met. Residents’ views are informally canvassed and these views are taken into account. This report refers to comments residents made to the commission. The assistant manager says that resident’s views will be sought more regularly and formally from now on. Residents manage their own financial affairs or have assistance from their family or representative. Additional charges are carefully recorded and residents are provided with detailed records of all additional payments requested from them. Members of staff try to minimise risks to residents by good practice. The safety of residents would, as stated elsewhere in this report, be enhanced if all staff receive the full range of “mandatory” training. The level of fire safety training has increased. As a result of recommendations in the previous inspection report, accident and complaint/concern records have improved for the benefit of staff and residents. The annual quality assurance assessment (AQAA) contains a declaration that all necessary maintenance and safety certificates are in place and up-to-date. Responses from residents as contained in their completed commission quality assurance questionnaires indicate a high level of satisfaction with procedures at the home. The main request is that serious consideration is given to helping them remain more mentally and physically active. Rosset Holt Home DS0000023998.V340268.R01.S.doc Version 5.2 Page 22 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 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 x x x 3 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 Rosset Holt Home DS0000023998.V340268.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Rosset Holt Home DS0000023998.V340268.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Rosset Holt Home DS0000023998.V340268.R01.S.doc Version 5.2 Page 25 - 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. 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