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Inspection on 28/11/08 for Rossetti Lodge Residential Home

Also see our care home review for Rossetti Lodge Residential Home for more information

This inspection was carried out on 28th November 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

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

The location of this home, within walking distance of Minnis Bay sea front views and to the community facilities of Birchington shopping centre and other seaside towns, is likely to be attractive to current and potential residents. The property has retained a number of original, characterful features. Comprehensive pre-admission assessments are carried out to determine whether the residents` needs can be met. The acting manager is very experienced and knows the service, staff and residents well. The home promotes Equality and Diversity and procedures are in place. Residents have a choice to follow any religious beliefs they may have and are encouraged to do so. Care plans are person centred involving the resident in writing and reviewing their plan of care. Any special dietary needs are catered for and any physical disability people may have is taken into account at the pre-admission stage. Residents said they enjoy living at Rossetti Lodge and are happy there. There is an open, welcoming and friendly atmosphere with good communication between residents, staff and visitors. It was observed and confirmed by residents that staff are kind, patient and respectful. The acting manager reported good relationships with a range of health professional who regularly visit the home. Residents said they liked the choice of varied, wholesome food. A new chef has recently been appointed. Staffing levels are good and staff are well trained, supported and supervised. The home has access to the Kent County Council`s `Training 4 Care` initiative. NVQ training is encouraged and 50 % of staff have completed NVQ 3. A further 2 staff members are doing NVQ 3. Good recruitment procedures are followed to ensure that residents are protected. The home provides a homely environment for its residents. However, an Infection Control issue has still to be addressed.

What has improved since the last inspection?

The Statement of Purpose and Service User Guide have been updated providing residents and relatives with information about the home. Information in the AQAA confirms that one of the previous requirements and most of the recommendations have been acted upon. Care plans are comprehensive, person centred, underpinned by risk assessments and regularly reviewed.Activities have improved and minibus outings organised. A new nurse call system has been installed. All policies and procedures have been reviewed in 2008 thus providing staff with current information to underpin their practice. Staff have received a good training package.

What the care home could do better:

The acting manager is not registered with the CSCI. She has not yet started training for the registered manager`s award (RMA). This is a requirement of this report. An Infection Control issue, identified at the previous inspection, has not been resolved. During this inspection a number of options to facilitate this were discussed. Whilst residents are treated with respect for their dignity, staff must be mindful that continence aids are discreetly stored and toiletries are personal to the residents. The home must develop an annual development plan as part of the home`s quality assurance system. This issue has been identified at previous inspections. This is a requirement of this report. The views of all stakeholders should be central to both processes, to properly measure the home`s success in meeting its aims, objectives and Statement of Purpose. It is acknowledged that Regulation 26 visits are now carried out and records maintained.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Rossetti Lodge Residential Home Rossetti Lodge Residential Home 3 Sea View Road Birchington Kent CT7 9LB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lisbeth Scoones     Date: 2 8 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Rossetti Lodge Residential Home 3 Sea View Road Rossetti Lodge Residential Home Birchington Kent CT7 9LB 01843841571 01843848180 g.fielder@rossetticare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Kiki Clementina Cole Type of registration: Number of places registered: care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 24 The registered person may provide the following category of service only:Care home only-( PC) Tto service users of the following gender: Either Whose primary care needs on admission to the service are within the following category Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Rossetti Lodge is a detached two-storey building in a quiet residential setting, situated on the corner of Sea View Road and St Mildreds Avenue. It has 15 ground floor bedrooms and 4 bedrooms on the first floor. There are 5 double bedrooms, currently used for single occupancy, and the remainder are all registered as single rooms. As this home pre-existed the National Minimum standards, an exemption has applied in respect of its spatial dimensions, most notably in respect of its bedroom space. Nine Care Homes for Older People Page 4 of 28 Over 65 24 0 Brief description of the care home are below 10 sq.metres (the standard now is 12 sq.m) and only one double room meets the standard that now applies (16 sq.m). All the bedrooms have a call bell point and a number have television points. There is a stair lift to the first floor. There are 3 lounge areas and 2 dining areas, on the ground floor, all interlinked. There is a small front garden (the entrance to the property opens straight onto pavement) but the lounge and all the ground floor bedrooms have their own patio door onto a rear garden, enclosed on all sides, with areas put to lawn and flowerbeds. In terms of access and community links, the home is within walking distance of a bus top and the local railway station (which includes a regular London service), seafront and Birchington town centre, with all the community facilities and transport links that implies. There is no on-site parking but there is unrestricted kerb-side parking on Sea View Road and St Mildreds Avenue. Care staff work a rota that includes two waking carers on duty at night. The current weekly fees range from £350 - £420. Additional charges payable include: clothing, toilet requisites, stationery, dry cleaning, hairdressing, chiropody, physiotherapy, newspapers, special beverages / meals, medical requisites (other than by prescription), spectacles, hearing aids, batteries and continence aids. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection was carried out on 28th November 2008. It comprised discussions with the acting manager, the care staff on duty, maintenance man and conversations with a number of residents and two visiting relatives. An accompanied tour of the premises was carried out, a lunchtime session observed and documentation examined in respect of care plans and risk assessments, staff rota, staff and training files, training matrix and medication records. The acting manager was present and assisted throughout and a comprehensive feedback was given at the end of the inspection. Key Lines of Regulatory Assessment (KLORA) have informed the judgments made based on records viewed, observations made and written and verbal responses received. KLORA are guidelines that enable The Commission for Social Care Inspection Care Homes for Older People Page 6 of 28 (CSCI) to make an informed decision about each outcome area. The inspection was further informed by an AQAA (annual quality and audit) completed by the acting manager. 9 Residents and 5 members of staff returned a comment card sent to the home prior to the inspection. Comments thus received are incorporated in the report. The acting manager reported in the AQAA that the home had received one complaint, which was investigated and resolved. No safeguarding vulnerable adult referrals were made. The last Key unannounced inspection was carried out on 13th December 2007. What the care home does well: What has improved since the last inspection? The Statement of Purpose and Service User Guide have been updated providing residents and relatives with information about the home. Information in the AQAA confirms that one of the previous requirements and most of the recommendations have been acted upon. Care plans are comprehensive, person centred, underpinned by risk assessments and regularly reviewed. Care Homes for Older People Page 8 of 28 Activities have improved and minibus outings organised. A new nurse call system has been installed. All policies and procedures have been reviewed in 2008 thus providing staff with current information to underpin their practice. Staff have received a good training package. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using 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. Residents are provided with information about the services the home provides. Residents can be confident that they are appropriately placed due to good preadmission assessments and are able to visit the home prior to admission. This home does not provide intermediate care. Evidence: Since the previous inspection, the Statement of Purpose and Service User Guide have been updated. They are available to residents and their relatives and were seen on display and in residents care files. They are also available from the homes website. A large print version is available. It was evident that residents are assessed by the acting manager or other senior staff Care Homes for Older People Page 11 of 28 Evidence: prior to admission. This is done to ensure that the home can meet the needs of the residents. The acting manager said that the assessment form and care plan front sheet are to be amended to ensure that information re equality and diversity is adequately covered. Prospective residents or representatives are encouraged to visit the home and each resident is offered a trial stay of four weeks before their admission is confirmed by contract. Prospective residents, their families, advocates and relevant health care professionals are involved in the assessment process. Specialist advice is sought from external sources where required. Rossetti Lodge does not provide Intermediate care. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using 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. Residents health and personal care are recorded in an individual needs assessed care plan which is current and regularly reviewed. Residents are mostly protected by the homes medication procedures. Residents are treated with dignity and respect for their privacy. Evidence: Each resident has a care plan and three were inspected in detail. Since the previous inspection these have much improved, are person centred and provide comprehensive information. Care plans are underpinned by risk assessments as necessary, which are regularly reviewed. A recommendation was made that these are extended, e.g. re skin integrity for people at risk of skin breakdown. Residents and their relatives are involved in care plan review. It was recommended that this be evidenced on the care plan. One relative said that although she was aware there was a care plan, she had not contributed to it. Care Homes for Older People Page 13 of 28 Evidence: Staff write daily records at the end of each shift. These include a checklist re personal care provided. It is evident that residents are referred to specialists as their needs change. The manager and staff reported that they have a very good rapport with outside professionals such as GPs, pharmacist, district nurses and care managers, chiropodist, dentist and optician. The acting manager reported that formal care reviews by care managers now take place more regularly. The delay in such reviews had been described in previous reports. It was recommended for monitoring purposes that these reviews are recorded on the professional page. Body maps are used to record any wound care, bruises and injuries. Residents weights are monitored regularly. A dietician is available for nutritional advice. Staff spoken with have a good understanding of residents individual needs and preferences. A key worker system is in place. This would ensure a rapport and continuity of care. Medication is kept in a trolley in the staff room, which also contains training records and other documentation. Medicines are only administered by staff who have been trained. The acting manager reported that two members of staff are to receive medication/refresher training. MAR charts were examined and in general well maintained. The majority of these are computer generated by the pharmacist but some are hand written. It was observed that medicines are administered in accordance with the homes guidelines. Controlled medication is kept in an appropriate cupboard. A CD audit was satisfactory. It was recommended that an initials list be completed, that all handwritten transcriptions be double signed, that medication for disposal is clearly separated from those in use and that the carpet be replaced with a floor covering that is washable. Residents feel that staff are kind and gentle, this was confirmed by observation and discussion with visitors. Staff treat the residents with courtesy and respect for their privacy and dignity. Staff should however be mindful that continence aids are discreetly stored and that all toiletries are personal to the residents. A residents relative said, I cant fault them in any way. Another, They are kind and friendly. A discussion ensued about staff knowledge of residents thoughts and wishes at the time of their death. The manager reported that 9 members of staff have received palliative care training in 2008. See also standard 30 in respect of staff training. Care Homes for Older People Page 14 of 28 Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using 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. Residents are provided with suitable activities that meet their needs. Residents are given choices thus allowing for some level of control over their lives. They are supported to keep in contact with family and friends. Residents are provided with a choice of wholesome and appetising meals. Evidence: Residents past interests, likes and dislikes and key information are noted in their individual records and this includes religious practice if the resident wishes. Good examples of Life Histories were seen. Such information would assist the staff in meeting residents social and cultural needs. Choices are available at mealtimes and the care plans reflect residents choices about their routines. An activities timetable was seen on display, which is applied flexibly. Examples include interactive pursuits such as Bingo, board games, puzzles and quizzes, jokes and poem sessions, sing-song sessions and cards and puzzles. At the time of the inspection a music for health session was in progress. This is provided once a month and much enjoyed by the residents. Some residents like to read magazines, books or papers. A Care Homes for Older People Page 16 of 28 Evidence: residents interest in gardening was encouraged by the planting of bulbs and creating of flower baskets. One or two residents go out of their own accord. A hairdresser visits weekly. The home does not employ an activities organiser and a senior care worker has taken the responsibility for coordinating activities within the home. Staff were interacting with the residents in a pleasant and chatty manner. The home provides in-house entertainments and minibus outings. There are weekly exercise sessions and volunteers visit the home bringing their pets. The home provides a communion service. A photo board showed pictures of much enjoyed events. There was evidence that the home is getting ready for Christmas with the assistance from the residents. It was evident that relatives are made welcome. Two visitors who visit frequently were spoken with. They look after my Mum, They are good to her and make me feel welcome were comments made. The home has recently employed a new chef who was off duty on the day of the inspection. The acting manager was in charge of cooking that day. It was evident that food choices are always offered as well as cakes, fruit and drinks throughout the day. Five care staff have received Food Hygiene training in 2008. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using 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. Residents feel comfortable to raise any concerns they may have knowing that these will be dealt with swiftly and discreetly. Residents are protected from harm. Staff are very clear about their responsibilities relating to protecting residents. Evidence: A complaints leaflet is readily available to residents and their relatives. A complaints procedure is available as well as a complaints and concerns box. Residents and relatives spoken with said they would know who to speak to when they had a complaint. I tell the manager, said a visitor. A resident told the inspector of his concerns. The acting manager is aware of the issues and is trying to address these. The Home keeps a record of all complaints received by them. The AQAA received prior to the site visit indicates there had been one complaint received by the home in the last 12 months. This was addressed within the 28-day timescale. The Commission has not received any formal complaint since the last inspection. See also standard 33 in respect of quality assurance. Current procedures for responding to suspicion or evidence of abuse or neglect are in place to ensure the safety and protection of residents. The Manager and other staff Care Homes for Older People Page 18 of 28 Evidence: spoken with have a sound understanding of safeguarding vulnerable adults procedures. Staff are well supervised and seven care staff have received safeguarding vulnerable adults training in 2008. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents experience a good quality of life in an environment that is homely, clean, safe and well-maintained environment. All areas visited were comfortably warm, fresh and free from unpleasant odours. The home must ensure that residents are protected from the risks of infections by ensuring that robust preventative systems are in place. Evidence: All areas of the home inspected were found to be comfortable and reasonably clean and there were homely touches throughout. Comfortable temperatures were maintained throughout the inspection visit. Bedrooms visited were in general homely with residents personal belongings. Those on the ground floor have access to the enclosed courtyard garden. There area no ensuite facilities. The previous report recorded that some showers, baths and WC facilities are not being used. It further recorded that the sluicing facility had been assessed by the Kent Protection Agency. At this inspection, a review of these facilities was discussed in the context of the homes plans to install a sluice facility. Further evidence of such Care Homes for Older People Page 20 of 28 Evidence: discussions was noted in records of Regulation 26 visits. It is the providers responsibility to ensure that residents are protected from the risk of infection by having robust preventative systems in place. The previous inspection reported an improvement of better quality furniture, soft furnishing and carpets. Following that inspection a new call bell system has been introduced. As part of the homes development plan, further improvements to the home must be identified with timescales for implementation. It was noted that lighting in the library room is still inadequate for people who wish to read. The library is also used as a thoroughfare to the staff room and two residents bedrooms. The area is further used to store large pieces of equipment such as a hoist and weighing scales. It is recommended that the use of this room be reviewed for the comfort and safety of the residents. It was further noted that the lounge carpet was worn and stained and would benefit from replacement. See also standard 33 in respect of quality assurance. The previous inspection reported that there is a limited range of equipment and adaptation available in this home. Overall periodic audits by specialists such as Occupational Therapists have been strongly recommended to ensure the home maintains its capacity to meet the needs of its residents. This recommendation still stands. At this inspection three members of staff said that the homes moving and handling equipment is not adequate. This was discussed with the acting manager who said that additional equipment is being purchased. The maintenance person works full time and is responsible for all maintenance, improvements and safety checks. He demonstrated a genuine commitment to provide a good service to the residents. Hot exposed pipe work was noted in a bathroom/toilet area. This was immediately acted upon but should have been dealt with prior to the inspector pointing it out. See also standard 33 in respect of quality assurance which should include safety checks. The AQAA reported that all maintenance checks are up to date including the current gas safety certificate and electrical installation certificate. Additional detail in respect of electrical work to be carried out was provided. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using 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. Residents are cared for by sufficient numbers of staff who are well trained and supervised. Residents are protected by a sound recruitment process. Training is available to the staff providing them with the skills required to meet the needs of the residents. Evidence: The acting manager reported that there is a stable workforce with some care staff having worked in the home for many years. Due to recent departures, agency staff are sometimes used to make up the shortfall. Two residents said that they prefer to be looked after by the regular staff who know them well. The current occupancy is 14 residents. For the number and dependency of the residents it would appear that adequate staffing levels are maintained. Staff and residents confirmed that in general there are sufficient numbers of staff on duty to care for the residents. Staffing levels for the morning shift comprised the acting manager (who was also cooking that day), two care workers, a domestic and laundry person and maintenance man. A musical activity was provided during the inspection. The home employs a Finance and Admin manager who has been working at the home since 2002. Care Homes for Older People Page 22 of 28 Evidence: Residents and their relatives spoke highly of the staff. They said that staff are very pleasant and caring. They do anything for you. The record of a recently employed care worker confirmed that robust recruitment procedures are in place and the home employs only staff that have been properly vetted. Staff are required to undertake a Skills for Care compliant induction programme. Since the previous inspection, staff training and supervision have much improved. 50 of care staff have an NVQ level 3, two care staff have enrolled in 2008 to take the level 3 NVQ. The chef has started NVQ level 2 in catering and the domestic a level 3 in care. Staff benefit from access to Kent County Councils Training 4 Care programme, which provides statutory and specialist training. In addition to statutory training, staff have received training in diabetes, palliative care, challenging behaviour, mental capacity act and adult protection. A training matrix and training analysis give a good overview of training had and planned. Staff spoken with said they enjoyed the training. It was further reported that staff meetings and supervision keep staff informed and up to date. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using 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. Residents are cared for by an acting manager who is competent and experienced but not registered with the CSCI. She runs the home in an open inclusive manner and involves residents in decision-making. The quality assurance system places the views of residents and their relatives at the centre. The system however is not formalised and not part of the homes development plan. Residents safety and well being is being protected and promoted. Evidence: Since the previous inspection, in January 2008, the registered manager has left. The home is currently managed by the acting manager who has been working at the home for 11 years and became the deputy manager in 2003. She is supported by a Finance and Admin manager and senior care staff. The acting manager is yet to be registered Care Homes for Older People Page 24 of 28 Evidence: with the CSCI and has yet to enroll for the registered managers award (RMA). She has a NVQ level 3 qualification in care. The acting manager was present and assisted the inspector throughout the visit. The atmosphere at Rossetti Lodge is relaxed and the open door policy evident at this inspection. All staff spoke highly of the acting managers organisational and communication skills. Staff confirmed that they have regular supervision and attend staff meetings. The home is not involved with residents monies. The home pays for chargeable items and invoices the residents. All residents are provided with a lockable drawer to safely keep items of value to them. In respect of quality assurance, no formal system is in place that ensures that the service is continually reviewed. As reported at previous inspections, in order to demonstrate that the home is run in the best interests of the residents, the provider must produce an annual development plan. A (preferably professionally recognised) quality assurance system should evidence that there is continuous self-monitoring involving the residents and internal audits should take place at least annually. It is acknowledged that Regulation 26 visits are carried out regularly and records of such visits were seen. The previous inspection reported that a satisfaction survey was carried out in November 2007. No such surveys were carried out in 2008 apart from one in respect of food choices when a new chef was employed. Policies and procedures have been reviewed in 2008. The full time maintenance person keeps the home well maintained, decorated and safe. He carries out safety checks in respect of hot water, fire drills and fire equipment testing. See also standard 25. As reported on the AQAA, all property maintenance records are up to date. Accident records are well maintained and the CSCI is made aware of any reportable incident in accordance with Regulation 37. Staff are provided with all statutory training at regular intervals. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 31 9 That the registered person employs a registered manager and that an application be received within three months (28 February 2009) To ensure that the manager is appropriately qualified 28/02/2009 2 33 24 That the registered person 28/02/2009 shall establish and maintain a system of reviewing and improving the quality of care at the care home To ensure that the standards of care at the care home are reviewed and improved Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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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