CARE HOMES FOR OLDER PEOPLE
Rossetti Lodge Residential Home Rossetti Lodge Residential Home 3 Sea View Road Birchington Kent CT7 9LB Lead Inspector
Christine Grafton Announced Inspection 6th December 2005 09:40 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 Rossetti Lodge Residential Home DS0000023514.V259791.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rossetti Lodge Residential Home DS0000023514.V259791.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Rossetti Lodge Residential Home Address Rossetti Lodge Residential Home 3 Sea View Road Birchington Kent CT7 9LB 01843 841571 01843 848180 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) Ms Kiki Clementina Cole Lisa Abdullah Care Home 24 Category(ies) of Past or present alcohol dependence (1), Old registration, with number age, not falling within any other category (23) of places Rossetti Lodge Residential Home DS0000023514.V259791.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. To admit one (1) Service User with past or present alcohol dependence, whose date of birth is 19/09/40 . 8th June 2005 Date of last inspection Brief Description of the Service: Rossetti Lodge is a detached building with 15 ground floor bedrooms and 4 bedrooms on the first floor. There are 5 double bedrooms identified on the home’s schedule of accommodation, including one that is only 12.8 sq.m., currently used as a single. The remainder are all singles. Bedroom sizes were previously agreed as a pre-existing home and several are smaller than the national minimum standards specify. There is a stair lift to the first floor. All bedrooms have a call bell point and some rooms have television points. There are 3 lounge areas and 2 dining areas, all interlinked. The majority of the ground floor bedrooms have a patio door leading to the enclosed rear courtyard garden, with lawn and flowerbeds. The home is within easy reach of the railway station, seafront and local shops. The home is staffed by a manager and team of carers, plus a cook. Care staff work a rota that currently consists of two waking carers on duty at night. According to the homes statement of purpose, it aims to provide the best possible care and consideration in comfortable surroundings within a homely atmosphere. Rossetti Lodge Residential Home DS0000023514.V259791.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an announced inspection carried out by two inspectors over a two-day period lasting 9 hours. Additional time was spent in preparation and report writing. The main focus of the inspection was to check progress made in meeting the 15 requirements and 3 recommendations from the last unannounced inspection of 8th June 2005 and look at some of the key standards. Time spent in the home comprised of: a tour of the building, talking to the manager, 2 staff members, 6 residents and checking records. As part of the pre-inspection process, a pre-inspection questionnaire was completed and has been used in the preparation of this report. Feedback was sought from residents and relatives prior to inspection. 14 residents and 4 relatives returned their comments cards. These provided useful feedback about the home and services provided. Issues raised were explored during the inspection. At the time of this inspection there were 14 residents. The care of 5 residents was case tracked. What the service does well: What has improved since the last inspection?
There have been some improvements in the quality of the care plans, medication storage and procedures. There is a new medication trolley, a proper medication refrigerator and controlled drugs cupboard. These were seen to be clean and well organized and the trolley has the capacity to hold all of the medications.
Rossetti Lodge Residential Home DS0000023514.V259791.R01.S.doc Version 5.0 Page 6 Some improvements have been made to the environment since the last inspection, including: the redecoration of the entrance hall, dining room, shower rooms and five bedrooms. Some new carpets have been fitted and those in the inner hall and stairs have made quite a difference. New flooring in the kitchen is another improvement and there are also two new refrigerators and a microwave. What they could do better:
Whilst it is recognised that some improvements have been made since the last inspection, there is still much that the management needs to do to meet all of the key standards. This is necessary to make sure that residents receive consistent care in a clean, homely and safe environment. There are a number of things identified in this report that follow on from the last two reports, where either no action has been taken, or insufficient action taken. The main things are as follows, but the reader is advised to read the full report for details of other things identified at this inspection that do not meet the standards and where improvement is necessary. The number of staff on duty during the day is still not sufficient to ensure that the home is kept clean, hygienic and odour free. Bedrooms were dusty and carpets dirty. Care staff were having to fit cleaning tasks in between their care tasks. Staff also have to leave the main building to attend to the laundering of residents’ clothing and bedding. There have been some changes in residents’ dependencies since the last inspection, but even with the loss of a highly dependent resident, the management must make sure that all residents changing needs are accurately reflected in their care plans and regularly reviewed. There were inconsistencies in the care plans that could place residents at risk of their needs not being properly met. The manager needs to monitor the way staff administer the medications to make sure that they follow the safe procedures. Building maintenance still needs to be improved. The management have been asked at the last two inspections to draw up a maintenance and improvement plan, but this has not been forthcoming, so has again been requested. As all of the lounge and dining areas are interlinked and cannot be closed off, smoke pervades throughout these communal areas from the designated smoking area in the sun lounge at the back. This is not very nice for those people who do not smoke. The smell of tobacco smoke was apparent in the inner hall, before the lounge door was opened. The management have been asked to look at ways to provide a smoke free environment for those who do not smoke. No action has been taken to make sure that the call bell system is readily accessible for residents in bedrooms and communal areas. The call bells do not have the facility to attach pull cords, so residents have to be able to reach the call bell push on their bedroom wall to summon help. There is no call bell
Rossetti Lodge Residential Home DS0000023514.V259791.R01.S.doc Version 5.0 Page 7 point in the lounge areas. This impacts on the number of staff needed on duty, particularly during the evenings, when there is only two staff on duty. Improvements are needed in the procedures for maintaining hygiene and infection control in the home. If a designated cleaner cannot be recruited, there must be a separate designated person to do the cleaning each day, in addition to the care staff, to make sure that the home is kept clean. The way clinical waste is moved between the ground floor bathroom and the sluice room needs reviewing to make sure it does not place staff at risk of harm. The procedure for accessing the sluice room by going through the kitchen poses a number of safety risks that must be addressed within a formal procedure that takes account of food hygiene regulations and health and safety. 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. Rossetti Lodge Residential Home DS0000023514.V259791.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rossetti Lodge Residential Home DS0000023514.V259791.R01.S.doc Version 5.0 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&3 The home’s statement of purpose and service users’ guide do not provide all the necessary information for prospective residents to make an informed choice about the home’s suitability. The home makes sure that prospective residents’ needs are properly assessed before they move into the home. It is not the general policy of the home to admit people for intermediate care, so standard 6 was judged as not applicable at this inspection visit. EVIDENCE: The home’s statement of purpose and service users’ guide are displayed on notice boards in the entrance hall and in the dining room. There is also a wealth of other information on display and readily available for residents and visitors to read. This includes the complaints procedure and copies of the home’s previous inspection reports. However, the statement of purpose and service users’ guide do not make it clear about the number of bedrooms that do not meet the minimum size specified in the standards, or certain other physical aspects of the building that fall below the standards, but have been agreed as a pre-existing home. Rossetti Lodge Residential Home DS0000023514.V259791.R01.S.doc Version 5.0 Page 10 The manager confirmed that she carries out pre-admission assessments for prospective residents at their own homes or in hospital. A new resident had been admitted since the last inspection, but due to the distance away that the person lived; the home had liaised with the care manager and had obtained a faxed copy of the care management assessment two weeks before admission. This was seen to contain detailed up to date information that covers all the things specified in standard 3. The home had started its own assessment process upon admission and a plan of care for daily living had been drawn up. Rossetti Lodge Residential Home DS0000023514.V259791.R01.S.doc Version 5.0 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 9 The home’s care planning system has improved and generally provides adequate information. However, the care plans and healthcare records still contain gaps that place residents at risk of their needs not being fully met. Medication practices have improved but care staff were not complying with the medication procedure to ensure the safe handling of medicines. EVIDENCE: The care of five residents was case tracked and it was seen that the quality of the care plan records was variable. The care plans contained information covering a range of care needs and action plans for staff to follow. However, in some cases evident needs had not been included and some care plans had not been updated, even though it was clear that needs had changed. Risk assessments were seen as part of the care plan documentation, but these are still generalized and not specific. The recording of relevant information, cross-referencing and reviewing of information still needs to be developed. For example, a continence review did not reflect the increase in assistance needed as indicated in the personal hygiene section of the care plan and the care needs identified in the care plan were not reflected as being provided in the daily records.
Rossetti Lodge Residential Home DS0000023514.V259791.R01.S.doc Version 5.0 Page 12 The care plan for a resident who was having leg dressings carried out by the community nurses had nothing recorded about this treatment. There was no detail of any leg ulcer on the body map chart and a dislocated hip identified on the body map was not referred to in the care plan. Without this, staff are dependent upon the verbal transfer of this information, which is dependent upon staff memories. The manager stated that the community nurses keep their notes at the home while the treatment continues. However, as these notes are kept separately there still remains the risk that this information could be overlooked and that staff might not know how to meet the resident’s needs. The home has a new medication trolley, a proper medication refrigerator and controlled drugs cupboard. These were clean and well organized and the trolley was of sufficient size to hold all of the medication. However due to there being a step to the room where this is stored, staff are not able to wheel the trolley around the home for the medication round. The lunchtime medication round was observed and overall, practices and record keeping have improved. However, it was observed that medication was being administered from a bottle without first reading the label to ensure the correct medicine was being given to the correct resident. The first medication round of the day is at 08.30hrs the same time breakfast is served, therefore those needing to take medicine on an empty stomach are not receiving the medicine at the correct time. Staff spoken to expressed that they would like to be able to use the new medicine trolley to wheel around the home. Rossetti Lodge Residential Home DS0000023514.V259791.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 & 14 The lifestyle at the home satisfies the expectations and preferences of current residents, who are able to exercise choice and control over their lives, within their capacity to do so. Residents are provided with limited opportunities for stimulation. EVIDENCE: Several residents spoke about their individual pastimes and interests, including reading, watching television and listening to music. Some residents spoke about their enjoyment in taking part in the twice-weekly activity sessions. However some comments were made that there is not much to do on the remaining afternoons when the leisure therapist is not there. Residents confirmed that daily routines are flexible and that they can choose how they wish to spend their time. Some choose to stay in their bedrooms, except for meal times, while others prefer to sit in the lounges, either for some of the time, or for the whole day. Residents said their visitors call at various different times. Relatives’ comments cards returned indicated that they are made to feel welcome whenever they visit. The manager gave examples of how residents have been encouraged to exercise choice and maintain control over their lives; for example, one resident has their own electric kettle and refrigerator in their bedroom. Residents are encouraged to bring their personal possessions into the home and a number of rooms have been personalised.
Rossetti Lodge Residential Home DS0000023514.V259791.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The home has a satisfactory complaints procedure. Residents feel that their concerns are listened to and would be acted on. Policies and procedures are in place to safeguard residents from abuse. EVIDENCE: Residents spoken to said they had no complaints and felt comfortable in speaking with the manager or staff if they had any worries. The home’s complaints notice is prominently displayed in the entrance hall and dining room. There is a system in place to record any complaints and show the follow up action taken. The home has a policy and written procedures on abuse, ‘whistle blowing’ and restraint, which are kept in the staff room. The manager confirmed that these policies are covered at staff induction and are regularly discussed. The manager confirmed that any suspicions of abuse would be reported to care management and to the commission. Rossetti Lodge Residential Home DS0000023514.V259791.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 22, 23, 24, 25 & 26 There was some evidence of improvement to the décor of the home since the last inspection, but the outstanding matters still do not provide residents with a safe and pleasant environment to live in. The call bell system does not provide sufficient protection for residents. The home is not being kept sufficiently clean and hygienic. Infection control procedures still pose a risk to residents and staff. EVIDENCE: A number of areas in the home have been redecorated since the last inspection, including: the entrance hall, dining room, shower rooms and five bedrooms, with some new carpets fitted, for example in the inner hall and on the stairs. New flooring has been fitted in the kitchen and two new refrigerators and a microwave provided. Woodwork has been painted in various other places, for example, skirting boards and doorframes. However the previous requirement to submit an action plan to the commission for a maintenance and improvement programme has not been met. Rossetti Lodge Residential Home DS0000023514.V259791.R01.S.doc Version 5.0 Page 16 Building issues identified at previous inspections still remain, for instance: the first floor bathroom and a rotten window frame in one bedroom. A number of other maintenance/refurbishment issues were identified at his inspection, including: moss on the external fire escape, difficulty in sliding the sun lounge patio doors open and shut, the lack of an extractor to remove tobacco smoke from the sun lounge area where residents smoke, a water leak in the sun lounge roof, some worn carpets and dusty wheelchair frames. The call bell system does not provide call points in lounge areas and call bells in bedrooms can only be reached at the point of source. The radiator in the ground floor bathroom is unguarded and was very hot to touch. The home is currently without a cleaner, so care staff are cleaning bedrooms in the afternoons in between their care tasks. A number of bedroom carpets were dirty and in need of cleaning, furniture was dusty and cobwebs were seen hanging from ceilings in places. There were offensive odours in two bedrooms. The procedure for the transfer of clinical waste includes lifting clinical waste bags through the ground floor bathroom window to the sluice room on the other side. Staff then have to walk through the kitchen to access the sluice room from the outside of the building. A staff member described the procedure for dealing with clinical waste and the cleaning of commode pans that includes the changing of protective clothing and hand washing. However this procedure has not been written down and there is a risk of the spread of infection if the staff do not follow the correct procedures when going through the kitchen to complete these tasks. Rossetti Lodge Residential Home DS0000023514.V259791.R01.S.doc Version 5.0 Page 17 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 & 30 The number of staff available is not sufficient to meet residents’ needs and maintain a clean environment. Recruitment procedures are generally sound, but some improvements are necessary to make sure service users are fully protected. The induction training of new staff is sufficient to ensure they have the required basic skills of care. EVIDENCE: Five weeks staff rotas were seen. These indicate that there are two carers on duty throughout the day, plus the manager works supernumerary shifts over a five-day period, on which days she acts as the third person. At weekends there are two staff on duty for care, plus one person for cooking in the mornings. Care staff have to perform non-care duties such as doing the cleaning, attending to the laundry (that requires them leaving the main building to access the laundry in the grounds) and dealing with the evening meal (when the rota indicates there are only two staff on duty). The home currently employs 11 care staff and a cook, plus the manager. At least half of the care staff work part-time and all of them work as both carers and cleaners, with some staff doing the cooking on the cook’s day off. Residents said that the staff are kind and caring but very busy. The manager said there have been difficulties in recruiting a part time cleaner. A relative’s comment card indicated a shortage of staff had affected the cleanliness of a bedroom and the state of a resident’s dress. The staffing levels do not take into consideration the impact on the care duties that non-care tasks require.
Rossetti Lodge Residential Home DS0000023514.V259791.R01.S.doc Version 5.0 Page 18 Two staff files were checked for new staff employed since the last inspection. These were seen to contain most of the relevant paperwork in relation to the requirements of legislation, for example application forms, identity checks, references, job descriptions and statements of the terms and conditions of employment. A record sheet is completed showing dates the criminal records bureau (CRB) checks had been applied for, with the reference number, but it was unclear when the completed CRB disclosures were received. There were separate e-mail print off records of the POVA first checks. The files lacked evidence of full employment checks and interview records. Evidence in staff files sampled indicates that the induction process meets the Skills for Care specification and had been completed in the appropriate timescale. The training matrix indicates that staff have attended a variety of training days this year, plus there are a number of short courses planned between January and March 2006. Rossetti Lodge Residential Home DS0000023514.V259791.R01.S.doc Version 5.0 Page 19 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35, 37 & 38 Satisfactory procedures are in place to safeguard residents’ financial interests. Some record keeping improvements are necessary to fully safeguard residents’ best interests. Some working practices do not promote the health, safety and welfare of residents and staff. EVIDENCE: The manager stated that in most cases, relatives assist residents with their financial affairs and bring in spending money for them. Some relatives prefer to be invoiced for expenditures such as chiropody and hairdressing and records were seen. One resident’s personal allowance record did not show the actual amount of personal allowance received, as expenditure for cigarettes had been deducted before the entries. Receipts for items purchased were seen and the records included two staff signatures. Rossetti Lodge Residential Home DS0000023514.V259791.R01.S.doc Version 5.0 Page 20 As well as the individual daily records in residents’ care plans, staff write notes in a communal report book and a staff communication book. Entries in these communal books were seen to contain confidential information about some residents that should only be recorded in their individual records. Some health and safety issues were raised with the manager, including the method for washing the commode pans, access to the sluice room via the kitchen and the non-use of footplates when moving residents in wheelchairs. Environmental risk assessments were seen to be updated in April 2005, but these did not address risks identified at this inspection. The fire safety logbook was seen to be in order except that monthly emergency lighting tests were not recorded. Portable electrical appliance tests had not been completed. Rossetti Lodge Residential Home DS0000023514.V259791.R01.S.doc Version 5.0 Page 21 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 2 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 2 2 2 2 2 1 STAFFING Standard No Score 27 1 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x 2 x 2 2 Rossetti Lodge Residential Home DS0000023514.V259791.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation 6 Requirement Timescale for action 31/03/06 2 OP7 3 OP8 The statement of purpose and service users’ guide must contain clear and accurate information about the physical environment, indicating where it falls short of the minimum standards. (Previous requirement made 24/11/04 not met). Up to date copies of both documents to be submitted by 15 Care plans must be accurately 31/01/06 completed. Monthly reviews must be carried out and recorded. Care plans must be updated when changes occur. (Previous requirement 24/11/04 & 08/06/05 partially met and carried forward). 12, 13, 14 Residents health care needs 31/01/06 & 15 must be fully met. The registered persons must ensure that needs identified in the various assessment tools are followed up. New needs identified in the daily records must be followed up and recorded in the care plans. (Previous requirement 08/06/05 partially met and carried forward).
DS0000023514.V259791.R01.S.doc Version 5.0 Rossetti Lodge Residential Home Page 23 4 OP9 13(2) 5 OP19 23 6 7 OP20 OP22 23 16, 23 8 OP25 13(4) 9 OP26 13(3) 16(2) The registered persons must ensure that staff adhere to the correct procedure for administering medications. Medications must be administered at appropriate times in accordance with the BNF guidance. An action plan must be submitted showing a building audit and programme for delivering a safe, wellmaintained environment with planned timescales. To cover previous outstanding requirements from 24/11/04 and 08/06/05, plus those identified at this inspection. The registered persons must take action to ensure that there is a smoke-free sitting room. The registered persons must take action to ensure that the call bell system in the home is suitable to meet residents’ needs. Residents must be able to summon assistance from bedrooms, toilets, bathrooms and lounges with the addition of pull cords if necessary. (Previous requirement 24/11/04 and 08/06/05 to submit an action plan with timescales for replacement and interim measures to add additions - not met). The registered persons must take action to address the risk of burns from the unguarded bathroom radiator. Action plan to be submitted. (Previous requirement 08/06/05 not met). The registered persons must ensure safe infection control procedures are followed. System for the transfer of clinical waste to be reviewed and action taken to ensure safety, including
DS0000023514.V259791.R01.S.doc 31/01/06 31/01/06 31/01/06 31/01/06 28/02/06 31/01/06 Rossetti Lodge Residential Home Version 5.0 Page 24 the provision of foot operated pedal bins. There must be a written procedure for staff to follow when dealing with the transfer of commode pans to the sluice room and the staff access to the sluice via the kitchen. (Previous infection control requirement 08/06/05 partially met). The home must be kept clean, hygienic and free from offensive odours. The registered persons must provide sufficent numbers of suitably qualified, competent and experienced staff on duty to meet residents’ needs. Staffing numbers must be appropriate for the health and welfare of all residents, including suffient ancillary staff. Evidence to be submitted. (Previous requirement 08/06/05 and 24/11/04). The registered persons must ensure that staff files contain all of the information specified in the regulations, to include evidence of completion of CRB/POVA checks, full employment checks and interview records. (Previous requirement 24/11/04). The registered persons must keep a record of the full amount of money received on behalf of a resident, plus any amount returned, or used, on the resident’s behalf. Personal information about the care provided to residents must be recorded appropriately in their individual files. The registered persons must take appropriate action to promote and protect the health,
DS0000023514.V259791.R01.S.doc 10 11 OP26 OP27 16(2) 18 31/01/06 31/01/05 12 OP29 19 31/03/06 13 OP35 17 Sch 4 31/12/05 14 OP37 17 31/12/05 15 OP38 13(4), 23 31/03/06 Rossetti Lodge Residential Home Version 5.0 Page 25 safety and welfare of residents and staff. The home must be properly assessed for environmental risks and action taken to address any risks identified. Risks observed at this inspection include: the non use of wheelchair footplates; access to the sluice via the kitchen; unsafe procedure for washing of commode pans; non completion of monthly emergency lighting tests; no evidence of portable electrical appliance tests. Action plan to be submitted. 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 3 Refer to Standard OP9 OP12 OP21 Good Practice Recommendations That a Controlled Drugs Register is purchased and put into use. That residents are provided with more opportunities to participate in activities. That a review of the current toilet and bathing facilities is undertaken to ensure that the facilities provided meet residents’ needs (as discussed with the manager during this inspection). That a review of the individual bedroom space requirements is undertaken for each resident to ensure that bedrooms have sufficient space to suit their needs. Account to be taken of use of mobility aids and wheelchairs. 4 OP23 Rossetti Lodge Residential Home DS0000023514.V259791.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
© This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rossetti Lodge Residential Home DS0000023514.V259791.R01.S.doc Version 5.0 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
