Care Home: Rose Brae Nursing Home

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What the care home does well People that use services live in a welcoming and comfortable homelike care home, which has been improved to offer more living space and a choice of quieter areas in which to sit as well as improved dining space so have more choice where they spend their day and free time. People that live at the home made positive comments about living as Rose Brae and said, "I might be going home or moving nearer my daughter but if I have to stay here I would it`s marvellous, no complaints or moans about anything. The staff are really nice and caring and I can talk to them if I`m not happy with anything. The staff also sit and talk with me and help to cheer me up". Another person said "I feel happy and this place is relaxed and I can say if I want something or am not satisfied as the staff listen to what I say. I can talk to staff about how I feel, they listen and know how to help me so I feel quite calm after speaking to them. I feel quite at home and can do what I want and can care for myself but there is someone there when I need help" The home provides staff with a training programme so staff were provided with training and support to do their jobs. The home treats people with dignity and respect and we saw this throughout the visit. People that use services had access to a complaints procedure so could be confident they can raise concerns so they will be acted upon. Appropriate staffing levels are provided so people that use services were supported around their needs. What has improved since the last inspection? Staffing levels had improved so the needs of people living at the home were met and there was sufficient staff to do the cleaning , laundry and cooking. Employment checks on staff had improved so people that live at Rose Brae were protected by improved employment procedures. The care plans of people that use services contained more information about them and their abilities to care for their own needs so staff knew when people needed support and help to meet their needs. The care plans of people that use services contained guidance for staff on how to help and support people remain safe. Staff training has improved with more suitable training taking place and more staff holding an NVQ level 2 qualification so there is a more skilled staff team. Training on safeguarding adults had improved with training taking place regularly so staff were aware of their responsibilities of what they should do if they suspected the care of people living at the home was being neglected or they were being abused. What the care home could do better: An application to register as the manager must be made to the Care Quality Commission so that we and the people that live and work at Rose Brae will be confident the home is run in their best interest. People that use services must be asked about their social interests and offered the opportunity to be involved in recreational and social activities of their choice so they can live fulfilling lives. Quality assurance must improve so mistakes made on the management of the safety of building and seeking the views of people that live at the home, their relatives and staff are sought regularly so the home is managed more effectively. The home should improve how decisions about daily living made by people that use services are reflected in their care plans so staff and others involved in their care understand how important peoples` daily decisions about their lives and decisions about their future are to them so the agreements about how they make or are supported to make decisions are clearly understood. The home should make daily menus available for people that use services so they know the choices of meals available to them and decide on their choice of meals. The home should keep accurate records of the training that staff have completed so people that use services will be confident they are cared for by competently trained staff. The home should ask people that live there and their relatives through meeting with them or other methods what they think about the quality of the facilities and services offered at Rose Brae so improvements they would like to be made are done. The home should have regular staff meetings and individual meetings between the manager and staff to discuss the management of the home, personal development, training and areas for improvement so staff have the opportunity to contribute to their own personal development as well as that of the home. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Rose Brae Nursing Home 8 Spital Road Bebington Wirral CH63 9JE     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: Anthony Cliffe     Date: 3 0 0 4 2 0 0 9 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. that people have said are important to them: They reflect the things 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 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Rose Brae Nursing Home 8 Spital Road Bebington Wirral CH63 9JE 01513345549 F/P01513345549 rosebraenursinghome@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Shaid Hussain, Mrs Zulqarnain Hussain care home 30 Number of places (if applicable): Under 65 Over 65 30 0 old age, not falling within any other category physical disability Additional conditions: 0 9 The registered person may provide the following category of service only: Care home with nursing - Code N, To service users of the following gender: Either, Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, Physical disability - Code PD (9), The maximum number of people who can be accommodated is: 30. Date of last inspection Brief description of the care home Rose Brae is a converted three storey mature house, situated in the residential area of Spital, Bebington, and is close to local amenities. The home offers thirty places for nursing care for up to 30 older people and can accomodate up to 9 people with a physical diabaility. In 2009 a new extension was added and provides five additional ground floor bedrooms with ensuite facilities. Additional lounges and dining space have been created with the addition of the extension. The home offers a variety of acomodation Care Homes for Older People Page 4 of 29 Brief description of the care home including en suite facilities. All areas of the home are accessible by wheelchair, including the large, landscaped rear garden and patio area. There is car parking at the front of the building. At the time of the visit fees ranged from three hundred and ninety to five hundred and fifty pounds per week and do not include hairdressing, chiropody, newspapers, etc. Information about the home can be obtained directly by contacting the home manager or owner. Care Homes for Older People Page 5 of 29 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: References to we, our or us represent the Care Quality Commission This unannounced visit took place on the 30th April 2009 and lasted over seven hours. Two inspectors carried out the visit. This visit was just one part of the inspection. Other information received was also looked at. Some weeks before the visit the manager was asked to complete a questionnaire called an Annual Quality Assurance Assessment (AQAA) telling us what they thought they did well, what they needed to do better and what they had improved upon since the last visit, to provide us with up to date information about the services provided. This helps us to determine if the management of the home see the service Care Homes for Older People Page 6 of 29 they provide in the same way we do and if our judgements are consistent with home owners or managers. During the visit various records and the premises were looked at. People that use services, staff, manager and owner were spoken with and gave their views about the service. We were unable to provide questionnaires to people using the service or health and social care professionals involved in their care due to the information given to us by the manager being insufficient. The owner also confirmed that surveys we sent to the home for staff to complete had been given to the manager to deal with and the owner had been informed these had been given out to staff but we had not received any. What the care home does well: What has improved since the last inspection? Staffing levels had improved so the needs of people living at the home were met and there was sufficient staff to do the cleaning , laundry and cooking. Employment checks on staff had improved so people that live at Rose Brae were protected by improved employment procedures. The care plans of people that use services contained more information about them and their abilities to care for their own needs so staff knew when people needed support and help to meet their needs. The care plans of people that use services contained guidance for staff on how to help and support people remain safe. Staff training has improved with more suitable training taking place and more staff holding an NVQ level 2 qualification so there is a more skilled staff team. Training on safeguarding adults had improved with training taking place regularly so staff were aware of their responsibilities of what they should do if they suspected the care of people living at the home was being neglected or they were being abused. Care Homes for Older People Page 8 of 29 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 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 29 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. Information is provided to people that use services about Rose Brae so they can decide if the home is suitable to meet their needs. Information is gathered about their needs and choices so they can decide if the home can meet their needs. Evidence: The home has an open day at the weekend when people that may choose to live at the home can visit with family members so they can view the facilities and meet people that live there. The home has an open door policy so viewing the home is flexible. People that choose to live at Rose Brae can have trial periods so they can see if they like living at the home. Visits can be arranged to share a meal or have respite care so moving into the home can be flexible to suit individual arrangements. The home provides information about moving in with a brochure and information about the facilities and services offered at the home called a statement of purpose so people have information about the home Care Homes for Older People Page 11 of 29 Evidence: before they decide if they want to live there. A copy of the report we did at our last visit to the home was also available so people that may choose to live at the home can see what we said about the quality of services and facilities available. Care Homes for Older People Page 12 of 29 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. People that use services receive regular care with dignity and respect and see health professionals when needed so their health and welfare is cared for. Evidence: We looked at the care records of four people that use services. Care plans gave details as to the personal help and support needed by people using the service so staff knew when to provide help and support and what care people using the service could provide for themselves. Care plans contained some information on how and when people using services wanted or needed help and support to remain healthy. We could see that people that use services had access to health professionals so they received the right health care. An example of this was that a person that had recently moved into the home had been told in hospital they would not walk again. With support form staff at the home the person was walking again with a walking aid. We saw that a person living at the home had pressure sores and staff had asked for help from a skin care specialist called a tissue viability nurse who gave advice on how to care for the wound. The records we saw showed that with care the wound was getting better. Care Homes for Older People Page 13 of 29 Evidence: Reviews of care and daily records gave a picture of how peoples health was improving so could demonstrate they received the right care. Reviews of care showed that relatives were invited to reviews and contributed to or signed care plans so important information was gathered and shared about people that use services. Mobility information and guidance on how to manage pressure sores were included so staff had information on what to do if medical attention was needed. The home demonstrated good relationships with the mental health services with the mental health of people being reviewed regularly so appropriate care could be provided. we saw the home was looking after the nutrition and mobility of people using the services and using records called risk assessments to make sure that staff understood if the weight or mobility of people needed to be watched more closely and get help if needed. A person using the service said, Since I have been here I have put on weight, before I was not eating properly or looking after myself. It is very relaxed here and I have help when I need it. Medication policies were sufficiently detailed so staff had guidance on how to receive, store, administer, record and dispose of medicines safely. The home had a clinic room for the storage of medicines. This contained the policies and procedures for medicine administration with specimen signatures for the staff responsible for the management and administration of medicines so staff were aware of their responsibility and accountability for managing and administering medicines. Storage included controlled drugs storage. The arrangements for the storage and administration of controlled drugs were looked at and found to be safe. Arrangements were in place for people that use services to manage their own medicines so could take them independently. We spoke to a person that had managed her medicines before she moved into the home and said she had been asked if she wanted to manage her medicines but said she did not feel confident enough to do so, so staff at the home managed them for her. The home had completed documents called risk assessments to see if people were capable of managing their medicines and recorded if they were not so staff knew who was not able to manage them. Care Homes for Older People Page 14 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to live a lifestyle of their choice but information held about them does not support that they are directly included in the decision making process or offered a choice of lesiure activities so are not always involved in everyday decisions. Evidence: The home had organised talking books and newspapers for people that use services so people with visual problems could enjoy listening to up to date news or a book and keep in touch with everyday events. Regular outside entertainment was provided by a visiting organist and accordionist and a lounge contained an electric piano so the pianist could play music for people that use services and visitors. Local clergy visit the home to speak with people living there so they have opportunities to practise their faith. Since the last visit the home had not been able to recruit an activities coordinator so there was no one to plan and encourage people to do activities. The owner showed us that the home was waiting for the necessary clearance called a Criminal Records Bureau check to be received so he could employ someone. We saw some people that use services reading newspapers and magazines, watching TV and listening to music. We did not always see staff sitting and talking with people Care Homes for Older People Page 15 of 29 Evidence: that use services so they did not always have social contact. The majority of people living at the home were seen to be sleeping so not engaged in doing anything. We spoke to staff and they said they had time so sit and talk to people living at the home and did beauty therapy, played games or would put on a DVD so people living at the home had some opportunity for social contact. A person living at the home said, We have things to do I like watching TV, reading and listening to music. The staff also sit and talk with me and help to cheer me up. People living at Rose Brae had information gathered about what was important to them and for them in their lives so staff provided care based on their wishes. This included information about their daily routines, how they liked their appearance to look, what clothes they liked to wear and how they wanted their care to be arranged. This was included in the information gathered about life histories. We saw that staff treated people that use services with courtesy, dignity and respect and sought their views about how they wanted to be supported and saw staff help them make decisions. We did not see information about how people that use services made decisions or where they lacked capacity, experience or judgement to make decisions so could not confirm why, when, where and how staff supported them to make decisions or what decisions they made for them or supported them to make. Examples of this were that some people living at the home were said to choose that they wanted to stay in their bedrooms for long periods during the day. Care plans about communication or social contact did not support how these decisions had been made were people living at the home had dementia so the decision making process did not always include people using the service. The routines of the home were seen to be flexible and meals were seen to be varied and supported a balanced diet with advice sought from dietitians where necessary. People that use services and they said they enjoyed their meals. Meals were described as, fantastic and The meals are nice and I get different meals. I dont always know whats being served but the cook tells me whats available. The cook said she asked people that lived at the home what they wanted each day and cooked this for them but menus were kept in the kitchen so people that use services could not see what choices were available to them. Care Homes for Older People Page 16 of 29 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. People that use services are protected by the safeguarding adults procedure in place so people that use services will be confident they are protected at all times. Evidence: During the visit we saw the complaints policy was displayed at the front entrance for people using the service, relatives and visitors to see so they had access to it. The records we saw also contained a copy of the complaints procedure. We had received five complaints about the home since our last visit and we asked the owners to investigate these. The owners investigated the complaints to our satisfacion as well as meeting with us in March 2009 to assure us the complaints would not be repeated. We spoke with people that lived at the home and they said they were comforatble about speaking to staff if they were unhappy so could be confident concerns or complaints were listened to. Policies and procedures were in place to protect vulnerable adults called the safeguarding adults procedures. The safeguarding adults procedure is how we, the local council, police and other agencies respond to and manage allegtaions or suspicions of abuse against vulnerale adults. The home had made one safeguarding referral to the local council and a protection plan was in place for a person living at the home so the home protected the welfare of people living there. Care Homes for Older People Page 17 of 29 Evidence: Staff at Rose Brae had received safeguarding training which helped them to respond to suspicions or allegtaions of abuse or neglect to make sure vulnerable adults were protected. Staff spoken with said they received safeguarding adults training during their induction. Staff spoken with during the visit were knowledgeable about the safeguarding adults procedure and how to report their concerns so could protect vulnerable people. Care Homes for Older People Page 18 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that use services live in a comfortable and safely maintained building so their health and safety is promoted. Evidence: Since the last visit an extension to the home had been built. The extension included two additional lounges where people that use services can sit and relax so they can choose not to watch television. One of the lounges has natural skylight and patio doors leading to the garden, which has been levelled for wheelchair users and planned to be landscaped so people living at the home have access to a safe secure garden area. Two walk in showers and four toilets are available on the ground floor and are designed so facilities for physically disabled people are provided to use. The extension includes 5 ground floor bedrooms, two lounges and a designated dining room, and disabled toilet and shower. The entrance to the home has been adapted for wheelchair use so disabled people have access to the home and its facilities. Additional car parking space is now provided at the entrance to the home which so gives easier access form a busy main road. A new heating system has been installed as part of the extension being built. Improvements in the decor had been made with vertical blinds being fitted to windows Care Homes for Older People Page 19 of 29 Evidence: so people living in the home had more privacy. New carpets had been fitted throughout the ground floor to so wheelchair users had easier access in the home. Additional specialist beds had been bought for people living at the home to use so they had the specialist equipment they needed. Care Homes for Older People Page 20 of 29 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. Good employment procedures and policies are in place so people that use services are protected by the recruitment process. Evidence: We saw the staff numbers in place supported the needs of people that use services so they had sufficient help with their needs. There were three staff on duty as well as the manager and owner. Additional staff were later on duty to assist with domestic, laundry and catering duties. The owner also works at the home four days a week and seemed to have a good relationship with people that use services and staff and we could see the staff team was supported. The owner described his role as administrator, gardener and handyman but wanted to recruit staff to these positions. The home had been using agency staff to cover shifts following the resignation of the manager and some care staff but had used staff from one agency so people that use services had continuity of care. The home had recruited new staff and was waiting for the necessary checks to be completed on others. Staff we spoke with described training as good and varied and helped staff understand the needs of people living at the home so they were kept up to date with working practise. Staff had received training on a variety of subjects. Staff said they had the opportunity to complete NVQ level 2 qualifications which area nationally recognised Care Homes for Older People Page 21 of 29 Evidence: qualification in social care. The information returned to us before the visit by the manager said 19 staff were employed and 7 had an NVQ 2 qualification so staff have an opportunity to gain a qualification in social care. We examined the recruitment records of two staff employed at the home. Recruitment procedures were good and included staff having to complete an application form, full employment history and two references sought about their suitability for employment. The recruitment of staff also included a Criminal Records Bureau (CRB) disclosure which is a check of staff to see they are suitable people to provide personal care and support to vulnerable adults. Staff were provided with a variety of training which included health and safety, food hygiene, moving and handling, safeguarding adults and nutrition but staff training records were not all up to date so we could not confirm that all the necessary training had been completed. We talked to staff about their practise and they were confident about their skills and experience. Care Homes for Older People Page 22 of 29 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. Quality assurance could be improved so areas for further development are identified and maintaining safety in the home is consistent so the welfare of people that use services is promoted. Evidence: At the beginning of the visit we were informed that the registered manager had resigned and left the employment of the home a few days prior us visiting. The owner introduced the registered nurse on duty as the new manager and she confirmed she had applied for, been interviewed and accepted the post as manager and had the letter offering her the post as manager with her so we were able to confirm this. The new manager had been working at the home since October 2008 so could provide continuity in the management of the home. We were assured by the owner that we would be receiving an application to register the manager as the registered manager for the home so were confident a competent person had been appointed but could not confirm her suitability until the process to register as manager had been completed. Care Homes for Older People Page 23 of 29 Evidence: The owner said the previous manager had left due to performance and personal issues. The owner said the quality assurance system in the home includes health and safety checks of the building, fire safety, care records and medicine management but could not produce documents to support his claims so we could not see a quality assurance system in place. The owner was able to demonstrate that a quality audit of the home had been completed in September 2008 when the home was assessed for the ISO 9001 award. The ISO 9001 award is a nationally recognised award for developing quality and investing in the development of organisations. The owner was able to demonstrate that quality assurance had been done for the ISO 9001 award which included a staff training and development programme. The owner was open in saying he thought the ISO 9001 award was sufficient to monitor quality within the home and accepted this was not an ongoing process which needed to be done so he could see where improvements needed to be made and included consulting people that use services about the quality of care and standards within the home. The home has satisfaction surveys available for people living at the home as well as relatives and visiting professionals so they can comment upon the quality of care or raise concerns about the home. The owner said he had sent out a number of questionnaires to relatives but could not produce the results so we could not see what the views of what other people who were involved with the home as relatives or professionals had to say about the quality of care or standards within the home. The owner had not yet introduced meetings with people that use services or their relatives and intended to do so, so they could have the opportunity to be involved in how the home was managed. Staff meetings were not held regularly so staff did not have opportunities to discuss their ideas for improvement, about concerns and training. The owner uses memos as and when required to request staff to do anything. Rose Brae do not usually manage or keep personal monies of people living at the home or act as an appointee for people that use services. Personal monies were managed by people using the service or their families. The home kept some monies for people that wished to deposit monies for personal use. The home kept records for any monies received and withdrawn and the amounts of theses audited by the owner. The information sent to us by the manager before the visit said all the required maintenance and safety checks has been completed as required but when we checked the records for the testing of fire equipment we found the fire alarms had not been Care Homes for Older People Page 24 of 29 Evidence: tested since the end of January 2009 so the fire safety of the building was not confirmed as working properly. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 12 16(2)(m)(n) The registered person must 08/04/2008 ensure that people that use services are consulted about their social interests and lifestyle choices and the planning, coordination, variety and a choice of social activities provided so they can lead fulfilling lives. Care Homes for Older People Page 26 of 29 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 12 16 People that use services must be asked about their social interests and offered the opportunity to be involved in recreational and social activities of their choice so they can live fulfilling lives. 21/07/2009 2 31 8 An application to register as the manager must be made to the Care Quality Commission so that we and the people that live and work at Rose Brae will be confident the home is run in their best interest. 21/08/2009 3 33 24 Quality assurance must 20/07/2009 improve so mistakes made on the management of the safety of building and seeking the views of people that live at the home, their relatives and staff are sought Page 27 of 29 Care Homes for Older People regularly so the home is managed more effectively. 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 1 14 The home should improve how decisions about daily living made by people that use services are reflected in their care plans so staff and others involved in their care understand how important peoples daily decisions about their lives and decisions about their future are to them so the agreements about how they make or are supported to make decisions are clearly understood. The home should make daily menus available for people that use services so they know the choices of meals available to them and decide on their choice of meals. The home should ask people that live there and their relatives through meeting with them or other methods what they think about the quality of the facilities and services offered at Rose Brae so improvements they would like to be made are done. The home should have regular staff meetings and individual meetings between the manager and staff to discuss the management of the home, personal development, training and areas for improvement so staff have the opportunity to contribute to their own personal development as well as that of the home. 2 14 3 33 4 36 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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 © (2009) 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. 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