Care Home: Rose Cottage Nursing Home

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What the care home does well People receive the information they need to help them make a choice about the service. Before moving into the home people have there needs assessed and are able to visit the home if they wish. Each person had a care plan which detailed their health personal and social care needs. People`s health care needs were meet. People told us they were treated with respect and our observations confirmed this. A range of activities were organised people were encouraged to keep in touch with family and friends and were encouraged to make choices wherever possible. People told us they were in the main happy with the food provided and choices were offered. People told us they felt safe; staff received training on safeguarding adults and were able to tell us how they protected people on a daily basis. There were procedures in place to ensure infection control and staff told us they were provided with appropriate cleaning materials and equipment. People told us in the main there was always enough staff on duty. Staff were appropriately trained to do their job and received refresher training to make sure they were updated with good practice. The records checked showed that people were protected by the recruitment procedures; this included thorough checks of references and criminal records. The home is well managed and staff work in an organised and confident way to provide a good service to people. People told us they are able to comment on the way the service is run and examples were given of how they have effected change. There are safe procedures in place for the management and overseeing of people`s finances and people told us they were satisfied with the arrangements for this. Staff told us they received regular supervision; they were able to tell us the action they took on a daily basis to promote the health safety and wellbeing of the people they support and themselves. What has improved since the last inspection? There is evidence to show that changes are made following comments from surveys from people using the service. The provider makes regular visits and a report of findings was available for inspection. Records of medication administration were in the main correct. Activities were provided and people were able to choice whether or not to take part. There was a rolling programme of redecoration in place. Staff did not start work at the home until all appropriate checks were carried out. The manager is now working though her NVQ level 4 in management and care. What the care home could do better: The policy and procedures in place for the safe management of medication needs to be followed at all times. To make sure that people`s rights are further promoted staff should make sure they knock before entering peoples bedrooms. CARE HOMES FOR OLDER PEOPLE Rose Cottage Nursing Home Station Road Halfway Sheffield South Yorkshire S20 3GS Lead Inspector Shirley Samuels Unannounced Inspection 17th September 2008 09:00 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 Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rose Cottage Nursing Home Address Station Road Halfway Sheffield South Yorkshire S20 3GS 0114 251 0595 F/P 0114 251 0595 none 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) RC Developments Limited Mrs Elizabeth Helena Hodson Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 16 OP Old Age, not falling within any category, N (Nursing Care) beds 13 OP Old Age, not falling within any other category, PC (Personal Care) beds. 24th August 2006 Date of last inspection Brief Description of the Service: Rose Cottage is a care home providing personal and nursing care for twentynine older people, with sixteen nursing beds and thirteen personal care beds. The home is privately owned. Rose Cottage is situated at Halfway in a residential area with good access to public services and amenities (e.g. Supertram, bus services, shops, libraries etc). The accommodation is over three floors accessed by a lift. The home is well decorated, with a majority of single rooms and one double. The home has an appropriate number of lounges and dining rooms. The gardens are landscaped and there is a car park. The home said that the fees vary as they have people from a number of local authorities placed at the home. On the day of the visit the manager told us the fee raged from £327.00 £5 – 364:00. Extra charges are made for hairdressing, chiropody and newspapers and magazines. Copies of the inspection report are made available from the home. Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two star. This means people who use the service experience good quality outcomes. “We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken.” This was a key inspection carried out on this service by Shirley Samuels on the 17/09/08 from 9am-3pm. In the report we make reference to “us” and “we”, when we do this we are referring to the inspector and the Commission for Social Care Inspection. This was a key inspection and all the key standards were checked. The inspector sought the views of five people using the service, six staff, questionnaires were received from three relatives and we spoke to two relative on the day of the visit. The manager was present and was given feedback throughout the inspection. During this visit we looked at the environment, and made observations on the staff’s manner and attitude towards people. We checked samples of documents that related to peoples support, care and safety. These included three assessments and care plans, three medication records, and three staff recruitment files The inspector looked at other information before visiting the home. This included the Annual quality assurance assessment (AQAA). This is a form completed by the owner and the manager of the service which tells us how they think the service is doing, what has improved and what further action they plan to take to develop the service. The inspector would like to thank everyone for their cooperation and welcome. Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 Page 7 There is evidence to show that changes are made following comments from surveys from people using the service. The provider makes regular visits and a report of findings was available for inspection. Records of medication administration were in the main correct. Activities were provided and people were able to choice whether or not to take part. There was a rolling programme of redecoration in place. Staff did not start work at the home until all appropriate checks were carried out. The manager is now working though her NVQ level 4 in management and care. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 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 Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 and 6 People using the service experience good outcomes in this area This judgement has been made using available evidence including a visit to this service. People are provided with information and are assessed before moving into the home. EVIDENCE: In the entrance to the home there is written information about the home and people told us they or their family were provided with information at the time of admission. In the AQAA the manager told us people have a pre admission assessment to ascertain if the home can meet their needs. For people referred though a social worker the home obtains a copy of the care management assessment. Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 Page 10 The records showed that people were assessed, staff told us they had the information they needed to make a judgement about whether or not they would be able to met peoples needs. People told us they were able to come and look round if they wished. Many of them told us family members came and looked round for them. The home does not provide intermediate care. Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 People using the service experience good outcomes in this area This judgement has been made using available evidence including a visit to this service. Each person has a plan of care, health care needs are met, and people’s rights are respected. There were some shortfalls regarding the safe storage of medication. EVIDENCE: In the AQAA the manager told us people are supported to make their own decisions, people have care plans that are individualised and care plans are reviewed regularly. She added that checks are made on the medication system to make sure staff are following procedures. Each person had a care plan that detailed their needs and what action staff needed to take. Care plans were reviewed monthly and there was evidence to show that changes were recorded. Relatives told us they were able to contribute to the care plan and people using the service told us that staff did Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 Page 12 talk to them about their needs and their preferences. This means that people are able to contribute to their care plan. Records were kept of visits by Doctors, Dentist, Opticians, chiropodist etc. People told us there health care needs were met and staff did not hesitate to call for a visit when this was necessary. This means that people’s health care needs are met. Staff responsible for the administration of medication are trained and competent. People told us they receive their medication on time and we made observation of medication being administered appropriately and people being supervised. Since the last inspection we received concerns from a visitor who found medication in a chair in the lounge. This was the outcome of lack of supervision of an individual who was reluctant to take the medication. The manager carried out an investigation and action has been taken to make sure people have taken their medication. On the day of the visit a medication trolley was found unlocked in an unlocked room. This is poor practice and places people at risk and creates a risk of unauthorised access to medication. This was reported immediately to the manager the faulty lock was repaired and the trolley locked. In the main appropriate records were kept of medication administration and there was a system for recording medication received into the home and medication returned or destroyed. The medication procedures used at the home is externally audited by the pharmacy a report on findings is prepared and recommendations for improvement made. This means that in the main the medication procedures are safe, the system is monitored and action taken to address shortfalls. People spoke positively about the staff and said they were treated with respect and dignity. One person told us that staff do not always knock before entering their bedroom and that they objected to this. Staff were able to give us some examples of how on a daily basis they promoted peoples rights, For example offering choice, listening, speaking to people in a proper manner and encouraging independence. Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 People using the service experience good outcomes in this area This judgement has been made using available evidence including a visit to this service. Activities are provided, contact with family and friends is encouraged, choice is promoted and people are provided with a balance diet. EVIDENCE: In the AQAA the manager told us the home treats people as individuals and tries to make daily routines of daily living as flexible as possible. She added the home has a mini bus, which allows people to go out for personal or group outings. People told us they were offered the opportunity to take part in activities if they wish. The records showed that people were able to go out of the home for trips to the coast, out for meals, swimming as well as pastimes, which take place within the home. This means that people’s recreational needs are met. Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 Page 14 People told us they were able to make choices about the way they spent their day. Staff told us it was important to get to know people this allowed them to make choices on their behalf based on what they know about them. People told us in the main they were happy with the food provided. They said there were occasions when the food was “hit and Miss” but acknowledged that it was difficult to please all the people all the time. Staff were observed offering assistance to people who needed it this was done in a patient and sensitive manner. People on soft or liquidized diets were catered for and food presented appropriately. Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the service experience good outcomes in this area This judgement has been made using available evidence including a visit to this service. Complaints were taken seriously and people were protected from harm. EVIDENCE: In the AQAA the manager told us the home has a clear and accessible complaints procedure displayed in the home illustrating the timescales and how complaints are dealt with. People told us they knew how to make a complaint. One person said they had not needed to complain but had some “little niggles” which had been sorted out to their satisfaction. Relatives told us they were happy with the way the home responded to concerns or comments. This shows that complaints are taken seriously. People told us they felt safe at the home. Staff told us they had received training on the protection of adults and were able to give examples of types of abuse and the action they would take if an allegation was made to them are if Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 Page 16 they witnessed an incident. This shows that there are procedures in place to protect people from harm and for reporting incidents. Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People using the service experience good outcomes in this area This judgement has been made using available evidence including a visit to this service. The environment is reasonably maintained and there are procedures in place to maintain good standards of hygiene. EVIDENCE: In the AQAA the manager told us, we have a rolling programme of maintenance redecoration to ensure the environment is well maintained and offers people a homely place to live. Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 Page 18 There is a maintenance person employed at the home who is able to carry out repairs. The records show that redecoration and replacement of carpets have taken place since the last inspection. People told us they were happy with their bedrooms and told us linen was changed regularly and staff paid attention to the cleanliness of the home. Staff told us they were provided with gloves and aprons, appropriate cleaning equipment and materials. This means the home is well maintained, pleasant and hygienic. Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 People using the service experience good outcomes in this area This judgement has been made using available evidence including a visit to this service. Staff are competent and the recruitment procedures protect people from harm. EVIDENCE: In the AQAA the manager told us all staff receive induction training and regular updates, 75 of care staff are trained to NVQ level 2 in care. “ Staff work in a manner which promotes liberty, we enable residents to feel safe and secure whilst promoting independence”. The records show that the staff have a range of skills and experience, there is a gender and age mix and people told us in the main they were happy with the approach of the staff. Staff were observed approaching people in a friendly calm and respectful manner this promoted people’s wellbeing. Staff were also observed offering reassurance and support to people who were disorientated or confused. This shows a good level of understanding of the needs of the people they were supporting. Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 Page 20 The records showed that full recruitment checks including references and criminal records are checked before people start work at the home. This means people are protected by the recruitment procedures. Staff told us they receive regular training and are able to identify training needs as part of their supervision. The records show that staff have received essential training such as moving, handling, first aid, fire safety, bereavement and the protection of vulnerable adults. This shows that staff receive the training they need to do their job. Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 People using the service experience good outcomes in this area This judgement has been made using available evidence including a visit to this service. The home is well managed and there are safe working practices in place. EVIDENCE: In the AQAA we were told the manager of the home has many years experience running care homes and has run rose cottage since the opening in 1996. She has a management qualification and is currently working to NVQ level 4 in management and care. Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 Page 22 Staff spoke positively about the manager and told us she was approachable and that they had confidence in the management of the home. People told us that they were are able to comment on the way the service is run. The records show that people are able to complete questionnaires. The results of these are collated and there was evidence to show that changes had taken place following comments and request made by people. This shows that the home is run in the best interest of the people. There are procedures in place for the management of people’s finances. The manager told us that representative or relatives manage the majority of finaces. We checked the records for three people the records were correct receipts for expenditure were kept and the balance in cash was correct. This shows that people’s financial interest is safeguarded. Staff told us they had received health and safety training and training in safe moving and handling. There was equipment available to assist staff and there were records to show that equipment was regularly serviced. There was a fire risk assessment in place and staff receive regular fire safety training. Staff were able to give us examples of how on a daily basis they promoted the health safety and wellbeing of people using the service. They also understood their responsibility for there own safety. This made sure that people’s health safety and welfare is promoted. Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO 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 OP9 Regulation 13 Requirement To make sure medication is managed safely. Medication must be securely stored. Timescale for action 20/10/08 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 Refer to Standard OP10 Good Practice Recommendations To further promote peoples rights staff should always knock and wait to be invited into people’s bedrooms. Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rose Cottage Nursing Home DS0000021802.V372054.R02.S.doc Version 5.2 Page 26 - 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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