Care Home: Rose Court Nursing And Residential Home

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What the care home does well The manager makes sure that the staff only care for those people whose needs they can meet. The staff make sure that the residents are clean, comfortable and well dressed. A relative made the following comments: `Everything about Rose Court is first class`. `I can only say how pleased I am. A caring home and good surrounding`s. The care plans contain a lot of information about the residents` daily routines and how they are to be cared for. The meals provided are varied and nutritious and the residents have a good choice of menu. Activities are considered to be a very important part of the residents` day. In order to protect the residents from harm, management make sure that they check people out properly and safely before offering them a job. Management make sure that the staff are properly trained so that they have the knowledge and skills they need to protect and meet the needs of the residents. Management continue to improve the way that they check out the quality of care and the services provided for the residents. They have exceeded the standard expected. What has improved since the last inspection? CARE HOMES FOR OLDER PEOPLE Rose Court Nursing And Residential Home 44-48 Water Street Radcliffe Manchester Lancashire M26 4DF Lead Inspector Grace Tarney Unannounced Inspection 14th August 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 Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rose Court Nursing And Residential Home Address 44-48 Water Street Radcliffe Manchester Lancashire M26 4DF 0161 724 9040 0161 724 5357 rosecourt@schealthcare.co.uk www.southerncrosshealthcare.co.uk Southern Cross Home Properties Limited 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) Mrs Karen Davies Care Home 109 Category(ies) of Dementia (7), Dementia - over 65 years of age registration, with number (40), Mental disorder, excluding learning of places disability or dementia (1), Old age, not falling within any other category (60), Physical disability (4) Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 109 service users to include the following: Clarence Unit. Older People (OP) 18. Both sexes. Over 65 years of age. Within the 18 (OP) there can be up to 1 (PD) Physical Disability (PD) 1 Male (Named individual under 65 years of age) Dementia (DE) 1 Female (Named individual under 65 years of age) Dementia (DE) 1 Male (Named individual under 65 years of age) Sandringham Unit. Older People (OP) 42. Both sexes. Over 65 years of age. Within the 42 there can be up to 1 (PD) Dementia (DE) 1 Male (Named individual under 65 years of age) Mental Disorder (MD) 1 Female (Named individual under 65 years of age) Earl of Wilton Unit. Dementia (DE)(E) 40. Both sexes. Over 65 years of age. Dementia (DE) 2 Females (Named individuals under 65 years of age). Dementia (DE) 1 Male (Named individual under 65 years of age) Dementia (DE) 1 Both sexes under 65 years of age The service should employ a suitably experienced and qualified manager who is registered with the Commission for Social Care Inspection. The named service users must be cared for on the designated units. Once placement for the 8 named service users (3 DE (female) 3 DE (male) and 1 MD (female) and 1 PD (male) has ended the previous registration categories will be reverted to. Suitably qualified and experienced registered nurses must provide 24 hour nursing care on the Sandringham and Earl of Wilton Units. 2. 3. 4. Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 5 Date of last inspection 17th July 2007 Brief Description of the Service: Rose Court is a purpose-built detached property that is situated in a residential area of Radcliffe. The home is close to main bus routes and is not too far from the motorway network. A variety of shops are close by. There is plenty of parking to the front and the side of the home for the use of staff and visitors. The home is registered to care for residents with a variety of needs. The home is divided into 4 separate units. On the ground floor there is Clarence Unit. This unit is for elderly residents who have social care needs. On the first floor there is Sandringham Unit. The elderly residents in this unit have either nursing or social care needs. Also on this floor is the newly developed Windsor Unit. This unit is for people with dementia who do not require nursing care. On the top floor is Wilton Unit. This unit is for mainly elderly residents who have dementia and require nursing care. The units on the first and second floors are reached either by stairs or a passenger lift. Each unit has large lounge and dining areas. Accommodation throughout the home is provided in mainly single bedrooms, several of which have an en-suite facility of toilet and wash hand basin. Most of the toilets and bathrooms have aids to assist any resident with a disability or mobility problem. The manager told the Inspector that the weekly fees within the home ranged from £374.95 to £465. An extra £25.00 per week is charged for a resident occupying an en suite bedroom. Additional charges are made for private chiropody, hairdressing and newspapers. This information was received on the 14/08/2008. A copy of the most recent Commission for Social Care (CSCI) inspection report is displayed in the reception area. Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. The home was not told that this inspection was to take place although many weeks before the inspection, we (The Commission) chose some residents to send questionnaires (comment cards) out to. The questionnaires asked what people thought about the care and quality of the service provided. 6 questionnaires were returned. We also sent questionnaires out to the staff at the home. What they felt about the care and services provided is written in different sections throughout this report. Also before the inspection we asked the manager of the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they did at present, what they felt they did well and what they needed to do better. This helps us to determine if the management of the home see the service they provide the same way we do. Two Inspectors visited the home and spent 9 hours there. We looked at care and medicine records to make sure that the health and care needs of the residents were being met. We also looked around the building at some of the bedrooms, bathrooms, toilets and sitting areas to check if they were clean, warm and well decorated. We also looked at the menus and looked at what the residents had for their breakfast, lunch and evening meal. We also checked how many staff were provided on each shift to make sure the residents needs were being met, and also looked at how management recruit and train their staff. We also looked at how management check that the care and services that they provide is what the residents and their relatives want, or expect. How the home manages the residents’ spending money was also checked out. In order to get further information about the home we also spent time talking to 3 residents, 2 visitors and 4 staff members. Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? What they could do better: To ensure the health and wellbeing of the residents more attention needs to be given to the management of medicines on Clarence Unit. Please contact the provider for advice of actions taken in response to this Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 8 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 Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 9 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 Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 10 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): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are properly assessed before they are admitted to the home and this gives an assurance to everybody that a person is only admitted if the staff can meet their needs. EVIDENCE: Before any resident was admitted to the home a senior member of staff from the home undertook an assessment of their needs. The assessment looks at what help and support the prospective resident needs in all aspects of daily life. The 3 assessments we looked at were detailed and gave a clear indication of the residents’ needs and what they could and could not do for themselves. The information from the AQAA document sent to us stated that if a prospective resident is able to, they are invited to visit the home themselves. Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 11 They are also encouraged where possible to visit for meals or planned overnight or weekend stays. Standard 6 does not apply. The home does not provide Intermediate Care. Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 12 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 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care plans show what care needs the residents have and care practices ensure that their needs are met in a safe and dignified way. EVIDENCE: Individual care plans were in place for each resident. The care plans of 4 of the residents were looked at. They were detailed and gave clear instruction and guidance on how the care needs of the residents were to be met. They also provided a lot of information about the residents’ daily routine, their past life and their interests. The care plans were reviewed regularly so that any change in the residents’ condition could be identified and appropriate action taken. The care plans detailed the religious and cultural needs of the residents. One of the residents was of the Hindu Faith. It was clearly identified in the care plan the arrangements for this residents’ personal and dietary needs. There Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 13 was also a sheet with useful Punjabi words on to help with communication between the resident and the staff. The staff looked at whether or not there was any risk in relation to the residents developing pressure sores, any risk of falling and also if they were at risk due to problems with their diet and fluid intake. They also looked at and they wrote down, how any resident was to be assisted with being moved around and by how many members of staff and what equipment, if any, was to be used to assist in safe moving and handling. These risks were looked at regularly. One of the residents had a lot of nursing needs so we visited her in her bedroom. She looked comfortable and well cared for and all the correct type of equipment was in place to ensure that her needs were met. Residents were weighed regularly and we saw that staff put into place a plan of care to manage any weight loss identified. Inspection of the care files showed that the residents had access to health care professionals, such as dentists, opticians and chiropodists. Equipment necessary for the prevention and treatment of pressure sores was available and in use. The medicines on Windsor Unit and Clarence Unit were looked at. A safe system was in place on Windsor. Overall a safe system of medicine management was in place on Clarence Unit. The medicine keys were kept securely and identification photographs of each resident were kept with the medication administration records (MAR sheet). Only staff trained in medication management deal with the medicines. The following things however needed putting right: • Controlled drugs were being stored safely however other medications were being stored in the Controlled Drugs Cupboard instead of Controlled Drugs only. Management agreed to ensure that the other medications were kept separate. The Controlled Drug Medication of one resident had not been recorded correctly in the Controlled Drug Register. The date and time that it had been given had not been written in. It is a legal requirement to record this information. A MAR sheet prescription had been changed by hand from 3 times a day to once at bedtime. This had not been dated or signed by the staff member responsible for changing it. There was no evidence to show why it had been changed and who had changed it. To prevent mistakes being DS0000017336.V369980.R01.S.doc Version 5.2 Page 14 • • Rose Court Nursing And Residential Home • • • made staff must sign the change then have it checked and countersigned. A record must be made of the reason and date of the change. 3 of the residents were receiving injections from the district nurses. 2 of the residents were not being given the injections in accordance with the prescription and 1 of the residents did not have a prescription administration sheet. Although it is the responsibility of the district nurses to ensure the medicine is given as prescribed, it was of concern to us that the staff had not identified the discrepancy. Management agreed to discuss this with the district nurses. 1 resident was prescribed a pain-relieving patch to be given once a week. It was being given regularly but at different times of the day. This was because there was no time written on the medication administration sheet. The Manager told us that it was to be given in the morning and she would ensure that this was done. Giving medications at the required same correct time ensures that they will work effectively. 1 resident was having anticoagulant tablets but it was not very clear on the MAR sheet what the exact dose was to be. There were no written instructions on either a letter or anticoagulant book from the clinic. The manager was advised to ensure that staff had some written confirmation of the dose to be given. This can prevent mistakes being made and therefore protect the residents from harm. The residents looked clean and comfortable and were suitably dressed. Their hair was neat and tidy and clothes were clean and ironed. Staff spoke to them in a respectful and quiet way, although there was plenty of friendly banter. Staff confirmed that the importance of ensuring privacy, respect and dignity is part of their initial training. Residents told us: ‘The staff speak nicely and respectfully’. ‘Couldn’t ask for anything bette’r. A relative told us: ‘My relative receives care and support always. The GP and district nurse make regular visits’. Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 15 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 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to exercise choice and control over their lives as far as they are able and enjoy the activities available to them. Residents are given a choice of well-balanced and nutritional meals. EVIDENCE: The residents’ routines of daily living and their social interests were recorded in their care plans. The home has full time activities organiser who arranges activities throughout the home. There is a varied programme of activities throughout the week and the programme of activities is displayed in the reception area and on each unit. The activities organiser keeps a file for each unit in which she documents the activities that have taken place. Activities such as arts and crafts, reminiscence sessions and board games are undertaken. In addition outside entertainers are brought in on a regular basis. The residents have enjoyed several trips out in recent weeks. Photographs of their outings were displayed throughout the home. Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 16 The information from the AQAA document sent to us told us that regular trips out for shopping or going for a pub lunch were very popular. We were told that they are planned in advance and relatives are encouraged to continue with their social and recreational pursuits with the resident. We were also told that the home has daily access to a bus which helps the residents get out into the community. Whilst we were on the units we saw the care staff doing various activities with the residents. Some were playing soft ball games and others were having beauty treatments. On Wilton Unit there is a reminiscence pub called the “Wilton Arms”. This is open to all the units on specified days and times. Some residents and their relatives do visit the Wilton Arms for a “pub lunch” or just sit there whilst visiting. There is also a tuck shop within the home. Residents can buy sweets, drinks and toiletries. The home also produces a newsletter that gives news items about the home, the staff and the residents. It also contains items of general interest. The care plans gave information about the residents’ religions and whether they practiced their faith. Staff told us that visiting clergy of different faiths visit the home and are always welcome. We saw visitors coming and going throughout the day and they seemed to know the staff very well. One relative told us that they are able to visit at any reasonable time. We did not eat with the residents but saw what they were having for breakfast on Windsor Unit and lunch on Sandringham Unit.The tables were nicely set. The food was served from a heated trolley and looked appetising and the portions were good. There was a choice of main course and dessert. A lighter meal is served at lunchtime and the main meal is served in the evening. Hot and cold drinks were being served throughout the day. Members of staff told the Inspector that food and drinks are available out of hours and that milky drinks are always available. Residents told us: ‘The food is excellent’. ‘The food is very good. I am never hungry’. We did see that the drinks were served from plastic cups that had an advertising slogan on. We told the Manager that we felt they looked institutionalised. We also noted that the thermal tea and coffee jugs were very stained. Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People feel able and know how to complain. Staff have a good knowledge and understanding of what abuse is, thereby reducing the possible risk of harm to residents. EVIDENCE: The complaints procedure was displayed and it is also included in the Service User Guide. It is easy to understand and gives an assurance that complaints will be responded to within 28 days.A complaints log is kept at the reception area so that residents, relatives or staff can write down any complaints that they have. We were told that the Manager checks the complaints log every day and takes action to solve any issues raised. Since the last inspection we have received 2 complaints about Rose Court. 1 was anonymous and was about the disruption being caused to the residents whilst the new Windsor Unit was being organised. We were satisfied with the fact that management were doing everything they could to minimise disruption. The second complaint was about a care issue. The family were told to come back to us if they were not happy with the response from the management of the home. They did not contact us again. 1 staff member told us: ‘The Manager takes concerns seriously’. Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 18 A copy of the Local Authorities Protection of Vulnerable Adults Procedure was in place and a discussion with the senior staff identified that they were very aware of the procedure to follow in the event of any allegation of abuse. Training in the protection of vulnerable adults has been undertaken by staff and is ongoing. Records of training were kept on staff files. Since the last inspection there have been 3 safeguarding incidents whereby residents have been abusive to others. These incidents were handled properly and involved the social services adult protection team. A visiting adult protection professional was visiting the home whilst we were there. He commented that he felt the Manager undertook very detailed investigations and that he was “impressed”. Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 19 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 21 22 24 25 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in suitably adapted, comfortable surroundings that are continually being improved. EVIDENCE: There is level access to the front of the home with adequate parking both at the front and to the side of the home. As a security measure the front door is kept locked. There is a secure garden at the back of the home and a newly created decked area to the front of the home where the residents can sit out. The 1st floor units now have a new secure garden area with decking that can be accessed from the lounge on Windsor. Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 20 Windsor Unit. The unit has recently been redecorated. 10 rooms to date have been refurbished with new furniture and matching bedding and curtains. All these rooms have a lockable space and overriding safety door locks. The dining and lounge areas were clean and well decorated. There were enough toilets and bathrooms to meet the needs of the residents. Toilets were close by to bedrooms and lounge areas and most had aids and adaptations to assist the residents. Some of the bedrooms also have en-suite toilets. Clarence Unit. The lounge and dining areas were clean and well decorated. Comfortable new lounge chairs were in place. The corridor leading onto this unit had been redecorated and it looked bright, clean and fresh. There were enough toilets and bathrooms to meet the needs of the residents. Toilets were close by to bedrooms and lounge areas and most had aids and adaptations to assist the residents. Some of the bedrooms also have en-suite toilets. Several of the bedrooms were in need of redecoration. Some had peeling wallpaper and marked woodwork. There was no call bell in room 15. We also saw that the ceiling and bed lights were not working in some of the bedrooms and bathrooms. This was discussed with the handyman who fixed it whilst we were there. We were told that the lights do “trip” at times. This was discussed with the Manager who said that it would be looked into. Sandringham Unit. New carpets had been fitted on the corridors. The décor however was in need of attention. Paper was peeling off in parts and woodwork was marked. The Manager told us that this was part of the rolling programme of redecoration. The lounge/dining areas were warm and suitably furnished. We noted however that there were food splashes on the walls. There were enough toilets and bathrooms to meet the needs of the residents. Toilets were close by to bedrooms and lounge areas and most had aids and adaptations to assist the residents. Some of the bedrooms also have en-suite toilets. 2 of the toilets had no call bell leads from the ceiling. The Manager told us that she would get this sorted out when the regular handyman was back from his leave. 1 of the toilets had a grab rail to help the residents rise from the toilet but this was not within easy reach of the toilet. This could cause a resident to fall. Tracking has been installed in 2 of the bathrooms. Hoists are attached to the tracking and this enables residents to be moved safely into the bath. The majority of the bedrooms were suitably furnished and every door had an over riding door lock to ensure privacy. Some bedrooms had been recently decorated. Some bedrooms had new furniture and a lockable space for storing anything that was of value to the resident. Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 21 Wilton Unit. New carpets had been fitted on the corridors and the corridors had recently been repainted. The lounge/dining areas were warm and suitably furnished. There were enough toilets and bathrooms to meet the needs of the residents. Toilets were close by to bedrooms and lounge areas and most had aids and adaptations to assist the residents. Some of the bedrooms also have en-suite toilets. All the toilet doors were painted yellow. This was to make identification of toilets easier for the residents. 1 of the toilets had a grab rail to help the residents rise from the toilet but this was not within easy reach of the toilet. This could cause a resident to fall. The majority of the bedrooms were suitably furnished and every door had an over riding door lock to ensure privacy. Some bedrooms had been recently decorated. Some bedrooms had new furniture and a lockable space for storing anything that was of value to the resident. The bedroom doors were painted different colours to try and help the residents identify their own bedroom. 3 of the bedrooms did smell strongly of urine. We were told that the carpets were being continually being deep cleaned and we did see the domestic working very hard to keep the units clean and fresh. We looked at the small kitchen on Wilton Unit. The fridge was dirty and in need of defrosting. Some of the food in it was out of date. The microwave oven also needed cleaning. Food was not being stored correctly. Cereals, tea and coffee were stored uncovered and the bread bin did not close properly. Uncovered food can result in contamination causing harm to the residents. We were told before we left the home that the kitchen staff had cleaned the kitchen and covered the food and had been made aware that it was their responsibility to ensure the small kitchens were kept clean in the future. The rooms throughout the home were individually and naturally ventilated, they were all centrally heated and the radiators were covered. Staff hand washing facilities were in place in bedrooms, bathrooms and toilets. Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 22 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 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by staff that are suitably trained and safely recruited. EVIDENCE: Inspection of the duty rotas throughout the home showed that, apart from Clarence Unit, there are enough staff on duty over a 24-hour period to meet the needs of the residents living at the home. Staff expressed their concerns that they did not have enough staff on in a morning on Clarence Unit to give the residents the care and attention that they deserved. We asked the staff if they had spoken to the manager about this. We were told that they had not. We passed this information onto the Manager who told us that she would discuss this with the staff and if a problem was identified then more staff would be provided. 1 resident told us: ‘The staff are wonderful. They are lovely girls’. The information from the AQAA document sent to us, and the information that we looked at in the training file showed that 68 of the staff had obtained their NVQ level 2 or above in care. This is very good progress. Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 23 The personnel files of 3 staff members were inspected. All were in order and showed that the staff had been properly and safely employed. Induction training is provided for all newly employed staff. This is to make sure that they understand what is expected of them and that people are cared for properly and safely. We were given a copy of the training statistics for the home. This showed us what training every staff member had undertaken. The information received from the AQAA document also told us about the training that the staff received. From a discussion with the manager and inspection of the records we saw that a wide range of appropriate and ongoing training in moving and handling, dementia care, basic food hygiene, fire safety, health and safety, medicine management and other relevant topics are provided to staff at the home. Comments from staff were: ‘Very thorough company for training’. ‘Provides lots of training for staff of all levels of qualifications’. Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is safe and well managed. Management continually look at the care and facilities they provide so that the residents’ welfare is protected. EVIDENCE: The Registered Manager of the home is a qualified nurse and has over 20 years experience of management and working in the field of caring for older people. She has worked for the Company for several years and she has a management qualification. She keeps herself regularly updated with training, both in management and care issues. Staff made the following comments: ‘We all know what is expected of us’. ‘She is very strict but very fair’. Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 25 ‘She does spot checks and visits the units every day’. ‘Offers support and information to staff. She is always looking at ways of improving care. Takes on board any concerns from relative’s. Information from the AQAA document sent to us and documents we looked at showed that a great deal of work continues to go into providing and further developing a quality assurance system for the home. This is to check on the quality of the care and services provided. From what we looked at it is obvious that the Company want to make sure that they get things right for the residents.Every month the manager of the home has to check on lots of things that affect the health, safety and wellbeing of the residents. She has to record all her findings and then senior management check the findings and then act on anything that may need attention. The systems in place for the management of residents’ money were good. Any money held for the resident is in a group bank account but any interest earned is subdivided for each person. Information received from the AQAA sent to us and from random checking of servicing records showed that the homes’ fixtures, fitting and equipment are properly maintained and regularly serviced. We saw that regular weekly checking and testing of fire detection system, fire exits and emergency lights was undertaken and documented. Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 26 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 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x 3 2 x 2 3 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 4 x 3 x x 3 Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 27 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(2) Requirement Timescale for action 14/08/08 2. OP9 13(2) 3 OP22 13(4)(a) Clarence To ensure that a true record is kept of drugs received and administered and to comply with legal requirements the Controlled Drug Register must be filled in accurately. Clarence 14/08/08 A record must be made of the reason and date of the change of any medication. To prevent mistakes being made, thereby protecting the health and welfare of the resident, staff must then sign the change then have it checked and countersigned. You must make sure that 22/08/08 residents are protected from avoidable risks to their health and safety. Call bells must therefore be fitted to the toilets and the bedroom that are without them. Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 28 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 OP9 Good Practice Recommendations Staff should ensure that they have some written confirmation of the dose of any anticoagulant to be given. This can prevent mistakes being made and therefore protect the residents from harm. To protect the residents from harm, consideration should be given to repositioning the grab rails in the toilets identified in this report. 2. OP22 Rose Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Court Nursing And Residential Home DS0000017336.V369980.R01.S.doc Version 5.2 Page 30 - 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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