Care Home: Rose Meadow

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What the care home does well Rosemeadow is an older style purpose built home which employs friendly staff who work hard to make sure that the people living there are comfortable and well cared for. There is clear written information provided for prospective residents looking to move into a care home. All prospective residents are visited by the managing team of either the manager or care co-ordinator for an initial assessment to ensure that they can meet there individual needs. The managing team encourage participation from residents family or their social worker to ensure a smooth admission process. Soon after the resident moves in the care co-ordinator discusses the plan of care with them and this is compiled to ensure that the care staff care for them in a satisfactory manner to help them become part of the small community. Visitors consulted said that they were always made to feel welcome when they visited and during this inspection it was clear that the homes welcoming atmosphere encourages people to visit quite often. People living at the home are offered choices throughout the day especially with their choice of food where it was observed that meals are of a good standard with plenty of fresh fruit and vegetables routinely used. Any complaints that people have are listened to and acted upon immediately with the majority reaching a satisfactory outcome. There is enough staff on duty to make sure that the residents needs are met, with the majority of the staff having worked at the home for a number of years. The staff team receive a good all round training to ensure they have the residents best interests at heart. What has improved since the last inspection? The last inspection resulted in two requirements and two recommendations being issued. There has been one recommendation developed which benefits residents who have a sight problem who can now access the newsletter in audio format. Staff receive regular meaningful supervision sessions with the managing team to help them develop their care skills. What the care home could do better: The building is of an old style care home and the County Council must plan to make improvements to the environment for the comfort of the residents. Two requirements are ongoing and must be acted upon the shaft lift between the first and ground floor is very small and makes it quite difficult for residents to access both floors of the building. The residents do not have control of the heating in there own rooms as this is controlled centrally it would benefit residents to be able to control there own temperature in their rooms. The building has the old style metal window frames and consideration for double glazing should also be considered in future development plans. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Rose Meadow Yarmouth Road North Walsham Norfolk NR28 9AU     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: Hilda Stephenson     Date: 1 3 0 5 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 26 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 26 Information about the care home Name of care home: Address: Rose Meadow Yarmouth Road North Walsham Norfolk NR28 9AU 01692402345 01692402345 liz.lockwood@norfolk.gov.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) : Norfolk County CouncilCommunity Care care home 30 Number of places (if applicable): Under 65 Over 65 30 old age, not falling within any other category Additional conditions: 0 From time to time the home may accommodate one service user over the age of 65 years who has dementia and is named in the Commission`s records. Total number not to exceed thirty (30). People who need wheelchairs to assist with independent mobility at the point of admission can only be accommodated in rooms numbered 34, 41, 66 and 68 Date of last inspection Brief description of the care home Rose Meadow is a care home providing personal care and accommodation for up to 30 older people. The cost of a placement as given to the CSCI is #376.09. This does not include hairdressing, chiropody, toiletries, newspapers or magazines. The home has 29 permanent placements and 1 respite care placement. There is a day centre attached to the home and managed by the care home. This offers up to 12 day care places on Wednesdays, Thursdays and Fridays. The home is owned by Norfolk County Council and is located on the outskirts of North Walsham, being quite close to shops, pubs and other local amenities. The home was purpose built and accommodates service users on two floors. Norfolk County Council has completed some refurbishment and redecoration Care Homes for Older People Page 4 of 26 Brief description of the care home and has plans for further improvements to the home. All service users have their own bedroom but several of these are rather small. The communal areas are plentiful and offer a variety of seating areas including a quiet room and large dining room. There is a shaft lift that offers access to the first floor. The lift is, however, very small and does not comfortably accommodate a wheelchair. There is a large garden that service users benefit from in the summer months. Care Homes for Older People Page 5 of 26 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: Care services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The unannounced key inspection of this service has been carried out by using information from previous inspections, written information provided by the manager and comments received from residents, visitors, staff and others who work or visit the home. The fees for living at the home are £383.61 per week, with additional charges for hairdressing, chiropody and personal items. This unannounced visit took place during the day on the 13th May 2009. The acting manager and care co-ordinator were in attendance during most of the day. Prior to the Care Homes for Older People Page 6 of 26 inspection the manager provided a completed Annual Quality Assurance Assessment (AQAA) giving details of what the homes strengths and weaknesses were and how these could be adapted to improve care for residents who live there. During the inspection a tour of the premises was undertaken, staff practice was observed, records and files were read and checked and residents and staff were consulted. What the care home does well: What has improved since the last inspection? What they could do better: The building is of an old style care home and the County Council must plan to make improvements to the environment for the comfort of the residents. Two requirements are ongoing and must be acted upon the shaft lift between the first and ground floor is very small and makes it quite difficult for residents to access both floors of the building. The residents do not have control of the heating in there own rooms as this is controlled centrally it would benefit residents to be able to control there own temperature in their rooms. The building has the old style metal window frames and consideration for double glazing should also be considered in future development plans. Care Homes for Older People Page 8 of 26 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 26 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 26 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. People thinking about moving into Rosemeadow are given clear information regarding the service they will receive and have their care needs assessed prior to moving in. Evidence: There had been no recently admitted residents to the home so two residents at random was chosen to check their admission process and follow through by checking the care plans and speaking to them both in the form of case tracking. The manager is contacted when a prospective resident wants to move in. The manager or Care Coordinator visits the resident to obtain pre-admission details about their individual care, health and social needs to make sure that the home can cater for these before admission. The manager then invites the resident or there family to visit the home to see their room and facilities on offer. The fees and charges are discussed at this point and a contract is drawn up including the fees and room to be occupied. The resident is admitted and is allocated a key worker. The manager arranges a review after the Care Homes for Older People Page 11 of 26 Evidence: initial four weekly period to ensure the resident and family are satisfied with the care in place. The pre-admission details from the initial visit help towards compiling the care plan for the long term care needs to enable the staff to look after the resident with their best interest at heart. One of the residents spoken to confirmed that they had received the written information about the home to enable them to make up their mind before moving into Rosemeadow. The statement of purpose had recently been updated but still contained the (closed) Norfolk office address, this was immediately rectified by the acting manager. Care Homes for Older People Page 12 of 26 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. The health and personal care that people receive is based on their individual needs, with the principle of dignity and respect put into practice. Evidence: All care plans inspected were of a good standard, were up to date and person centred. The care plans contained details of health, social and where necessary mental health care needs including the activities of daily living. Those residents with memory impairment have a life history including details of the residents family background, work life and hobbies and interests to help staff to provide a service that reflects peoples wishes and needs. Evidence of how staff implement nutritional needs of residents especially those who are most vulnerable are in place. Care plans and risk assessments are reviewed by the care co-ordinator and key worker on a monthly basis or when needs change. Medication is administered by the care co-ordinator or senior carer on duty. Two of the medication records were checked and found to be good order. Evidence that Care Homes for Older People Page 13 of 26 Evidence: medication is stored and audited regularly was seen this makes good practice. Staff were observed treating residents with respect and courtesy at all times, this was confirmed by residents who were spoken to during this visit. One stated staff are lovely here, theyre ever so kind. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People make choices about their daily lives, a range of activities are available and a varied nutritional menu is offered. Evidence: The acting manager organises the monthly list of activities following the monthly residents meetings, to ensure that residents opinions are used. The activities list was displayed in the reception area which included a pamper session, knitting club, cooking, out of the box, a movie evening, exercise to music, a sing-along, gardening club and bowls. In between these arranged activities were reminiscence sessions and residents meetings. A display of a recent outing provided for the men to the Norwich Football Club was in reception, one of the residents confirmed it was a lovely outing, thoroughly enjoyable. The next outing arranged is to a local bowling alley. The acting manager confirmed that two outings a month is offered when extra staff are brought in and a local minibus is used. The care plans showed the activities the residents had been included in. The previous inspection recommended that residents with sight difficulties should have access to audio books and local newsletter which had been implemented. People living at the home said they were able to bring in their own Care Homes for Older People Page 15 of 26 Evidence: personal possessions when they moved in which went towards helping them settle in. The menu was displayed outside the dining room and contained two choices for lunch time and a selection for tea time. The large dining room was comfortably furnished with four residents accommodated round each table. The lunch was roast lamb or macaroni cheese and a selection of vegetables with a choice of two desserts. Meals are served on an individual basis from the servery so residents can ask for a small meals or have seconds if required. One residents stated I asked for my favourite for tea and I got it the same day, it was wonderful how quick they got it. All the residents who were spoken to confirmed how much they enjoyed the food at Rosemeadow. Care Homes for Older People Page 16 of 26 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 who use the service have access to a good complaints procedure and are protected by a trained staff team. Evidence: The acting manager explained how complaints are dealt with within the home. All complaints and concerns are logged, investigated resulting in a satisfactory outcome for residents. One complaint was followed through and the resident was happy to speak about how the staff had dealt with it and was happy with the outcome. Residents confirmed that they felt safe, listened to and able to speak to the acting manager or staff if they were unhappy about anything to do with their care. Staff spoken to had completed training in adult protection and were aware of how to report an incident following the whistle blowing policy. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable homely environment, although improvements to some of the physical aspects of the building are needed. Evidence: Rosemeadow is a purpose built care home, although is now quite dated and requires some modernisation. The accommodation comprises of single bedrooms which come in various sizes, some are below the minimum standard, and have no en suite facilities. There are toilet and bathing facilities close to the bedrooms on both floors. Access to the first floor is by a very small shaft lift and should be considered for updating in the future. There are five comfortable lounges some are used for watching television others are furnished to accommodate residents who wish for peace and quiet. The dining room is large and seats four residents round each table. There is a large well maintained garden surrounding the building with acces from a variety of rooms. The home caters for day care of local older people and residents are offered the use of these facilities when needs arise. The day centre is looked after by a small team of staff and is an added bonus for residents. Two requirements from the previous inspection regarding the shaft lift and the ability for residents to adjust the heating in their own rooms will be re-issued so the Council Care Homes for Older People Page 18 of 26 Evidence: can plan for these to be included in development plans. They should also consider the recommendation for changing the metal style windows to more modern double glazing in the future. Care Homes for Older People Page 19 of 26 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. Staff are available in sufficient numbers to look after people living at the home. Evidence: Inspection of the staff rotas, observation during this visit and discussion with residents demonstrated that there were enough staff on duty to meet the needs of the residents. The day centre has a separate staff team. There were enough domestic staff on duty to keep the home clean and tidy who also had built a good rapport with the residents. The cook and kitchen assistant cook and cover for both lunch and tea time meals allowing the care staff to concentrate looking after the residents. Evidence of the home having access to a handyman and gardening services was in place. The acting manager provided evidence that fifteen out of twenty five staff had achieved the accredited NVQ2 training which shows that they encourage staff to develop their skills. This was acknowledged and the home should be commended for this. Both the acting manager and Care Co-ordinator are undertaking a module from the NVQ4 training to help them achieve to a higher level. Staff records showed that staff are recruited following clear guidelines to ensure that they are appropriately vetted before commencing employment. Care Homes for Older People Page 20 of 26 Evidence: A sample of staff files showed that staff had attended training to enable them to keep up to date in line with the current needs of the residents. The acting manager showed copies of recorded staff supervision sessions and staff spoken to stated that these were beneficial. Care Homes for Older People Page 21 of 26 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. The management and administration of the home is good ensuring the staff have the residents best interests at heart. Evidence: The registered manager is looking after another home for a short period, so their is an acting manager in post temporarily. She is a long standing Care Co-ordinator who has worked at the home for a number of years. She is experienced to take on this role for a short term period. The acting manager carries on with an open door policy and staff confirmed that they can see her if they had any concerns. Residents spoken to knew that there was an acting manager in place showing that information is passed onto people living there. The acting manager organises regular residents meetings and then draws up the months activities after these meetings which include residents input, which is good practice. Care Homes for Older People Page 22 of 26 Evidence: The results of the last quality assurance survey was seen and the majority of residents, visitors and professional staff were satisfied with how the home is managed. All residents monies are kept in individual containers and checked on a regular basis, a sample of these records were checked and in good order. Staff files show that health and safety training is undertaken at regular intervals and that staff supervision has been developed and become part of the routine of staff development. A sample of the maintenance records such as the water temperatures, boiler maintenance, fire and fire equipment, lift safety, hoists, accidents, and security of the building was checked and recorded in detail. The current insurance certificate was deemed out of date, although the acting manager stated that the new certificate was usually slow to be sent to them from Head Office. Overall, the home appears to be well managed with residents and staffs health and safety of paramount importance. Care Homes for Older People Page 23 of 26 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 22 23.2a All residents should have 13/05/2010 easy access between the first and the ground floor. The present lift makes this difficult for some residents. All residents should be able 13/05/2010 to control the temperature of their own rooms. 2 25 23.2p Care Homes for Older People Page 24 of 26 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 22 25 All residents should have easy access between the first and ground floor. The present lift makes this difficult for some wheelchair users. . 18/05/2010 2 25 23 Residents should be able to control the temperature of their own rooms. . 18/05/2010 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 2 19 38 The home would benefit by having the old style metal windows replaced. The insurance certificate is out of date and the new certificate should be displayed. Care Homes for Older People Page 25 of 26 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. 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