Care Home: Rose Villa Nursing Home

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What the care home does well The home provide a nice homely environment for the people living in it where they can make the choices they want to make. The home is staffed by a good skill mix of staff and they come from a variety of backgrounds and ages. Visitors are encouraged to visit freely and if possible share a meal with the person they are visiting. Staff try to make everyone welcome. The meals are all cooked fresh each day and provide a daily choice of at least two dishes. The home is kept clean and odour free. The relatives and visitors are given time to talk to the staff about any issues that arise. They produce good general care plans and assessments and maintain the review and update of these. The home maintain good links with GPs, District Nurses, Stoma Care Nurses, Speech Therapist, Dietician and the Enablement Team. The home manages infections well, none having spread in the home. There is a good selection of equipment and this is kept well maintained. There was evidence that staff all work well together as a team. What has improved since the last inspection? The home have had a Customer Services course for some staff and this has improved the staffs approach to visitors to the home especially. The medication ordering and stock control has improved which has organised the amount of stock kept in the home and reduced mid-cycle ordering. The management have increased the number of domestic hours and have more flexible shifts so that a cleaner/laundry person is available in the afternoon. People living in the home and visitors are more aware of the staff on duty and the menu for the day as this information is written on white boards and displayed in the home. Some new furnishings have been purchased and are in use and carpets have been replaced. The home is more secure due to new locks on the doors and extra lighting has been fitted outside for the benefit of visitors and staff. What the care home could do better: The manager plans to introduce more structured training re Dementia, Difference and Diversity, Nutrition, End of Life Care and Abuse. Providers of these courses are being sought and some in-house training is to be developed to compliment it. New Furnishing needs purchasing and this is part of our on-going refurbishment plans. The dining area in particular requires attention to facilitate more persons being able to dine at the table and make it a more social event. The manager wants to further develop person centred care plans and all qualified staff will have an input into this (the content and the structure). She also plans to restart the relatives meetings, a letter will be sent out with the invoices. A more lively activities programme which will commence with the start of our new Activities Person in June. Key inspection report Care homes for older people Name: Address: Rose Villa Nursing Home 148/150 Eccleshall Road Stafford Staffordshire ST17 9AA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Joanna Wooller     Date: 1 6 0 6 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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 Villa Nursing Home 148/150 Eccleshall Road Stafford Staffordshire ST17 9AA 01785254760 F/P01785214263 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Jayantical James Bhikhashai Patel care home 35 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: Age: Physical disability (PD) age 60 and above. The maximum number of service users who can be accommodated is: 35 The registered person may provide the following category of service only: Care Home with Nursing (Code N); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Physical disability (PD) 35 Date of last inspection Brief description of the care home Rosevilla is situated on the Eccleshall Road leading to the M6 (junction 14), in a residential area about one mile from Stafford town centre. Rosevilla is a registered care home offering 24 hour nursing care, which aim to offer a high standard of care and accommodation for thirty-five people. The home has mostly single bedrooms, all with en-suite toilet facilities. There are 3 double rooms for those who prefer to share, but these may be used as larger single rooms. The home started life as two large properties that have been extensively extended to Care Homes for Older People Page 4 of 26 35 Over 65 0 Brief description of the care home provide the facilities it offers. Rosevilla consists of two floors, serviced by a lift in the original building, and a purpose built ground floor unit of single rooms with ensuite facilities. The persons living in the home have a choice of two lounges to choose from, one with views to the back of the property and one with views to the front. The opportunity to become involved with activities is also available with the homes activity organiser (Post is currently advertised) Home cooked food is provided and special dietary needs are catered for. The service users have access to all areas of the home including the gardens. There is ample parking space for visitors. 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: The quality rating for this service is 2 star. This means that that people who use this service experience good quality outcomes. This unannounced inspection took place over one day between the hours of 09:00 to 14:00hrs. The Manager was not in the home. A senior nurse and the provider participated in the inspection process. The deputy manager came in to the home and also contributed to the inspection. The inspection included the following elements, a walk around the building, observation and inspection of records relating to provision of care, discussions with people, who use the service, case tracking whereby we select several people who use the service, chat to them and look at their care plans and lifestyle in the home. discussions with several of the staff members on duty, observation and sampling of other services provided such as catering and laundry, and an inspection of the managerial aspects Care Homes for Older People Page 6 of 26 such as staffing issues, training, recruitment and health and safety. We were made welcome in the home and all assistance was given to gain the evidence required for the report. We had dealt with no complaints since the last inspection. People who use the service were complimentary about the staff, the care and the environment. Relatives spoken to commented on the good qaulity meals and the staffs care and attention offered to people living in the home. The home manager sent us their annual quality assurance assessment (AQAA) when we asked for it. This document was completed to a good standard and gave us all the information we asked for. The fee information in the Statement of Purpose applied at the time of the inspection; persons may wish to obtain more up to date information from the service. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: The manager plans to introduce more structured training re Dementia, Difference and Diversity, Nutrition, End of Life Care and Abuse. Providers of these courses are being sought and some in-house training is to be developed to compliment it. New Furnishing needs purchasing and this is part of our on-going refurbishment plans. The dining area in particular requires attention to facilitate more persons being able to dine at the table and make it a more social event. The manager wants to further develop person centred care plans and all qualified staff will have an input into this (the content and the structure). She also plans to restart the relatives meetings, a letter will be sent out with the invoices. A more lively activities programme which will commence with the start of our new Activities Person in June. 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 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. All persons admitted to the home receive a pre-admission assessment to ensure their individual needs can be met. Evidence: The Aqaa told us that the home Provide a friendly welcome to prospective users Have a clear and easy to read Statement of Purpose and Users Guide Give open appointments for people to view the home so that they can see the home and staff at any time of the day.Ensure prompt assessments for prospective service users and work well with the Enablement Team. We saw that the manager or her deputy pre-assess all prospective new admissions. This is a comprehensive procedure which records all aspects of care needs and requirements of the individual. Consideration is taken for the existing people living at the home also. We saw that the doctor and other health professionals opinion may be included at this stage. Care Homes for Older People Page 11 of 26 Evidence: One lady spoken to told us she was well received at the home and felt settled straight away. Two relatives told us that their mother had been admitted to the home for respite and she was been well attended to. They told us that the manager had met her prior to admission and taken all the details to ensure the home can meet her needs. 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. People that use the service have their individual health, personal and social care needs set out in a care plan. Medication administration, storage and ordering follows the homes policy and procedure. People living in the home felt that they are treated with respect and their privacy is upheld. Evidence: The Aqaa told us that the home Have good general care plans, they review and revise care plans as needed, Manage our medicines, refer residents to other health professionals promptly, maintain links with all local Doctors and re-assess all assessments each month. We saw that the health, personal and social care needs were identified in individual care plans, including risk assessments and health professionals visits. We saw that the care plans were appropriately reviewed and updated and where possible the individual was also involved in the review process. General conditions were evidenced to be monitored and assessed. Referral to other health professionals was evident and a Macmillan nurse was in the home at the time of the visit. Social worker reviews were Care Homes for Older People Page 13 of 26 Evidence: present in care records where necessary, with future review dates included. The home provides equipment for the promotion of tissue viability and prevention of pressure sores. Treatment for pressure sores is discussed with wound care specialists and concise records were kept to ensure progress is made. Some profile beds had been purchased to assist the individuals comfort and aid nursing procedures. We saw that the home ensure the individuals have access to NHS facilities and appointments are attended as necessary. We saw that the home protects the people living in it by following their policies and procedures to ensure safe administration and storage. No discrepancies were noted. One lady told us The staff are respectful to me and give me chance to do things for myself. Sometimes they have time to chat and other times they seem too busy. I am content in the home and enjoy my room. A visitor told us I am quite happy with the care my Mum receives. Nothing seems too much trouble. I always get a warm and friendly welcome. The visiting doctor told us The home always call to discuss peoples condition and they are very professional at all times. She finds the staff helpful. 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 living in the home experience lifestyles that match their expectations. They maintain control over their lives and make individual choices. Contact with family and friends is encouraged at all times. People living in the home receive a balanced diet of home cooked food. Evidence: The Aqaa told us that the home have Reviewed the menus and introduced a five week revolving menu and more people are sitting at the dining table for meals. We evidenced that people were given choices throughout the day for meals, drinks and seating. Some people preferred to stay in their own rooms, others liked the company and sat in the communal lounge. We evidenced visitors coming in to the home and being welcomed by the staff. Visitors signed in and out of the home. Visitors told us they were always welcomed in to the home and kept up to date about their relatives health. We looked at the menus and spoke to the kitchen staff. The kitchen had been awarded a 4 star Rate My Place certificate. Scores were reduced due to the kitchen cupboards Care Homes for Older People Page 15 of 26 Evidence: and general work space organisation requiring an update. The menus appeared well balanced with a good variety of choice. Activity input at the home has been limited due to two newly employed co-ordinators not being suitable for the role. Recently a carer has been offered the position and she will be commencing the role as soon as her care hours are covered. Staff were seen talking to people and encouraging them to be independant. One person living at the home told us that she does get given choices in all areas of her care including meals, drinks and attention. She enjoys having her personal possessions around her and the staff respect that. One relative told us The food always smells appetizing and looks well presented. Sometimes the staff seem very busy at meal times but some people need feeding. The staff always ask Mum what she would prefer, and she gets plenty of drinks offered her. There arent many activities but most people seem content watching the television and spending time with their visitors. The staff do their best to keep everyone living here motivated. One person living in the home told us I like it here because I can please myself and its very comfortable. 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 living in the home are confident that their complaints will be listened to and they are protected from abuse. Evidence: The Aqaa told us that the home Act promptly to all complaints, have a clear and easy to understand complaints procedure on display to everyone and listen to and treat all complaints seriously. We saw that the complaints procedure was displayed in the home and also included in the service user guide and statement of purpose. People spoken to were made aware of the complaints procedure on admission and knew who to complain to. They told us they were able to talk to the staff so any issues were addressed straight away. No complaints had been received in the home or to the local CQC office. No vulnerable adult situations were reported and social worker reviews were being carried out. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people live in a clean, safe and well maintained home. Evidence: The Aqaa told us that the home Provide a safe, comfortable and homely environment. Have good Infection Control Measures. Keep the home well decorated. They have good access to the grounds for the Service Users and their families and the home is secure and clean. We found that the home was safe and well maintained. The grounds were well tended and pleasant for those who wished to sit in the fresh air. Easy access is available for those less able with the use of ramps. The home is checked for fire safety and the maintenance man is responsible for the testing and compliance. We saw that the home was clean, pleasant and hygienic. A sample of bedrooms were seen and found to be well personalised and safe. Trip hazards are identified by the staff and addressed to reduce the risk. Communal lounges and dining room were sympathetically organised and comfortable. The manager plans to alter the dining room by replacing the larger table with a few smaller ones for more cozy dining. Care Homes for Older People Page 18 of 26 Evidence: Redecoration continues on a rolling programme and the replacement of furniture is ongoing. Some lounge seats have been replaced, however the overall look of the lounges and comfort for the people living in the home would be improved with further seats being purchased. The laundry and bathroom facilities were all in good order and well maintained. One assisted bath requires resurfacing or replacement. 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. Persons living in the home have their needs met by a group of skilled nurses and carers. The staff are trained to ensure people living in the home are in safe hands at all times. Evidence: The Aqaa told us that the home have Good skill mix of staff, a diverse workforce and they encourage staff to do NVQ or some other training. We evidenced that staff training is planned throughout the year and staff are invited to several different dates to ensure they can attend. Training shortfalls are highlighted by the administrator which is brought to the attention of the manager who then organizes in house training sessions. We looked at staff files and those seen had the necessary information and were in order. The manager closely follows the staff recruitment policy and procedure to ensure that the new employee is suitable to work in the home. Staff skill mix is assessed on each off duty roster and the manager assesses the staff numbers depending on the occupancy and the needs of the people living in the home. There were some staff vacancies which were being covered by existing staff whilst the posts were being filled. One trained nurse, two carers and one domestic were Care Homes for Older People Page 20 of 26 Evidence: currently advertised. 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 home is well managed and run in the best interest of the people living in it. Individual financial interests are safeguarded and the health, safety and welfare of staff and people living in the home are promoted and protected. Evidence: The Aqaa told us that the home Open and inclusive management and complete Quality control. We saw that the home was being well managed and many improvements were noted since the last inspection. The administrator now deals with the homes paper work which gives the manager time to support the staff in caring for the people living in the home. The manager has initiated new processes which ensures that peoples needs are met and customer satisfaction is maintained and improved. The staff have attended a customer care course to assist them in meeting needs and to be receptive to the group of people living in the home. Care Homes for Older People Page 22 of 26 Evidence: Relatives told us the staff were generally happy and always welcoming. Quality assurance systems were in place and evidenced to be effective. The feedback from the surveys is discussed with the manager and her staff and any unsatisfactory issues are addressed. Financial arrangements in the home were well managed and no discrepancies were reported. People living in the home were generally able to look after their own financial affairs but senior staff would support them if needed. We saw that health and safety is considered an important aspect of the home management and all effort is made to ensure staff and persons living in the home are safe. Safe working practices are monitored and addressed through staff training and updates. Risk assessments are personalised and meaningful to avoid accidents, prevent injuries and maintain nutritional well being. Accidents are recorded and monitored for any trends in place and time. Staff induction training is established in the home for all new staff. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R 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 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 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 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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