Care Home: Rosedale Care Home

What the care home does well Residents expressed a great deal of satisfaction regarding the quality of service they receive at Rosedale care home, a view echoed by all staff spoken to, including two visiting relatives. Their views including those of staff, have been reflected throughout the report. The assessment and admission process is good and this ensures that the resident`s needs are appropriately met on admission to the home. The care plan is of a good standard and reflects how identified needs are being addressed. The implementation of health and personal care needs are being monitored internally through a monthly review system, which involves the resident and their representative. Activities offered to residents provide them with a good level of stimulation. Meals offered to residents are of a good standard. Quality and diversity issues are being promoted and residents are treated with dignity and respect. The accommodation is homely and comfortable. A high standard of cleanliness was evident throughout those areas viewed. The staff members on duty were positive about different aspects of their work and they are well supported. All staff members receive training including mandatory training. NVQ training for staff is being given a high profile. Staff receive regular supervision. The registered manager is skillful, knowledgeable and experienced to manage this service. Care and staff management systems within the home are well organised and effective. The manager benefits from the support of an experienced director who also ensures appropriate standards are maintained. What has improved since the last inspection? There were three requirements made in the last inspection report dated 7 June 2007. These have been implemented to good effect. A care plan has been introduced for all assessed needs with sufficient guidance to staff to ensure continuity of care for everyone living at the home. Medication balances are being maintained and brought forward, in order to ensure an audit can be undertaken. A varied diet that is of a good standard is being offered to meet the individual needs, preferences and nutritional needs of the people in residence. Evidece demonstrates that the overall standard of care and support for the residents has continued to improve, a view echoed by the manager, staff, residents and visiting relatives spoken to. What the care home could do better: There are 2 requirements and 2 recommendations arising from this report, which needaddressing. The remaining five staff who have not received training in safeguarding vulnerable adults must complete this course. Accessing this essential training would further ensure the protection of residents. Specific risk assessments must be undertaken for each of the resident accommodated in the bedrooms on the third floor, due to the slanting ceiling. This is so that remedial action is taken as required to ensure the safety of the occupants. Recommendation The resident, where appropriate and their representative should sign the care plan; this would demonstrate their involvement in the care planning process and their agreement with its contents. The monthly review minutes should be in greater detail, in order to reasonably reflect relevant issues occuring over a month period. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Rosedale Care Home 36 Lansdowne Road Luton LU3 1EE     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: Neil Fernando     Date: 2 8 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 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Rosedale Care Home 36 Lansdowne Road Luton LU3 1EE 01582481188 F/P01582481188 rosedale1@live.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Cornelius Crowley,Mr Stephen Giles care home 20 Number of places (if applicable): Under 65 Over 65 20 20 20 20 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: 0 0 0 0 Categories: Older people with physical disorders, mental disorders or dementia OP, PD(E), MD(E), DE(E). Numbers of service users 20. Age over 65 years including the two named service users under the age of 65 years who are currently accommodated at Rowles House. Date of last inspection Brief description of the care home Rosedale is a large three-storey home located in a residential suburb of Luton, within a mile of the town centre. There are local shops, parks and churches close by. The home is registered to provide care for 20 people over the age of 65. Accommodation is provided on three floors linked by stairs and a passenger lift. All the bedrooms are single rooms. Communal facilities consist of a lounge/diner on both the Care Homes for Older People Page 4 of 29 Brief description of the care home ground and first floor and a conservatory off the ground floor lounge. A well-maintained garden is available at the rear of the property, with flower beds, trees and garden furniture. It is accessible and well used by residents in the warmer weather, in particular. There is some private car parking facility to the front and some time limited road parking available on the street outside the home. A copy of the service users guide and inspection report is available for residents and visitors to read. The fees for this service vary between £460 and £540 per resident, per week; the exact fees are reflected in individual contracts for the residents. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. We, the Care Quality Commission, undertook this unannounced key inspection on 28 May 2009, the last having occured on 7 June 2007. We spoke with six residents, the manager and the deputy manager, the director, two care staff and two visiting relatives. We had a look round the home and viewed a range of records the service must keep. At the time of the visit, there were nineteen people in residence with one vacancy. We have received an AQAA (Annual Quality Assurance Assessment), a document which Care Homes for Older People Page 6 of 29 gives the manager the opportunity to tell us how the home is meeting the standards and regulations. We have also received surveys from six residents and seven staff. The manager was available throughout the inspection. An annual service review was carried out on 16 May 2008. What the care home does well: What has improved since the last inspection? What they could do better: There are 2 requirements and 2 recommendations arising from this report, which need Care Homes for Older People Page 8 of 29 addressing. The remaining five staff who have not received training in safeguarding vulnerable adults must complete this course. Accessing this essential training would further ensure the protection of residents. Specific risk assessments must be undertaken for each of the resident accommodated in the bedrooms on the third floor, due to the slanting ceiling. This is so that remedial action is taken as required to ensure the safety of the occupants. Recommendation The resident, where appropriate and their representative should sign the care plan; this would demonstrate their involvement in the care planning process and their agreement with its contents. The monthly review minutes should be in greater detail, in order to reasonably reflect relevant issues occuring over a month period. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Anyone considering Rosedale as a home, either for themselves or for someone else, is appropriately assessed, given the necessary information and opportunity to visit the home, so that their identified needs could be met on admission. Evidence: The home has a statement of purpose and a service users guide, which have been reviewed and updated as appropriate. A copy of the most recent inspection report is also available to residents and visitors to read. Each resident is issued a contract at the time they move into the home, which has been signed by the the resident and their representative. It states the terms and conditions of their stay at the home. Surveys received from all six residents also confirm that they have been given written information about the homes terms and conditions. Care Homes for Older People Page 11 of 29 Evidence: Case files for three residents were examined and they all contain good pre-admission assessments completed by the manager, prior to an offer of a placement being made. They provide a detailed profile of the residents needs and the level of assistance required. These assessments provide information relating to health matters including pressure care, mobility, nutrition, social and recreational activities, culture and religion and personal capabilities and preferences. These assessments are all clearly signed by the manager. Information about the prospective resident is also sought from their representative, health and social care professionals. There is very good documentary evidence to demonstrate that the prospective resident and their representative are encouraged to visit the home and meet with staff and have a meal with the other residents, as necessary. Residents have a care plan prepared for them, which is based on the assessment of needs. There is a wide range of specialist services available to the home via GP referral and other appropriate channels. Examples include district nurses and occupational therapists. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents observed during the course of the visit appeared to be well cared for and they were being treated with dignity and respect. Evidence: The AQAA states Set up detailed individual care plans, identifying all needs and choices for, health, personal and social wellbeing and a plan for how these may be achieved. Where applicable incorporating Advance Plan of Care. Ensuring that they are monitored and reviewed regularly (or monthly as a minimum requirement), with the service user/family where possible and recorded correctly. The care plans for three residents were checked. The information they contain is in good details and up to date. The residents needs including health, personal hygiene, dressing, mobility, communication, food and culture and religion are clearly being identified and addressed. The resident, where appropriate and their representative should sign the care plan; this would demonstrate their involvement in the care planning process and their agreement with its contents. Staff members spoken with Care Homes for Older People Page 13 of 29 Evidence: demonstrated a good understanding of equality and diversity issues relating to residents they are key workers for, in particular. The care plans viewed include evidence of the involvement of health care professionals. An annual review is completed by a social worker from the placing authority for each resident. Senior care staff have delegated responsibility to undertake a monthly review for each resident. Evidence indicates that these reviews are being completed regularly. However, review minutes should be in greater detail, in order to reasonably reflect relevant issues occurring over a month period. Records seen indicate that risk assessments are completed and updated by staff, as and when required. The policy and procedure on medication is available and accessible to staff members. Only designated staff are authorised to administer medication. Medication is stored in a locked cupboard; there is also a medication trolley, which is stored in the medication cupboard. There is a specimen signature sheet at the front of the medication records file and each medication chart has a photograph attached, so that residents could be easily identified. There is no controlled medication in use currently. A staff member was seen administering medication soon after tea time and this task was carried out satisfactorily. The medication administration records were examined for eight residents and these were in order. Residents spoken with said that they receive their medication on time. Privacy and dignity is a subject included in the induction programme for all staff. Personal care was seen being given in an appropriate and respectful manner; the feedback received from residents about the standard of their care is very positive.The staff are very good is a typical comment made by residents. Two visiting relatives also made positive comments about the staff. They are lovely and very approachable and put you at ease. I visited four homes but this one is very nice, said a visitor. Care Homes for Older People Page 14 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social and recreational activities facilitated promote an appropriate level of stimulation. Residents can be assured that they will be offered a varied diet that meets their requirements Evidence: The AQAA indicates We gather as much background information on each individual to identify their previous lifestyle, in order to establish their expectations, preferences and accommodate their social, cultural, religious and recreational interests and needs. The staff spoken with indicate that each resident is a unique individual with individual views, wishes and needs. The care plans for three residents were examined; they show that residents are being assisted to follow the lifestyle of their choice as discussed and agreed at the time of their assessment. Four residents spoken with said they are satisfied with their lifestyle at Rosedale home. There is an activities programme in place. There is good evidence to show that residents are being encouraged to continue to participate in various activities of interests or hobbies they may have had before. Staff are also clear that they Always Care Homes for Older People Page 15 of 29 Evidence: respect a residents right to decline to participate in any activities offered. Residents are encouraged to be proactive in their views about the services offered and make suggestions about improvements or new initiatives. Residents and their representatives are encouraged to complete an annual customer satisfaction questionnaire. Activities are arranged either individually or in small groups; they are both planned and ad-hoc, to make the most of the weather for example, or the expressed wishes of the residents. Outside entertainment is planned at regular intervals and residents are informed well in advance. Social events and trips out are offered to service users throughout the course of the year. The hairdresser was here yesterday and some children visited and did a bit of dancing and I liked this very much, said a resident; Good amount of activities all the times and Plenty of it, said two other people. The owners have recently purchased a minibus, which is being shared by all four homes within the organisation. The manager and staff said that this is very helpful for residents to access outside activities. Representatives of different faiths visit the home regularly so that residents can attend services and speak with the representative of their choosing about their spiritual needs. There is a number of experienced staff from different cultural backgrounds and they bring a wealth of knowledge, and promote the quality and diversity of the people who use the service. Evidence shows that staff encourage residents to maintain good contact with family and friends. Visitors are welcomed; residents spoken with said that their visitors could come into the home at anytime. Two visiting relatives remarked on the welcome they receive and confirmed that there are no restrictions on visiting. All mail is delivered to the residents unopened but assistance is offered if the resident so wishes. They are also supported with personal correspondence if this is their wish. The menu is varied, wholesome and nutritious. There is a choice of main meal offered for lunch and tea, including the option to have something different from the advertised menu. Care plan viewed clearly takes into account the dietary and cultural needs of the resident, as well as their tastes and preferences and consistency of the food. Meals are offered at regular intervals and requests can be made for food at anytime. Hot and cold drinks are available at all times. Lunch was well presented; the cook takes pride in the quality, quantity and presentation of meals. The menus are also in pictorial form, which are rotated on a four-weekly basis. The cook seeks the views of the residents daily, about their taste and preference and residents are actively involved in planning any changes to the menus. Mealtimes are relaxed and social interaction, encouraged. Those requiring assistance are helped by the staff in a respectful, discreet and dignified manner. Residents expressed a good deal of satisfaction regarding food offered to them. Examples include Good quantity of food served always, food is very Care Homes for Older People Page 16 of 29 Evidence: good and the food is fine. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The systems in place should adequately protect residents. Accessing essential training on safeguarding vulnerable adults for those staff who have not done so, would further ensure the protection of residents. Evidence: The AQAA states Ensure that all service users and/or their families/representatives have a copy of our complaints procedure and understand it. The document is comprehensive with clear objectives and timescales indicated. Robust recruitment policy. Assure the safeguarding of vulnerable adults, safeguarding service users money/valuables. The previous inspection has established that the home has satisfactory written complaints and safeguarding procedures in place. These have been updated in February 2009. Staff interviewed said that the complaints procedure is available and accessible to them. They demonstrated an understanding of the procedure and said that they know what to do if they receive a complaint. The home maintains a record of complaints. The manager reported that there have been no complaints made to the home about any aspects of the service since the last key inspection in June 2007. None have been made to the Commission during the same period. Care Homes for Older People Page 18 of 29 Evidence: Residents spoken with and two visiting relatives confirmed that they felt able to raise a concern, if dissatisfied with the service. I would speak to the manager if I was worried, reported a visiting relative and I would speak with any staff if I wish to make a complaint, reported a resident. Records indicate that all staff, bar five members have received training on safeguarding issues. The remaining five members must complete this essential training, in order to protect and promote the welfare of residents. The manager is aware that remedial action is required. All three staff members spoken to showed an understanding of the safeguarding procedure. There were no safeguarding matters pending at the time of the visit. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents living at Rosedale care home benefit from a comfortable, clean environment that is well maintained. Evidence: We undertook a brief tour of the premises to include nine bedrooms, two lounge/diners, conservatory and two bathroom/toilet facilities. The decoration and furniture and fittings in the lounge/diners and bedrooms are of a good standard. There is adequate space for residents to sit quietly and or meet with their friends. There is good evidence to indicate that the resident is consulted on furniture and decoration for their room to suit their taste and preference. Personal possessions can be brought into the home to help the resident make their room as personal as they would wish. Those people with dementia benefit from this sense of familiarity and families are encouraged to enable this to happen. However, staff ensure that personal possessions brought into the home comply with the health and safety and fire regulations. The bathroom and toilet facilities viewed have been adapted to meet the needs of people with a physical disability. Suitable specialist equipment is available and serviced regularly. The home is well maintained. Care Homes for Older People Page 20 of 29 Evidence: All areas viewed were noted to be clean, tidy and fresh smelling. Staff were observed to wear suitable protective clothing when carrying out certain activities. Domestic and clinical waste is disposed of in an appropriate manner. Specific risk assessments must however be undertaken for each of the resident accommodated in the bedrooms on the third floor, due to the slanting ceiling. The manager is aware that remedial action would be taken as required, in order to ensure the safety of the occupants. Residents spoken with expressed a good deal of satisfaction with their physical environment. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The numbers and skills of the staff are adequate to provide a good standard of care. The homes robust recruitment and training processes ensure residents are protected from harm. Evidence: The AQAA tells us As declared in our statement of purpose, we have experienced, competent, well trained staff. We avoid using agency staff, in the event of absences, fellow staff will cover shifts or our core group of staff from our sistering homes on the same road will assist. This offers continuity of staff, with service users always having the opportunity to recognise their carer. The staff compliment meets the service users individual needs in accordance with the layout of the building. Staff duty rotas for a period of four weeks and discussions with residents and staff members indicate that the minimum numbers of care staff required for looking after the people accommodated in the home are indeed being rostered on duty. There is a minimum of four care staff including a senior member available at all times during the day shifts and 2 waking members, on each night. There are plenty of staff around, said one resident. Members of staff on duty, care and ancillary, were seen to treat people living in the Care Homes for Older People Page 22 of 29 Evidence: home with kindness and good skill. They showed empathy and commitment towards those people they looked after. I think this home is very nice. Staff sensitively deal with residents who show behavioural difficulties; never seen any staff who speak sharply or express any form of impatience with the residents said a visiting relative. The recruitment files for three members of staff, including the latest recruit were looked at. They all contain evidence of the necessary recruitment checks and information required by the regulations. Records show that all new members of staff are provided with induction. Other specific training courses completed by staff since the previous key inspection includes Medication, Dementia, Death and Dying, Bereavement, Aggression and Violence, Continence management and safeguarding Vulnerable Adults. The manager said that arrangement are in hand for all staff to receive taring in Mental Capacity Act. Nine of the eighteen care staff have completed their NVQ level 2 or 3 training and another two member are currently doing the same course. On completion, a good ratio (61 ) of staff would have this qualification ,which means that staff are being equipped with the appropriate skills and knowledge to deliver an improved quality of service to residents. Training is excellent reflected a staff in their survey. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is very well managed and the staff team, appropriately supported. This ensures a good and safe standard of service delivery for residents. Evidence: The AQAA states The registered manager is registered, responsible, fit, qualified, competent, skilled and accountable, who ensures the service users and staff benefit from the ethos, leadership and management approach of the home. The registered manager has been managing this home for over four years. She has completed the Registered Managers Award in 2006; She has also received training in the Mental Capacity Act. She clearly has the knowledge, experience and skills to run a home for older people. Staff and residents told us that the manager is always helpful. One staff describes management support as Very good, I think its really good because the management look after the residents and staffs needs as well, said another member spoken with. There is clear evidence that the manager is discharging Care Homes for Older People Page 24 of 29 Evidence: her responsibilities fully and to very good effect. An annual survey seeking the views and experience of residents, their representatives and appropriate professionals regarding the quality of service offered at Rosedale care home is undertaken by the manager; this was last completed in January 2009. Evidence demonstrates that the outcomes together with remedial actions, have been shared in writing/verbally with all participants and a copy of the report, sent to the Commission. The outcomes of the survey are also displayed in the main entrance area for the benefit of residents and visiting relatives and professionals. The owner has undertaken monthly visits to the home, in order to ensure that appropriate standards are being maintained.A sample of visits reports was viewed and is satisfactory. The care and staff management systems within the home are well organised. Staff received regular recorded supervision. Staff who spoke with us said they are fully satisfied with their supervision; management support was described as Very good; The home has a very good leadership and team work is a priority to ensure residents health and safety, and well being, reflected a staff in their survey. Staff are not involved in the management of residents financial affairs. However, a small amount of money is retained on behalf of some residents for their day today expenses. The administrative records including receipts examined for two residents are noted to be in order. We looked at some of the records the home is required to keep; these were found to be in order. Policies and procedures are available and accessible to staff. Various checks are undertaken and good records are maintained. Fire drills are carried out regularly and checks of break glass points, weekly. The annual fire risks assessment has been completed. Staff have received all mandatory training to promote the safety of residents and their colleagues. Care Homes for Older People Page 25 of 29 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 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 18 18 The remaining five staff who 15/08/2009 have not received training in safeguarding vulnerable adults must complete this course. Accessing this essential training would further ensure the protection of residents. 2 23 23 Specific risk assessments 15/07/2009 must be undertaken for each of the resident accommodated in the bedrooms on the third floor, due to the slanting ceiling. This is so that remedial action is taken as required to ensure the safety of the occupants. 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 27 of 29 1 7 The resident and their representative should sign the care plan where appropriate; this would demonstrate their involvement in the care planning process and their agreement with its contents. The monthly review minutes should be in greater detail, in order to reasonably reflect relevant issues occurring over a month period. 2 7 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!