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Care Home: Rosedale Home

  • 122 Marske Lane Bishopsgarth Stockton-on-Tees TS19 8UL
  • Tel: 01642528088
  • Fax: 01642528091
  • Planned feature Advertise here!

Rosedale is owned by Stockton-On-Tees Borough Council and is a residential home for elderly people. The home has four distinct units, the Oaks, Willows, Poplar and Laurel. Each unit consists of a lounge/dining room, a small kitchen with basic equipment, where residents and their visitors can make refreshments, a small television lounge, two individual lavatories and one within the bathroom. All bedrooms contain a wash hand basin. The home provides care and accommodation for older people who are physically frail, or short term care for people who have dementia. There is one unit, which provides intermediate care for up to six weeks during which time clients receive intensive rehabilitation. The assessment / discharge support service on Oaks unit also has some therapy input. The home is set in its own grounds and is a large single storey dwelling. There is a small shopping area nearby. The fees still need to be clarified.

  • Latitude: 54.576999664307
    Longitude: -1.3609999418259
  • Manager: Mrs Jean Spedding
  • Price p/w: ~
  • UK
  • Total Capacity: 44
  • Type: Care home only
  • Provider: Stockton-on-Tees Borough Council
  • Ownership: Local Authority
  • Care Home ID: 13245
Residents Needs:
Old age, not falling within any other category, Dementia, Physical disability

Latest Inspection

This is the latest available inspection report for this service, carried out on 30th January 2009. CSCI found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

For extracts, read the latest CQC inspection for Rosedale Home.

What the care home does well Rosedale provides a warm, homely and friendly place for people to live and for other people to stay for a short time following admission to hospital or for a short assessment period. It provides a very good level of care by well-trained and knowledgeable staff. People using the service said, "It is wonderful here, I came two to three weeks ago from hospital for rehabilitation, it has helped me, I have managed to get my independence back".Another person said, "I really feel that they have helped me, they have been helping me to get fit so I can go home". Relatives also spoke very highly of the home and the staff and were clearly satisfied that their loved ones needs were being well met. A relative said, "He/she is very much and individual, they look after her/him very well, and are definitely meeting her/his needs". "The staff have the knowledge and skill, they are excellent and able to meet his/her needs". "When he/she was unwell they attended to it straight away, got the GP, medication and involved the district nurse". Another relative said, "Being here has made a difference to her/him, he/she is looking much better, we are very happy with how she is being cared for". In the main, good care records are in place and certainly for people living at Rosedale on a permanent basis, they are extremely informative and person centred. Good systems are in place for dealing with and managing complaints should the need arise. There is little staff turnover at Rosedale. There are good training opportunities in place and all staff undertake both mandatory health and safety training as well as client specific training. 75% of care staff are trained to NVQ level 2 or above. Staff said, "They support my personal growth and development, always supported and never refused training, I strive to keep learning". Rosedale is extremely well managed with effective systems in place. Staff spoke highly of the management team and said, "The office staff are very good, supportive to both staff and residents, they are approachable, you can talk to them". "It is a very well run, well organised home". "The manager is flexible, she will bend over backwards to help you and if you have any problems you can go to any of them". What has improved since the last inspection? At last inspection, one requirement and one recommendation were made, both of which have been addressed. These related to the need to update the Adult Protection Procedure and to ensure that gaps in employment history of new staff were explored. What the care home could do better: It is commendable that of the key standards looked at during this inspection, there have been few improvements identified that had not already been planned for by the manager. A significant refurbishment plan is underwaywith new lighting, redecoration and new carpets. Some of this is to take place before the end of the financial year 30 March 2009. An area however of concerns was in relation to the medication systems. Immediate action was taken to address the issues identified during the inspection and confirmation received that at the appropriate action has been taken and the improvements made. The way in which care plans are evaluated would also benefit from further information. CARE HOMES FOR OLDER PEOPLE Rosedale Home 122 Marske Lane Bishopsgarth Stockton-on-Tees TS19 8UL Lead Inspector Jackie Herring Key Unannounced Inspection 30th January 2009 9:30am X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosedale Home Address 122 Marske Lane Bishopsgarth Stockton-on-Tees TS19 8UL Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01642 528088 01642 528091 Stockton-on-Tees Borough Council Mrs Jean Spedding Care Home 44 Category(ies) of Dementia (10), Old age, not falling within any registration, with number other category (20), Physical disability (10) of places Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 20 Dementia - Code DE, maximum number of places: 12 2. Physical disability - Code PD, maximum number of places: 10 The maximum number of service users who can be accommodated is: 44 29th January 2007 Date of last inspection Brief Description of the Service: Rosedale is owned by Stockton-On-Tees Borough Council and is a residential home for elderly people. The home has four distinct units, the Oaks, Willows, Poplar and Laurel. Each unit consists of a lounge/dining room, a small kitchen with basic equipment, where residents and their visitors can make refreshments, a small television lounge, two individual lavatories and one within the bathroom. All bedrooms contain a wash hand basin. The home provides care and accommodation for older people who are physically frail, or short term care for people who have dementia. There is one unit, which provides intermediate care for up to six weeks during which time clients receive intensive rehabilitation. The assessment / discharge support service on Oaks unit also has some therapy input. The home is set in its own grounds and is a large single storey dwelling. There is a small shopping area nearby. The fees still need to be clarified. Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is three stars. This means the people who use this service experience excellent quality outcomes. This Key Inspection was to check that the home meets the standards that the Commission for Social Care Inspection say are the most important for the people who use the services, and that it does what the Care Standards regulations say it must. This inspection was conducted in two inspection days. During the inspection, a number of records were looked at, including records of people who use the service, along with staff recruitment and training records. The medication systems was also looked at and discussed at length. Discussion also took place with the people living at Rosedale, the manager, unit manager and staff. The manager has completed the Annual Quality Assurance Assessment (AQAA), the services self-assessment of how well they think they are meeting standards. This was received prior to the inspection and some of information has been reflected within the report to support the judgements made. The AQAA was extremely well completed. We have reviewed our practice when making requirement to improve national consistency. Some regulations from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the services are not being put at risk or harm. In future if a requirement is repeated it is likely that enforcement action will be taken. What the service does well: Rosedale provides a warm, homely and friendly place for people to live and for other people to stay for a short time following admission to hospital or for a short assessment period. It provides a very good level of care by well-trained and knowledgeable staff. People using the service said, “It is wonderful here, I came two to three weeks ago from hospital for rehabilitation, it has helped me, I have managed to get my independence back”. Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 6 Another person said, “I really feel that they have helped me, they have been helping me to get fit so I can go home”. Relatives also spoke very highly of the home and the staff and were clearly satisfied that their loved ones needs were being well met. A relative said, “He/she is very much and individual, they look after her/him very well, and are definitely meeting her/his needs”. “The staff have the knowledge and skill, they are excellent and able to meet his/her needs”. “When he/she was unwell they attended to it straight away, got the GP, medication and involved the district nurse”. Another relative said, “Being here has made a difference to her/him, he/she is looking much better, we are very happy with how she is being cared for”. In the main, good care records are in place and certainly for people living at Rosedale on a permanent basis, they are extremely informative and person centred. Good systems are in place for dealing with and managing complaints should the need arise. There is little staff turnover at Rosedale. There are good training opportunities in place and all staff undertake both mandatory health and safety training as well as client specific training. 75 of care staff are trained to NVQ level 2 or above. Staff said, “They support my personal growth and development, always supported and never refused training, I strive to keep learning”. Rosedale is extremely well managed with effective systems in place. Staff spoke highly of the management team and said, “The office staff are very good, supportive to both staff and residents, they are approachable, you can talk to them”. “It is a very well run, well organised home”. “The manager is flexible, she will bend over backwards to help you and if you have any problems you can go to any of them”. What has improved since the last inspection? What they could do better: It is commendable that of the key standards looked at during this inspection, there have been few improvements identified that had not already been planned for by the manager. A significant refurbishment plan is underway Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 7 with new lighting, redecoration and new carpets. Some of this is to take place before the end of the financial year 30 March 2009. An area however of concerns was in relation to the medication systems. Immediate action was taken to address the issues identified during the inspection and confirmation received that at the appropriate action has been taken and the improvements made. The way in which care plans are evaluated would also benefit from further information. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3 and 6 were looked at during this inspection. People who use the service experience good quality outcomes in this area. People’s needs are assessed before moving to the home and they are assured those needs can be met. People who are admitted for intermediate care have their needs met by trained and skilled staff. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The AQAA detailed, “Prior to residents/clients admission to the home, their individual comprehensive assessment, which has been completed by the appropriate professional, is read by the management team, to ensure that the identified individual assessed needs can be met by the service Rosedale provides. Potential residents/clients and their family are encouraged to pre visit Rosedale before admission date. This hopefully helps relieve the ‘fear of the unknown’ and meet the staff who will be caring for them”. This was Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 10 observed during the inspection, with people having a look around to see if Rosedale would be suitable for their loved ones. Three sets of assessment and care records were looked at. One from each of the units. There was a copy of the care management assessment in all of the files looked at. The actual assessment varied due to the differing service specifications for each of the units. In a file of someone who was living at the home permanently, there was evidence of ongoing reviews which showed satisfaction with the service and that this person’s care needs were being well met. People who are admitted for rehabilitation or assessment (intermediate care), different arrangements are in place for their admission. The manager said that there are times when they would benefit from having from having more information and that it would be helpful to conduct a face-to-face meeting prior to admission. They are in the process of looking to develop this further. There are two dedicated units for people admitted for intermediate care, one for rehabilitation and one for assessment, which is provided for a period of up to six weeks. There is a dedicated staff team providing the intermediate care services including physiotherapists and occupational therapists as well as support staff. People who were receiving intermediate care were spoken to, without exception spoke very highly about the service provided. They said, “It is wonderful here, I came two to three weeks ago from hospital for rehabilitation, it has helped me, I have managed to get my independence back”. Another person said, “I really feel that they have helped me, they have been helping me to get fit so I can go home”. Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 7, 8, 9 & 10 were looked at during this inspection. People who use the service experience good quality outcomes in this area. People receiving the service are extremely happy with the way in which care is delivered by staff. Records detailing how health and personal care is to be delivered are generally satisfactory, however additional details information will strengthen these further. The way in which medication is managed needs to be strengthened further to ensure that people using the service are not put at risk. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Three sets of care records were looked at, one each from three of the four units. The information contained within the individual files differed in detail depending upon the service. For people who live at Rosedale on a permanent basis, assessment of needs are completed and there are associated care support in place with the actions specified. These are a combined document. The file was very well laid out and Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 12 there was information to show that the person’s relative had been involved, and records had been signed by them. The pen portrait was very well written and was clearly person centred. The information was informative and included likes and preferences such as time for going to bed and getting up and information such as specific equipment to manage continence. There were supporting risk assessments in place and identified risk such as nutrition and risk of chocking. The monthly evaluations/reviews of care are taking place, however these are not a valued based evaluations and do not give information as to the effectiveness or not of the care being provided. This was discussed with the manager and one of the unit managers, who agreed and said that a review of the current records would take place to incorporate a more detailed evaluation. Within the short-term services there was less information available. There was, however sufficient information regarding people’s needs and the support that was needed, whether it be from an assessment perspective or from a rehabilitation perspective. People spoken to were very positive about the care and support provided. One person said, “I am very happy here, I have been very well cared for, I can’t think of anything to improve things, everything is just lovely”. A relative said, “He/she is very much and individual, they look after her/him very well, and are definitely meeting her/his needs”. “The staff have the knowledge and skill, they are excellent and able to meet his/her needs”. “When he/she was unwell they attended to it straight away, got the GP, medication and involved the district nurse”. Another relative said, “Being here has made a difference to her/him, he/she is looking much better, we are very happy with how she is being cared for”. A member of staff who worked within the rehabilitation unit said, “You enable them rather than do for them. You promote their independence more for them returning home”. One of the therapy assistants talked about people being individuals and the need to meet their emotional and psychological needs. They also spoke of the partnership work with social workers and community psychiatric nurses. Other health care professionals such as infection control nurse and community matrons are involved with Rosedale providing support to the manager and staff. The medication systems were looked at. The storage is suitable and secure. It was confirmed that only senior staff are involved with the ordering and administration of medication and they have all been fully trained to do so. Medication management within Rosedale is a little more complex due to the Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 13 different services being provided and the frequency of admissions and discharges. The manager said that they had been having some problems with their supplying pharmacist and were in the process of changing to a new pharmacist, who was working well with them in preparation for the change over. Some problems were identified with the medication system. There was no record of medication received into the home and there had been some difficulty with the permanent residents medication when last ordered resulting in a five-day emergency supply being issued. On the day of the inspection the administration records for these were not available, they were however found later within people’s individual records. The records of shorter stay residents were looked at and these were all appropriately recorded, with no gaps in the administration records. The manager acknowledged that some of the systems needed to be strengthened. She has already taken steps to obtain additional recording tools so that medication could be audited and tracked. During the inspection the manager contacted North Tees Primary Care Trust, pharmacy and requested a visit from them to audit the systems and to give guidance and support. Immediate action was taken to fully audit the medication, which was completed within two days of the first inspection day. An action plan was received detailing the action taken and additional measures put into place. A copy of the PCT’s audit was also forwarded, which showed that the systems were good and that they had achieved 87 in the audit. Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 12, 13, 14, 15 were looked at during this inspection. People who use the service experience good quality outcomes in this area. People who use the service have opportunities to take part in activities. They are supported to live in a flexible environment where there is choice of routines and promotion of independence. The food provided is of a very good quality and meets the dietary and cultural needs of the people who use the service. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: As with the assessments and records of care, very different activities take place within the different units and are dependant upon the needs of the individual. Through discussion with staff, it was confirmed that different activities take place within the different units and in line with the specific services. For example, in the rehabilitation unit, people will be involved in daily life skills such as making a cup of tea, baking or making a light meal. In the permanent care unit activities have a different focus, there is some entertainment, sing-a-longs and nail care. Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 15 Staff spoken to said that people are encouraged to make decisions where possible in all aspects of their lives. Examples given for people living at Rosedale permanently included, “having a lie in if they want, can have a bath morning or afternoon, have a choice of meals but it is about them doing their own thing and about knowing what their needs are”. A relative said, “I can’t fault this place at all, there are always friendly smiles when visiting”. It was confirmed that there were choices at mealtimes. The menu was looked at which is a four-week menu with traditional British food. Blackboards are also on display within the different dining rooms informing people of the meals for any particular day. People are very pleased with the meals provided at Rosedale. There is a four-week rolling menu and people confirmed that there was a choice a mealtimes. Without exception, people spoke extremely highly of the meals. People said, “The meals are very good, enjoyed everything, the tables are also nicely set”. Another person said, “The food is fabulous, there is a menu and a choice”. A relative spoken to said, “As a visitor, I feel welcome, the atmosphere is brilliant, as is the food and the care”. Staff said, “The meals are lovely, really lovely, there is a choice and we are also aware of special needs, such as pureed diets for people who have swallowing difficulties and other dietary requirements such as people suffering from celiac disease”. Staff said that they were also aware of people spiritual needs and that they did have church visitors every Sunday, but that arrangements would be made if people wanted to go to Church. Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 16 & 18 were looked at during this inspection. People who use the service experience good quality outcomes in this area. People are able to raise concerns and the complaints procedure is available within the home, this needs some additional information. Appropriate systems are in place for dealing with complaints and safeguarding issues. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The AQAA detailed that there had been no complaints since the last inspection. A number of commendations had been received in the form of letters and cards. The AQAA stated, “Rosedale welcomes complaints as a way of reviewing and monitoring the service we deliver. We promote an ‘open door policy’ at Rosedale and the management team make themselves available and are very approachable, which we hope gives the complainant the confidence to refer their concern/complaint”. People spoken to said they had no complaints about the service and if they did, they were aware of what to do. They said that they would have no hesitation in speaking up if they were unhappy with anything. The AQAA detailed, It was stated, “Rosedale has an accessible complaints procedure in place in a written format, which is easy to understand and available in other languages and formats e.g. large print”. A copy of the complaints procedure was available within the home. Staff confirmed that they had receiving training about Protection of Vulnerable Adults and there were training records in place to support this. Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 19 and 26 were looked at during this inspection. People who use the service experience good quality outcomes in this area. People have a safe and generally well-maintained environment in which to live. The home was clean and extremely homely. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Rosedale provides care for people within four units. Each unit is service specific. One is currently being used in the short term to provide respite care for people with dementia. One unit provides permanent care for older people. Another unit provides rehabilitation to enable people to return to their own homes whilst the fourth is an assessment unit. There are lounge/dining areas within each of the units and these were extremely homely. There was also a small quiet lounge available within each of the units. Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 18 On both inspection days, the home was clean and odour free. There are dedicated staff who attend to the housekeeping duties on each of the units. A refurbishment plan is in place and it was observed during the inspection that work is underway. This includes the replacement of carpets; redecoration along with plans to extend the car parking facility. An area that should be considered further is the glass window above the bedroom doors. People said that they were disturbed at night with the corridors lights, whilst other people had blocked them out with paper. Notice boards containing a range of information were on display within the home. People said, “It is lovely here, lovely and clean, with nice beds and lovely towels”. Staff spoken to confirmed that there was sufficient equipment in place to meet people’s needs, including moving and handling equipments such as transfer/handling belts. Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 27, 28, 29 & 30 were looked at during this inspection. People who use the service experience excellent quality outcomes in this area. People are very satisfied with the care they receive from well-trained and qualified staff. The recruitment procedures ensure that people are protected. The manager recognises the need to ensure all staff are well trained. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Staffing levels and skill mix was discussed with the manager who said that there was always a unit manager on duty between the hours of 7.30am until 10pm. She said that there was always two staff on each of the units during the day and one at night and that the staff are allocated to work on specific units, ensuring continuity of care. The manager believed that there was sufficient staff to meet the needs of the people at Rosedale. It was also confirmed that there were rarely vacancies at the home and very little staff turnover. A member of staff said, “I feel confident in my job role, there is sufficient staff available and always help at hand, the staffing levels are flexible”. Three sets of staff records were looked at. All contained the information needed to show that very good recruitment practices are in place, including fully completed application forms, Criminal Records Bureau Checks and Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 20 appropriate references. There had been no recent staff appointments, although currently two positions are in the process of being recruited. Discussion took place with the manager about the process of recruitment, and very good systems were described. People living at the home, their relatives and staff believed that there was sufficient staff on duty to meet everyone needs. People said, “The staff are nice, they are really good, they bathe your regularly, there is no set time to go to bed or get up, nothing is too much trouble”. For new staff there is a five-day induction programme, which includes mandatory training as well as protection of vulnerable adults. It was also confirmed that new staff complete the Skills for Care induction. The manager described this as essential and carried out prior to commencing at Rosedale. The manager also said that there are a number of in house courses and that a lot of the training is delivered within the education centre at Ideal House. Training records were made available, which showed effective planning of year on year mandatory training as well as client / service specific training that is linked to staff’s individual development. The local authority sends out training information and courses, which staff at the home take fully advantage of. One of the unit managers leads up on the training, some of the recent training included Freedom of Information, Diversity training as well as Infection Control, which included MRSA and other acquired infections. 75 are trained to NVQ level 2 in care or above, which is good. Staff spoken to said that the training was ongoing and that mandatory training is part of a rolling programmes. There are clear systems in place for ongoing staff development and for people to undertake additional responsibilities, such as developing management skills. A member of staff said, “They support my personal growth and development, always supported and never refused training, I strive to keep learning”. A relative spoken to said, “The girls are excellent, they have been good to me, I can talk to them and they listen”. Another relative said, “I can’t recommend Rosedale enough, he/she has had physiotherapy, which has helped, I believe the staff have the knowledge and expertise to meet people’s needs”. Staff spoke positively about the team and how they worked together and supported each other. One staff member said, “The team are very passionate about the service”. “We have trust in each other, it is a good team”. Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 31, 32, 33, 35 & 33 were looked at during this inspection. People who use the service experience excellent quality outcomes in this area. People benefit from a well run and well managed home, in which systems are in place to ensure safety and protection. The manager provides very strong leadership to the staff team and continuously strives to improve standards within the home ensuring that people’s needs are well met. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The manager is registered with CSCI and has been for some considerable time and is highly competent to run the home and meets its stated aims and objectives. They have considerable knowledge, experience, qualification and skill to manage Rosedale effectively. The manager’s qualifications exceed those required by CSCI. They are very aware of the allocated budget and Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 22 strive to ensure that there is, “a high standard of care delivering while keeping the environment safe, clean and well furnished”. The structure includes four unit managers along with the care team. In discussion with the manager, they are not currently whole time supernumerary. Whilst the home is being well managed, this should be reviewed as the home is very busy, with more admissions and discharges than others and the manager needs to be off rota more frequently to attend to the overall management of the home and to be available to support the unit managers and their teams. Ranges of quality assurance systems are in place within Rosedale. Regulation 26 visits take place on a monthly basis. The AQAA detailed, “Quality assurance procedures are in place to ensue the interest of the individual are being met, gaining their views, choices and preferences on how the service is or should be delivered”. A copy of the most recent report was made available which showed overall satisfaction with the service and care provided. The AQAA was completed to a very good level with lots of detailed information. This along with discussions that took place showed that Rosedale was being very well managed but that the manager and staff were being proactive in always looking at what they could do better and definitely looking for continuous improvements. A member of staff spoken to said, “There is always room for improvement, you can make suggestions and feel that I am listened to”. “It is a home that will move forward”. People spoken to thought that Rosedale was a very well run and managed home. They spoke of the approachability of the manager and management team and the way in which they were supported. Staff spoke highly of the management team and said, “The office staff are very good, supportive to both staff and residents, they are approachable, you can talk to them”. “It is a very well run, well organised home”. “The manager is flexible, she will bend over backwards to help you and if you have any problems you can go to any of them”. The systems for managing people’s personal allowances were not looked at but this was well detailed within the AQAA. It was stated, “The management team ensures that policies and procedures are in place to safeguard the residents/clients personal money, valuable and belongings. Residents/clients have the right to look after their won finances but if they choose to the management team can take care of this. We record all transaction of money held in the safe, using double signatures on individual cash cards”. Staff also confirmed that supervision takes place on a regular basis. One of the unit managers described the process for supervision, which is cascaded to the individual unit managers to carry out. Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 23 As previously described, good systems are in place to ensure the home is operated safely, with staff attending the required health and safety training and supporting risk assessments being in place. The AQAA detailed that there was a full range of policies and procedures in place. The manager did however say that an area for improvement was a full review of the policies and procedures to make them much more specific for the individual units as there were currently quite broad and generic. Accidents are well recorded and there is good analysis in place. They are monitored daily be the duty manager and there are risk assessments and monitoring forms. The accidents are also reviewed by the local authorities safety officers. Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 X 3 X X 3 Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13 Requirement The medication systems must be robust. The must be records in place to show medication that has been ordered, that this has been checked and that accurate records are in place to show medication received. The planned audits of the systems must be implemented. Accurate records must be in place for the administration of Controlled Drugs. This will make sure that people receive their medications correctly and the treatment of their medical condition is not affected. Timescale for action 19/02/09 Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP7 OP19 Good Practice Recommendations The evaluations of care should be relevant to the care plan and should give information about the effectiveness of the planned care. The planned refurbishment programme should continue. Consideration should be given to reducing the level of light to the bedrooms at night through the over door windows. Consideration should be given to increasing the amount of supernumerary time for the manager, enabling more support to be given to the team and further development of the service. 3. OP31 Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rosedale Home DS0000038046.V374009.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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