Care Home: Rosedale Nursing Home

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What the care home does well The people I spoke to said they were happy with the care and support they receive. One person said `I would give this place a score of 110% it is great, they have got me walking a bit further than I could when I first came, the staff are tip top`. Another said that the staff are `lovely and very hard working`. The pre-admission assessments are thorough and the majority of people commented that they had sufficient information about the home before choosing to live there. One person said `my family sorted this place out for me, they came to look around and the manager came to see me in hospital`. The people who live at the home and their relatives confirmed that they know how to raise a concern or make a complaint, if they needed to. One person said `I would tell the staff or the manager if I have a problem but I`ve never had one`. The staff are aware of their responsibilities if they believe that neglect or poor care practice is taking place and were confidant that if they raised any issues the manager would investigate. There are thorough recruitment and selection procedures in place, to make sure that staff are suitable and safe to work with the people who live at the home. All the staff receive a range of training to equip them with the skills and knowledge they need to do their work properly.People said they enjoyed the food they were given and said that there was a good choice. One person said `the meals are great, I really enjoy my breakfast, I can have it in my bedroom the staff ask me what I want and bring it for me`. What has improved since the last inspection? Since the last inspection care plans have been updated and records maintained of peoples weight and dietary requirements. Documented risk assessments on window restrictors and bed rails have been reviewed and updated on all care plans also. Bed rail protectors are now available for all beds fitted with bed rails and some window restrictors have been repaired. An activities coordinator has been appointed to the home and has been a big success with some residents. During this inspection she was on leave, however people made very positive comments about the activities that were now being provided. There is an ongoing program for refurbishment and redecoration in the home and people live in a safe comfortable environment. What the care home could do better: There have been no requirements made from this inspection. The manager and staff team must continue to maintain and build upon the good service it is providing. CARE HOMES FOR OLDER PEOPLE Rosedale Nursing Home The Old Vicarage Catterick Road Catterick Garrison North Yorkshire DL9 4DD Lead Inspector Bridgit Stockton Unannounced Inspection 21st May 2008 09:30 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 Nursing Home DS0000064332.V366450.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 Nursing Home DS0000064332.V366450.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosedale Nursing Home Address The Old Vicarage Catterick Road Catterick Garrison North Yorkshire DL9 4DD 01748 833302/4948 01748 834468 rosedale.mmnh@googlemail.com 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) Maria Mallaband Care Group Limited Mrs Julia Wright Care Home 68 Category(ies) of Old age, not falling within any other category registration, with number (68), Physical disability (68), Physical disability of places over 65 years of age (68) Rosedale Nursing Home DS0000064332.V366450.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users in category PD to be aged 50 years and above and to require nursing care. 30th April 2007 Date of last inspection Brief Description of the Service: Rosedale is a care home providing nursing care and personal care only for up to 68 service users. It is located near the centre of the garrison town of Catterick. The home comprises of two buildings. It is set in extensive grounds with protected wooded areas to the north and west, and lawn to the south facing aspect of the home. The home is owned by Maria Mallaband Care Homes Limited. Main Building This building was previously a vicarage. There have been several additions to the original building since being opened in 1986; one on two floors as well as a twelve-bedded single storey unit. An additional 9 beds were provided in February 2004 in the main building with an extension and internal rearrangement of the internal spaces. The Lodge This is a separate 21-bedded unit within the curtilage of the grounds. It was opened in February 2004 and is being used for service users admitted for personal care only. Access to the upper floors in both buildings is facilitated by two vertical lifts. Rosedale Nursing Home DS0000064332.V366450.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 2 star. This means the people who use this service experience good quality outcomes. The purpose of this inspection was to assess the quality of the care and support received by the people who live at Rosedale Care Home. The methods I used to gather information included a visit to the home, conversations with the people who live there, their relatives, healthcare professionals and the staff. I looked in detail at the care and records of four people, examined other records and looked around the home. I spent six hours at the home. The manager also completed some paperwork for us called an annual quality assurance assessment. This provides valuable information to help me form a judgement about the quality of service offered at the home What the service does well: The people I spoke to said they were happy with the care and support they receive. One person said ‘I would give this place a score of 110 it is great, they have got me walking a bit further than I could when I first came, the staff are tip top’. Another said that the staff are ‘lovely and very hard working’. The pre-admission assessments are thorough and the majority of people commented that they had sufficient information about the home before choosing to live there. One person said ‘my family sorted this place out for me, they came to look around and the manager came to see me in hospital’. The people who live at the home and their relatives confirmed that they know how to raise a concern or make a complaint, if they needed to. One person said ‘I would tell the staff or the manager if I have a problem but I’ve never had one’. The staff are aware of their responsibilities if they believe that neglect or poor care practice is taking place and were confidant that if they raised any issues the manager would investigate. There are thorough recruitment and selection procedures in place, to make sure that staff are suitable and safe to work with the people who live at the home. All the staff receive a range of training to equip them with the skills and knowledge they need to do their work properly. Rosedale Nursing Home DS0000064332.V366450.R01.S.doc Version 5.2 Page 6 People said they enjoyed the food they were given and said that there was a good choice. One person said ‘the meals are great, I really enjoy my breakfast, I can have it in my bedroom the staff ask me what I want and bring it for me’. What has improved since the last inspection? What they could do better: 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 Nursing Home DS0000064332.V366450.R01.S.doc Version 5.2 Page 7 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 Nursing Home DS0000064332.V366450.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. People’s needs are properly assessed prior to admission to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans I looked at showed that comprehensive pre-admission assessments had been carried out before offering someone a place. This is to make sure that the home can meet the person’s needs. A senior member of staff (usually the manager) visits the person at home, or in hospital to discuss their care needs. Social Services assessments are also used to determine this as well; these were also available to look at. People are welcome to visit the home before reaching a decision. I also looked at contracts people have with the home. These were detailed and included a breakdown of the fees and who was responsible for paying for the care provided. The home does not provide intermediate care. Rosedale Nursing Home DS0000064332.V366450.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use the service experience good quality outcomes in this area. Good systems are in place to ensure that health care needs of the people are met. People can be confident that their privacy and dignity is protected and that they are treated with respect. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: I looked at four care plans in detail, to make sure that people’s health and personal care needs are being met in the way the person prefers. I found the plans to be comprehensive and well written. Careful and thoughtful strategies to address particular needs or problems were well documented and sensitively written. The plans demonstrated that people are in receipt of individual planned care and support. There was evidence of involvement of specialist healthcare people such as the community psychiatric nurse, the dietician and continence nurse. Rosedale Nursing Home DS0000064332.V366450.R01.S.doc Version 5.2 Page 10 During my visit I looked at how peoples medication was looked after by the staff at the home. Administration of medication is carried out properly and audited by the manager on a regular basis. Some staff had not recorded the amount of medication received into the home on behalf of an individual. To make audit easier all staff need to be reminded to document this on the medication administration record once they have received the medication. Staff were seen to be treating people with respect and dignity and this was also reflected within the care plans. One person said that the ‘girls are nice and kind to us all’, another said ‘ nothing is a bother for the staff they are just great.’ Staff were seen knocking on peoples bedroom doors before entering. Rosedale Nursing Home DS0000064332.V366450.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. The recreational and social needs of people are well catered for which enables them to make daily choices and promotes independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During my visit the atmosphere in the home was friendly and welcoming, with visitors coming and going throughout the day. Some people were enjoying chatting with each other; some were listing to music or else reading. An activities program was on display. The program was varied and included church services, bingo and sing-a-longs. One person told me that they really enjoyed the organised trips out in the finer weather and had recently attended a local ice cream parlour. One person makes arrangements to be collected by taxi to go out nearly every day and staff support them in doing this. Everyone said the food was good, and a choice of meals was offered. One person said ‘ we get top notch food here, we are very lucky to have nice cooks.’ Another resident said ‘ I had salmon for lunch followed by home made rice pudding it was delicious.’ Rosedale Nursing Home DS0000064332.V366450.R01.S.doc Version 5.2 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. People can be confidant that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are adequate written policies and procedures in place to deal with complaints and the care staff spoken to confirm they were aware of these. Staff knowledge of these help ensure that they were able to address any issues or anxieties of the residents, relatives and visitors to the home. People who live at the home told me they would speak to the manager or any of the staff if they had any concerns or complaints. Staff told me that training has taken place in the protection of vulnerable adults in abuse. I looked at four personnel files and found that staff recruitment procedures were adequate and staff were employed and deployed following appropriate checks. The manager and staff team were clear and confident in the protection of vulnerable adult procedures. Rosedale Nursing Home DS0000064332.V366450.R01.S.doc Version 5.2 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. People live in a safe, comfortable, well maintained and homely environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All the bedrooms that I saw reflect the person’s individual preferences and taste. There is a programme of re-decoration for the bedrooms, as well as for the rest of the home. Several bedrooms and some communal areas have recently been re-decorated and look fresh and attractive. The bedroom doors all have locks, and there is a lockable storage space in the rooms. This means that people can keep their belongings private and secure. The home is fresh, clean, comfortable and well looked after. Everyone who commented agreed that the home is always well kept. One person said ’my room gets cleaned everyday, the cleaning staff do a vary good job’. Rosedale Nursing Home DS0000064332.V366450.R01.S.doc Version 5.2 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. People can be confident that staff are trained and on duty in sufficient numbers to meet their assessed needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The rotas and staff numbers suggest that there are enough staff on duty at all times to meet the needs of the people who live at the home. I looked at a selection of staff files. They all included completed application forms and two written references. The files showed that satisfactory Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) register checks have been obtained. I was assured that no new member of staff starts work until a POVA register check had been completed. Then, if the CRB check had not been received, they would work only under the supervision of an experienced staff member. The manager makes sure that staff have the necessary training to help them do their work as well as possible. There is a wide range of courses available and the records confirmed that the staff are allowed the time to attend. Rosedale Nursing Home DS0000064332.V366450.R01.S.doc Version 5.2 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good The home is safe and well managed and people who live and work at the home can contribute to the decision-making processes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has the qualifications and the skills to manage the home effectively. Residents and relatives meetings are held, although they are not very well attended. The home sends out questionnaires to relatives, in order to gain information about how people view the service and what improvements they would like to see. The operational manager visits the home and carries out audits, to make sure the home is operating to company policy. Rosedale Nursing Home DS0000064332.V366450.R01.S.doc Version 5.2 Page 16 I looked at the records held at the home regarding people’s personal allowance. All transactions are recorded correctly and receipts are kept. One person’s money was counted and matched the total on the record. Policies and procedures are kept up to date; to make sure they provide relevant information to guide staff on how to act in every situation. All the regular health and safety checks for the home are carried out in a timely manner. Staff have basic health and safety training. All these measures make sure that the health, safety and welfare of the people who live at the home is promoted and safeguarded. Rosedale Nursing Home DS0000064332.V366450.R01.S.doc Version 5.2 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 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 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Rosedale Nursing Home DS0000064332.V366450.R01.S.doc Version 5.2 Page 18 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations It is recommended that all quantities of medication received into the home on behalf of a service user is recorded on the medication administration record. This is to make audit easy, any errors or misappropriation of medication will then be easily detected. Rosedale Nursing Home DS0000064332.V366450.R01.S.doc Version 5.2 Page 19 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 Nursing Home DS0000064332.V366450.R01.S.doc Version 5.2 Page 20 - 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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