Care Home: Rosedale Residential Home

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What the care home does well People and their relatives are happy with the care and support that they receive. The staff team are working together to improve the daily lives of people who use the service. It was evident that staff are working to find out about people and their preferred routines and preferences. As a result one person helps the cook with drying the breakfast dishes and some have made cakes with help and support from the Cook. Visiting arrangements are flexible and surveys from relatives confirm that Staff help people to keep in touch with their relatives. Staff welcome visitors, which helps encourage them to visit. People were happy with the food and confirmed that they are offered choices. What has improved since the last inspection? This inspection has identified that considerable improvements in many areas have been made since the key inspection carried out in November 2007. Care plans, which instruct and guide staff in the care provided are now much more detailed and reflective of people`s individual care needs, helping to ensure their needs are met. Records identify an improved understanding of the importance of carrying out assessments such as nutritional risk assessments and assessments for the risk of pressure ulcers. Staff are also seeking advice and support from relevant health professionals, which is helping to ensure they get the care, and treatment that they need. A sample check of the management of medication identified that systems for recording medication received and administered were clear and easy to follow. The overall management of medication was better, helping to ensure that people are receiving their medication as prescribed. Staff training needs are being identified; staff are receiving training to help them meet the specific needs of people who use the service, helping to ensure that people`s needs are met. Recruitment procedures are now more thorough with appropriate checks and references obtained before staff start work helping to protect people who use the service.Management oversight of the service has improved which has helped to raise standards and provide better outcomes for people who use the service. What the care home could do better: Advice has been given to review the lighting levels in the corridors to ensure that there is sufficient light at all times of day to ensure that people are able to move safely and comfortably around the home. The Acting Manager has identified other required work on the premises and is including within the maintenance plan. . CARE HOMES FOR OLDER PEOPLE Rosedale Residential Home 68 Rockingham Road Kettering Northants NN16 8JU Lead Inspector Kathy Jones Unannounced Inspection 18th April 2008 08:15 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 Residential Home DS0000068813.V362709.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 Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosedale Residential Home Address 68 Rockingham Road Kettering Northants NN16 8JU 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) 01536 512506 R & Z Jagroo Limited Post vacant Care Home 19 Category(ies) of Dementia - over 65 years of age (7), Learning registration, with number disability over 65 years of age (1), Old age, not of places falling within any other category (19), Physical disability over 65 years of age (2) Rosedale Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Rosedale will limit the service to the following service user categories: Older people (OP) 19. Older people with Physical Disabilities (PD(E)) 2. Older people with a Learning Disability (LD(E)) 1. Dementia over 65 years of age (DE(E)) 7. That Rosedale be registered to provide personal care to a maximum number of seven in the category of dementia (DE(E)) of whom one person (R.L.) is aged 64 years. The maximum number of service users that can be accommodated at Rosedale is 19. 8th November 2007 2. 3. Date of last inspection Brief Description of the Service: Rosedale is a privately owned care home currently registered to provide personal care and accommodation for 19 Older People including 7 people with dementia and two with a physical disability. Rosedale is a large detached house situated on the outskirts of the town centre of Kettering providing good access to local amenities. At the time of the inspection all bedrooms were being used for single occupancy and ten of the rooms have en-suite facilities. Bedrooms on the first floor can be accessed by the stairs or a shaft lift. The home has two lounge areas and a dining room, all located on the ground floor. There is also a small garden and patio area leading off from one of the lounge areas. At the time of this inspection the fees charged to funding bodies were given as being between £341.55 and £359.01 per week, dependent on assessed needs. In addition to these fees, residents are expected to pay a ‘top up fee’, which ranges between £6 and £40 per week. The amount of the top up fee is dependent on the care needs, the size of the room and whether it has en-suite facilities. Fees for privately funded residents’ are between £395 and £420 per week dependent on the room and whether en-suite facilities are available. The service user guide states that the fees include personal care, accommodation, meals, laundry and some toiletries. Additional charges include chiropody, hairdressing, newspapers, telephone calls, dry cleaning and some Rosedale Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 5 toiletries. It also identifies that there are fund raising events to help pay for some of the activities. Information about the services provided including the complaints procedure is available in the statement of purpose and service user guide, which are located in residents’ rooms. There is a copy of the last inspection report with the statement of purpose and service user guide in the main hall, which is available to visitors. Rosedale Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. Standards identified as ‘key’ standards and highlighted through the report were inspected. The key standards are those considered by the Commission to have a particular impact on outcomes for residents. Inspection of the standards was achieved through review of existing evidence, pre-inspection planning, an unannounced inspection visit to the home and drawing together all of the evidence gathered. The pre-inspection planning was carried out over the period of half a day and involved reviewing the service history, which details all contact and correspondence with the home and previous inspection reports. Three statutory requirement notices were served as a result of breaches of regulations following the last key (main) inspection carried out in November 2007. Inspections were carried out in December 2007 and January 2008 to monitor compliance with the notices. Information from these inspections was also taken into account as part of the planning. This unannounced inspection visit covered the morning and afternoon of a weekday. The inspection was carried out by ‘case tracking’, which involves selecting samples of residents’ records and tracking their care and experiences. Observations of the homes routines and care provided were made and views on the care provided were sought from people who use the service, visitors and staff. Additionally questionnaires were sent to a random selection of people to ascertain their views. At the time of completion of the report, responses had been received from two residents and two relatives. Their views have been considered as part of the inspection and some comments incorporated within the report. The management of residents’ medication was checked through reviewing the medication for a sample of people. A sample of staff files were reviewed to check the adequacy of the recruitment procedures in protecting people who use the service. Communal areas and a sample of bedrooms were viewed and observations were made of people’s general well being, daily routines and interactions between staff and people who use the service. Rosedale Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 7 Verbal feedback was given to the Acting Manager and the Deputy Manager throughout the inspection What the service does well: What has improved since the last inspection? This inspection has identified that considerable improvements in many areas have been made since the key inspection carried out in November 2007. Care plans, which instruct and guide staff in the care provided are now much more detailed and reflective of people’s individual care needs, helping to ensure their needs are met. Records identify an improved understanding of the importance of carrying out assessments such as nutritional risk assessments and assessments for the risk of pressure ulcers. Staff are also seeking advice and support from relevant health professionals, which is helping to ensure they get the care, and treatment that they need. A sample check of the management of medication identified that systems for recording medication received and administered were clear and easy to follow. The overall management of medication was better, helping to ensure that people are receiving their medication as prescribed. Staff training needs are being identified; staff are receiving training to help them meet the specific needs of people who use the service, helping to ensure that people’s needs are met. Recruitment procedures are now more thorough with appropriate checks and references obtained before staff start work helping to protect people who use the service. Rosedale Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 8 Management oversight of the service has improved which has helped to raise standards and provide better outcomes for people who use the service. 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 Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 9 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 Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 10 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): 1, 3, standard 6 is not applicable as intermediate care is not provided. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission process establishes the needs of people prior to admission, helping to ensure that their needs can be met. EVIDENCE: Surveys received from two residents confirmed that they had received sufficient information to help them make a decision about moving in to Rosedale. One person who uses the service said that two members of staff had visited them at home to discuss their enquiry about moving in to the home. There is a statement of purpose and service user guide, which helps to provide people and their families with information about the services provided by Rosedale. This information includes details of the fees and what the fee covers. A copy of the statement of purpose and service user guide is available and Rosedale Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 11 kept in the hallway next to the visitors book making it very accessible to visitors. Additional copies are provided in each person’s room. Other information such as a copy of the most recent inspection report and a copy of Rosedale’s newsletter is also available, helping people to be informed. Review of the care file for a recently admitted resident confirmed that an assessment of their needs was carried out prior to their admission. Information about their needs had also been obtained from Social Services. The annual quality assurance self assessment states: Information is collected prior to admission about people’s religion, ethnicity, sexuality, and disability. They are also asked how they would prefer to be called. Their beliefs and wishes are respected at all times. This gathering of information is important to ensure that the needs of people admitted are met. Rosedale Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 12 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are reflective of peoples care and health needs, they are reviewed regularly and there are good systems in place to manage their medication, helping to ensure that people get the care and support that they need. EVIDENCE: Surveys received from two people who use the service confirm that they receive the care and support that they need and surveys from two relatives confirm that the needs of the people using the service are met. People spoken to during the inspection including a relative said that they were happy with the care being provided. It was identified at the inspection carried out in November 2007 that repeated requirements relating to care planning and the management of medication had not been met. As a result of this, statutory requirement notices, which are part of the enforcement process, were served. Since that time random inspections Rosedale Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 13 have taken place to check compliance with the requirements made in the notice. The annual quality assurance self assessment submitted to the Commission for Social Care inspection identifies that a lot of support had been provided by other professionals in writing care plans and providing training to staff relevant to residents’ needs. This inspection has identified that considerable improvements have been made in the management of medication, planning of care, instruction to staff and monitoring of residents’ health care needs since the key inspection carried out in November 2007. All outstanding requirements have been met resulting in improved outcomes for the people who use the service. From a sample check of peoples care plans it was found that these are now much more detailed and are reflective of peoples individual care needs. The care plans were also seen to take account of people’s preferred care routines. Care plans are important documents which help to guide staff as to the actions required of them to meet residents needs. The detail and the individuality of the care plans helps to ensure that people receive consistent care according to their particular needs. Records identify an improved understanding of the importance of carrying out assessments such as nutritional risk assessments and assessments for the risk of pressure ulcers. There was evidence that where a risk had been identified, action had been taken to seek professional advice about the risk and any actions that could be taken to reduce the risk. For example the District Nurse had been contacted about pressure area care. Care plans are reviewed regularly and entries in the review confirm that people’s health and welfare needs are monitored. It was evident that a lot of work had been carried out to improve systems and practice in relation to the management of medication. A sample check of the management of medication identified that systems for recording medication received and administered were clear and easy to follow. From the records it was easy to see how much medication had been received, administered and how much was in stock helping to ensure that people’s prescribed medication is being administered properly and does not run out. A sample check indicated that the medication was available and being administered as prescribed. Codes were being used appropriately on the medication administration records to record when prescribed medication had not been given. An explanation of the reasons why the medication was not given was clearly detailed on the reverse of the record. Medication was also Rosedale Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 14 securely stored and it was confirmed that staff competence to administer medication is kept under review. It was confirmed at the time of the inspection that none of the people who use the service were receiving medication covertly. Discussion indicated that there was a much better understanding of people’s rights and the need to consider why people may be refusing medication. Staff were heard and observed to treat and speak to residents with dignity and respect. People were well groomed and all personal care was carried out in the privacy of people’s rooms. Rosedale Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 15 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. This judgement has been made using available evidence including a visit to this service. Visitors are encouraged and welcomed into the home and people are happy with the quality of food provided. Routines are flexible and allow residents’ choices in their daily lives. EVIDENCE: At the time of admission information is gathered about peoples daily lives. People spoken with were happy that their preferences in respect of daily routines are respected and confirmed that they are able to get up and go to bed when they want to. Observations identified that the staff team are working together to improve the daily lives of residents. One resident likes to help the cook with drying the breakfast dishes and this has become part of her daily routine. Some people have also made cakes with help and support from the Cook and it was confirmed that regular opportunities would be given for people to take part in such activities. Rosedale Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 16 Records and discussion indicated that people are encouraged to continue attending any clubs that they had been attending prior to admission where possible. Activities such as bingo and films are provided. Staff were also observed to take opportunities to spend some time sitting and chatting with people. Advice was given to gather more information about people’s lives and interests, particularly for those people less able to express themselves. The information may help in providing activities, which suit individuals and help to enhance their daily lives. Visiting arrangements are flexible and surveys from relatives confirm that Staff help people to keep in touch with their relatives. During the inspection Staff were heard to welcome visitors, which helps encourage them to visit. Those that are not able to visit are able to keep in touch by telephone. Surveys from people who use the service say that staff listen and act on what they say. Observations confirmed that people do have choices in their daily lives, which include choices about where to spend their day, where they eat and what they eat. The Deputy Manager has received training on the Mental Capacity Act 2005 and more staff are scheduled to attend which will aid their understanding of their responsibilities and people’s rights. They are encouraged to continue practising their religion while residing in the home. Some of them prefer going to church and effort is made to accommodate their wishes. While others have their own priest visiting them on a regular basis in the home. People spoken with and the two who completed surveys confirmed that they like the meals. The annual quality assurance self assessment identifies that the time of lunch has been changed as a result of listening to people’s views. There is a new cook and People were complimentary about the food and said they always have a choice. One stated, “If I do not like the food, they will offer me something else”. The menu shows two choices of main meal, however the Cook said that she checks each day with residents and also adapts the menu according to preferences. Staff spoken with were also complimentary about the food provided for people and felt that the menus were improving with more fruit and vegetables now being provided. Rosedale Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 17 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. This judgement has been made using available evidence including a visit to this service. There are procedures for dealing with concerns and complaints, which people are aware of and staff are aware of their responsibilities for protecting the people in their care. EVIDENCE: Surveys received from two people who use the service and two relatives confirmed that they know how to make a complaint. Contact details for the Registered provider are available in the service user guide, which allows people to raise any issues directly with them. A comments and suggestions book is available in the hallway, which allows residents and visitors to express their views. This contained positive comments about the care provided and also some suggestions for improvements, which were mainly environmental. A record of complaints is kept which confirmed that action is taken to address the concerns raised. Social services have recently looked into an allegation about the treatment of people who use the service. No evidence was found to support the allegation. Two staff members spoken with during the inspection understood their Rosedale Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 18 responsibilities to report anything that concerned them about the way people are treated. Information received through surveys and discussion with staff, people who use the service and a relative was positive about the way people are treated. One person said “ I feel that staff do their best for residents.” Rosedale Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 19 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. This judgement has been made using available evidence including a visit to this service. The home was clean, comfortable and some re-decoration and improvements are taking place, providing a pleasant environment for people who live there. EVIDENCE: The annual quality assurance self assessment confirmed that the Registered Provider was: “to continue assessing the need to improve the premises and health and safety of residents and carry out work accordingly.” Observations, discussion with staff and review of records during the inspection confirmed that improvements to the premises are being made. The Acting Manager and Deputy Manager had carried out a check of all areas of the home in order to prioritise maintenance, re-decoration and refurbishment priorities. Rosedale Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 20 Recent improvements include replacement of the front lounge carpet and improvements to the bathing facilities. The bathroom on the first floor had previously been unsuitable to meet the needs of people who live in the home as it contained a domestic type bath with no lifting aid to assist people in and out of the bath. This has now been replaced with a wet room, which contains a shower, which is more accessible. People are however given a choice and may use the downstairs bath if they prefer. People spoken with were satisfied with the environment in which they live and someone commented that although the building was old, they felt that the care was good which was the most important thing. Advice was given to review lighting levels, particularly in the corridors on the ground floor. From recent inspections it would appear that the adequacy of the lighting is affected by a number of factors, which include the particular doors open at the time and the weather. Given that some people who live in the home have poor sight it is important that good lighting levels are maintained in all areas. A sample tour of the home, confirmed that a good standard of cleanliness is maintained. Comments from people who live at Rosedale supported this. One person stated, “It has improved greatly since the new housekeeper came”. Staff confirm that they have received training in infection control and that procedures are followed. Advice was given at a previous inspection to carry out the Department of Health risk assessment for infection control to ensure that appropriate measures are in place to reduce the risk of infection for residents. It was confirmed that the Department of health guide ‘ ‘Essential Steps’ to assess your current infection control management’ is being used to assess the adequacy of current infection control systems. Rosedale Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 21 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. This judgement has been made using available evidence including a visit to this service. The improvements in the provision of staff training and the recruitment procedure provide better protection and care for people who use the service. EVIDENCE: People spoken with during the inspection were satisfied that there is enough staff to meet their needs. During the inspection staff were observed to respond quickly to the needs of people. Relationships between staff appeared good and the whole staff team appeared to be working together as a team to meet people’s needs. There was a pleasant atmosphere with staff taking time to chat with people throughout the day. The annual quality assurance self assessment identifies that 57 of the staff team have or are working towards a National Vocational Qualification (NVQ) at Level 2 or above. The NVQ provides staff with a basic understanding of the care needs of older people and of care practices. Previous inspections have highlighted shortfalls in staff training. The annual quality assurance self assessment states, “We have identified training needs in Rosedale Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 22 relation to residents needs and ensured that staff have received training required”. This inspection confirmed that action has been taken to address the shortfalls in staff training and the training that has been booked indicates that the importance of training in equipping staff to meet residents needs is understood. During the inspection carried out in January 2008 concerns were identified about the adequacy of the recruitment process in protecting people. A member of staff had been employed without a criminal record bureau clearance being obtained by R&Z Jagroo Ltd. No check had been made against the protection of vulnerable adults register either. However since that time recruitment processes have improved and a check of three staff files confirmed that appropriate checks had been carried out, providing better protection for people who use the service. Rosedale Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 23 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. This judgement has been made using available evidence including a visit to this service. Improvements in the management and oversight of the service have resulted in improved outcomes and reduced risk for people who use the service. EVIDENCE: Standard 31 relates specifically to the registered manager and their experience and qualifications. There has been no registered manager in post since the current registration in January 2007. However this standard is considered from the perspective of the adequacy of the management arrangements, as this is considered a key aspect of ensuring that residents receive appropriate care. In the absence of a registered manager, responsibility for the management of the service lies with the organisation. Rosedale Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 24 Since October 2007 the day to day management of Rosedale has been carried out by one of the Directors of the organisation who took the role of Acting Manager and the Deputy Manager. The Deputy Manager is currently undertaking her National Vocational Qualification Level 4 Registered Manager Award. The Commission for Social care Inspection have been informed that an application for registration of a manager will be submitted by June 2008. The inspections carried out in April, July and November 2007 all identified concerns in several areas, which impacted on the quality of care and risk to people who live in the home. As a result of failures to meet requirements made in inspection reports statutory requirement notices were served. Additional inspection took place in December 2007 and January 2008 to check compliance with the notices. Continuing problems were identified with the management of medication and the possibility of further enforcement action was given serious consideration. However this inspection has confirmed that considerable improvements and progress has been made in all areas and that outcomes for people who use the service are much better. Information received in the annual quality assurance self assessment and through discussion during the inspection identified that some changes to staff working practices have been made to ensure that the wishes of people who use the service are respected. Elements of a quality assurance system are in place and surveys have been sent out recently to visiting professionals such as District Nurses, General Practitioners and a Community Psychiatric Nurse to get some feedback on the care provided. There was evidence that audits such as medication audits are being carried out regularly. It is also planned that audits will start to take place in other areas. The findings of this inspection confirm that there is a more rigorous approach to reviewing and improving aspects of the service provided. People are able to manage their own financial affairs where able and independent advocacy is accessed where appropriate to assist with this. No health and safety concerns were identified during the inspection. Staff confirmed that they have received appropriate training, which includes fire safety, movement and handling, first aid and health and safety. A concern raised at previous inspections and in a statutory requirement notice about the safe storage of dental cleansing tablets has now been addressed and these were found to be safely stored. The annual quality assurance self assessment confirms that regular maintenance and equipment checks are carried out which include maintenance Rosedale Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 25 of the passenger lift. No date was given for the last electrical wiring check, however it was acknowledged that this needed to be arranged. Rosedale Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 26 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X 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 2 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 N/A X 3 X 3 X X 3 Rosedale Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 27 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 OP25 Good Practice Recommendations Lighting levels should be reviewed in corridors to ensure they are well lit whether doors are open or closed to assist people with poor sight and reduce the risk of accidents. ( A recommended lighting level is lux 150) Rosedale Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Residential Home DS0000068813.V362709.R01.S.doc Version 5.2 Page 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. 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