Care Home: Rosedale Retirement Home

What the care home does well During this inspection we found that Mr Menon was helpful and keen to assist us. Because of the focus of this visit we did not identify which areas the home is doing well in. What the care home could do better: We have repeated our requirement about updating care plans because, although reviews have been done, the care plans have not been updated. We strongly recommend that fresh care plans are done because of the risk that staff will be confused by the mixture of old and new information in the current care plans if they have further amendments made to them. More needs to be done to improve the written information about the care people need. This is important to help staff have a good understanding of how they should be looking after each person who lives at the home. Information regarding staff recruitment must be available for us to inspect and Mr Menon needs to organise a way to do this. Records of money spent for people need to be checked to make sure that money deposited in the past has all been correctly accounted for. Whilst the hands on care given to people living at the home is central to their well being, well organised leadership,management and administration is essential to keep a care home running well. The owners need to address this issue as this is a vital way to stabilise the day to day efficiency of the service. Inspecting for better lives Random inspection report Care homes for older people Name: Address: Rosedale Retirement Home Ashfield Crescent Ross on Wye Herefordshire HR9 5PH one star adequate service 12/11/2008 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Denise Reynolds Date: 2 3 0 1 2 0 0 9 Information about the care home Name of care home: Address: Rosedale Retirement Home Ashfield Crescent Ross on Wye Herefordshire HR9 5PH 01989565851 F/P01989765851 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Autumn Days Care Ltd care home 24 Number of places (if applicable): Under 65 Over 65 0 24 dementia old age, not falling within any other category Conditions of registration: 24 0 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: Dementia (DE) 24 Old age, not falling within any other category (OP) 24 The maximum number of service users who can be accommodated is: 24 Date of last inspection Brief description of the care home Rosedale is situated in a residential area on the edge of the town of Ross-on-Wye. A purpose built extension to the existing home was completed in 2004. This has created an inner courtyard garden and some of the bedrooms have a door that opens into the garden so that people can enjoy the garden from their room. Most of the rooms in the home are singles and some of these have ensuites so that people have the privacy of their own toilet facilities. There are steps which have to be negotiated to reach a few of Care Homes for Older People Page 2 of 10 1 2 1 1 2 0 0 8 Brief description of the care home the bedrooms, although there is an internal lift and a wooden ramp to help people who have restricted mobility. The 24 places may be used to accommodate older people who have care needs arising from general ageing, or as a result of a dementia type illness. The home has a contractual arrangement with Herefordshire County Council to use 5 places for respite care. The home provides written information about the service it provides in a Statement of Purpose and Service User Guide. This information is required so that people have the information they need when they are choosing a care home that is going to suit them. Anyone thinking of moving to the home should receive a copy of a Service User Guide and the Statement of Purpose should be available to read at the home. People who want information about how much it costs to stay or live at Rosedale should ask the owners for this information. Care Homes for Older People Page 3 of 10 What we found: We did this random inspection for two reasons. We needed to check if some of the requirements we made after our inspection in November 2008 had been dealt with. We also had to look at some specific information at the home as part of an ongoing safeguarding investigation with Herefordshire Council staff. We did not look in detail at issues where the timescales for requirements had not passed. We arrived to do our inspection at 1pm and stayed until 6pm. We looked at certain care records and records about peoples personal money and spoke to staff and the owner, Mr Menon. We did not spend much time in parts of the home where we would see the people living there. This was because of the specific focus of this inspection. The information we looked at in relation to the safeguarding investigation is not all included in this report. This is partly because the investigation by ourselves and Herefordshire Council has not been completed and partly because it relates to a specific person and is confidential. CARE PLANS In November we made a requirement that written care plans must be updated as peoples needs change. This is so that staff all know about the changes and how this affects the care they need to provide. At this inspection we found that most people living at the home had had a recent review by a senior member of staff to check what their care needs are at the moment. We looked at some of these and found that they contained helpful information. We also made a requirement in November that care plans need to give clear information about peoples specific care needs. This is to make sure that staff are aware of and understand the care they need to give to each person and the correct way to do this. When we did this inspection, the timescale for this requirement had not passed. However, the care records we looked at still need better information about the care people need. For example, the records for one person gave no guidance to staff about how to respond when the person becomes very restless. This is a significant aspect of the care the person needs and we consider that the lack of clear guidance for staff may already have resulted in poor outcomes for the person. We will be checking if this requirement has been met when we go back to the home. MOVING AND HANDLING We made a requirement when we inspected in November that the owner must ensure that staff do not use incorrect methods of moving people. This is because it is important for people to be moved in a way that is as safe and comfortable for them as possible. We were told at this inspection that six staff did a moving and handling course on 15th January. We will be looking at the impact of this on how they do their work when we go back to the home. RECRUITMENT ARRANGEMENTS Care Homes for Older People Page 4 of 10 We made a requirement following the last inspection about recruitment records containing all the information required by legislation. This was so the records will meet legal requirements and provide evidence that safe recruitment practices are being followed. Mr Menon told us that there were no new staff working at the home yet (ie since we made that requirement). We will therefore look at this again when we go back to the home. Mr Menon also told us that none of the recruitment records were being kept at the home for security reasons. We highlighted the legal requirement to make these records available for inspection. He agreed to consider how he would do this without compromising security. During our inspection we found a staff CRB certificate amongst a box of residents information. Mr Menon told us it had been put there so it would be somewhere staff would not see it, ie for privacy. This was at odds with Mr Menon telling us that all recruitment papers were kept away from the home. REGULATION 26 We made a requirement after the last inspection for the owners to carry out and report on the visits to the home required by this regulation. This is because the reports are an important tool for owners to use to monitor the service and make sure it is being run in the best interests of the people who live there. Although Mr Menon does not at present keep this information at the home he sent it to us straight after the inspection. This shows he is fulfilling the legal requirement although the information needs to be more structured so he covers all the required topics. We have guidance about this on our website. RECORDS OF PEPOLES PERSONAL SPENDING When we did the inspection in November we were shown new records setting out how peoples personal spending is being dealt with now. However, during this inspection we found that the old records had not been checked or audited to make sure they were up to date. There was no evidence to show that outstanding balances had been dealt with. ADMINISTRATION AND ORGANISATION We found that the office is very untidy and disorganised with years of paperwork in cupboards without any system in place to be able to locate information. The hidden CRB certificate was one example of this as was the time it took to locate some of the information we asked for during the inspection. A senior member of staff has been appointed as deputy manager but there is no registered manager at the home at present. The deputy manager has some hours allocated for dealing with care records. Mr and Mrs Menon spend some time at the home and they are being supported with this by their son. During this inspection we formed the view that either the amount of management time is insufficient or is not being used to best effect. We formed this view because of the amount of work that still needs to be done at the home to improve the way it is managed. What the care home does well: Care Homes for Older People Page 5 of 10 During this inspection we found that Mr Menon was helpful and keen to assist us. Because of the focus of this visit we did not identify which areas the home is doing well in. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action 1 7 15 Regulation 15(2)(b) When a 31/12/2008 persons care needs develop or change you must make sure that the written plans about their care are reviewed and updated. This is so that staff all know about the changes and about how this affects the care they need to provide. 2 7 15 Regulation 15(1) When a 31/01/2009 person has specific and/or specialist care needs the home must ensure that their written care plan gives clear information about the care to be given by staff in these areas. This is to make sure that staff are aware of and understand the care they need to give to each person and the correct way to do this. 3 8 12 Regulation 12(1)(a) and (b) 31/12/2008 You must ensure that staff do not use incorrect methods of moving people. This is to make sure that people are moved in a way that is as safe and comfortable for them as possible. Care Homes for Older People Page 7 of 10 4 19 12 Regulation 12(4)(a) You 31/01/2009 must make arrangements to ensure that staff are able to have conversations about the care of people who live in the home in private. So that the privacy of people living in the home is protected. 5 27 18 Regulation 18(1)(a) You 31/03/2009 must ensure that the staffing arrangements ensure that there are enough staff on duty every day to meet the personal and social care needs of people who live at the home and that these staff do not routinely have to undertake other duties. So that people who live in the home are cared for by staff who are able to spend the time they need providing personal and social care. 6 29 17 Regulation 17(2), Schedule 4, para 6 Recruitment records must include all of the information required. So that your staff recruitment records provide evidence that safe recruitment practices that minimise the risk of unsuitable staff being employed is followed at all times. 31/12/2008 Care Homes for Older People Page 8 of 10 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 35 17 Regulation 17(1)(a) Schedule 28/02/2009 3 You must make sure that the records of financial transactions for people living in the home are up to date and complete. This is to make sure that all money held and spent on behalf of people who live in the home has been accounted for. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 32 The owners need to improve the arrangments for leadership, management and administration at the home. Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 10 of 10 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!