Care Home: Rosedene

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What the care home does well Some of the residents have lived together for some years and therefore know each other and the services that Rosedene provide well. With new residents it was evident from looking at documentation, that assessments prior to moving into Rosedene are undertaken and based on the individuals health, social and personal care needs, including needs relating to their religious, ethnic and cultural backgrounds, to ensure they can be met in the homes setting. People Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 6who use the service said that their introduction to the home was `good` and could not think of ways to improve this further. Each of the people who use the service has an individual, written care plan, which sets out the goals of their placement in the home, to help them to develop their skills and independence. People who use the service have opportunities to make decisions about important aspects of their lives, with assistance from staff, if they need it and are supported to take risks so that they can enjoy fuller and more active lives in and out of the home. People who use the service are encouraged to maintain valued relationships with their families and friends, with staff support as necessary. People who use the service have clear information on what is expected of them and their rights as residents of a care home. They are aware, for example, that they will be expected to help out with household tasks such as menu planning/ preparation and cleaning, so that they can develop their skills and independence and know what to do if they wish to make a formal complaint about something they do not like. People who use the service said they `liked` the food. There is good access to health agencies and from documentation inspected it was evident that access to specialist services is also available. The home has a robust medication process and procedure, which promotes the safe administration of medicines to residents in the home. People who use the service are appropriately supported with their personal care so that they maintain their dignity. Staff were observed to assist them with their needs quietly and unobtrusively. There are adult protection policies and procedures in place to safeguard residents. These are shared with staff so that they are aware of what to do if they have any concerns in this area. Rosedene environment is suitable for the residents living there. The home was clean and tidy throughout at the time of the unannounced inspection. People who use the service showed the inspector their rooms, which are personalised according to their individual tastes. The staff team demonstrated throughout the inspection positive interactions with people who use the service and assisted them with personal care needs in a discrete manner. Staff confirmed access to training is available. The inspector was welcomed to the home in a friendly manner by staff and people who use the service. All were aware of the reason of the inspection. What has improved since the last inspection? The registered providers have employed a maintenance person to help in the upkeep of the home. This is an additional post and the registered provider said that sharing this role would enable the registered provider to spend more time with people who use the service. The registered providers have decorated some parts of the home and are in the process of updating the laundry area and garage. The level of staff training has increased with staff recently attending courses on first aid, medication, safeguarding, infection control and the Mental Capacity Act. One member of staff has completed her LDAF 2 and all care staff have a minimum of NVQ level 2. The level of activities remains varied and people who use the service spoke highly of the clubs, work placements, day centres and holidays that they attend. The previous recommendation to separate the care planning and assessment process has been addressed. What the care home could do better: No statutory requirements were identified at this inspection. Recommendations were made to improve practice further and were discussed with the registered providers who were keen to address the recommendations made. They are as follows: The homes Statement Of Purpose and Service Users guide should include staff qualifications and staff levels so that People who use the service and their representatives are confident that staff are able to meet their needs. The registered provider should review the care planning records, as currently there are 3 documents, which outline the care that a person needs. It is recommended that the care plan documents be amalgamated so that staff have one care plan to work with which informs, guides and direct staff in the interventions of care needed so that people who use the service receive consistent care. It is recommended that the presentation of some documentation, for example care plans, reviews, complaints and risk assessments are reviewed so they can be in accessible or meaningful formats for people who use the service. It is recommended that the registered provider attend the intermediate food hygiene course and the Safeguarding (investigators) courses to gain greater knowledge in these areas, which can then be cascaded to staff. To promote infection control it is recommended that paper towels are purchased and are in place in the kitchen and bathrooms.It is recommended that the homes fire risk assessment be reviewed to ensure that it adheres to current legislation. CARE HOME ADULTS 18-65 Rosedene 22 Rosewarne Road Camborne Cornwall TR14 8BE Lead Inspector Lynda Kirtland Unannounced Inspection 15 and 18 January 2008 09:30 Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 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 Rosedene DS0000009087.V352293.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 Adults 18-65. 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. Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosedene Address 22 Rosewarne Road Camborne Cornwall TR14 8BE 01209 714238 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) Mr Alcwyn Samuel Henry Parker-Price Mrs Gwyneth Helen Parker-Price Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users must be aged 50 years or over upon admission to the home. 25th April 2006 Date of last inspection Brief Description of the Service: Rosedene is a registered home providing accommodation and personal care for up to 5 adults with a learning disability who must be aged 50 years or over when they are admitted. It is owned and managed by the registered providers, who provide most of the necessary care and support to the People who use the service. Two part-time carers assist them. The home is close to the centre of the town of Camborne and within easy reach of local shops and services. The home is able to provide transport for People who use the service should they need it. The home is a detached, two-storey, family dwelling with a spacious front garden and a patio. People who use the service private accommodation is situated across both floors. The upper floor is reached via a staircase. All of the service users are provided with single, furnished bedrooms. Two of the bedrooms have wash hand basins. The home has three bathrooms, two on the ground floor and one on the first floor. There are two lounges and a separate dining room. People who use the service have some access to the kitchen, but this is limited because it is quite small. They have tea and coffee making facilities near to their lounge. The aim is to provide People who use the service with care in a comfortable and homely setting and to encourage them to be involved in a wide range of activities in the local community. All the people attend day care and/or college placements during weekdays; they are helped to get to social clubs and resources in the local community during evenings and weekends. Fees range from 314.00- £609.00 per week, according to information provided by the registered providers to the Commission, which was received on 15 January 2008. There are additional charges made to people who use the service towards the cost of transport and holidays. Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key inspection took place on 15 January 2008 and was unannounced. A further visit to the home on the 18 January allowed the opportunity to meet with the people who use the service. The visits lasted for approximately eight hours. Information about the home received by the Commission since the previous inspection was taken into account when planning the inspection. The purpose of the inspection was to ensure that people who use the service needs are appropriately met in the home, with particular regard for ensuring good outcomes for them. This involved interviews with people who use the service, observation of their daily life and care provided. There was an inspection of the home’s premises and of written documents concerning the care and protection of the residents and the ongoing management of the home. Staff were interviewed and observed in relation to their care practices and there was a discussion with the registered providers. The principle method used was case tracking. This involves examining the care notes and documents for a select number of people who use the service and following this through with interviews with them and staff working with them. This provides a useful, in-depth insight as to how their needs are being met in the home. At this inspection, two people who use the service were case tracked. In talking with all the people who use the service they said that they were ‘happy’, ‘its great here’ and ‘I wouldn’t want to live anywhere else’. They cold not think of any improvements on the care and services that Rosedene currently provides. The Commission received the Annual Quality Assurance Assessment, which is a questionnaire that the registered provider completed. The AQAA describes the services and facilities that Rosedene provide and identifies what areas they do well in and where they want to make further improvements. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. What the service does well: Some of the residents have lived together for some years and therefore know each other and the services that Rosedene provide well. With new residents it was evident from looking at documentation, that assessments prior to moving into Rosedene are undertaken and based on the individuals health, social and personal care needs, including needs relating to their religious, ethnic and cultural backgrounds, to ensure they can be met in the homes setting. People Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 6 who use the service said that their introduction to the home was ‘good’ and could not think of ways to improve this further. Each of the people who use the service has an individual, written care plan, which sets out the goals of their placement in the home, to help them to develop their skills and independence. People who use the service have opportunities to make decisions about important aspects of their lives, with assistance from staff, if they need it and are supported to take risks so that they can enjoy fuller and more active lives in and out of the home. People who use the service are encouraged to maintain valued relationships with their families and friends, with staff support as necessary. People who use the service have clear information on what is expected of them and their rights as residents of a care home. They are aware, for example, that they will be expected to help out with household tasks such as menu planning/ preparation and cleaning, so that they can develop their skills and independence and know what to do if they wish to make a formal complaint about something they do not like. People who use the service said they ‘liked’ the food. There is good access to health agencies and from documentation inspected it was evident that access to specialist services is also available. The home has a robust medication process and procedure, which promotes the safe administration of medicines to residents in the home. People who use the service are appropriately supported with their personal care so that they maintain their dignity. Staff were observed to assist them with their needs quietly and unobtrusively. There are adult protection policies and procedures in place to safeguard residents. These are shared with staff so that they are aware of what to do if they have any concerns in this area. Rosedene environment is suitable for the residents living there. The home was clean and tidy throughout at the time of the unannounced inspection. People who use the service showed the inspector their rooms, which are personalised according to their individual tastes. The staff team demonstrated throughout the inspection positive interactions with people who use the service and assisted them with personal care needs in a discrete manner. Staff confirmed access to training is available. The inspector was welcomed to the home in a friendly manner by staff and people who use the service. All were aware of the reason of the inspection. Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: No statutory requirements were identified at this inspection. Recommendations were made to improve practice further and were discussed with the registered providers who were keen to address the recommendations made. They are as follows: The homes Statement Of Purpose and Service Users guide should include staff qualifications and staff levels so that People who use the service and their representatives are confident that staff are able to meet their needs. The registered provider should review the care planning records, as currently there are 3 documents, which outline the care that a person needs. It is recommended that the care plan documents be amalgamated so that staff have one care plan to work with which informs, guides and direct staff in the interventions of care needed so that people who use the service receive consistent care. It is recommended that the presentation of some documentation, for example care plans, reviews, complaints and risk assessments are reviewed so they can be in accessible or meaningful formats for people who use the service. It is recommended that the registered provider attend the intermediate food hygiene course and the Safeguarding (investigators) courses to gain greater knowledge in these areas, which can then be cascaded to staff. To promote infection control it is recommended that paper towels are purchased and are in place in the kitchen and bathrooms. Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 8 It is recommended that the homes fire risk assessment be reviewed to ensure that it adheres to current legislation. 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. Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are given information about the services that Rosedene provide. People’s needs are assessed prior to moving into Rosedene, and are given opportunities to participate in this process. EVIDENCE: Rosedene’s Statement Of Purpose and Service Users guide describe the facilities and services that they offer. However they would benefit from adding into the document staffing qualifications and describing how the home is staffed. The majority of people who use the service have lived with each other for some time and therefore know each other and the home well, all said they were ‘happy’ at the home and ‘give it the thumbs up’. Pre admission assessments occur to determine if the service will be able to meet the person’s individual needs before moving into the home. People who have recently moved into the home said that this ‘went well’ and ‘everyone was nice’. They could not think of how this could be improved. Contracts of care were seen and were satisfactory. Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service have goals led, written care plans, which fully reflect and address their needs. They are assisted to make decisions about their lives and to safely develop their skills and independence to enhance the quality of their lives. EVIDENCE: People who use the service have a care plan, which addresses all their needs. It is suggested that the registered provider review the care planning records, as currently there are 3 documents, which outline the care that a person needs. It is recommended that the care plan documents be amalgamated so that staff have one care plan to work with which informs, guides and direct staff in the interventions of care needed so that people who use the service receive consistent care. These are reviewed and it would be good practice to include in the review people who use the service and their representative’s comments about the care they have received and what they want to work toward in the future. Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 12 It is recommended that the presentation of some documentation, for example care plans, reviews, complaints and risk assessments are reviewed so they can be in accessible or meaningful formats for people who use the service. People who use the service said that they are able to make choices about things that are important to them. Where necessary, the registered providers assists them, for example in accessing the community, if they lack confidence in going out alone. People who use the service who are more confident have their own door keys and are able to come and go from the home as they please. People who use the service are encouraged to participate in a wide range of activities in the local community. The registered providers had completed written risk assessments, which are individualised and appropriate to each of the people who use the service, depending on their individual needs, risks and abilities. People who use the service attend six monthly residents meetings so that they can share their ideas on the services that Rosedene provides. This is additional to care plan reviews and talking with people who use the service on an informal bases. Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use the service are able to take part in a wide range of activities in and out of the home, which are appropriate to their ages, individual needs, interests and cultural backgrounds so that they develop their skills and confidence. They are supported to maintain valued social and family relationships so that they are not isolated or institutionalised. They are provided with a wholesome and varied diet so that they enjoy their meals and stay healthy. EVIDENCE: People who use the service told the inspector that they attend day centres, work placements, social clubs and that they enjoyed the holidays they went on. They could not think of any further activities that they wished to attend and said there ‘is lots to do’. Individual care plans and daily care records provide good evidence that the individual’s interests and abilities are fully considered in planning their daily activities, which are planned with them individually. Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 14 People who use the service are encouraged to maintain valued relationships with their families and friends, with staff support as necessary, which their daily care records confirmed. They are able to make telephone calls in private if they wish. People who use the service have signed up to written contracts for their placements, which clearly set out their rights and responsibilities in respect of their placements in the home. Where the registered providers assist them with the management of their financial affairs, there are clear records and records of consultation with them about how they would like to spend their personal funds. People who use the service said that the food ‘is good’ and are supported and encouraged to eat healthily. They undertake shopping, planning for and preparing meals with assistance from staff. Nutritional needs and preferences are considered as part of the care planning process. People who use the service views around menu planning are sought in residents meetings. All the residents looked healthy and well nourished. The home has an ordinary, domestic kitchen, due to its size it is difficult for people who use the service to access therefore the registered provider has ensured that people who use the service have access to breakfast cereals, and drinks in the dining area at all times. The registered provider said that the majority of staff have attended food hygiene course. It is recommended that one of the registered providers attend the intermediate food hygiene course. Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are supported with regard to their personal care and have access to appropriate health care services. Medication is safely managed so as to protect People who use the service from medication errors. EVIDENCE: Individual care plans address their personal care needs. People who use the service appeared to be attractively and fashionably dressed and were well groomed so that they can comfortably take part in community life. The home has suitable bathroom facilities so that they can attend to their personal care in private. People who use the service healthcare needs are considered as part of the care planning process and regularly reviewed. Documentation showed that people who use the service have access to external healthcare providers, including specialists, when they need to. People who use the service said that they attend the hospital, doctors, and opticians when needed and are offered support to attend these appointments from the registered provider. There are suitable medication storage facilities. People who use the service do not currently self-administer medication. Rosedene medication policy is satisfactory. Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 16 Rosedene uses the Monitored Dose System (MDS) so that medication in the main is received in blister packs. From inspecting the medication process it was evident that staff receive and administer medication safely. MAR sheets recorded medication the home had received, and when administered. An audit of loose medication showed that the numbers recorded as present in the home tallied with the tablets stored in the cabinet. Advise was given how to record this more clearly which was taken on board by the registered providers immediately, as was advise given in respect of ‘transcribing’, when there is a need to amend MAR sheets by hand. A disposal of medication record is kept. The registered provider agreed to gain a copy of the latest medicine guidelines for care homes, for reference. All staff are trained to administer medication. Boots Pharmacist undertook a medication audit in September 2007 and no issues were identified. Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are listened to and respected so that their views, concerns and complaints are taken seriously and acted upon. There are formal and informal systems in place to ensure that they are able to feel safe in the home. EVIDENCE: People who use the service told the inspector that they are ‘happy’, ‘safe’ and ‘have no worries’ at Rosedene. They said that if they had any worries or concerns they would tell the registered provider and felt confident that they would be listened too and acted on. Rosedene has a written formal complaints procedure and have formal and informal opportunities to raise any concerns with staff before they become serious complaints. The home, and Commission have received no complaints. The home has written procedures to guide staff on what to do if they suspect a person is at risk of abuse. There are records to show that staff are recruited on the basis that they are suitable to work with vulnerable adults in a care setting and appropriate checks are made. People who use the service are not isolated in the home, but take part in a range of activities in the local community and have relationships with people from outside of the home that they can communicate serious concerns to. The registered providers have attended the Safeguarding course (alerter) It is recommended that they attend the follow up course (investigators). Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,30, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and comfortable and safe to provide service users with independence, a good quality of life and adequate protection from infection. EVIDENCE: People who use the service showed the inspector around the home. They said they were ‘pleased’, ‘happy’ with their private bedrooms, which were decorated with their personal items, and furnishings. The home is a domestic style building, well situated for people who use the service to access the local community. It is well maintained and comfortable and provides people who use the service with a choice of communal areas, in addition to their private accommodation. There are records of appropriate safety risk assessments and equipment checks and staff training to keep people who use the service safe from fire and other environmental hazards. The home appeared clean and tidy at the time of the unannounced inspection. All staff have attended training in food hygiene and infection control. There are clear written guidelines for staff to prevent the spread of infections in the home. It is recommended that paper towels be installed in the kitchen and bathroom areas to promote infection control systems further. Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are competent and qualified to care for vulnerable adults in a care setting. They are recruited on the basis of recruitment and selection procedures that are fair, safe and effective to ensure that they are suitable to work in a care setting. They have access to ongoing training so that they have the necessary skills to work with people who use the service. EVIDENCE: People who use the service said that the staff are ‘nice’, ‘kind’ and that they would approach them with any concerns. They felt there was always a staff member on duty that would assist them with all their needs. The staff rota showed that one member of staff is on duty at all times, plus management support. At night one member of staff sleeps in. People who use the service said that they felt able to approach staff in the night if they need them. The registered provider said that he has just employed a maintenance person, which will allow him to spend more time with people who use the service. There are two part carers plus the registered providers who provide staff cover in the home. Care staff undertakes all personal care duties plus with residents Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 20 assistance cleaning and hep with some domestic tasks dependent on the persons individual skills. From observations of staff interaction with people who use the service it was evident that they communicate with residents in a competent, fair, patient manner and work with them at their pace. Staff commented that they enjoy working at Rosedene with the current resident group, feel they work together well as a team and that they have good management support. Nearly all the staff has achieved a minimum of NVQ level 2. Staff have also recently attended training in adult protection, medication, infection control, Mental Capacity Act and first aid. One member of staff has just completed her LDAF 2 The home’s staff recruitment records indicate that staff are appointed on the basis of written application forms and equal opportunities interviews. Appropriate checks are made of their suitability to work with vulnerable adults in a care setting. The registered providers have adopted the induction programme for new staff from Skills for Care criteria plus devised a homes own induction pack. Formal and informal supervision of staff occurs and records confirmed this. Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,42 Quality in this outcome area is, good. This judgement has been made using available evidence including a visit to this service. The home is well run for the benefit of People who use the service. They are appropriately consulted about the running of the home so that ongoing improvements are based on their views. The home is safe and secure for the protection of people who use the service. EVIDENCE: The registered providers are qualified and experienced, having run the home for several years. People who use the service said that the home is well run and the staff member interviewed confirmed this. The registered providers undertake regular training to update their knowledge and skills. They are very closely involved in the direct day-to-day running of the home. People who use the service confirmed that they are satisfied with the care and services provided to them at the home. In addition to regular, daily contact with the registered providers, during which they can make their views and wishes known informally, there are formal quality assurance meetings held Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 22 every six months, with records maintained. These consider important aspects of the home’s management that affect the daily lives of the People who use the service such as food, quality of the accommodation, holidays and activities. People who use the service could not think of any improvements needed to the daily running of the home. It is recommended that when a formal quality assurance process has been completed that a copy of the quality assurance findings are sent to the Commission. Records are stored confidentially, and the detailed notes adhere to the Data protection Act thus allowing confidentiality for each person in the home. Records of risk assessments, regular equipment tests and checks and staff training provide good evidence that the home is well maintained and safe for people who use the service. It is recommended that the homes fire risk assessment be reviewed to ensure that it adheres to the current legislation. Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 3 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 4 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 X Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? 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 YA1 Good Practice Recommendations The Statement Of Purpose and Service Users guide should include details of staffing levels and qualifications in the home so that people who use the service and their representatives are aware of the staffing expertise and have confidence in their skills. The registered provider should review the current care planning documents and ensure that the care plan guides and directs staff in more detail as to what interventions they want staff to do to provide consistent care to the people who use the service. The presentation of documentation such as care plans, reviews and complaint policy would benefit from review so that they are presented in more meaningful formats to the people who use the service. The registered provider should attend the intermediate food hygiene course to gain further knowledge and enhance skills in the management of food. The registered provider should attend the Investigators DS0000009087.V352293.R01.S.doc Version 5.2 Page 25 2 YA6 YA2 3 YA6 4 5 Rosedene YA17 YA23 6 7 8 YA30 YA39 YA42 Safeguarding course and cascade the training to other staff members. Paper towels should be installed in the kitchen and bathrooms to promote infection control systems. The findings of the quality assurance process with any actions the home intends to take should be sent to the Commission. The fire risk assessment should be reviewed to ensure that it meets new legislation Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Rosedene DS0000009087.V352293.R01.S.doc Version 5.2 Page 27 - 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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