Care Home: Rosegarth Residential Home

What the care home does well One person said "I love it here, especially the food". We asked people what the home does well and these are some of the comments we received: - The home is always spotless, the staff are friendly, the food is good. - The staff are always friendly, welcoming and kind. - It is always clean and tidy, bedrooms and clothing kept regularly clean, staff very kind and caring. - Nice small, friendly home, food always looks good. People`s needs are assessed before they move in to make sure the home will be able to meet those needs. People, or those close to them, are encouraged to visit the home to help them decide if it is the right place for them. People`s care needs are recorded and these records are kept up to date to make sure staff have the information they need to care for people properly. People living in the home or their representatives are involved in planning how their care needs are to be met. This helps to make sure care is delivered in a way that takes account of people`s wishes and abilities. Daily routines are relaxed and flexible enough to take account of people`s preferences. The pace of life at Rosegarth is gentle and quiet times are planned into the day. By not having the television on all day the home encourages people to talk to each other. The home encourages people to share any concerns they might have and deals with issues as they arise. This means that people very rarely feel the need to make a formal complaint although there is a complaints procedure which people are aware of. What has improved since the last inspection? There were 3 requirements following the last inspection and they have been dealt with. Following recent changes to the management of the home the owner has decided to take on the role of registered manager. She has made an application to the Commission and this is currently being dealt with. The home has an ongoing programme of maintenance and redecoration and continues to provide a safe and pleasant place for people to live. All the required checks are completed before new staff start work to make sure people are only cared for by staff that are suitable to work with vulnerable adults. The owner confirmed that CRB (Criminal Records Bureau) checks have been completed for all staff. What the care home could do better: We asked people what the home could do better. One person said they did not always enjoy the evening meals and two people said they would like to see more activities/entertainment arranged. Another person suggested putting a half door on the kitchen to discourage people fromgoing in there all the time. They said this would reduce the risk of people being injured. The home should keep the night staffing arrangements under review to take account of people`s changing needs. Paper towels or hand dryers should be provided in toilets and bathrooms to help reduce the risk of cross infection. Developing a more person centred approach to social care would help to ensure that everyone living in the home gets the support they need to follow their personal interests. The home should keep a record of visitors so that they know how many people are in the building in the event of a fire or other emergency. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Rosegarth Residential Home 5 Clifton Road Ben Rhydding Ilkley West Yorkshire LS29 8TT     The quality rating for this care home is:   two star good service 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. Lead inspector: Mary Bentley     Date: 1 9 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Rosegarth Residential Home 5 Clifton Road Ben Rhydding Ilkley West Yorkshire LS29 8TT 01943609273 01943603690 rosegarth@mail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Carol Taylor Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 18 Number of places (if applicable): Under 65 Over 65 3 14 1 dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home 0 0 0 Rosegarth is privately owned by Mrs Carol Taylor. It is a care home, which does not provide nursing care. The building is a large detached house with an extension and has room to care for up to eighteen people. It is in a quiet residential area of Ilkley, the sign outside is discreet and there is nothing to distinguish it from other houses on the road. There is a good bus route nearby which runs into the town centre. However to walk to the home from the main road, there is a hill. Care Homes for Older People Page 4 of 26 Brief description of the care home The home has eighteen single bedrooms; six of these have en suite facilities. There are also communal areas, which are spacious and comfortable. There is a stair lift to the first floor and a call system is fitted in all bedrooms, toilets and bathrooms. Rosegarth is well maintained both inside and outside. There is a safe and accessible garden area to the front of the house, with seating and some car parking. In May 2009 the weekly fees ranged from 400.00 to 650.00 pounds. The fee includes hairdressing, chiropody treatments and toiletries. People buy their own newspapers and if they have a telephone in their own room, they are responsible for the bill. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last key inspection was carried out on 7 June 2007. Since then we have reviewed our practice when making requirements to improve national consistency. Some requirements from previous reports may have been deleted or carried forward into this report as recommendations. This is only done when it is considered that people using services are not being put at significant risk of harm. In future, if a requirement is repeated it is likely enforcement action will be taken. This is what we used to write this report: Surveys returned to us by people using the service and from people with an interest in the service such as visiting health care professionals and staff. We received 6 surveys, Care Homes for Older People Page 6 of 26 some were completed by relatives on behalf of people living in the home. Information we have about how the home has managed any complaints. What the service has told s about things that have happened since the last inspection. These are called notifications and are a legal requirement. We have not received many notifications since the last inspection. This was discussed during the visit to make sure the home is aware of what they are required to inform us about. Relevant information from other organisations. A site visit carried out by one inspector. This was an unannounced visit and we spent approximately 6.5 hours in the home. During that time we spoke to people living in the home, staff and management. We looked at various records including care records, we looked at some parts of the home and observed staff as they carried out their duties. The home had not received their Annual Quality Assurance Assessment (AQAA) when we visited. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. The home agreed to complete the AQAA and send it to us as soon as possible. What the care home does well: What has improved since the last inspection? What they could do better: We asked people what the home could do better. One person said they did not always enjoy the evening meals and two people said they would like to see more activities/entertainment arranged. Another person suggested putting a half door on the kitchen to discourage people from Care Homes for Older People Page 8 of 26 going in there all the time. They said this would reduce the risk of people being injured. The home should keep the night staffing arrangements under review to take account of peoples changing needs. Paper towels or hand dryers should be provided in toilets and bathrooms to help reduce the risk of cross infection. Developing a more person centred approach to social care would help to ensure that everyone living in the home gets the support they need to follow their personal interests. The home should keep a record of visitors so that they know how many people are in the building in the event of a fire or other emergency. 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 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed before they move in to make sure the home will be able to meet these needs. Evidence: The home told us that peoples needs are always assessed before they move in and we saw evidence of this in the records. The deputy manager is clear about the admission criteria and understands the importance of taking account of the needs of the people already living in the home. Whenever possible people or those close to them are encouraged to visit the home before making decision about moving in. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are met in a way that takes account of their preferences and abilities and people are treated with dignity and respect. Evidence: We looked at five peoples care records. The care plans have information about peoples personal, health and social care needs and how these needs are to be met. The care plans have information about what people can do for themselves and what support they need from staff. The care records include a daily care sheet which shows how people like to spend their time in the morning, afternoon and evening. It also has information about any special needs that the person may have, for example if they need a particular diet. We saw that people or those close to them are involving in drawing up and reviewing the care plans. The deputy manager told us that reviews take place about every 3 months when people are new. As people become more settled in the home reviews normally take place every 6 to 12 months. Care Homes for Older People Page 12 of 26 Evidence: There are risk assessments in place to identify if people are at risk of falling or of developing pressure sores. When people are found to be at risk care plans are in place to show how the risk will be reduced. Peoples weight is checked every month however the home does not do nutritional risk assessments. It is recommended that they are done to identify people who may be at risk of malnutrition. We discussed this with the deputy manager and she agreed to put a nutritional risk assessment in place. Nursing care is not provided in the home and district nurses visit to look after peoples health care needs. The records showed that people also have access to other NHS services such as GPs and physiotherapists. People told us they always get the medical support they need, one person said when needed the local doctor comes. Medicines are stored safely and there are suitable systems in place to make sure that people get their medicines as prescribed. Senior staff have had training on managing medicines and staff are not allowed to help people with their medicines until they have been trained. No one in the home was managing their own medicines when we visited. The deputy manager said that if people wanted to manage their own medicines the home would do a risk assessment to make sure it was safe for them to do so. People looked well cared for and told us that they are. One person said they get very good personal care, especially at night or if you are ill. We saw that staff were kind and respectful in their interactions with people. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to make choices and have control over their lives. Overall peoples social and recreational needs are met however this could be improved by developing a more person centred approach to social care. Evidence: Daily routines are relaxed and flexible. People can choose whether to spend their time in one of the communal areas or in their own rooms. After lunch most people have a rest for about an hour before the afternoon activities start. The television in the main lounge is not on during the day, if people want to watch day time television they can do so in their own rooms. The deputy manager told us people like to watch television in the evening and many enjoy watching the soaps. The home provides a range of activities which include arts and crafts, a reading group and sing a longs. There is a fortnightly minibus trip to local areas of interest and people told us they really enjoy this. The comments we received from people about activities varied, one person said Care Homes for Older People Page 14 of 26 Evidence: activities are frequent and well organised. Another said they would like to see more entertainment arranged, they said they have bad eyesight and are unable to read or write and I am desperate for more to do. Another person said they felt the home could improve by having a dedicated member of staff to arrange more activities for people rather than relying on staff finding time between doing other duties. The home organises two big events every year, a garden party in July and a Christmas party. They said people always enjoy these events and they are well supported by relatives. A church service is held in the home once a month for people who wish to attend. This is a Christian service and reflects the religious needs of people living in the home. The home supports people to keep in contact with family and/or friends. During the visit we saw people receiving visitors at various times. People go out with family, friends or on their own, for example one person goes to Keep Fit classes and another enjoys visits to the local pub. We observed the meal service at lunch time. The tables were nicely set, the meal service was well organised and people were given plenty of time to enjoy their food. People told us they enjoyed lunch and most people said they always enjoy the food, especially the home baking. One person said they did not always enjoy the evening meal. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable systems in place to make sure that peoples concerns and/or complaints are taken seriously and acted on and to make sure that people are protected from abuse. Evidence: People told us they know who to speak to if they are not happy and said they know how to make a formal complaint if they need to. The home has not had complaints since the last inspection in 2007 and none have been referred to us. The home encourages people to discuss any concerns they might have and issues are dealt with as they arise. This means that people seldom feel the need to make formal complaints. There are suitable systems in place to make sure that people are protected from abuse. There has been one referral to the local safeguarding (adult protection) unit in the past 2 years. The home co-operated fully with the investigation and took appropriate action in response to the concerns raised. The majority of staff have done training on the protection of vulnerable adults. Earlier this year all the staff received training on the Mental Capacity Act and the Deprivation of Liberty legislation. This has helped them to understand what they are required to do to protect peoples rights. Care Homes for Older People Page 16 of 26 Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable, pleasant and safe place for people to live. Evidence: The home was clean and free of unpleasant odours when we visited. People told us the home is always clean and fresh. One person said it is always clean, tidy and attractive. The communal rooms on the ground floor are comfortably furnished and the standard of decor is good. The home has lovely gardens where people can sit when the weather permits. A stair lift provides access to the first floor for people who are not able to walk up the stairs. The home does not have a passenger lift. All the bedrooms are single rooms and some have en-suite facilities. People have lots of their personal belongings in their rooms. The home told us people can have locks on their doors if they want them. There are systems in place to reduce the risk of cross infection and staff have received training on infection control. There are no paper towels in the toilets and bathrooms Care Homes for Older People Page 18 of 26 Evidence: and we recommend that they are provided to further reduce the risk of cross infection. The deputy manager said she would deal with this. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are usually enough staff to meet peoples needs. Staff get the training they need to help them understand and meet the needs of people living in the home. People are protected because all the required checks are done before new staff start work. Evidence: People told us that staff are usually available when they need them and said staff usually listen and take notice of what they say. People said the staff are always kind, friendly and welcoming. Relatives told us the staff are readily accessible to residents and their relatives. During the week (Monday to Friday) there are usually 3 care staff on duty between 8:00am and 3:00pm; this includes a senior member of staff. At the weekend this reduces to 2 care staff. Throughout the week there are 2 care staff on duty between 3:00pm and 10:00pm. Overnight from 10:00pm to 8:00am there is one member of staff awake and one on call who sleeps on the premises. The home told us that the night staffing arrangements are adequate to meet the needs of the people living in the home and said that the on call person is very rarely called upon. This arrangement should be kept under review to take account of peoples changing needs and the homes fire risk assessment. Care Homes for Older People Page 20 of 26 Evidence: We looked at three staff files and they showed that all the required checks had been completed before new staff started work. These included PoVA (Protection of Vulnerable Adults) and CRB (Criminal Records Bureau) checks and two written references. All new staff have induction training with an external training company. The induction training programme meets the recommended national standards and is designed to make sure new staff get the knowledge and skills they need to care for people properly. Each member of staff has an individual training record. The records showed that staff have received training on a variety of subjects including dementia and palliative care. Approximately 50 of the care staff have achieved an NVQ (National Vocational Qualification) in care at level 2 or above. The deputy manager has done training on coaching and mentoring and staff have regular supervision where they are able to discuss their training needs. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is appropriately managed. People are able to share their views and contribute to the development of the service. Evidence: There has been a change of manager since the last inspection. The owner is taking over the role of registered manager and the Commission is currently processing her application. The owner and deputy manager have a very hands on approach to the day to day running of the home. People living in the home, relatives and staff told us the management are available, approachable and supportive. People or those close to them are involved in reviewing their care needs at least once a year. As part of the review process people are asked to complete a questionnaire giving their views of the service. The results of these questionnaires are used to identify areas where the service can be improved. The home does not have formal meetings for the people who live there, they consult with people in informal Care Homes for Older People Page 22 of 26 Evidence: discussions and on an individual basis. Staff meetings are held as and when there is a need. There is a care meeting every month where staff discuss peoples needs and any changes that might be needed to peoples care plans. Senior staff meet once a week and information about peoples needs is shared daily in staff hand-overs. The home does not have any involvement with peoples finances. If people are not able to manage their own money and do not have someone to help them with this the home will help them to arrange an independent financial advocate. We looked at a selection of maintenance records and they showed that equipment and installations are serviced and maintained in good working order. The home does not have a book for visitors to sign in and out. This should be provided to make sure there is an accurate record of who is in the building in the event of fire. This was discussed during the visit. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 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 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 2 8 12 Nutritional risk assessments should be done to identify people who may be at risk of malnutrition. A more person centred approach to meeting peoples individual social and recreational needs would help to make sure that everyone living in the home gets the right support to make the most of their abilities, follow their personal interests and develop new interests. A record of visitors entering and leaving should be kept so that the home knows how many people are in the building in the event of fire or other emergency. 3 38 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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. 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