Care Home: Roseleigh Care Home

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What the care home does well Roseleigh provides a clean, pleasant and well-maintained home for people to live. Staffs work well together as a team to provide the people who use the service with a comfortable and homely environment, offering a good standard of care. The home has a designated training co-ordinator who organises the staff training. The manager and training co-ordinator encourage all staff in the home to undertake as much training as they are able to. What has improved since the last inspection? Since the previous inspection new assessment documentation was being used in the home. It was comprehensive and covered all areas of needs along with risk assessments in areas such as: pressure area, moving and handling, nutritional needs, dependency and a physical and social assessment. Surveys are sent out annually to people who use the service, along with relatives and other professionals such as District Nurses and Doctors to seek their views about life in the home and the service provided. The last annual survey had all positive comments, however the manager said an action plan would have been formulated if there had been any issues or concerns are raised. To ensure the safety of the people who use the service a keypad lock had been put on both the entrance door and the lift. What the care home could do better: Continue to provide a high standard of care to the people who use the service. For staff to continue with NVQ training. CARE HOMES FOR OLDER PEOPLE Roseleigh Care Home Lytton Street Middlesbrough TS4 2BZ Lead Inspector Val Daly Unannounced Inspection 6th March 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Roseleigh Care Home DS0000056173.V360723.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Roseleigh Care Home DS0000056173.V360723.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Roseleigh Care Home Address Lytton Street Middlesbrough TS4 2BZ 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) 01642 656122 01642 659700 roseleigh@mimosahealthcare.com Mimosa Healthcare (No 9) Ltd Mrs Susan Abdi Care Home 50 Category(ies) of Dementia (26), Old age, not falling within any registration, with number other category (24) of places Roseleigh Care Home DS0000056173.V360723.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th January 2007 Brief Description of the Service: Roseleigh is a care home for older people and also for people suffering with dementia. The home can accommodate up to 50 residents. All rooms are single and have en-suite facilities with a WC and hand basin. There are two separate units in the home; the ground floor accommodates older people and the first floor accommodates people suffering with dementia. It is situated in an urban area and overlooks a greenbelt and play area for children. The garden is enclosed and has a paved area where people can sit outside. The home was purpose built and is owned by Mimosa Healthcare. At the time of inspection the fees range from £378 to £399 per week. Roseleigh Care Home DS0000056173.V360723.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection was a key unannounced inspection and was completed by an inspector in one inspection day. As a key inspection, all of the key standards were examined. This was to check that the home meets the standards that the Commission for Social Care Inspection say are the most important for the people who use services, and that it does what the Care Standards regulations say it must. A number of records were looked at including assessments of people who use the service and plans of care, staff recruitment records, complaints and maintenance records along with the annual quality assurance assessment. Three people who use the service, two members of staff and the manager, were engaged in discussion about living at Roseleigh. The manager had completed an Annual Quality Assurance Assessment prior to the inspection. The AQAA is the services self-assessment of how they think they are meeting the National Minimum Standards. This information is received prior to the inspection and it is then used as part of the inspection process. On the day of the visit the manager provided the information and documentation required. The Commission for Social Care Inspection sent a number of surveys to the home for people who use the service to complete. Six were completed and returned. Comments received can be read within the report. This was a positive inspection; people were open and friendly and welcomed discussion about the home. What the service does well: Roseleigh provides a clean, pleasant and well-maintained home for people to live. Staffs work well together as a team to provide the people who use the service with a comfortable and homely environment, offering a good standard of care. The home has a designated training co-ordinator who organises the staff training. The manager and training co-ordinator encourage all staff in the home to undertake as much training as they are able to. Roseleigh Care Home DS0000056173.V360723.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Roseleigh Care Home DS0000056173.V360723.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Roseleigh Care Home DS0000056173.V360723.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have their needs assessed. EVIDENCE: Care managers carry out assessments prior to a person moving into the home to ensure their needs can be met. The home manager also carries out her own assessment, meeting with the prospective person, either in his or her own home or in hospital. This information was viewed in the files of four people who use the service. Since the previous inspection new assessment documentation was being used in the home. It was comprehensive and covered all areas of needs along with risk assessments in areas such as: pressure area, moving and handling, nutritional needs, dependency and a physical and social assessment. There is also a ‘thinking ahead tool’ where it is documented who to contact if the person becomes seriously unwell, religious and cultural beliefs, use of pain relief and whether or not the person would wish to be admitted into hospital. A life history of the person is taken, which is very informative and can Roseleigh Care Home DS0000056173.V360723.R01.S.doc Version 5.2 Page 9 assist with the social care plan. Two people who use the service interviewed informed the inspector during discussion that their relatives had visited the home before they moved in. Relative comment cards stated that they had enough information before deciding if the home was right for their family member. The home does not provide intermediate care. Roseleigh Care Home DS0000056173.V360723.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Four care files were examined and they each contained an individual plan of care. The plans were evaluated and reviewed regularly. Information was also included following on from the life history on how the person likes to spend their day. There was evidence that the person’s health care needs were being met. Risk assessments were in place where needed, for one person, risk of falling, and use of a walking aid. The plans of care are agreed and signed by either the person who uses the service or their relative. Policies and procedures are in place for the ordering, receipt, storage, disposal and administration of medication. For people wishing to manage their own medication a risk assessment and management process was in place. Staffs who administer medication had received safe handling of medication training. The manager also carries out an annual staff competency assessment. This Roseleigh Care Home DS0000056173.V360723.R01.S.doc Version 5.2 Page 11 was confirmed in staff training records and during staff interviews. People interviewed said the staffs were kind and respectful. Comment cards from relatives and people who use the service stated ‘I am very pleased with all aspects of care provided and availability of staff when needed’, ‘Care staff are nice and helpful’, Care staff do their job well with a sense of humour’ ‘Staff are friendly and caring’. Roseleigh Care Home DS0000056173.V360723.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use the 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 who use services are able to make choices about their lifestyle. A variety of food is offered. EVIDENCE: The home employs an activity co-ordinator who provides a variety of activities in the home, dominoes, snooker, darts, bingo, quizzes, and arts and crafts. There is also a motivation class every month, which is very popular and people in the home carry out an exercises from their chairs. People who use the service also enjoy outings to the local theatre to join in with ‘old time music’ and ‘songs from the swinging sixties’. The home has a secure garden area for people to enjoy in the better weather. At the time of the inspection a Summer House had just been put in place and the manager had ordered furniture for it so that people who use the service would be able to sit in comfort and enjoy the garden. Two people interviewed during the inspection said they ‘enjoyed looking out into the garden area, and were looking forward to sitting outside in the summer’. Religious services take place in the home and residents are able to receive communion if they wish. People who use the service said their relatives were able to visit at any time and were always made to feel welcome. Roseleigh Care Home DS0000056173.V360723.R01.S.doc Version 5.2 Page 13 The menu showed that a variety of food is offered to residents and more alternatives are available. Three people spoken to say they enjoyed the food and were given choices by staff prior to the meal being served. They also said if they did not want the main meal an alternative would be offered. The majority of people in the home eat their meals in the dining areas but they are able to eat in their rooms if they wish. Roseleigh Care Home DS0000056173.V360723.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the 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 know how to complain and the home has an appropriate procedure in place. Training for staff in adult protection has taken place, keeping people who use the service safeguarded. EVIDENCE: Three people interviewed said that they would be comfortable speaking to a member of staff if they had any concerns. Comment cards from relatives and people who use the service stated ‘a member of staff explained how to make a complaint but I have never needed to’, I would go to the manager if I had a complaint’. The home has a complaints policy and procedure in place. There had not been any complaints made to the home since the previous inspection. The home has a whistle blowing policy and an adult protection policy in place. There was evidence in the staff training file to show that staff had received training in Adult Protection’. During interviews with staff they confirmed they had received training were aware of the procedure to follow in the case of suspected abuse. Roseleigh Care Home DS0000056173.V360723.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Roseleigh is comfortable, homely and well maintained. EVIDENCE: A tour of the home was carried out. People’s bedrooms contained personal possessions and were comfortable and homely. At the time of the inspection the home was in the process of opening a new thirteen bedded unit for younger people who suffered from dementia. The Unit had it’s own lounge and bath/shower facilities and the dining area would be communal within the whole home. The home was very clean and tidy without any odours. Refurbishment had been carried out around the home and carpets had been replaced in the hallway and corridors. The manager said that bedroom furniture was planned to be replaced. At the time of the inspection a Summer House had just been put in place and the manager had ordered furniture for it so that people would be able to sit in comfort and enjoy the garden. Roseleigh Care Home DS0000056173.V360723.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use the 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 vetting and recruitment practices are robust. Staffs is trained and qualified and relevant information that safeguards people who use the service is in place. EVIDENCE: The home has a rota in place, which is flexible for the needs of the people who use the service. There is a policy and procedure in place for the recruitment of staff. Staff records showed that the required information, references and CRB checks were in place prior to staff commencing work in the home. The home has a designated training co-ordinator who organises the staff training. New staffs receive induction training using the Skills for Care Induction Standards, which may take up to six months. The manager and training Co-ordinator encourages all staff in the home to undertake as much training as they are able to. Since the previous inspection staff had undertaken training in many areas such as NVQ levels 2 and 3, Adult Protection, Fire Safety, Moving and Handling, Safe Handling of Medication, Infection Control, Dementia Care level 2, and the Mental Capacity Act. All staff had undertaken 4 units of Palliative Care training. At the time of the inspection 61 of the carers had achieved NVQ level 2 in care and a further 19 were working towards it. Roseleigh Care Home DS0000056173.V360723.R01.S.doc Version 5.2 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 People who use the 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 regularly reviews aspects of its performance through a good programme of self-review, which include seeking the views of residents, staff and relatives. Finance systems are robust. EVIDENCE: The manager is qualified and competent to run the home. The area manager visits the home monthly and reports on many aspects of the home, the building, care records, health and safety. Surveys are sent out annually to people who use the service, along with relatives and other professionals such as District Nurses and Doctors to seek their views about life in the home and the service provided. The last annual survey had all positive comments, however the manage said an action plan would have been formulated if there had been any issues or concerns are raised. Staff meetings are held monthly and minutes are kept. Formal meetings for people who use the service are not Roseleigh Care Home DS0000056173.V360723.R01.S.doc Version 5.2 Page 18 held, however one to one or small group discussions take place regularly. Three people interviewed felt that their thoughts and points of view were listened to by the manager. Records showed that the home has a formal supervision system for staff in place with senior staff in each department being responsible for supervising their staff. Resident’s finances and records were kept appropriately with signatures in place. Documentation showed that water temperatures are taken weekly and was within the recommended range. The manager completes a summary of accidents, which are analysed monthly. Staffs receive regular training in Health and Safety and there is a full training plan in place. To ensure the safety of the people who use the service a keypad lock had been put on both the entrance door and the lift. Roseleigh Care Home DS0000056173.V360723.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 3 X 3 Roseleigh Care Home DS0000056173.V360723.R01.S.doc Version 5.2 Page 20 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. Refer to Standard Good Practice Recommendations Roseleigh Care Home DS0000056173.V360723.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Roseleigh Care Home DS0000056173.V360723.R01.S.doc Version 5.2 Page 22 - 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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