Care Home: Rosemount

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What the care home does well The home has a pleasant atmosphere and visitors are made welcome when visiting their friends or relatives. The residents were positive about how it feels to live in the home an example was one who said they felt "happy living here, and the staff are lovely". There is good leadership and the staff work hard to make sure that people living in the home have their nursing and medical needs met. The staff in the home are well trained and skilled in the roles they undertake and they are supervised regularly to make sure that they remain confident and competent. Care plans are detailed, individualised and up to date and clearly show the staff how to give the care in a way which is safe and maintains the residents dignity and ability to make choices. Residents are encouraged to take part in the decisions about how they live their lives and they are supported to maintain contact with their relatives and local community. The improvements to the decoration and furnishings has resulted in the home being pleasant and nicely presented. What has improved since the last inspection? Since the last inspection there have been continued improvements in the home. All of the requirements identified at the last inspection have been met. The improvements made to achieve this were:The improvement of the care planning so that they now contain sufficient information for the staff on the care to be provided for each resident. The improvement of the management of the medicines including controlled medicines to make sure that it is safe and secure. The manager has provided a significant amount of training to make sure that the staff working in the home have the skills and experience necessary for the work they do. The manager is now registered with the Commission for Social Care Inspection. The home now provides adequate numbers of staff to meet the needs of the people living in the home. What the care home could do better: No requirements were made as a result of this inspection. The following recommendations were made. The records of food and fluids given to those residents who are at risk of not maintaining their intake should be completed in sufficient detail and the fluid intake charts should be "totaled" after 24 hours. This will make sure that there can be confidence that the residents are having their needs met. It is recommended that the meal time organisation is reviewed paying particular attention to the way staff are being allocated to make sure that it is a positive experience of all of the people living in the home.It is recommended that the manager undertakes the review of staffing in the home to ensure that there is always sufficient staff on duty at times when they are required. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Rosemount Sunningdale Rosemount West Monkseaton Whitley Bay Tyne & Wear NE25 9YF     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: Suzanne McKean     Date: 1 6 0 3 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 27 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 27 Information about the care home Name of care home: Address: Rosemount Rosemount Sunningdale West Monkseaton Whitley Bay Tyne & Wear NE25 9YF 01912510856 01912510866 rosemount@fshc.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Cotswold Spa Retirement Hotels Limited (wholly owned subsidiary of Four Seasons Healthcare Ltd) Name of registered manager (if applicable) Mrs Helen Louise Alexander Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Rosemount is a purpose built care home of traditional brick build design on one level, there is a car park to the front of the building. This allows level access to the home. It is situated in the residential area of West Monkseaton, Whitley Bay. The home is easily accessed by metro, bus and car. All accommodation is provided in single, en-suite bedrooms and there are a selection of communal facilities, including lounges, dining rooms and a conservatory. There are Care Homes for Older People Page 4 of 27 care home 60 Over 65 59 0 0 1 Brief description of the care home no shared rooms. The home charges fees between £356 and £505 depending upon the needs and requirements of the individual residents. The home provide information about the service through the service user guide and a copy of the last inspection report from Commission for Social Care Inspection is available in the entrance to the home. Care Homes for Older People Page 5 of 27 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: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken Summary: This is an overview of what the inspector found during the inspection. How the inspection was carried out:Care Homes for Older People Page 6 of 27 Before the visit we looked at, the information we have received since the last visit on 13th October 2008. How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service and their relatives, staff and other professionals. The returned surveys from residents, staff and visiting professionals. The visit: An unannounced visit was made on 16th March 2009 it was started at 09:30 and was carried out over 7 hours. During the visit we, talked with people who use the service, relatives, staff, the manager and visitors. Looked at information about the people who use the service and how well their needs are met. Looked at the records which must be kept. Checked the staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building and parts of the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last visit. We told the manager what we found. What the care home does well: What has improved since the last inspection? What they could do better: No requirements were made as a result of this inspection. The following recommendations were made. The records of food and fluids given to those residents who are at risk of not maintaining their intake should be completed in sufficient detail and the fluid intake charts should be totaled after 24 hours. This will make sure that there can be confidence that the residents are having their needs met. It is recommended that the meal time organisation is reviewed paying particular attention to the way staff are being allocated to make sure that it is a positive experience of all of the people living in the home. Care Homes for Older People Page 8 of 27 It is recommended that the manager undertakes the review of staffing in the home to ensure that there is always sufficient staff on duty at times when they are required. 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 27 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 27 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. Good pre admission assessments make sure that the home is prepared for the person moving in and that the resident can be confident that the home can meet their needs. Evidence: The home uses the company assessment document which is designed to give the staff in the home information a way of recording information about the needs of the people who are considering moving into the home or staying for a short period. The very detailed assessment tool assists the staff to find out about all of the aspects of peoples lives and needs. The manager is confident that it gives her the information she needs to make the judgment about offering a place. Potential residents can visit the home and spend time in the communal areas prior to making the decision to move in but those spoken to on the day had relied on their Care Homes for Older People Page 11 of 27 Evidence: relatives to make the choice for them. During the visit a potential resident visited the home and the manager took time to show her around and provided her with the information she would need to help her to make the decision to move into the home. Care Homes for Older People Page 12 of 27 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. Good systems and records make sure that health and social care needs are delivered in a respectful way and the care plan documentation shows how this is achieved. Evidence: Each person living in the home has an individual care plan which is developed from the detailed admission assessment and added to throughout their stay. These care plans show that the personal and health care needs of the resident are being met and how that is being achieved. The staff could describe the needs of the residents and were clear about the way that they had to record the care given and the need to report any relevant issues to senior staff. Care plans are in place around both the physical needs and the social care needs of the people living in the home. Necessary risk assessments are completed for a selection of areas including falls, nutrition and deterioration in skin condition. These were being reviewed and the reviews were detailed and up to date. Care Homes for Older People Page 13 of 27 Evidence: Generally the care plans are person centered although the manager has plans to develop this further and there are training sessions planned for the staff. The staff work hard to make sure that they communicate well within the team and with outside primary care team advisors. The records of food and fluids given to those residents who are at risk of not maintaining their intake were not being completed in sufficient detail. They were not always being completed accurately and the fluid intake charts were not being totaled after 24 hours. These records are necessary and need to be accurate. The manager agreed to review this and take the necessary action. Residents are supported to access NHS services and facilities as and when they need to. The care plans showed that the specialist advisors are used for individual people living in the home and their advice is followed closely. The Community Matron visits the home to make sure that the residents are given the medical care they and she supports the staff to make good clinical decisions. The residents and their representatives are supported to take part in the review of their care. Residents said that they felt well cared for by the staff and an example of this was the staff are lovely and the staff are around to help me when I need it, and nothing is too much trouble for them. Residents were dressed for the activities they were undertaking and looked comfortable and tidy. A number of residents were positive about the care they were being given and were complementary about the staff. Care was given in a discreet manner taking into account the individual residents previous lifestyles and the way they want to spend their time. They were being kind and polite with cheerful banter taking place throughout the day. The residents are encouraged to maintain contact with their families, friends and visitors and can use either their own rooms or the communal areas. The relatives are given good assistance to help them to be as involved in the care as they feel comfortable. One visitor in particular said that they were positive about the way he had been supported in assisting to provide care to their relative. The home manages the administration of prescribed medication appropriately. There are appropriate systems in place to arrange for the ordering of the residents medication and the records were up to date and in good order. The home has a contract for the disposal of the medication which is no longer required and the records of this were in place. Controlled drugs are managed appropriately. Specific routes of Care Homes for Older People Page 14 of 27 Evidence: administration are followed and any omissions or changes to the way that the medications are given are recorded. Care Homes for Older People Page 15 of 27 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. The residents are given opportunities to spend their leisure time doing things they enjoy and are supported to maintain contact with their families and the local community. Evidence: There is an activities co-ordinator employed for 39 hours per week. She has been involved in the development of individual life stories. Some are being completed by the residents with the help of their families others are being assisted by the staff. The staff are knowledgeable about the social and recreational care needs of the people living in the home. This was shown in the care plans where there is a individual social activities sheet, and social history sheets and was confirmed by residents. There are regular activities for the service users. One service user described some of the opportunities they had been offered and although they felt that this was enough they did not always want to take part. The social activities offered include skittles, play your cards right, dominoes, and a knitting club. There is also monthly visit by an entertainer and there is a plan for the Mayor to visit the home over easter to judge the easter bonnet competition when staff make a bonnet for an individual resident. Service users Care Homes for Older People Page 16 of 27 Evidence: confirmed that they are free to join in social activities if they wish and that they are not made to join in activities if they do not want to. The residents are supported to continue their religious practices and there are opportunities for residents to participate in services which are appropriate to their particular faith and beliefs. A relatives commented that they are aware of the activities that the staff organises for the service users. The home supports the relatives to make positive contribution to the care provided in the home. The visit covered the time when lunch is served and the food looked and tasted pleasant and it was well presented. The residents were complementary about the food and they were being supported to choose between the two main courses on offer. Residents are asked the day before the meal. However, when they did not seem to want or be enjoying the choice they made they were offered the alternative. The desert being served was bread and butter pudding, although an alternative of yoghurts or fresh fruit were available. Staff were sensitive when assisting the residents with their meals. The organisation in the high lounge was good and the staff were well organised, however this was less well organised in the low dining room. One resident remarked on the noise level in the dining room and two of the residents were becoming agitated when they had to wait for some time before being served. It is acknowledged that the staff in the low dining room were relatively new to the home, however the organisation of the meal times should be reviewed to ensure that the dining experience is a positive one for all people living in the home. Care Homes for Older People Page 17 of 27 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 good policies and procedures in place to that make sure those complaints are dealt with efficiently and that residents are safeguarded from abuse. Evidence: The complaints procedure is made available to residents and relatives through the service user guide. Relatives confirmed that the staff and the manager listened to their views and opinions. The manager and the senior staff are committed to responding to any concerns raised, even those that are minor in nature. There is a good system for the management of complaints. The records of complaints were well organised and identified any action taken in response to any investigation. There is an appropriate protection of vulnerable adults policy and staff were aware that any events effecting the welfare of the residents must be looked at with reference to the safeguarding guidance and that CSCI need to be informed. There is a whistle-blowing policy which is made known to the staff very early in their employment through the induction process. Care Homes for Older People Page 18 of 27 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 offers accommodation that is clean and well maintained, and has design features to help people of this client group, this promotes their dignity, comfort and welfare of people living in the home. Evidence: Rosemount is a single storey, purpose built home constructed to provide accommodation for older people. The building is sited in a mainly residential area in Monkseaton, close to the Metro station and local shops including a large supermarket. It is appropriately maintained and access into, and within it, is good and it meets the needs of those people who have mobility difficulties or have use of walking aids or wheelchairs. There are assisted bathing facilities for residents who have moving and handling needs and require assistance from staff to bath safely. All bedrooms and toilets have suitable locks on the door to ensure privacy. This provides the opportunity for residents to remain independent and to enjoy good levels of privacy. There are sufficient numbers of communal areas for people living in the home to choose from. These include a range of lounges, dining rooms and communal spaces Care Homes for Older People Page 19 of 27 Evidence: that residents can use, these are well decorated and clean. The bedrooms are of varied shapes and sizes and they were well decorated, furnished and were personalised to the taste of the occupant. There has been a programme of redecoration and replacement of the bedroom furniture. Residents were asked how they felt about their rooms and all were happy with the level of cleanliness. The manager has a good understanding of Health and Safety issues and he is responsible for facilitating good practices that safeguard the people living there. It is well decorated and furnished and there was no unpleasant odours anywhere in the home. Safety checks are carried out in line with the homes policies. The staff are trained in control of infection procedures, and were using these practices throughout the day, to minimise the risk of cross infection. There are sluice disinfectants and the homes arrangements for laundering are good including a sluicing facility on the washing machines. Care Homes for Older People Page 20 of 27 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 skilled, well trained, and competent staff employed in sufficient numbers to make sure that they can provide good care to the residents. Evidence: The home maintains good staffing levels. On the day of the visit the staffing was, the Manager, two qualified nurses and nine care staff. The homes management structure gives good leadership to the nurses, carers, and domestic staff. There were sufficient numbers of domestic and catering staff on duty. These levels are appropriate for the number and dependencies of the people living in the home and to make sure that their personal and health care needs are being met. The nurses and care staff are encouraged to go on a variety of courses. They are given the necessary training to make sure that they are able to carry out their roles safely including moving and assisting, fire, control of infection, first aid and food hygiene. The manager has had some recent problems with maintaining the staffing levels in the home. This has been as a result of a number of issues including staff sickness, staff needing to take holiday and staff suspensions. The sickness levels have been high and the manager and regional manager is focusing on this as part of the homes development plan. Care Homes for Older People Page 21 of 27 Evidence: Staff records are kept of recruitment and selection. A sample of these were examined and found to contain the necessary information to make sure that the residents are safeguarded from harm by good employment processes. The induction of staff is in line with current good practice guidance. Additional training is given to staff around other areas such as infection control, catheterisation and wound management. Care Homes for Older People Page 22 of 27 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 management systems are working effectively to protect service users and staff and to make sure that the home is run in the best interest of the people living there. Evidence: The manager has been in post since January 2008 and is registered with CSCI. She has a long history in providing care or older people, and has experience in managing another similar home for another large company. She has additional training in tissue viability (caring for people at risk of deterioration in ther skin condition and appropriate treatment). She provides good leadership in the home and has appropriate qualifications, experience and skills to make sure that the home is managed in the best interest of the people living there. She has worked hard with the team to make improvements and is continuing to make sure t hat she is always aware of any current best practice so that it can be incorporated int he way they provide care. Care Homes for Older People Page 23 of 27 Evidence: There is a quality assurance system in place, which is used to identify any necessary improvements. Residents and relatives are asked their views on the service provided through annual surveys carried out by the company. The manager arranges residents meetings the last of which was on 27th February 2009 and was attended by relatives, notes are made of these meetings and were available. There is a very comprehensive relatives surveys carried out by the company to elicit their views. This involves sending a survey to all of the relatives, these are then analysed centrally with anonymous information given to the home so that they can make changes if necessary. The company have a very detailed way of collecting information form each home. This is a weekly report which includes a list of residents at risk either that they have a wound, are loosing weight or are judged as being poorly. The information is used to look at the way the home is being resourced and managed. The regional manager also undertakes visits to the home to both provide support and to monitor the homes performance. During the visit the home was tidy and there were no health and safety issues evident, there is a good system for making sure that all of the equipment and services are safe and well maintained. There is also a series of checks carried out and the records of these were up to date. The home has a system to assist residents in managing their personal finances/allowances. The individuals money is kept separately and the records are maintained well. There are receipts kept for any purchases made on behalf of the residents and there are systems in place to make sure that people in the home are provided with money for them to have the items they need. The records are audited. Care Homes for Older People Page 24 of 27 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 25 of 27 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 7 The records of food and fluids given to those residents who are at risk of not maintaining their intake should be completed in sufficient detail and the fluid intake charts should be totaled after 24 hours. This will make sure that there can be confidence that the residents are having their needs met. It is recommended that the meal time organisation is reviewed paying particular attention to the way staff are being allocated to make sure that it is a positive experience of all of the people living in the home. 2 15 Care Homes for Older People Page 26 of 27 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). 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