Care Home: Rosemount Residential Care Home

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What the care home does well The Statement of Purpose and Service Users Guide ensure that people have access to the information about the home and the service provided. Plans of care are recorded clearly and provide the information the staff need to meet peoples assessed needs. Medicines are stored safely and administered by trained staff. Following advice from the pharmacist, homely remedies are no longer kept at the home. Meals are home cooked by a professional chef and people are offered choice and variety. The complaints procedure is accessible to the residents and visitors to the home. The residents have access to both wall mounted and personal call bells. This means that the means to call for staff assistance are always available to them. The registered manager is well qualified and both she and the staff on duty at the time of the site visit demonstrated a good understanding of the needs of the people who use the service. What the care home could do better: Clear evidence is needed to show that the people who use the service, and where applicable their families and professional representatives, are directly involved in care planning and reviews. Evidence should be kept to show that any form of restraint, including cot sides, has been assessed on an individual basis and approved by the residents Case Manager and the Community Nursing Service. Handwritten entries on the medication administration record sheets should be signed by the person making the entry and verified and countersigned by a second person. The provision of foundation and on-going training could be better. Staffing levels need to be continually monitored to ensure that they are high enough to meet the needs of the residents. Random inspection report Care homes for older people Name: Address: Rosemount Residential Care Home 48 Old Exeter Street Chudleigh Newton Abbot Devon TQ13 0JX one star adequate service 21/07/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Judy Hill Date: 1 2 0 5 2 0 1 0 Information about the care home Name of care home: Address: Rosemount Residential Care Home 48 Old Exeter Street Chudleigh Newton Abbot Devon TQ13 0JX 01626853416 01626852398 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Rosemarie Anne Noon Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mariarod Care Homes UK Ltd care home 20 Number of places (if applicable): Under 65 Over 65 0 20 20 dementia old age, not falling within any other category physical disability Conditions of registration: Date of last inspection Brief description of the care home 20 0 0 2 1 0 7 2 0 0 9 Rosemount Residential Home is registered to provide accommodation and care for a maximum of twenty people who are elderly and who may have dementia or physical disabilities. The home is situated close to the town centre, which has a range of shops and other Care Homes for Older People Page 2 of 12 Brief description of the care home local facilities. Information about the home service is available from the home in a Statement of Purpose, Service User Guides and a brochure and copies of inspection reports can be obtained from the home or are available on the CQC website. The current fees range from £309 to £450 a week. Extra charges are made for dry cleaning, visits from the hairdresser, private chiropody, private telephone installation and calls, private care of peoples choice and personal toiletries. Care Homes for Older People Page 3 of 12 What we found: Since the last key inspection a Statement of Purpose and Service Users Guides have been have been produced. We were given copies of both of these documents and found them to be clearly written and to provide good information about the home and the service provided. We looked at the plans of care of the two most recently admitted residents and found these to be clearly presented and informative. Risk assessments had been carried out and action to minimise risk had been included. We saw evidence that monthly reviews are taking place but no evidence in either in the care plans or reviews to tell us that the people who use the service have a direct input in either planning or reviewing the care that they receive. The records and our conversations with the registered manager told us that the health of the residents is continuously monitored and timely referrals are made to the professional health care services as and when necessary. We saw that cot sides were being used for one resident. We were told that this was done at the request of the residents family and saw evidence of this in a signed record. However, the use of cot sides is a form of restraint and evidence of the approval of their use should also be obtained from a health care professional and the placement authority. The residents medication is stored in a locked cupboard and a trolley which are kept in a designated drugs room, which is also kept locked. We looked at the medication administration records and found them to be clear and up to date. An information sheet containing details about each of the drugs that the residents take had been included with the records so that the staff administering the medicines knew what each item of medication was needed for and could look out for possible side effects. The registered manager told us that she had taken advice from the Pharmacist about the use of homely remedies and no longer keeps any at the home. Some of the medication administration sheets had hand written entries which had not been signed by the person making the entry and a second person to verify the accuracy of the information recorded. We observed the registered manager and staff working with the residents during the lunchtime period. This was a very busy time but the people who needed help to move from their easy chairs to dining chairs and help to eat their meals were seen to be treated with dignity and respect by the registered manager and staff. The residents were offered a choice of two set meals. These were sausages and mash with fresh vegetables or roast beef and roast potatoes with fresh vegetables. Pudding was either apple pie and custard or fresh fruit salad and ice-cream. The home employs a professional chef, who in addition to providing lunches for the residents, provides a meals on wheels luncheon service four people in the community. We spoke with the chef and he clearly understands and is meeting the dietary needs of the Care Homes for Older People Page 4 of 12 residents who needed their meals to be pureed and people who are diet controlled diabetics. The complaints procedure is included in the Statement of Purpose and Service Users Guides and copies are also displayed in the entrance hall and in residents bedrooms. The Annual Quality Assurance Assessment tells us that two complaints have been received in the past year and that both were dealt with and upheld. The registered manager told us that she had recently qualified as a Safeguarding trainer which qualifies her to provides training for her staff. The Annual Quality Assurance Assessment tells us that policies and procedures are in place to safeguard people from the threat of abuse. The registered manager told us that several of the bedrooms and bathrooms were in the process of being upgraded. We saw some of the bedrooms that had been redecorated and refurnished and care had been taken to make them both attractive and comfortable. Both wall mounted call bells and personal alarms that people can wear are provided so that staff assistance can be called for at any time of the day or night. One of the residents told us that the staff respond very quickly whenever he calls for assistance. Some of the residents now have keys to their bedroom doors which have been placed on different coloured ribbons so it is easy to identify who the key belongs to if it gets lost. The registered manager told us that the home is currently understaffed and that she is finding it difficult to attract new staff who she feels are suitable to work at the home. Because of this she is covering some care shifts herself. We looked at the staff rota and this showed us that there are three care staff on duty in the mornings and two on duty in the afternoons and evenings. One person is on waking duty from 9pm at night and one person provides sleeping in cover. We noted that some of the residents needed a high level of support and do not consider the current staffing levels are always high enough to meet their needs. This would apply when people need two members of staff to help them to get up and go to bed, when assistance is needed to use the toilet and at mealtimes. We looked at the records kept for the three most recently appointed members of staff. One had been appointed though an employed agency that recruits overseas staff. We saw applications and records of interviews for the other two. Safe practice had been used for one of these but only one reference had been obtained for the other and his CRB check had not been returned, although a POVA check had been completed. Records were seen of induction training but not of foundation training and the provision of on-going training could be improved. Regular one to one supervision is not currently being provided although the registered manager is in regular daily contact with the staff and carries out annual work appraisals. The registered service provider also manages the home and when necessary, covers care shifts as well. She is well qualified and clearly demonstrated a commitment to those she cares for. She is assisted by a deputy manager. Care Homes for Older People Page 5 of 12 Questionnaires are being used to gain feedback on the service provided from the residents and their families and changes to the service are being made as a direct result of some of the feedback received. However, annual development plans are not being developed to complete the quality monitoring process. The Annual Quality Assurance Assessment tells us that most of the required and recommended policies, procedures and codes of practice are in place and the registered manager is aware of additional policies and procedures that she needs to introduce and why. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 6 of 12 following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 7 of 12 Are there any outstanding requirements from the last inspection? Yes R No £ 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 7 12 The registered person must 28/09/2009 consult the residents when preparing and reviewing care plans. If any resident is not considered to have the capacity to contribute, clear evidence should be provided to support this assumption. This is to enable the residents to retain control over their lives. 2 27 18 The registered person must 29/10/2009 review the staffing levels to ensure that there are enough staff on duty at all times to meet the health and welfare, which includes their need for social and emotional support, needs of the people who use the service. This would improve the quality of care provided for the residents. 3 30 18 The registered person must 29/09/2009 ensure that all of the staff receive training that is appropriate for the work that they are to perform. This should include induction and foundation training that meets Skills for Care Standards, the provision of Page 8 of 12 Care Homes for Older People 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action up to date training in health and safety related topics, such as moving and handling, First Aid, Health and Safety, Fire Safety, Basic Food Hygiene and Infection Control and in specialised areas which relate to the assessed needs of the people who use the service, such as Dementia Care, caring for people with learning disabilities and caring for people with a diagnosed mental illness. This would improve the quality of care provided for the residents. Care Homes for Older People Page 9 of 12 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, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 27 18 The registered person must 17/06/2010 review the staffing levels to ensure that there are enough staff on duty at all times to meet the health and welfare, which includes their need for social and emotional support, needs of the people who use the service. This is to ensure that there are always enough staff on duty to care for the residents. 2 30 18 The registered person must 17/06/2010 ensure that all of the staff receive training that is appropriate for the work that they are to perform. This should include foundation training that meets the Skills for Care Standards, the provision of health and safety related training and training that relates specifically to the needs of people with dementia and diagnosed mental illnesses. This is to ensure that people Care Homes for Older People Page 10 of 12 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 can receive the best possible care. 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 Signed records should be kept to provide evidence that the placing authority and community nurses have assessed the need for cot sides to be used by any individual resident and have agreed to their use. The people who use the service, and where appropriate their families and professional Representatives, should be asked to sign their care planning and review records to provide evidence of their participation in the processes. Hand written entries on the medication administration record sheets should be sign by the person making the entry and by a second person who has verified that the information has been entered accurately. 2 7 3 9 Care Homes for Older People Page 11 of 12 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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