Care Home: Rosevilla Residential Home

What the care home does well Staff showed good knowledge and understanding of the personal needs of the people living at Rosevilla care home. During this visit they were observed talking to people in a polite manner and showed a good rapport with people living there. Care staff had worked hard to help people develop memory boxes. These are collections of items from the past that have meaning for the person and they were stored in small display cabinets outside each person`s bedroom. What the care home could do better: Updated financial care plans and clear policies need to be in place to help make improvements to the management of people`s finances in order to ensure they are safeguarded from any potential risk of financial abuse. Care plans should be continually reviewed and audited to ensure they consistently provide the necessary information and care plans that meet people`s changing needs. New staff must be provided with the right training and support to help them do their job and to help them to support people living at the home in the right way. A record of all training provided to staff, including skills induction training needs to be in place and be kept up to date. In order to safeguard the people who live at the home a robust recruitment and induction procedure must at all times be in operation, records must contain evidence that people are supervised while waiting for their full criminal record bureau disclosure to be obtained. Staffing levels must be kept under review in order to make sure that staffing levels are appropriate to the needs of the people living at Rosevilla. These reviews should include the opinions of both staff and the people living there. This will help to evidence that they have the right numbers and levels of staff to meet people`s needs. There should be ongoing meetings and consultation with the people who live at the home and their relatives. The manager must arrange audits and reviews of everyone`s medication and to ensure staff have the appropriate training and support to be able to safely manage people`s medications. Regular audits of the medication procedures would help to identify poor standards of practice and would help to show improvements overall in the safe management of medications at the home. Random inspection report Care homes for older people Name: Address: Rosevilla Residential Home Penkford Lane Collins Green Burtonwood, Warrington Cheshire WA5 4EE two star good service 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: Diane Sharrock Date: 0 3 0 6 2 0 1 0 Information about the care home Name of care home: Address: Rosevilla Residential Home Penkford Lane Collins Green Burtonwood, Warrington Cheshire WA5 4EE 01925228637 08717501948 nkenyon@rosevilla-cs.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Peter Nesarajah Type of registration: Number of places registered: Conditions of registration: Category(ies) : Rosevilla Residential Home Limited care home 35 Number of places (if applicable): Under 65 Over 65 0 dementia Conditions of registration: 35 The registered person may provide the following category/ies of service only: Care home only- Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia code DE The maximum number of people that can be acccommodated is: 35 Date of last inspection Brief description of the care home Rosevilla is a 31 bedded care home providing personal care for people with dementia. It can also provide care for a smaller number of older people with mental health problems. The home is in Collins Green, on the outskirts of the village of Burtonwood and is not far from Warrington. Accommodation is provided on both floors of the Care Homes for Older People Page 2 of 10 Brief description of the care home home. There are 15 first floor bedrooms and 16 bedrooms on the ground floor. Three bedrooms have en suite facilities. There are two lounges and two dining rooms. There is a passenger lift. Part of the top floor is used as living accommodation for the owners who live on site. Rosevilla has well maintained gardens. There is adequate car parking. The home has an adapted minibus, which is used to transport people living in the home and staff. Weekly fees for living at the home range from 379 pounds to 443 pounds. The registered manager is Mr Nesarajah. The homes statement of purpose, service user guide and latest inspection reports can be provided by the manager for people to access. Care Homes for Older People Page 3 of 10 What we found: We visited Rosevilla Care Home on 3 June 2010 to check on how the home was running, following concerns that had been raised in April 2010. Two inspectors visited the home and were there from 10:30 am to 6:00 pm. During our visit we met with the manager and planned the inspection around the routines of the home. We gathered information for this inspection in a number of different ways. We looked at the care records of four people who live at Rosevilla care home to check on the care they receive. We call this case tracking. We also met some of the people living at the home who were sitting in the lounge and dining room and spoke with four of the staff members on duty at the time of our visit. Before our visit we sent out survey forms to the home for people living there to fill in. The manager told us these had not been received. The outcomes from our visit are as follows. The manager had introduced a new system for the recording and management of care plans for each person living at the home. The plans were organised and covered some aspects of peoples personal and health care needs. They included information on personal care needs, health care, medication and other support needed. There was evidence of staff providing support for appointments with dentists, doctors and district nurse visits. The care plans we saw contained information about referrals to the doctors and district nurses when there were changes to a persons needs. The care records also included a number of tools and risk assessments such as for pressure areas and nutrition. However these care plans were not always consistently reviewed and some that identified medium risks didnt offer a care plan to show what would be done to help reduce the risks. There was no evidence of any type of audit to check that the care plans were being kept up to date and included all the information they should. Some staff felt the staffing levels needed to be increased and they thought the manager was trying to recruit more staff to be able to increase the staffing levels. Some felt the staffing levels needed on the day depended on what kind of day they were having especially when a staff member had to escort someone to hospital. Staff felt they didnt have any time to sit and talk to the residents as they were always so busy. This was something that a few residents described also. Some people said they didnt really get to spend a lot of time with the staff because the staff were always so busy. Some people said they didnt know whether there were any residents meetings ever organised but said they would like to go to them if they were organised. The manager/ provider did not have any evidence to show how the staffing levels had been calculated to make sure there were enough staff on duty to meet the dependencies of the people living at the home. One staff member who supported people with their medication had received training in dealing with medications. We noted they were also responsible for training other staff in medications although they had not received any specific training to be a trainer for medications. We looked at a sample of medications and how they were managed. Some medications were being stored and recorded correctly. We found one record where staff Care Homes for Older People Page 4 of 10 had consistently signed over 3 weeks that they had given a medication but staff thought it was no longer administered and wasnt even stored in the medication trolley. This identified that it was a high priority for the manager to check and review all medication and to ensure staff have the appropriate training and support to be able to safely administer and manage peoples medications. The manager did not carry out audits to check on medications and explained that he did not usually administer medications. Regular audits of the medication procedures would help to identify problems such as we found so that errors could be sorted out quickly. The manager must take all necessary actions to ensure the safe practice and management of everyones medications. We looked at three peoples finance records to see how they were being stored and looked after. The manager was in the process of updating the homes policies, procedures and records to improve the recording and management of peoples finances. One record we saw did not have a clear signature for a sum of money that was taken out of a residents money being stored at the home. The manager felt it would be clearer with the new records being implemented. Detailed financial care plans and up to date policies are needed for the safe management of the finances of the people who live at the home in order to ensure they are safeguarded from any potential risk of financial abuse. We looked at the homes complaints record book but it was empty. In the 12 months before our visit, the commission had received 2 anonymous complaints which had been referred to the local authority to review under their safeguarding procedures. There had also been approximately 4 safeguarding referrals made to the authorities. Some of them had been referred by the manager himself showing they had correctly followed the local guidance and procedures to help protect people. Staff told us that they were aware of the action they needed to take if anyone raised concerns regarding the home. We looked at a sample of staff training records and in talking to staff we found that several members of staff had received safeguarding training. Some residents we met were able to tell us that they would speak to staff if they were unhappy. One person said, I would let the staff know if Im worried about anything. Another person said she wasnt sure who to speak to. We looked at a sample of 3 staff files including 2 newly employed members of staff to see what safety checks and what training they had been supported with while employed at the home. One new staff member was working extra to the staff numbers at the time of our visit as part of her induction. However, there was no activity provided as the activity person was having to provide care hours during our visit. We noted that new staff had not been provided with a written skills induction training package. We also noted from the files we looked at that checks on newly recruited staff were not always as thorough as they should have been. Records must contain evidence that new staff have been appropriately checked before they begin work at the home and they must have evidence of supervision and induction while working at the home especially until a full criminal record bureau disclosure has been obtained. This will help to make sure that people living at the home are protected from possible poor practice. We could see that a training plan had been put together to cover the training needed by staff working at the home. Various training sessions had been booked with the local authorities and were due to be completed over the months following our inspection. The completion of this training will help staff to have the right skills and knowledge to help Care Homes for Older People Page 5 of 10 them do their jobs and to help them to support people living at Rosevilla in the right way. 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 following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 10 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 10 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 9 13 The manager must arrange audits and reviews of everyones medication and ensure staff have the appropriate training and support to be able to safely manage peoples medications. This would help to make sure that any errors with medicines are picked up and dealt with quickly so that people receive their medicines as prescribed. 29/07/2010 2 29 19 All the necessary recruitment 03/08/2010 checks, including inductions for new staff, must be carried out and recorded. Evidence must show that new staff have received been supervised at all times until their criminal record bureau disclosure has been obtained. This is to make sure that the people living at the home are protected from possible harm and poor practice and that Care Homes for Older People Page 8 of 10 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 the staff are suitable to work with vulnerable people. 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 Care plans should be continually reviewed and audited to ensure they consistently provide the necessary information to guide staff on how to meet peoples changing needs. Regular reviews of staffing levels should be carried out to make sure that there are sufficient staff on duty at all times to meet peoples needs. These reviews should include the opinions of both staff and the people living there. This will help to evidence that the home has the right numbers and levels of staff to meet peoples needs and requests. New staff must be provided with the right training and support to help them do their job and to help them to support people living at the home in the right way. A development plan should be produced and shared with people, staff and relatives at the home to help include people with the management and developments of their home and should include feedback to any of their requests and suggestions. There should be ongoing meetings and consultation with the people who live at the home and their relatives. Updated financial care plans and clear policies need to be in place to help make improvements to the management of peoples finances in order to ensure they are safeguarded from any potential risk of financial abuse. 2 27 3 30 4 33 5 34 Care Homes for Older People Page 9 of 10 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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