Care Home: Rosewood House

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What the care home does well People told us the care is “brilliant”.The house is suitable for people with different sorts of needs.There is good food and plenty to do.There are enough staff, and they know how to help.The home is well managed. What has improved since the last inspection? This is a new home. What the care home could do better: The health and safety checks must up dated. Key inspection report Care homes for adults (18-65 years) Name: Address: Rosewood House Polyphant Cornwall PL157PU The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Helen Tworkowski Date: 2 5 0 9 2 0 0 9 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. They reflect the things that people have said are important to them: 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 Care Homes for Adults (18-65 years) Page 2 of 28 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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 mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Rosewood House Polyphant Cornwall PL157PU 0156686230 0156686230 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Bowden Derra Park Ltd Name of registered manager (if applicable) Mrs Caryn Anne Jory Mrs Caryn Anne Jory Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 12 12 0 0 care home 12 learning disability physical disability Additional conditions: The maximum number of service users who can be accommodated is 12. The registered person may provide the following category of service only: Care home with nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) Physical disability (Code PD) Date of last inspection A bit about the care Care Homes for Adults (18-65 years) Page 4 of 28 home Everyone at Rosewood House has their own bedroom. The house is suitable for people who use wheelchairs. There is a garden and grounds to walk or sit in. Care Homes for Adults (18-65 years) Page 5 of 28 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 28 How we did our inspection: This is what the inspector did when they were at the care home. We met with the two people who live at Rosewood. We looked around the house. We talked with the Manager and looked at the paperwork. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well People told us the care is “brilliant”. The house is suitable for people with different sorts of needs. There is good food and plenty to do. Care Homes for Adults (18-65 years) Page 8 of 28 There are enough staff, and they know how to help. The home is well managed. What has got better from the last inspection This is a new home. Care Homes for Adults (18-65 years) Page 9 of 28 What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Care Homes for Adults (18-65 years) Page 10 of 28 Helen Tworkowski Colston 33 33 Colston Avenue Bristol Avon BS1 4UA 01179307110 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 Adults (18-65 years) Page 11 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 12 of 28 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. People can be confident that they will be provided with information about the home and that their needs will be known and taken into account if they choose to move to Rosewood House. Evidence: Rosewood House is a new service and and has recently been registered. As part of this process it has supplied the Commission with copies of the Statement of Purpose and Service User Guide. These are documents that provide information to people who are thinking about coming to live at the home, or their representatives, about what they can expect. We asked to see copies of these documents,they were readily available. The Service User Guide has pictures, to make it easier to understand. We were also show a version that has symbols, that may be used if people find this helpful.The people currently living at the home do not have nursing needs, and therefore 24 hour nursing is not being provided. Two people have moved to stay at the home. Both individuals had moved at short notice, however there was evidence that the people from the home had found out about the persons needs before the move. Care Homes for Adults (18-65 years) Page 13 of 28 Care Homes for Adults (18-65 years) Page 14 of 28 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 people who live at Rosewood House can feel confident that their needs will be known by staff, and that they will be involved in making choices in their lives. Evidence: Each of the people who live at Rosewood House has a Care Plan which explains the sort of help that they need and how it is to be provided. The Manager told us that staff read the care plans. There were also risk assessments for each person. These documents help to identify risks and actions taken to reduce or eliminate unnecessary risks. We were told that one of the peopleat Rosewood House manages his/her own money, and therefore is able to make his/her own decisions about how it is spent. We asked one person about some of the things he/she could choose, he/she said that there were no particular rules, and he/she didnt have to ask do things like make a cup of tea or coffee. Care Homes for Adults (18-65 years) Page 15 of 28 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 people who live at Rosewood House are provided with a range of activities and occupations both at home and in the local area. Evidence: One of the two individuals who lives at Rosewood enjoys spending time with people in the adjacent home, and therefore spends part of the day there. The other individual told us that he likes to watch TV, but also goes out to places such as supermarkets. He/she said that he is also able to do some cooking, and enjoyed cooking sausage and beans,and macaroni.The house has a kitchen where meals can be cooked, or they can be brought over from the main kitchen. There is a choice of meals. We spoke to one of the relatives of a person who lives at the home. She though that her relative was given enough to do, and that they understood that he/she liked a routine to make him/her feel secure. The daily routine also provided him/her with exercise, which meant that he/she was now walking better. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: We were told that the staff at the home keep relatives up to date with phone calls, when they are unable to visit. It is early days for both individuals, however consideration has been given to ensuring that they have enough things to do to occupy them, and to allow them to feel at home. Care Homes for Adults (18-65 years) Page 17 of 28 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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. People are provided with a good level of support to ensure that their physical, social and emotional needs are met. Evidence: A relative of one of the people who lives at Rosewood House described the care provided as Brilliant. She said that her cousin had arrived on a Friday, but by Monday he/she had already started to trust the staff, and to allow them to help him/her with care tasks, this was something that had not happened for time at the previous home. We were told how the care provided at Rosewood had made him/her feel more secure, and that the individual concerned is now laughing and talking more. We were also so told by the relative how staff from the home had arranged to have various long standing health problems dealt with. We looked at the records of care and saw that personal care needs and healthcare needs were being addressed. The Manager, Caryn Jory, told us about how they had successfully used de-sensitization techniques and build confidence and trust. We looked at the medication system, and was told that when the Manager was not on duty then one of the staff from the adjacent home administered medication. We discussed with the Manager that medication does not have to be given by a Registered Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: Nurse, but that any person administering medication must be trained and competent in this area. We looked at the records of medication and discussed with the Manager the need for a list of sample signatures, so that it can be confirmed who had administered medication by their signature. The Manager told us that they were supporting one person to discuss with the healthcare professionals whether he/she should continue to take some of their medication. This was being managed in a professional manner so that the individual was not pressurized to take the medication but was given the information needed to help him/her to decide. Care Homes for Adults (18-65 years) Page 19 of 28 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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 people who live at Rosewood can be confident that any concerns or issues that they raise will be dealt with appropriately. Evidence: We asked one of the people who lives at the home if he/she knew who they could talk to if heshe were not happy, he/she said that he/she did know who to speak to. We also asked one of the relatives and she confirmed that she felt able to raise any concerns if she had any. All three of the staff who responded to survey we sent out, said that they knew what to do if someone had a concern about the home. In the information sent to the Commission by the Manager, we were told that no complaints had been received. The Commission has not received any. There are procedures in place, from the time the home was opened, about how to deal with a concern, complaint or allegation of abuse. Care Homes for Adults (18-65 years) Page 20 of 28 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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. Rosewood House provides a very high standard of accommodation, that has the potential to become a very comfortable home to people with a range of complex needs. Evidence: Rosewood House is a new build home, and has been required to meet certain standards in relation to the space and facilities in the home. Only a few of the bedrooms have been completely finished with carpets and furniture. The Manager said that this was to help ensure that when people move to the home that they would have the opportunity to be involved in choosing the decor. Those rooms that have been completed are furnished and decorated to a high standard and reflect the individuals who live in the room. One person told us that he/she had a key to his/her room. The Manager explained that the building has the potential to be adapted to meet differing needs. The communal areas are light spacious and airy. There are only two people living at Rosewood House at the moment, so some areas of the home do not feel lived in yet. The kitchen is adapted so that people who use wheelchairs can cook. Care Homes for Adults (18-65 years) Page 21 of 28 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 people who live at Rosewood House can be confident that they will receive the care and support they need from well trained and competent staff. Evidence: The Manager told us that Rosewood House is staffed with a regular group of people who are employed by Bowden Derra Park Ltd as Bank Staff. At the moment it does not have its own staff team. We discussed with the Manager, Ms Caryn Jory, the fact that she is the only registered Nurse who works at the home, and therefore 24 hour nursing care is not provided. Ms Jory confirmed that neither of the people who live at the home have nursing needs, however if someone is admitted who does have such needs then nursing staff will be provided. We looked at the recruitment details relating to the staff currently working in the home. We found that appropriate checks had been made in relation to the recruitment of staff. We discussed with the Manager improvements in the recruitment check list, so that the date the Criminal Records Bureau Check is returned is included. There was evidence of an induction process. The Manager explained that staff go through an in house induction procedure before starting the nationally recognised Common Induction. All three of the staff who responded to the survey confirmed that they were given support to carry out their roles and that they had received training and were kept Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: up to date with new ways of working. The three staff said that there were always or usually enough staff on duty to meet needs. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 people who live at Rosewood House benefit from a well managed home. Evidence: Ms Caryn Jory has recently been registered as the Manager of Rosewood House, and therefore is considered appropritately trained and competent in this role. As part of the visit we also met with Mrs Cash, who is the Responsible Individual for Bowden Derra Park Ltd. Mrs Cash has carried out visits, on behalf of the company, to ensure that the home is being properly run. We asked the Manager about Quality Assurance. She explained that they have not yet sent out any surveys in relation to Rosewood House, however the quality of the service is discussed at weekly management meetings. The Fire Risk assessment for the home was carried out in February 09. Ms Jory explained the procedure that staff had been trained to follow in the event of a fire. This is different to what written down as part of the Fire Procedure. There must be no confusion as to the actions to be taken in the event of a fire. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: We asked about other risk assessments including a Legionella Risk Assessment. Ms Jory told us that checks were being made to ensure that there was no risk of infection. However there was no risk assessment. It is important to have a risk assessment as this determines what checks are needed and the frequency of checks. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes  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, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 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 Description 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 Description Timescale for action 1 42 13 Risk Assessments, including in relation to Legionella, must be carried out and implemented. Any discrepancies in relation to the fire procedure must be dealt with. 01/01/2010 This is to ensure that everyone at Rosewood House is not subject to unreasonable risks. 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 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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