Care Home: Rosier Home

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What the care home does well The service offers individual care and support to a range of people with varying degrees of physical and cognitive abilities, encouraging independence for as long as possible. There are regular residents` meetings and opinions and requests generate an action plan so ideas are carried forward. The staff team is stable and supportive of each other. Shifts are covered by regular staff and agency staff are not used so there is continuity of care for residents.One member of the management team is in the home on a daily basis to give hands-on care and monitor day-to-day practice. There was evidence of good recruitment practice and correct disciplinary procedures being followed when needed. What has improved since the last inspection? A number of rooms have had new carpet laid including one of the lounges. A new fire panel is being installed with replaced smoke detectors and emergency lighting. There was evidence that previous requirements and recommendations made from the last inspection have been actioned. CARE HOMES FOR OLDER PEOPLE Rosier Home 22-24 Harold Road Clacton On Sea Essex CO15 6AJ Lead Inspector Jane Offord Unannounced Inspection 4th July 2008 10:10 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosier Home Address 22-24 Harold Road Clacton On Sea Essex CO15 6AJ Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01255 427604 01255 223984 Mr Darren John Marles Miss Sonya Wase Miss Sonya Wase Care Home 16 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (2), Learning disability (2), Old age, not falling of places within any other category (16) Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 16 persons) The home may only accommodate two persons with dementia whose names were provided to the Commission in September 2002 The home may only accommodate two people with dementia and a learning disability who are under the age of 65 years, whose names were provided to the Commission in October 2006 and March 2007 The total number of service users accommodated in the home must not exceed 16 persons 19th April 2007 Date of last inspection Brief Description of the Service: Rosier Home is a detached two-storey property, situated in a quiet residential area of Clacton-on-Sea close to the town centre and the seafront. The service provides support and accommodation for sixteen older people. Accommodation is over two floors with access to the first floor by means of a passenger lift and stairs. There are two lounges and a dining room for communal use. The individual accommodation is provided in three double rooms and ten single rooms. All the rooms have at least a vanity unit and seven of the rooms downstairs in the newer extension have en suite facilities. There are communal bathrooms and toilets on both floors. At the back of the building there is a patio area and a ramp for wheelchair access. There is a pleasant garden at the front that is sheltered from the street by shrub planting. There is some parking to the front of the property and parking is permitted in the road outside. The registered providers are Mr Darren Marles and Miss Sonya Wase, who both take a hands-on role in running the home. Miss Wase is also the registered manager. The home charges between £383.04 and £393.33 per week with additional charges for chiropody and hairdressing services and for personal items such as newspapers, toiletries and clothing. Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this home is two star. This means that people who use this service experience good quality outcomes. This key unannounced inspection looking at the core standards for care of older people took place between 10.10 and 16.00 on a weekday. Mr. Marles one of the registered proprietors was present throughout the day and assisted the inspection process by providing documents and information. This report has been compiled using information available prior to the inspection, such as the annual quality assurance assessment (AQAA), which is a self assessment document completed by the service and sent to us, as well as evidence found during the visit. On the day a number of residents’ and staff files were seen, a tour of the home was undertaken, a variety of service certificates, policies and other records were inspected including the medication administration records (MAR sheets). Part of the medicine round at lunchtime was observed and the serving of the lunch meal was seen. A number of residents, visitors and staff were spoken with in the course of the day. Residents looked comfortable and well cared for, they were relaxing in the lounges and making use of the garden furniture on the patio to enjoy the sunshine. Visitors were welcomed and offered refreshment. There was a good deal of cheerful interaction and banter between residents and staff that was friendly and caring. The home looked tidy and there was evidence of considerable refurbishment and redecoration. There was an odour problem in only one room. The lunch looked and smelt appetising and was clearly enjoyed by the residents. Medication practice was safe. During the afternoon residents were entertained by a singer in the lounge. What the service does well: The service offers individual care and support to a range of people with varying degrees of physical and cognitive abilities, encouraging independence for as long as possible. There are regular residents’ meetings and opinions and requests generate an action plan so ideas are carried forward. The staff team is stable and supportive of each other. Shifts are covered by regular staff and agency staff are not used so there is continuity of care for residents. Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 6 One member of the management team is in the home on a daily basis to give hands-on care and monitor day-to-day practice. There was evidence of good recruitment practice and correct disciplinary procedures being followed when needed. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 6. Quality in this outcome area is adequate. Prospective residents can make an informed choice based on information available about the home but cannot be assured that the home will be able to meet all of their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose and service users guide are available for people to access in the main corridor of the home. They contain a lot of detail about the service and include the proprietors’ and staff qualifications, the admission procedure, the complaints policy, accommodation specifications and the care planning process. There are some details about the client group catered for but there is no mention that some residents may have a diagnosis of dementia, which could cause some behaviour issues. Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 9 The admission policy offers pre-admission visits so prospective residents can assess the facilities available and meet other residents and staff. The first month is considered a trial period to ensure that people have made the correct decision to move into the home. One visitor spoken with said they had been made very welcome when they visited looking for a place for a parent. The files for three recently admitted residents were seen and each one contained evidence that a senior member of staff had visited the prospective resident prior to offering them a place at Rosier Home. The pre-admission assessment records were mainly notes of an informal chat with the person and their representative. It was recorded that each person was given a copy of the service users guide at that visit to help them make an informed choice about the home. In discussion with a senior carer about the process it was clear that the manager and team had identified that the pre-admission assessment format needed to be more structured to ensure that all the prospective resident’s needs were captured. The carer said that the manager was in the process of designing a new format that would be introduced in the next few weeks. They demonstrated that they understood the importance of being able to confirm that the service could meet all the person’s needs before admission. Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is good. The needs of people who use this service will be met as they would wish and in a safe way, based on a detailed plan of care and good practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The files and care plans of three recently admitted people were inspected and showed that an admission assessment of needs is made that generates a plan of care to help meet the resident’s needs. The assessment looks at the person’s physical and mental health needs and includes their social background. Assessment is made based on the activities of daily living (ADLs) and covers personal hygiene, mobility, diet, continence and any history of falls. Any known allergies are recorded as well as night needs and the medication regime. One record noted that the person was, ‘alert, fully understands and is able to decide for themselves’. Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 11 The care plans had interventions for all the identified needs but could be a little fuller in the way the needs were to be met. In discussion with a senior carer they agreed that the format could be altered a little to make the information more accessible for staff. The care plans were divided into ‘problem’, ‘action’ and ‘desired objective’. There was evidence that the person’s key worker, who wrote a monthly report on the resident’s experience during the previous month, reviewed them each month. In the admission assessment details were recorded of any health professionals involved with the care of the resident, such as the GP, community nurse, chiropodist, optician and dentist. A record of visits to or by any professionals was kept in the files together with treatment prescribed. One record noted that the resident needed a referral to a specialist to be measured for a prosthetic shoe. One resident spoken with said that they had an admission to hospital planned for an operation in the next few weeks. The relative of one resident, who was very unwell, said that they were, ‘extremely pleased with the care given by the staff’. They went on to explain that their relative had been admitted to hospital recently and the poor level of care there had upset them. They had decided that they did not want their relative to go into hospital again and said the staff were working with the primary health care team to ensure all care was available in the home. They were satisfied that the home could meet their relative’s needs and were, ‘very happy with the present arrangement’. Records contained risk assessments relating to health and welfare issues that had been identified such as managing diabetes and breathlessness or one resident that disliked being immersed in a bath. One resident had objected to having footplates on their wheelchair. There was evidence that there had been a conversation with the resident about the potential dangers of not using footplates but they still did not want them. A risk assessment was generated in consultation with the resident, their representative and health professionals. The medication policy was seen and contained basic guidance. It needed expanded guidelines on further aspects of medication management including correct storage and recording for controlled drugs (CDs), the administration of ‘homely’ remedies and the covert administration of medicines. Medication was stored safely in a locked cupboard and the senior carer held the keys. The home uses a monitored dosage system (MDS) so medicines are prepared by the local pharmacist and put in blister packs for the home to dispense. Medication was offered discreetly with residents given the choice of having painkillers if they were prescribed on an ‘as required’ basis. MAR sheets were correctly signed after the medicines had been dispensed. To enable a full audit trail the number of tablets dispensed when there was a choice of dose should be recorded. Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 12 The controlled drugs records and storage were checked. The home only holds temazepam tablets under the controlled drugs restrictions. Records were being kept on loose sheets of paper and signed by two carers when tablets were dispensed but there was no running total so it was not possible to check that levels tallied with the records. A discussion was held with the senior carer and proprietor about the need to comply with legislation in regard to controlled drugs. They said they would seek advice from the pharmacist. The carer who administered medication said they had had medication training from a recognised trainer and had competency updates since. Staff records seen contained certificates of medication training undertaken by staff. Interactions observed during the day between staff and residents showed that staff respected the choices made by people. Staff knocked on doors before entry to rooms and assured that clothing was adjusted when moving people from chair to wheelchair. Staff spoken with were able to give clear examples of ways that they worked that maintained residents’ dignity and privacy while performing personal care for them. Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. People who use this service will be able to choose their pastimes and influence the choice and variety of the meals they receive. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The residents’ files seen contained records of their preferred pastimes and a life history so staff had some background knowledge of the person to enable them to make meaningful contact with them. Contact details of the next of kin and their relationship with the person were included as well as the resident’s religious interests if they had any. It was noted in one pre-admission assessment that the resident wished to attend church every Sunday and when they were told that the church was on the corner near the home the decision to move in was completed. Records showed that they did attend the church regularly. Activity records note a variety of pastimes that had taken place recently including having afternoon tea in the front garden, enjoying hand massage and nail painting, participating in a reminiscence session and enjoying a musical entertainment in one of the lounges. One resident said, ‘there is plenty going on’. Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 14 The minutes of residents’ meetings were seen and showed that requests from people generated an action plan to try to accommodate them. At one meeting there was a request for more local trips out as the residents felt that long trips were too much for them. The action plan showed that the outcome was that residents were taken to a local supermarket to buy their own toiletries, went out for an ice cream and had a theatre trip planned. They also expressed which entertainers they liked the best and asked if they could be regularly booked. The singer on the day of inspection was one of the choices and residents were heard joining in with some of the familiar songs. One resident spoken with said they enjoyed the singing but, ‘I really like the Elvis man, he is really good’. The monthly reports written by the key workers for each resident contained a lot of information about how the residents had spent their time. The home celebrates residents’ birthdays with a tea party and a birthday cake. One resident said, ‘I felt like a queen at my birthday party’. Visitors came and went during the day. They were greeted warmly and offered refreshment. One visitor said, ‘I am usually offered a lunch when I visit but have not accepted yet although the meals all look lovely’. One person said that they were kept well informed about the health status of their relative and that staff knew they could be contacted at any time. The menus have just been updated and offer a four-week rotation of meals to include more items requested during a recent residents’ meeting. The main meal of the day is at lunchtime and although the menus do not show a choice of dishes the cook was overheard offering an alternative on the day of inspection. The main dish was shepherds pie but residents were asked if anyone preferred spaghetti Bolognese. All chose shepherds pie and after the meal said, ‘it was lovely’, ‘XXXX is such a good cook I always enjoy the food’. The menus showed a roast dinner every Sunday and a choice of fish each Friday. A cooked breakfast was available for those who chose. At the meeting residents requested less stews now the weather was warmer, with more salads and fresh fruit to replace them. The action plan showed this was discussed with the cook and the shopping list was adjusted. Stores seen in the kitchen showed good stocks of fresh produce. Other requests were for kippers, more jacket potatoes and dumplings. The kitchen was visited and was clean and tidy. Dry stores were correctly stacked and had a wide variety of ingredients. Records showed that hot meals were temperature probed and temperatures of refrigerators and freezers were kept to ensure they were functioning within safe limits for food storage. Some food that was stored in the refrigerator was not labelled with content and date. Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is good. People who use this service will have their concerns taken seriously, be confident they will be investigated and protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a robust complaints policy that is available with the statement of purpose and the service users guide. The service users guide is given to all prospective residents at the initial meeting and a record is made that that has been done. Both documents are available in the main downstairs corridor for anyone to access. CSCI has not had any complaints about this service since before the last inspection. The complaints log contained two complaints made by residents in the previous months. One concerned a preference about the way chicken was served to one resident and it was noted that the cook was made aware of the person’s preference. The other related to a resident who did not wish to have footplates on their wheelchair. The outcome of this is recorded in the section of this report under health and personal care. One resident spoken with about the complaints procedure said they knew who to go to if they had a concern but, ‘there is nothing to complain about in my opinion’. A visitor said they had raised an issue once with the proprietor who had responded immediately and resolved the concern. Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 16 The service has a policy on protecting vulnerable adults from abuse that reflects the Essex guidelines issued by the committee for protection of adults. The policy needs to be updated to give guidance on the new initiative of Safeguarding Adults so staff can react speedily should the need arise. The home has a whistle blowing policy to protect staff who raise concerns about care practice. Staff files contained training certificates to show they had received instruction about recognising abuse. A number of staff have achieved an award at NVQ level 2 and abuse is covered during that study too. Staff spoken with were clear about their duty of care and able to describe fictional incidents to represent areas of subtle abuse. One visitor said they were sure their relative was safe in the home. They had, ‘never heard a raised voice or had a concern about any staff care’. Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24, 25, 26. Quality in this outcome area is good. People who live in this home will be in a comfortable environment with their own possessions around them. They can be confident that the home will be maintained and redecorated to keep the surroundings attractive. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Rosier Home is a large detached building in a quiet, residential part of Clactonon-Sea. It retains some of the original features in the form of some attractive stained glass windows in the lounges, two bedrooms and the stairwell. All the rooms are light and airy with high ceilings and a feeling of space. An extension to the rear of the main building was completed a few years ago and offers an additional seven bedrooms all with en suite facilities. There are three shared rooms that have ceiling track curtains for privacy. All the bedrooms in the main house have a vanity unit fitted. Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 18 Individual room seen during a tour of the home showed that residents had personalised them with ornaments, pictures, photographs and small items of furniture. Rooms looked clean and tidy with colour co-ordinated soft furnishings. A number had been recently redecorated and were fresh and bright. Only one room had an odour problem and the proprietor said they were looking at different solutions for managing the issue. The upstairs bathroom and toilet that had been subject to a requirement at the last inspection were seen and had both been redecorated. There were new curtains and the rooms looked bright and welcoming with new non-slip flooring in blue to match the colour scheme. In addition the downstairs bathroom has been refurbished and painted as well. Mr. Marles, one of the proprietors, does a lot of the redecoration in the home. One visitor said that Mr. Marles was always improving something, ‘I noticed today that he has replaced the flooring in my relative’s en suite’. Liquid soap and paper towels were provided throughout the home for infection control management. Protective clothing such as gloves and aprons were available for staff to use during tasks that carried a risk of cross infection. The policy about infection control covered the importance of good hand-washing techniques but did not cover the management of soiled linen. The laundry was seen and is adequate for the needs of the home. It was noted that washing was being dried in the sunshine outside, as the day was so nice. Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is good. The staff in the home are trained and skilled to support the people using the service and recruitment practice is robust to ensure residents are protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The duty rotas were seen and showed that there are two or three carers rostered during the day in addition either the proprietor or the registered manager is in the home too. Carers are responsible for the care of residents and the laundry. Usually there is a dedicated cook and cleaner to complete the team, however three members of staff had just left their posts for varying reasons, one was the cook. On the day of inspection one of the carers had taken an extra shift to cover the cooking duties. The proprietor said they had already advertised the posts and hoped to interview soon. In the meantime staff were rallying to cover shifts so agency staff were not needed, maintaining continuity of care for residents. Residents and visitors spoken with said the staff were very friendly and helpful. Nothing was too much trouble and they responded to requests willingly and rapidly. One resident said, ‘the girls are very good to me. Look they washed my slippers for me’. A visitor said, ‘the staff seem genuinely fond of the residents’. Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 20 The home employs eleven care staff at present and of those eight have achieved an award of NVQ level 2 or above. This exceeds the recommendation of 50 in standard 28 of the national minimum standards (NMS). The files of three newly employed staff were inspected and found to contain documentary evidence that the person’s identity had been verified and references had been taken up. Each one had a signed copy of the terms and conditions of their employment. Criminal record bureau (CRB) checks had been done and were stored in a separate file. The proprietor supplied the checks for the staff being tracked. One CRB had an entry and there was evidence in the file that this had been explored with the member of staff who had made a written statement about the incident. Induction records in the files showed that all the mandatory training was covered in the first six months including moving and handling, fire awareness, first aid, infection control and medication management. In addition there was training about care for people with dementia, food hygiene and protection of vulnerable adults. Certificates in the files showed that most subjects had been revisited and updated. Staff spoken with confirmed the training they had been given. The home has a policy for the management of a disciplinary issue and there was evidence in some files that the process had been put into action. Records were full and showed that the correct steps had been taken and decisions recorded. The proprietor said they did not like having to use the procedure but there were occasions when it was necessary to protect residents and other staff members. Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38. Quality in this outcome area is good. People who use this service can be confident that their opinions will be sought and that their welfare will be protected by present practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The proprietors, one of whom is the registered manager, have a number of years experience working in residential care. They had both previously obtained a City and Guilds foundation management course award but are now undertaking an NVQ level 4 in management. They share the management responsibility of the home with one working mainly at the start of the week and the other at the end. Staff and visitors spoken with said they are approachable and very hands-on with the care work. Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 22 Residents’ meetings are held every few months with minutes taken and made available to people who were unable to attend. Minutes of the most recent meeting showed that discussions were around meals, outings and entertainers. Requests for changes or introducing something new generated an action plan and an outcome record. Residents had requested a change in menus to reflect the summery weather with fewer stews and more salads. The action plan showed that this was discussed with the cook and the menus adjusted. There was discussion around planned outings and the activity records show that the residents’ views were taken account of. The proprietor explained the system for managing the personal monies for some of the residents. The amounts kept in the home are small and mainly for buying toiletries or paying the hairdresser. Money is kept in a locked filing cabinet in the office, which is kept locked when not occupied. The proprietor and manager hold a key. The records showed that all transactions are logged and receipts are kept and numbered for cross-reference. The contents of three envelopes were checked and they all tallied with the balances recorded. A number of service certificates and the fire log were seen. In March 2008 the passenger lift, the hoists and the rise and fall beds had all been serviced and passed for use. The proprietor said that the new electrical installation had been inspected and passed but they had not received the certificate yet. They would forward a copy to CSCI as soon as they had it. The fire log showed that checks were done monthly on fire extinguishers, alarms and fire doors. A fire drill was carried out monthly too. Minutes of staff meetings record that there is discussion about health and safety aspects of the work including fire awareness and control of substances hazardous to health (COSHH) products. Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NONE. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14 (1) (a) Requirement A full assessment of need must be undertaken on each prospective resident so people can receive confirmation that the service can meet their needs as they wish before deciding to move into the home. The storage, administration and recording of controlled drugs must be done following the guidance of the Royal Pharmaceutical society to ensure legislation is met and residents are protected. Timescale for action 04/07/08 2. OP9 13 (2) 31/08/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rosier Home DS0000017922.V367915.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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