Inspection on 26/09/08 for Ravensmere

This is the latest available inspection report for this service, carried out on 26th September 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ravensmere 22/06/06

Ravensmere 11/02/06

Ravensmere 28/09/05

Ravensmere 02/11/04

Ravensmere 13/05/04

Ravensmere 04/02/04

Ravensmere 18/12/03

Ravensmere 27/11/03

Ravensmere 18/09/03

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Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 05/12/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ravensmere 13-15 Manor Road Westcliff On Sea Essex SS0 7SR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Carolyn Delaney     Date: 2 6 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Ravensmere 13-15 Manor Road Westcliff On Sea Essex SS0 7SR 01702330347 01702337585 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Sheilla Denis Type of registration: Number of places registered: Health and Home Limited care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 24 The registered person may provide the following category 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: Old age, not falling within any other category - Code OP. Dementia - Code DE. Mental Disorder, excluding learning disability or dementia - Code MD. Date of last inspection Brief description of the care home Ravensmere Rest Home is a care home operated by Health and Home Limited. The service is situated within a residential area in Westcliff on Sea. The home is close to the seafront and a short walk from bus routes, main line railway station and local Care Homes for Older People Page 4 of 25 Over 65 0 0 24 24 24 0 Brief description of the care home shopping facilities. The home currently provides care and accommodation for up to 24 older people. The home is also registered to provide care for older people with dementia and mental disorders. Accommodation is provided on three floors in sixteen single and four double rooms. All but one room now has some form of en suite facility. A passenger lift provides access to most levels within the home. Four bedrooms at the home cannot be directly accessed by the lift. Service users being accommodated within these rooms must be able to negotiate some stairs. Limited parking is available at the front of the property, which has been laid to hard standing. There is a pleasant courtyard garden to the rear with outdoor seating. A copy of the homes Statement of Purpose is available in a folder in the homes lobby area or upon request. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was a routine unannounced inspection, which included a visit made to the home between the hours of 10.30 and 19.00 on 26th September 2008. As part of the inspection process we reviewed information we have received about the service over the last twelve months including notifications sent to us by the manager of any event in the home, which affects residents such as injuries, deaths and any outbreak of infectious diseases. We also looked at the information the manager provided us with in the homes Annual Quality Assurance Assessment. This document is a self-assessment which the registered provider / owner tell us what they do well, how they evidence this and the improvements made within the previous twelve months. Two relatives completed surveys. Six residents and one relative spoke with us during the site visit and their views and comments were reflected in the report. We also observed how staff Care Homes for Older People Page 6 of 25 interacted with residents when supporting them with activities such as meals, mobilising and providing recreation and stimulation. During the site visit, records including residents’ care plans and assessments, and staff training files were examined. A brief tour of the premises was carried out and communal areas including lounge and bathrooms were viewed. In addition some residents’ bedrooms were viewed. Information obtained was triangulated and reviewed against the Commission’s Key Lines for Regulatory Activity. This helps us to use the information to make judgments about outcomes for people who use social care services in a consistent and fair way. What the care home does well: What has improved since the last inspection? 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 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who move into Ravensmere are assured that their assessed needs will be met. Evidence: We were told in the Annual Quality Assurance Assessment that people who are looking for a care home are provided with comprehensive information about the home which accurately reflects the service without raising false hopes and expectations of residents and their families. There is a process for assessing a persons physical and mental healthcare needs before they are offered a place in the home. We looked at the assessments which had been carried out for two people before they moved into the home. Both assessments were detailed with information about each person and what support they needed to carry out their daily activities of living such as washing and dressing, mobilising and eating and drinking. Information was recorded in a way which reflected the individuals preferences for how they would wish to be cared for and identified how much of each activity they can complete independently or with support. Care Homes for Older People Page 10 of 25 Evidence: One resident who had recently moved into the home told us that they were pleased with the home and said I am pleased so far it suits me here. I needed help and some company. One relative who completed a survey said their loved one was clean, happy and well fed and that they were pleased they chose to move into Ravensmere. When a person moves into the home they are provided with a contract which describes their rights and responsibilities and those of the provider. The cost of a place in the home ranges from 558.62 to 780.00 per week. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents assessed needs are met and they are cared for in accordance with their expressed wishes. Evidence: We were told by the manager in the Annual Quality Assurance Assessment that staff respect residents wishes and are alert to their changing needs. We looked in depth at the care plans for two residents. These were very detailed and clearly described the care and support which both people needed. Information reflected each persons wishes for how they like to spend their days, including the times they like to get up and go to bed, how they like to have hair styled and preferences for washing and bathing. Care plans also included information about the residents capabilities and described how much of each activity they could manage independently or with the support of staff. Care plans were regularly reviewed by staff and amendments made to the plan where there had been changes to the persons condition or the treatment they receive. This helps to ensure that staff have up to date information about each resident. Residents looked clean and well cared for and were wearing appropriate Care Homes for Older People Page 12 of 25 Evidence: clothing. Residents told us that they were well cared for. One resident told us carers are very good and they know how to look after me. Another person said I really appreciate the care I get. One relative was spoken with and they said Care is really good, I would complain if it was not. Staff assess risks to each persons health and safety. Risks of injury, weight loss and developing pressure sores are assessed and staff develop a plan of care to help minimise these risks. We saw records to show that residents are weighed regularly and that they remain stable. Staff complete records of any falls, injuries or other incidents in the home which may affect residents. In the event of a fall or any injury to a resident, staff review and update the risk assessment to see if the level of risk has increased. A review of records indicated that risks to residents are well managed as there had been no serious injuries to residents. When a person moves into the home they are assessed to see if they would be capable of safely keeping and administering their own medicines. Due to the nature of their illnesses residents rely upon staff to support them and to manage their medicines. There is a detailed policy and procedure for staff to follow and they also undertake training periodically to maintain skills. We observed that medicines were stored safely and securely. Medication Administration Records were completed accurately and staff administered medicines to residents at the appropriate times. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents do not always have opportunities for social and recreational activities which suit their needs and reflect their wishes. Evidence: The manager told us in the Annual Quality Assurance Assessment that the home promotes a culture where residents have the choice to decide and determine their own daily routines We looked at care plans and staff had recorded residents preferred daily routines and their wishes for the times they like to get up and go to bed etc In the homes service users guide it is recorded that residents have long lost interest in being involved in an active social life and that their mental state, cognition and mobility further restricts and limits their abilities, desires and willingness to engage in hobbies. As a result of this belief there is no plan of activities. However this was not reflected in the comments made to us by some residents. One person told us that they enjoy activities but that by and large there is not alot going on, staff could do more to entertain us Another person said there is nothing much to do I dont like bingo so I usually end up watching television There are activities provided for residents including games, quizzes and karaoke, which some residents say that they enjoy. One resident said that they enjoy reading and that they receive books from the mobile library which Care Homes for Older People Page 14 of 25 Evidence: visits regularly. Staff take residents out for walks along the nearby seafront which they all say that they enjoy. However they do not feel that this happens enough. A cook is employed daily and there is a planned menu which is reviewed regularly. There was no alternative offered to the main meal. Residents told us that there is no choice of meal. One person said if we dont like the meal we could have a sandwich. On the day of the inspection one resident told us that they had asked for more fish and that staff had bought some sardines at their request. Residents had mixed views about the meals. Some people told us that the food was very good. Others said that food is ok. One person said that meals could have more flavour. They also said that they would like to have more fresh vegetables as they were usually given frozen vegetables. Residents told us that on occasions fresh fruit such as bananas, grapes and oranges were available. We observed the lunch and evening meal. Residents had fish and chips with beans and peas. A choice of sausages or sandwiches was offered for the evening meal. Staff were available to support residents at mealtimes and drinks and sauces to compliment the meals were readily available. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are treated well and safeguarded from harm. Complaints or concerns are taken seriously and dealt with promptly. Evidence: There is information in the service users guide and a policy displayed in the home, which describes how a person may make a complaint if they are unhappy with the home. The manager said that there have been no complaints made since the last inspection. Staff record complaints and a review of these records indicated that there have been none made since 2006. Residents told us that they have has no cause to complain. One relative said that the manager would sort out any issues quickly. People who completed surveys said that they had not needed to make any complaints. One person said I am sure they would respond appropriately but I have never needed to raise any concerns. The manager told us in the Annual Quality Assurance Assessment that the foremost aim of the home is to establish a culture where management and staff put the interests and protection of residents first. They told us that this achieved through thorough recruitment and ongoing training of staff, and a set of robust policies and procedures. We looked at how staff were recruited and the process was thorough. All of the checks including Criminal Records Bureau disclosures and PoVA First checks were carried out before a person started work at the home to help determine if they Care Homes for Older People Page 16 of 25 Evidence: were suitable to work with older people. Staff told us that they have received training so as to recognise and to deal with any safeguarding issues. They told us that they would report any issues to the manager and were aware of the homes whistle blowing policy and procedure. We looked at records in respect of staff training and these confirmed that staff receive training for managing challenging behaviour, effective communication and caring for people who have dementia or mental health problems. This helps to ensure that they are skilled to protect residents from abuse. Residents told us that they are well cared for and treated well. We have received no complaints or concerns about the home within the past twelve months. Care Homes for Older People Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a clean, safe and comfortable home which suits their needs. Evidence: Accommodation is provided over two floors and residents can access the first floor via a passenger lift. Residents have access to a large lounge diner and a secure garden area. Maintenance staff carry out regular checks and repair of equipment needed by residents. We were told in the Annual Quality Assurance Assessment that the layout, space and furnishing in the home is suitable for residents, meets their expectations and helps them feel relaxed and secure. Cleaning staff are employed and all areas of the home we looked at were clean and free from unpleasant odours. Relatives told us that the home is always clean. One person said the home is always spotless. Residents told us that they liked living in the home and we were invited to view two bedrooms. Residents can personalise rooms with photographs and ornaments of their choosing. Some residents had keys and could lock their bedroom doors if they chose to. Keys to bedrooms are offered to residents to support them in maintaining their privacy. People told us that the home is cosy and homely. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are well cared for and their needs are met by staff who are thoroughly recruited and skilled. Evidence: We were told in the Annual Quality Assurance Assessment that there is robust recruitment process and staff are employed in numbers to meet residents needs. Four care staff are employed in the morning, three in the afternoon and two at night. We looked at a sample of staff duty rotas and these indicated that staffing levels were maintained and that staff do not work excessive hours without having appropriate time off. This helps to ensure that staff are fit for work. In addition catering staff are employed from 7am to 3pm each day and domestic staff are employed for three hours every day, except Sundays to clean the home. Relatives told us that staff have the right skills and experience to care for residents. Residents told us that staff are very good. One person said staff are caring, helpful and very nice. Another resident said staff are exceptional in my humble opinion. We looked at how staff are recruited and assessed the files for two people who had commenced work since the last inspection. Both people had been interviewed and checks had been carried out in respect of their previous employment. Satisfactory references were obtained from previous employers and Criminal Records Bureau Care Homes for Older People Page 19 of 25 Evidence: disclosures and PoVA First checks were carried out. These checks help to ensure that people employed are suitable to care for older people. Once a person starts work they complete a period of induction to help them familiarise themselves with the daily routines, policies and procedures and the needs of residents. There is a training and development plan for staff and we looked at records which indicated that staff receive training which is relevant to their work and the needs of people living in the home. Training includes managing challenging behaviour, caring for people with mental health issues, safe moving and handling of people, health and safety and controlling the spread of infection. Staff told that they are supported and receive regular supervison to help them look after residents well. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Ravensmere is well managed and residents views and suggestions are taken into consideration when planning the day to day running of the home. Evidence: The manager is a qualified nurse who has experience of managing care settings. Residents, visitors and staff all commented positively about her. Staff feel well supported and residents and relatives said that they can bring any issues to her attention and they will be resolved quickly and efficiently. People told us that they home is well managed and that residents are well looked after. The manager asks residents, their families and others such as health professionals to complete surveys and to comment about the home. The manager had recently received surveys back and we looked at these. Comments made about the home were overall very positive. People said that Ravensmere is a well run home, capable of caring for people who are challenging. They said that the level of care is always to a high standard. Some people commented that there could be more activities provided. Care Homes for Older People Page 21 of 25 Evidence: The home does not keep any monies or valuables on behalf of residents. If residents choose to they may keep valuables in their bedrooms and are provided with lockable storage. If a resident choses to do this the home will not accept any responsibility for loss or damages. The policy in respect residents valuables is not reflected in the service users guide. We looked at how the home is maintained and the checks that are carried out so as to ensure that equipment and systems are kept in safe working order. Staff check hot water temperatures regularly to ensure that they are appropriate. Regular checks are carried out for fire, gas and electrical and installations and equipment and records and certificates are kept in respect of their checks, maintenance and repair. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 12 16 A range of planned activities must be provided, which meets the needs and wishes of residents. To promote independence and keep residents occupied and stimulated. 29/12/2008 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 15 The menus should be reviewed and alternatives to the main meal offered, which reflect the preferences of people living in the home Care Homes for Older People Page 24 of 25 Helpline: 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 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!