Inspection on 19/05/05 for Richmond House

This inspection was carried out on 19th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Richmond House 26/03/07

Richmond House 05/01/06

Richmond House 14/10/04

Richmond House 26/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Richmond House Mitchell Street Leigh Lancashire WN7 4UH Lead Inspector Judith Stanley Announced 19 May 2005 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 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. Richmond House F56 F06 S5694 Richmond V217262 190505 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Richmond House Address Mitchell Street Leigh WN7 4UH Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01942 682772 01942 682774 Southern Cross Healthcare Services Limited Ms Lorraine Lamb CRH Care Home with nursing 48 Category(ies) of OP Old Age 48 registration, with number PD Physical Disabilities under 65 years 8 of places Richmond House F56 F06 S5694 Richmond V217262 190505 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Home is registered for a maximum of 48 service users to include:up to 48 service users in the category of OP (Older People) up to 8 service users in the category of PD (Physical Disabilities under 65 years) 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 3. Within the maximum registered numbers there can be up to 34 places for people who require nursing care and up to 14 places for non-nursing care. Date of last inspection 14 October 2004 Brief Description of the Service: Richmond House (part of Southern Healthcare) is a two storey, purpose built care home located in a residential area of Leigh and is close to the main bus route. Local shops and a local pub are close by. It is pleasantly situated in its own grounds and has attractive gardens, there is ample car parking to the front of the Home. Level access to the Home is provided and a passenger lift ensures access to both floors. Richmond House F56 F06 S5694 Richmond V217262 190505 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was conducted over a period of 6 hours on one day. The first part of the day was spent talking with the manager and looking at the care plans and records. The remainder of the day was spent speaking with 6 residents, 3 visitors, and 4 members of staff as well as making a tour of the premises. Other staff and residents were spoken to over the course of the day. In addition, the manager gave out comment cards and 2 relatives comment cards were returned. At the last inspection the Home was measured against the National Minimum Standards (NMS) for Younger Adults (under 65) and Older People (over 65). After speaking with the manager it was clear that the nursing needs of the younger adults out weighed their physical needs, for example, at this time the younger adults living at the Home would not be well enough or able to take up opportunities for paid work or continue with any further education or to go out of the Home unaccompanied. Therefore at this inspection only the NMS for Older People were used to assess the Homes suitability. What the service does well: Several members of the staff team had worked at the Home for a long time and residents and relatives spoken with liked the present staff team. One relative spoke about the manager’s presence within the Home saying, that the manager is always around and that you can speak with her if you have any worries or concerns. Staff were described as “very kind and caring,” “helpful”, and “friendly”. The care plans which were looked at were detailed and gave up to date information and a clear picture of what each person needed help with. Offering care and support to younger adults under the age of 65 that have to live in a care home for older people. The staff understand that they have different tastes, likes and dislikes and require a different range of activities, which they do their best to plan for. Richmond House F56 F06 S5694 Richmond V217262 190505 Stage 4.doc Version 1.40 Page 6 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. Richmond House F56 F06 S5694 Richmond V217262 190505 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Richmond House F56 F06 S5694 Richmond V217262 190505 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3 & 5. Standard 6 is not applicable as Richmond House does not offer an intermediate care service. The Homes Statement of Purpose and Service User Guide are comprehensive providing service users and prospective service users with details of the services the Home provides enabling an informed decision about admission to the Home. Pre- admission assessments were good and formed the basis of the resident’s plan of care; ensuring needs were identified and met. There had been opportunities for prospective residents and their supporters to visit the Home, and for the resident to move in on a trial basis so that the suitability of the Home can be assessed. EVIDENCE: The service users information guide is available to all residents and copies were observed in bedrooms. It contains a description of the service and the facilities provided. Prospective service users and their relatives are provided with the information prior to admission to assist them make an informed choice of where to live. Richmond House F56 F06 S5694 Richmond V217262 190505 Stage 4.doc Version 1.40 Page 9 Three care plans were looked at. It was clear from the written records that a full assessment has been undertaken prior to anyone moving into Richmond House. There was evidence to confirm that social workers and other supporters had been involved in the assessment and admission process. The manager confirmed that each person was visited either at home or in hospital whether they were paying for themselves or being paid for by the local authority. The assessment document was detailed and included all the necessary areas to ensure that the Home and staff could meet the individual’s needs and expectations. Prospective service users are offered the opportunity to visit the Home and meet with the staff and other service users and to move into the Home in a trail basis. The trial basis extends to six weeks for older people, with an additional four weeks four weeks for younger adults, i.e. those under the age of 65. Richmond House F56 F06 S5694 Richmond V217262 190505 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 & 9 The standard of care planning and review was good, providing staff with information they needed to meet the resident’s needs. The health care needs of the residents were met, with evidence to inter-agency working, as needed. The systems for the administration of medication are good, with clear guidelines being in place to ensure resident’s medication needs are met. EVIDENCE: Three care plans were looked at, one residential, one nursing and one younger adult. Each record set out in detail the aspects of health, personal and social care needs of the resident, and showed amendments had been made when necessary, but at least once a month. The content had been based on the initial assessment. Risk assessments applied to all residents, for example, in relation to falls and the use of bedrails. All risk assessments had been reviewed at least once a month and had been adjusted, where appropriate. One relative spoken with said she was satisfied with the care plan, and that she was consulted about the content. She said she was involved in the drawing up of the care plan and was aware she could read the care plan when she wanted. Richmond House F56 F06 S5694 Richmond V217262 190505 Stage 4.doc Version 1.40 Page 11 The health care needs of the residents were being met with evidence of good multi-disciplinary working taking place on a regular basis. The residents and relatives spoken with all said they were satisfied with care provided. One relative said “the staff are brilliant, they provide good care and are very kind, they make me feel welcome whenever I visit and have provided good support for me”. All medication was noted to be securely stored in individual packs. All medication when given is recorded on the resident’s drug sheet. Staff who administer medication are trained and competent to do so. Richmond House F56 F06 S5694 Richmond V217262 190505 Stage 4.doc Version 1.40 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 &15 Social activities and meals were both well managed, providing daily variation and interest for people living in the Home. EVIDENCE: The Home employs an activities co-ordinator who plans a range of activities that were appropriate to the resident group. The Home currently offers care to seven younger adults who at this time their nursing needs outweigh their physical abilities. A range of appropriate activities is planned for younger adults, for example, listening to different music, snooker and trips out. From conversations, the Inspector believes that the service users currently living at Richmond House would not be able to secure employment and continue with their education or training. However they do benefit from the planned activities both indoors and outdoors. Several residents spoken with were looking forward to a visit from a local entertainer in the afternoon. All residents were asked if they wish to attend, of which most of them did. Relatives were also welcome to attend and commented on how they had enjoyed the afternoon. The activities co-ordinator confirmed that residents were encouraged to join in with group activities for example bingo, quizzes, board games, dominoes and arts and crafts, however they were free to peruse they own interest, one lady was observed sewing and another reading. Residents confirmed they enjoyed trips out to local venues and further a field for examples the illuminations at Blackpool. Richmond House F56 F06 S5694 Richmond V217262 190505 Stage 4.doc Version 1.40 Page 13 The dietary needs of residents were well catered for with a balanced and varied selection of foods available, menus were available for inspection. Breakfast is served on a flexible basis, lunch is the main meal of the day and a lighter afternoon tea is served, suppers are available if required. Hot and cold drinks were observed being served during the day and fresh fruit is readily available for residents to help themselves. Comments with regard to meals were generally good. Residents said they were offered a choice of meals, that the food was tasty and there was plenty of it. The cook caters for likes and dislikes and for special diets for example soft or diabetic foods. Meals are served in the main dining room; however, residents can dine in the privacy of their rooms if they wish. Richmond House F56 F06 S5694 Richmond V217262 190505 Stage 4.doc Version 1.40 Page 14 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 Systems were in place with regard to the investigation of complaints and adult protection issues, ensuring that residents were listened to and protected. EVIDENCE: A complaints procedure was in place, which was displayed around the Home on both levels. In addition the procedure was contained in the service user guide, which each resident has a copy of. The Home’s complaints book showed that there had been four minor complaints made to the manager of which were acting up on and substantiated, and the outcomes suitably recorded. There have been no complaints made to the CSCI since the last inspection. One relative spoken with said she was aware of the complaints procedure and who to complain to if it was needed. All staff have received some training in the protection of vulnerable adults and confirmed that they were aware of the correct procedures to be followed if they had any concerns of any abuse witnessed within the Home. Richmond House F56 F06 S5694 Richmond V217262 190505 Stage 4.doc Version 1.40 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 24 & 26 A recent programme of decoration and refurbishment had resulted in some improvements, providing residents with a safe, clean, pleasant and comfortable environment. EVIDENCE: From a tour of the building, it was seen that the premises were being well maintained to a good standard, both inside and out. There was evidence of redecoration and renewal of fittings and furnishings. Residents were pleased with the improvements to the Home, especially the bedrooms. The manager has implemented a programme where bedroom furniture is being replaced on a monthly basis. Residents said there bedrooms were comfortable and that they had everything they needed. It was evident that residents had been encouraged to personalise their bedrooms with small items of furniture, ornaments, mementoes and photographs. One residents spoken with said she preferred to spend time alone in her room and enjoyed watching her TV and perusing her own interests. The resident added that she does go to the dining room for her meals and joins in some of the activities. Richmond House F56 F06 S5694 Richmond V217262 190505 Stage 4.doc Version 1.40 Page 16 Systems were in place to control the spread of infection and staff were observed wearing appropriate aprons and gloves for different tasks. Staff spoken with were aware about the need for good hygiene and were knowledgeable about infection control procedures. The premises were observed to be clean and free from offensive odours throughout. Richmond House F56 F06 S5694 Richmond V217262 190505 Stage 4.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 & 30 Staff morale is good, with low levels of staff turnover. This ensures residents are provided with care by people they know and are familiar with. The recruitment and selection procedures are robust and staff are properly trained to deliver the care that residents need. EVIDENCE: The staff team have worked at the Home for some considerable time. This helps provide continuity and a high standard of care for the residents. The Home also employs a number of male carers which was seen be good for the residents especially for the younger male adults with whom they had built up a good rapport between each other. On inspection of some staff files evidence was available to demonstrate that all the necessary checks have been undertaken to ensure the protection of residents. Criminal Records Bureau checks (CRB) are obtained prior to commencing work and suitable references sought. The manager ensures that enough staff is on duty at all times to meet the assessed needs of the residents. Staff were observed carrying out daily tasks but had time to sit and talk with residents either in a group or on an individual basis. To ensure that staff are trained and competent to do their jobs, a comprehensive training programme is available. Staff spoken with said they felt the training provided was good and relevant to their jobs. They confirmed Richmond House F56 F06 S5694 Richmond V217262 190505 Stage 4.doc Version 1.40 Page 18 that they had the support of the manager who encouraged them and assists them with any training and formal qualifications, for example NVQs. Richmond House F56 F06 S5694 Richmond V217262 190505 Stage 4.doc Version 1.40 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 & 38 The manager provides strong leadership; guidance and support to staff to ensure residents receive a consistent high standard of care. Procedures and practices operating within the Home promote and safeguard the health, safety and welfare of the people living and working in the Home. EVIDENCE: The manager has worked at the Home for some considerable time and is very experienced and competent in her managerial role. The manager was observed to have a good understanding of the care needs of the residents and staff described her as open and approachable. It was evident that residents and relatives were comfortable in approaching her for advice and support. The manager is working to the NVQ level 4 and confirmed that this should be completed by June 2005. Richmond House F56 F06 S5694 Richmond V217262 190505 Stage 4.doc Version 1.40 Page 20 In the main, health and safety issues were good with regular maintenance checks of equipments being undertaken. All accidents and incidents were being correctly recorded and reported. From checking of staff training records, it was clear that staff have completed mandatory health and safety training, this includes a full induction programme, moving and handling, fire safety and first aid. Richmond House F56 F06 S5694 Richmond V217262 190505 Stage 4.doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 x x x x x x 3 Richmond House F56 F06 S5694 Richmond V217262 190505 Stage 4.doc Version 1.40 Page 22 No Are there any outstanding requirements from the last inspection? 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 Regulation NONE Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP31 Good Practice Recommendations The manager should complete the NVQ level 4 by 2005 Richmond House F56 F06 S5694 Richmond V217262 190505 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Turton Suite, Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG National Enquiry Line: 0845 015 0120 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 Richmond House F56 F06 S5694 Richmond V217262 190505 Stage 4.doc Version 1.40 Page 24 - 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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