Inspection on 16/08/05 for Cookham Riverside Nursing Home

This inspection was carried out on 16th August 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

Cookham Riverside Nursing Home 13/01/09

Cookham Riverside Nursing Home 23/02/07

Cookham Riverside Nursing Home 05/01/06

Cookham Riverside Nursing Home 09/12/04

Cookham Riverside Nursing Home 29/06/04

Cookham Riverside Nursing Home 16/03/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE COOKHAM RIVERSIDE NURSING HOME Cookham Riverside Berries Road Cookham Berks SL6 9SD Lead Inspector Susan Burton Unannounced 16 August 2005 at 09.05 am 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. COOKHAM RIVERSIDE NURSING HOME H52-H01 S10981 Cookham Riverside V232423 160805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Cookham Riverside Address Cookam Riverside Berries Road Cookham Berks SL6 9SD 01628 521249 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) Mr David Austen Edmonsdaon Miss Patricia Doreen Hadley Care home with nursing (OP)) 35 Category(ies) of Old age, not falling within any other category registration, with number (OP) of places COOKHAM RIVERSIDE NURSING HOME H52-H01 S10981 Cookham Riverside V232423 160805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 That numbers of persons for whom accommodation is provided any one time shall not eceed 35. 2 3 The category of persons accommodated shall be that of elderly people requiring nursing care. Persons under the age 0f 60 years will not be admitted except for convalescence or respite care for periods Date of last inspection 9 December 2004 Brief Description of the Service: Cookham Riverside is as its name suggests, is situated on the bank of the river, in the Thames-side village of Cookham. The home provides nursing care for up to 35 older people. It was purpose built in the 1970’s and lies towards the end of a private road just off Cookham High Street. Many rooms within the home overlook the River Thames, thus enabling residents to enjoy the pleasant river views.To the front of the property is a car park and to the rear, a patio area, with well maintained lawns and gardens stretching right down to the river. The gardens have level walkways for residents to enjoy and areas to sit, relax and delight in the constant interest and scenery that this unique riverside setting provides. Cookham has public transport, shops and amenities within walking distance of the home; the larger town of Maidenhead is approximately 3miles away. COOKHAM RIVERSIDE NURSING HOME H52-H01 S10981 Cookham Riverside V232423 160805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection on Tuesday 15th August 2005. The Registered Manager was on a day off and so the home’s deputy manager assisted this inspection. This inspection focused on the care plans of a random sample of residents in the home, the management of infection control and how the home enables autonomy and choice for its residents. The inspector spoke to eight individuals in the home, with more time spent with four particular residents asking them for their views generally about the quality of life in the home. This was generally a positive inspection, residents confirming their satisfaction with the care given to them and the quality of the service they receive. What the service does well: What has improved since the last inspection? The proprietor following a visit from an officer from the Health and Safety Executive and requirements made from previous inspections has agreed to ensure that water supplied to areas that resident’s use will be kept to 43° and below. The home has risk assessed those sinks in the home that are not used by residents. COOKHAM RIVERSIDE NURSING HOME H52-H01 S10981 Cookham Riverside V232423 160805 Stage 4.doc Version 1.30 Page 6 The homes maintenance man provided the inspector with a progress report of how the home is meeting the requirements made by Berkshire Fire and Rescue Service. 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. COOKHAM RIVERSIDE NURSING HOME H52-H01 S10981 Cookham Riverside V232423 160805 Stage 4.doc Version 1.30 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 COOKHAM RIVERSIDE NURSING HOME H52-H01 S10981 Cookham Riverside V232423 160805 Stage 4.doc Version 1.30 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) 3, 5 Residents who move into the home have their needs adequately assessed. Trial stays are offered to residents. EVIDENCE: A random sample of residents care plans and documents were reviewed and evidenced that satisfactory pre-assessment information had been recorded to ensure that the home was able to meet the prospective residents care needs. Examination of records and discussion with staff and residents evidenced that trial stays take place and that the time period allowed fully accommodated the residents needs to ensure the right decision is made whether to stay or not. COOKHAM RIVERSIDE NURSING HOME H52-H01 S10981 Cookham Riverside V232423 160805 Stage 4.doc Version 1.30 Page 9 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 in part,10 Documents and care plans set out each individuals care needs. Resident’s health care needs are fully met. EVIDENCE: A number of residents care plans and related documents were examined during this inspection. Each individual had on file their past medical history and current diagnosis which enabled an effective plan of care to be set out. Evidence of nutritional and skin assessments were on file along with appropriate risk assessments. Resident’s weights are monitored regularly. Care plans were also in place for resident’s emotional and psychological wellbeing. Care plans for one individual with infection control issues were not seen in place.The deputy manager advised the inspector that the home has been communicating with the local Public Health Nurses recently and that they were about to update those relevant care plans following this advice. The inspector shadowed the deputy manager for a short while during her medication round, the deputy manager was sensitive to the needs of the residents when administering their tablets. Medication administration charts were accurately filled in. COOKHAM RIVERSIDE NURSING HOME H52-H01 S10981 Cookham Riverside V232423 160805 Stage 4.doc Version 1.30 Page 10 Staff were observed and heard knocking on doors before entering and addressing residents appropriately. Residents confirmed that staff are respectful of their privacy and dignity. Residents make their own choices as to whether they integrate with others in the communal lounge or remain in their bedrooms. COOKHAM RIVERSIDE NURSING HOME H52-H01 S10981 Cookham Riverside V232423 160805 Stage 4.doc Version 1.30 Page 11 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) 12,14,15 The home has an activity programme, which is detailed in the residents newsletter. The home supports and enables the residents to make choices about their daily lives. The home has a comfortable pleasant dining room where appetising meals are provided which are appropriate to individual needs. EVIDENCE: A number of residents were asked about the activities provided in the home, as there was no provision seen on the day of inspection. A few residents advised the inspector that when the activity officer is absent or on leave very limited activity takes place, one commented that “there are times when feels a long day”. One residents did comment that they get bored on occasions. The home provides the residents with a regular newsletter, which sets out a calendar of events; the inspector was able to see from a previous newsletter what activity had been provided in previous months. Evidence from care plans and from discussion with the residents enabled the inspector to see that residents wishes and choices are acknowledged. Likes and dislikes are recorded. Residents were asked about whether the home allows them to rise and go to bed at times which suit them, all spoken to confirm that this takes place. Residents spoke of the care and kindness of the COOKHAM RIVERSIDE NURSING HOME H52-H01 S10981 Cookham Riverside V232423 160805 Stage 4.doc Version 1.30 Page 12 staff and their willingness to assist them and do what they can for them of which they were most appreciative. The home has a cosy and comfortable dining room. None of the residents the inspector spoke to in the morning knew what the meal choice of the day was. The menu was displayed on top of a cupboard at the far end of the dining room was printed in a very small font size. Those residents whose mobility is limited would not be able to see the menu from their tables. A large wipe board is situated in the dining room but did not appear to be used. Discussion took place with the deputy manager about how the home could improve this. Menus on each table in a large font size could be considered. All residents confirmed their satisfaction with the quality of the food that is provided in the home and advised the inspector that alternative choices are always available. The homes kitchen seen to be clean and tidy. COOKHAM RIVERSIDE NURSING HOME H52-H01 S10981 Cookham Riverside V232423 160805 Stage 4.doc Version 1.30 Page 13 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 No complaints have been entered on the homes complaints log since the last inspection. The resident’s rights are not adequately safeguarded by the homes blanket “Do Not Resuscitate” policy. EVIDENCE: The deputy manager provided the inspector with the homes complaints log no entries were seen recorded since the last inspection. The home has a large file of thank you cards and letters from friends and family commending them for their care and kindness to relatives. The inspector found that the home had a blanket “Do Not Resuscitate” policy in place. This policy should be reviewed to ensure it reflects recent legal and ethical recommendations on this complex issue and is within the Human Rights Act. Decisions made should be on an individual basis with an appropriate consultation with the resident with documentary evidence and include consultation with the residents GP and or Consultant; the capacity to consent should also be a consideration. Any decisions taken should be fully documented and made known to all staff. It was suggested that the home check with their solicitor and insurance company to ensure that any policy changes are within the homes legal and ethical boundaries and responsibilities. The inspector was concerned that some residents or their families may not be fully aware of this policy, although staff advised that it is discussed on COOKHAM RIVERSIDE NURSING HOME H52-H01 S10981 Cookham Riverside V232423 160805 Stage 4.doc Version 1.30 Page 14 admission. No documentary evidence was seen on those files examined during the inspection of this consultation or that consent had been given. COOKHAM RIVERSIDE NURSING HOME H52-H01 S10981 Cookham Riverside V232423 160805 Stage 4.doc Version 1.30 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, 20, 25 in part, 26 The home is working towards meeting the recommendations made by the Berkshire Fire and Rescue Service. Residents in the home have access to the homes delightful garden. The homes infection control policy needed to be made more available to staff, and that practices in the home are reflective of that policy. EVIDENCE: A requirement from the last inspection had been that the proprietor confirms in writing that all works recommended by the fire authority had been completed. The homes maintenance man provided the inspector with a progress report on what action was still outstanding, the remaining works are still within the fire authorities timescale. The inspector was advised that the home expects to have all the fire door seals in place by the middle of October. The home was seen to be clean and tidy and pleasantly decorated. The home has a beautiful garden with a delightful vista of the Thames River, some residents are able to watch the boats go by from their rooms upstairs or from COOKHAM RIVERSIDE NURSING HOME H52-H01 S10981 Cookham Riverside V232423 160805 Stage 4.doc Version 1.30 Page 16 the patio area of the garden. Comfortable seating and parasols are provided for the comfort of the residents. One resident was seen assisting the gardener with small tasks; she advised the inspector that she enjoyed the opportunity of maintaining her gardening skills. Discussion took place with the deputy manager in regard to the management of infection control within the home. Any care plans for the management of these infections need to identify and include the actions to be taken by staff both nursing and domestic to contain and manage the infection. The homes policy that was made available for the nursing staff was limited whereas the policy contained in the management file was much more detailed and appropriate, this should be made available to all staff. COOKHAM RIVERSIDE NURSING HOME H52-H01 S10981 Cookham Riverside V232423 160805 Stage 4.doc Version 1.30 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 An appropriate skill mix of staff meets the needs of the residents. EVIDENCE: A previous recommendation that the staff shift rota to was to show what capacity staff were working in had been addressed. Staffing numbers were not looked at during this inspection. Discussion took place with the deputy manager in regard to the domestic staffs role in management of cross infection. The homes policy on the management of hygiene and cross infection could include the housekeeping responsibilities of the domestic staff, which would be good practice. COOKHAM RIVERSIDE NURSING HOME H52-H01 S10981 Cookham Riverside V232423 160805 Stage 4.doc Version 1.30 Page 18 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) The Registered Manager of the home was not available for this inspection therefore none of these standards were inspected at this time. EVIDENCE: COOKHAM RIVERSIDE NURSING HOME H52-H01 S10981 Cookham Riverside V232423 160805 Stage 4.doc Version 1.30 Page 19 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 x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 2 COMPLAINTS AND PROTECTION 3 3 x x x x 3 2 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x x x x x x x COOKHAM RIVERSIDE NURSING HOME H52-H01 S10981 Cookham Riverside V232423 160805 Stage 4.doc Version 1.30 Page 20 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 18 Regulation 12 (2) Requirement The homes Do not resuscitate notice and policy is to be reviewed and be reflective of recent guidance. Residents are to be individualy consulted and if consent is given it is fully documented. Timescale for action 16/11/05 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. 2. Refer to Standard 15 26 Good Practice Recommendations Menus are to be available to all residents in a resident friendly format. Policy guidance on MRSA and other infections is to be available to all staff and is in line with current good practice procedures. COOKHAM RIVERSIDE NURSING HOME H52-H01 S10981 Cookham Riverside V232423 160805 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 1015 Arlington Business Park Theale RG7 4SA 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 COOKHAM RIVERSIDE NURSING HOME H52-H01 S10981 Cookham Riverside V232423 160805 Stage 4.doc Version 1.30 Page 22 - 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. 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