Inspection on 20/07/05 for Radiant Care Home

This inspection was carried out on 20th July 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

Radiant Care Home 27/03/09

Radiant Care Home 29/11/07

Radiant Care Home 09/08/06

Radiant Care Home 22/02/06

Radiant Care Home 30/06/04

Radiant Care Home 27/04/04

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

CARE HOMES FOR OLDER PEOPLE Radiant Home 53 Highbury Road Bulwell Nottingham NG6 9DD Lead Inspector Sharon Rosenfeld Unannounced 20 July 2005 09:30 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. Radiant Home C53 C03 S45217 Radient V239895 200705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Radiant Home Address 53 Highbury Road Bulwell Nottingham NG6 9DD 0115 975 3999 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 & Mrs D. P and L Hopewell Mrs Lota Hopewell Care home 18 Category(ies) of DE(E) Dementia - 65 and over, x 10 registration, with number OP Old age - 65 and over, x 18 of places Radiant Home C53 C03 S45217 Radient V239895 200705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30 June 2004 Brief Description of the Service: Radiant Home cares for up to eighteen older people, a maximum of ten beds are registered to accommodate people with dementia. The home is in a residential area close to local amenities and Bulwell town centre. The home is on two floors and there is a passenger lift. There are fourteen single bedrooms, one of which has an en-suite facility, and two double bedrooms. There are three day rooms. Radiant Home C53 C03 S45217 Radient V239895 200705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This statutory unannounced inspection took place over approximately four hours. The main method of inspection used was called case tracking which involved selecting two residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. Parts of the building were inspected and two care staff, one catering staff and the manager were spoken with. What the service does well: What has improved since the last inspection? What they could do better: Although the Registered Manager undertakes pre-admission assessments for all prospective residents, when the care is being purchased under Care Management arrangements a summary of the assessment is also required. The care plans need to be organised so that There should be a care plan developed that corresponds with each assessed need. Radiant Home C53 C03 S45217 Radient V239895 200705 Stage 4.doc Version 1.40 Page 6 The assessed needs of the residents must influence the number of staff provided. 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. Radiant Home C53 C03 S45217 Radient V239895 200705 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 Radiant Home C53 C03 S45217 Radient V239895 200705 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) 3 Not all residents move into the home having been assured that their needs can be met. EVIDENCE: The records of the person most recently admitted to the home were examined. The Social Worker had not shared a copy of the Care Management Assessment of need, which confirms the reason for referral and outlines the care required. The files do not contain a letter from the provider to the service user confirming that their needs can be met. Having said this, the manager visits all prospective residents prior to agreeing admission to the home. The assessment is holistic and covers the required areas and this is good practice. The home had a full documented medical history for the most recent admission . Radiant Home C53 C03 S45217 Radient V239895 200705 Stage 4.doc Version 1.40 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, 10, 11. There are some positive examples of care planning covering a broad range of assessed needs there are also some shortfalls that may impact on the health of residents if they are not addressed. Some records are not organised in a way that makes accessing the information required straightforward. The staff preserve the privacy and dignity of residents at the home. EVIDENCE: The individual care plan for someone recently discharged from hospital had been updated immediately to reflect her changing need and this is good practice. A booklet style of assessment, care planning and review is used, however some reviews are written on separate paper and are not collated so that they are easily accessible. The care plan of a person admitted on 10/06/05 had been started but not completed. The person was assessed to be at medium risk of falling and a corresponding care plan was in place. She was also assessed to be at some risk of developing pressure sores however the care plan had not been written about how this risk would be managed. Radiant Home C53 C03 S45217 Radient V239895 200705 Stage 4.doc Version 1.40 Page 10 The care plan of one person who was also assessed to be at risk of developing pressures sores states she should sit on a pressure-relieving cushion. When checked she did not have a cushion on her chair. Another person with swelling to the leg needs to have her leg elevated however this had not been encouraged. There are now five people with higher dependency needs who are cared for in bed and who require attention at night. Their needs assessments must be written to reflect how their needs are to be met and to enable the Registered Manager to justify current staffing arrangements at night. The majority of care plans contain comprehensive assessments that include appropriate action to take to manage the needs that have been identified. Some of the care planning highlights positive aspects of the person’s life and identifies things that will improve the persons’ quality of life. Again, this is good practice. The records indicate that there is involvement from community based health care professionals when necessary such as Continence Advisors and District Nurses. The staff were observed both directly and indirectly to be speaking with the residents in a respectful manner, offering choice and managing care situations in a way that preserves dignity. One person was receiving palliative care. The relatives are relieved that staff that they trust and respect are caring for this person, and they know they can visit as often, and for as long as they wish. Radiant Home C53 C03 S45217 Radient V239895 200705 Stage 4.doc Version 1.40 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) 13, 15 Contact with family and friends’ is supported. Meals are nutritious and balanced and offer a varied diet for residents. EVIDENCE: The staff continuously engaged with residents throughout the course of their duties. Three residents spoken with confirmed they liked living at the home. One person said how much she enjoys the garden and talked about the birds she sees from the window. Another person said she enjoys spending her time watching television and chatting with the other residents and staff. The accommodation is comfortable and homely and the atmosphere pleasant and relaxed. Two relatives, one of whom visited the home as a health care professional prior to his mother moving in, stated they are welcomed to visit at any time. They are able to be as involved as they wish in life at the home and they are confident in the skills of the staff and in the services provided. They said ‘the staff provide a loving and caring service’. The cook was spoken with. Traditional English meals are provided. Fresh fruit and vegetables was available and the meals are cooked fresh daily. Three residents confirmed they enjoyed their meals and that they had plenty to eat. Radiant Home C53 C03 S45217 Radient V239895 200705 Stage 4.doc Version 1.40 Page 12 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) These standards were not assessed on this inspection. EVIDENCE: Radiant Home C53 C03 S45217 Radient V239895 200705 Stage 4.doc Version 1.40 Page 13 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 The environment is homely, comfortable and safe. EVIDENCE: The home is set within a residential area. The external grounds are accessible to wheelchair users via ramps. There is gated access to the main entrance. The standard of the accommodation is very good. The lounges and dining areas are well decorated and have comfortable furniture. Three residents said they liked the accommodation provided. One private room in particular was highly personalised. One of the shared rooms seen did not have a privacy screen. The Registered Manager confirmed her plan to re-furbish the kitchen and this is supported by the CSCI. Radiant Home C53 C03 S45217 Radient V239895 200705 Stage 4.doc Version 1.40 Page 14 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. It was not evidenced that the staffing levels were sufficient to meet the needs of residents. EVIDENCE: There were two care staff on duty on the inspection day. There is one waking and one sleep-in staff on call at night. The Registered Manager confirmed that five people are now bed fast. A review of the care staffing arrangements for day and night is required because of the number of higher dependency residents accommodated. Relatives said that the home is aware they can obtain the support of specialist palliative care nurses to support their mother at night. The Registered Manager has stated the home can currently manage her care needs however it is recommended that this decision kept under review. Radiant Home C53 C03 S45217 Radient V239895 200705 Stage 4.doc Version 1.40 Page 15 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) 38. The homes practices promote and safeguard the health, safety and welfare of the residents. EVIDENCE: The home had recently been assessed by the Environmental Health Department. Requirements made at that visit have been implemented. The Registered Manager stated that a continuous programme of improvements is planned that will include the refurbishment of the kitchen. Radiant Home C53 C03 S45217 Radient V239895 200705 Stage 4.doc Version 1.40 Page 16 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 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 2 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 x x x x x x x x x x 3 Radiant Home C53 C03 S45217 Radient V239895 200705 Stage 4.doc Version 1.40 Page 17 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 3 Regulation 14 Requirement Timescale for action 15/08/05 2. 3. 7 8 4. 27 5. 3 A summary of the Care Management assessment and a copy of the Care Plan must be obtained prior to a resident moving into the home. 12, 13, 15 A corresponding care plan must be written for every identified need. 12, 13, 15 The staff must meet the needs of the residents according to the instructions in the care plan. This includes the provision of pressure relieving equipment and encouargein the elevation of legs to relieve swelling. 18 An assessment of residents needs must be undertaken that will justify continuation of current staffing levels during the day and night. A copy must be provided to the CSCI. 14 A letter confrming that the home can meet assessed needs must be sent to all prospective residents. 31/08/05 15/08/05 31/08/05 15/08/05 Radiant Home C53 C03 S45217 Radient V239895 200705 Stage 4.doc Version 1.40 Page 18 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 7, 8, 11. Good Practice Recommendations Keep the decision not to include support from specialist palliative nurses as the resident becomes increasing infirm under review. Radiant Home C53 C03 S45217 Radient V239895 200705 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Radiant Home C53 C03 S45217 Radient V239895 200705 Stage 4.doc Version 1.40 Page 20 - 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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