Inspection on 22/02/06 for Radiant Care Home

This inspection was carried out on 22nd February 2006.

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 20/07/05

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 Care Home Highbury Road Bulwell Nottingham NG6 9DD Lead Inspector Steve Keeling Unannounced Inspection 22nd February 2006 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Radiant Care Home DS0000045217.V279672.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Radiant Care Home DS0000045217.V279672.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Radiant Care Home Address Highbury Road Bulwell Nottingham NG6 9DD Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0115 975 3999 Mrs Lota Hopewell Mr Derrol Paul Hopewell Mrs Lota Hopewell Care Home 18 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (18) of places Radiant Care Home DS0000045217.V279672.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th July 2005 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 Care Home DS0000045217.V279672.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over a 5-hour period and involved one inspector. The main method of inspection was case note tracking, this is a method of selecting service users within the home and discussing with them their expectations and experiences of living within the home environment. The case tracking method also analyses the records of the service users to ascertain if the service users identified needs are being addressed appropriately within the care home setting and that their safety and well being is being maintained. On this occasion two service users notes were case tracked. Also as part of the case tracking process, a relative of service users was informally spoken with to further evidence the quality of care afforded to the service users. At the time of the inspection a total of 17 residents were accommodated at the home. It was evident that the manager and the care staff within the home are committed in the provision of a high standard of care for the service users. The acting manager and care staff within the unit was very helpful and cooperative thus ensuring that the inspection process progressed in a professional and efficient manner. What the service does well: What has improved since the last inspection? Radiant Care Home DS0000045217.V279672.R01.S.doc Version 5.1 Page 6 It was evidenced that the manager of the home now obtains a “summary of the assessment” which is now utilised when the Registered Manager undertakes pre-admission assessments for all prospective residents. Staffing levels at the home have been reviewed following a previous inspection and are now sufficient to meet the needs of the service users at the home. . 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. Radiant Care Home DS0000045217.V279672.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Radiant Care Home DS0000045217.V279672.R01.S.doc Version 5.1 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 the following standard(s): 3. 6. The case tracking procedure indicated that service users only move into the home after having been assured that their assessed needs can be met. The home does not operate an intermediate care service. EVIDENCE: The records of two service users who were most recently admitted to the home were examined on the day of the inspection. It was evidenced that the manager of the home now ensures that documentation from the Social Services department is obtained so as to confirm the reason for referral and outlines the care required, the documentation is utilised within the managers evaluation process. The assessment documentation utilised at the home is holistic in nature and addresses all aspects of care. It was established that the manager visits all prospective residents prior to agreeing admission to the home to perform the effective pre-admission assessment. Radiant Care Home DS0000045217.V279672.R01.S.doc Version 5.1 Page 9 Radiant Care Home DS0000045217.V279672.R01.S.doc Version 5.1 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 the following standard(s): 7. 8. 9. 10. The case tracking procedure established that some care plans examined did not fully address the health needs of the service users and as such it could not be established that health needs were being fully met at the home. No service users within the home are responsible for the administration of their own medication at the time of the inspection, although facilities for selfadministration of medicines are available. It was established that the manager of the home would perform a risk assessment to establish the safety of the service users in performing self administration of medication. EVIDENCE: During the inspection a random selection of care plans were examined it was established that some care plans lacked sufficient detail to guide staff in meeting service users assessed needs. The case tracking process revealed the care plan appertaining to the management of an indwelling catheter was insufficient in detail to ensure care staff are fully informed of appropriate actions to be taken if complications are experienced. Another care plan appertaining to the management of a service users with a history of alcohol abuse stated “ Do not let the service users near any alcoholic Radiant Care Home DS0000045217.V279672.R01.S.doc Version 5.1 Page 11 drinks” although if was evident that the service users would have access to alcohol as it was stored in the dining room on the windowsill. It is also a requirement that service users contribute to the care planning process, if they lack capacity the service users significant others should be consulted. The case tracking process evidenced that this requirement was not always adhered to at the home. The manager of the home confirmed that these elements within the care planning process requires further development and it was established that she would be providing further education to the care staff employed at the home in an attempt to address the aforementioned shortfalls thus establishing a clear, concise and informative care planning process. The Commission for Social Care Inspection will require an action plan that will clearly identify how the identified shortfalls within the evaluation and care planning process will be addressed by 31/03/06 At the time of the inspection no service users were responsible for the selfadministration of medicines. It was established that should a service user wish to be independent in the administration of medicines lockable facilities are available within the service users rooms to promote safety. Prior to commencement of self-medication the manager of the home would perform a risk assessment to ensure the service users are safe, if the service users were deemed as being safe, self-medication would be facilitated if at all possible. A relative of a service users spoken with at the time of the inspection, he stated that staff at the home maintains respect and dignity for the service users. The service user relative also stated that the staff always respected his relative’s privacy and dignity and that all the staff within the home are helpful and friendly. The visitor to the home also stated that staff spoke to all service users in a considerate and caring manner. It was established that staff always knocked on the bedroom doors of service users before entering thus promoting the principles of privacy and dignity. All service users were very presentable at the time of the inspection, a relative of a service user stated that the laundry facilities within the home are very good and that service users clothes were always returned promptly and in a clean well ironed condition. Radiant Care Home DS0000045217.V279672.R01.S.doc Version 5.1 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 the following standard(s): 12. 14. Service users have the opportunity and choice to participate in varied and stimulating social activities within the home and service users maintain contact with family, friends and representatives from the local community thus providing the service users with the ability to exercise choice and control over their lives. EVIDENCE: An activities coordinator is not employed at the home but it was evident that the service users are provided with appropriate activities throughout the day from a very dedicated team of staff within the home. Service users receive stimulating social activities such as knitting, bingo, guest entertainers, painting, colouring, film afternoons, reminiscence therapy, sing songs, movement to music (designed to aid movement and coordination). It was also established that a London based theatre company performs productions at the home three tines per year and the registered provider has a people carrier which is utilises should resident with to attend events beyond the homes immediate environment. Radiant Care Home DS0000045217.V279672.R01.S.doc Version 5.1 Page 13 Should the service users wish, staff at the home would accompany service users into Bulwell town centre to shop or browse. It was established that no restrictions are in place in relation to visiting times. A visitor to the home confirmed that the home operates an open door policy in relation to visiting times and reiterated that relatives and friends are also encouraged to take service users out for day trips as they wish. Radiant Care Home DS0000045217.V279672.R01.S.doc Version 5.1 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 the following standard(s): 16. 18. Service users feel confidant that any concerns or complaints will be listened to, taken seriously and acted upon by the manager in an attempt to protect the service users from potential abuse. EVIDENCE: Residents are protected by the policies and procedures at the home. The homes complaints procedure is on display at the entrance hall to the home. At the time of the inspection the service provider was not investigating any complaints and the Commission for Social care Inspection had not received any complaints appertaining to care provision at the home. A visitor to the home stated that he was confident that the manager and the care staff would always address any complaints in a sensitive and professional manner and that he would not hesitate to discuss any concerns in relation to the care afforded to his mother within the home environment. Service users within the home all stated that they felt safe and protected in the home. Staff spoken with are aware of the homes policies in relation to the protection of vulnerable adults and were aware of what actions would be required it they suspected abuse was happening within the home setting. The manager of the home utilises an effective quality assurance tool in the form of a questionnaire which relatives, service users and members of the multidisciplinary team are encouraged to fill out so that identified concerns can be effectively acted upon by the manager of the home. Radiant Care Home DS0000045217.V279672.R01.S.doc Version 5.1 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 the following standard(s): 21. 26. The water from hot water outlets exceeds 43 Degrees Centigrade which places service users at risk of scolding. The accommodation is maintained to a very good standard. At the time of inspection the home was clean and fresh. EVIDENCE: It was evident that the hot water temperatures from all hot water outlets within the home including the service users sinks far exceeded the recommended temperature of 43 Degrees Centigrade placing the service users at risk of scolding. The average temperature (which is recorded by night staff) was in the region of 65 degrees centigrade and the highest temperature was recorded at 67.2 (bedroom 16). The Commission for Social Care Inspection will require the manager to perform risk assessments to ensure service users are protected from the potential risk of scolding and will be required to fit thermostatic control devices to all hot water outlets by 31.08.06. so as to promote service users safety within the home. Radiant Care Home DS0000045217.V279672.R01.S.doc Version 5.1 Page 16 A partial tour of the premises was completed as part of this inspection. The accommodation was well decorated, comfortably furnished and maintained to a good standard. The gardens are attractive and accessible to service users. Service users spoken with said that they like their bedrooms and it was evident that service users had been encouraged to bring small items of furniture ornaments etc to personalise their individual rooms thus further promoting the homely environment. Radiant Care Home DS0000045217.V279672.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27. 29. 30. An appropriate number and skill mix of staff are employed at Radiant House Residential Home to meets the service users needs. Shortfalls were identified in relation to the recruitment process utilised at the home that could potentially place service users at risk. The manager of the home stated that the care staff receive appropriate training and are competent in meeting the needs of the service at the home. Although at the time of the inspection the “training matrix” was not available and as the Commission for Social Care Inspection will require the manager to forward documentary evidence to substantiate these claims. EVIDENCE: Staff rotas evidenced that a satisfactory number of staff were employed on the day of inspection and that the skill mix was appropriate to need the needs of the 17 service users at the home over a 24-hour period. Throughout the morning and afternoon period three carers were on duty and throughout the night period (2200-0700hrs) two cares are on duty. Two staff files were examined at the time of the inspection both of which contained appropriate documentation such as a Criminal Records Bureau checks (CRB) but no documentary evidence as to when Protection of Vulnerable Adult Checks (POVA) were performed prior to employment. Radiant Care Home DS0000045217.V279672.R01.S.doc Version 5.1 Page 18 It was also evident that two satisfactory references was not evident within one member of staffs documentation, as one reference simply stated that the prospective employee had been employed on a part time basis at the establishment which is not a satisfactory reference. The manager stated that the second reference was a verbal reference but no evidence was available to substantiate this claim. It was established that all new staff members received an appropriate induction process within the home and that all staff are currently studying to NVQ level 2 qualification. Evidence appertaining to the training opportunities afforded to care staff at the home was not available for examination and as such the Commission for Social Care Inspection will require evidence of the training opportunities provided to care staff at the home and evidence of the training opportunities planned for the forthcoming year (2006). Radiant Care Home DS0000045217.V279672.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35. Radiant house utilises appropriate methodologies to ensure that service users are protected from financial abuse. EVIDENCE: At the time of the inspection it was evidenced that the service users monies are effectively managed. The manager of the home could clearly demonstrate a financial audit trail for service users accommodated at the home, extra interventions, not included in the “care package” at the home, such as Podiatry services and hairdressing etc had receipts evident thus protecting the service users from financial abuse. The manager of the home pays for all additional costs at the home and relatives are invoiced appropriately. The system does not require the service user to have any personal monies at the home. Radiant Care Home DS0000045217.V279672.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X 2 X X X X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X x Radiant Care Home DS0000045217.V279672.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? No 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 7 Regulation 15 (1) Requirement The registered provider shall ensure after consultation with the service user, or a representative of his, prepare a written plan as to how the service users needs in respect of his health and welfare are to be met. The registered provider shall ensure that the assessment of the service user’s needs is kept under review and revised at any time when it is necessary to do so having regard to any change of circumstances The registered provider shall ensure that all hot water outlets have thermostatic control valves in situ. The registered provider shall ensure that new staff are confirmed in post only following completion of a satisfactory police check, and satisfactory check of the Protection of Children and Vulnerable Adults and have supplies two satisfactory references. The registered provider shall DS0000045217.V279672.R01.S.doc Timescale for action 31/03/06 2 8 14 (2) 31/03/06 3 21 13 (4) 31/08/06 4 29 19 31/03/06 5 30 18 (1) 31/03/06 Page 22 Radiant Care Home Version 5.1 ensure that person employed by the registered provider to work at the care home receive appropriate training to the work they are to perform. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Radiant Care Home DS0000045217.V279672.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Nottingham Area Office 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 Care Home DS0000045217.V279672.R01.S.doc Version 5.1 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. 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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