CARE HOMES FOR OLDER PEOPLE
Raleigh Court Cambridge Street Kingston upon Hull East Yorkshire HU3 2EP Lead Inspector
George Skinn Unannounced 28 July 2005 9:30 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. Raleigh Court J54_s869_Raleigh Court_v228762_280705_Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Raleigh Court Address Cambridge Street Kingston upon Hull East Yorkshire HU3 2EP 01482 224964 01482 219833 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) Humberside Independent Care Association Patricia Ann Robertson Care Home 56 Category(ies) of OP Old Age (56) registration, with number DE Dementia (56) of places Raleigh Court J54_s869_Raleigh Court_v228762_280705_Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: To accommodate two service users under 65 years of age. Date of last inspection 18/01/05 Brief Description of the Service: Raleigh Court provides personal care and accommodation for a maximum of 56 older people some of who may have memory impairment. It is owned by Humberside Independent Care Association Ltd (HICA) which is a not for profit organisation. The home is located on Cambridge Street off Anlaby Road, which is central to Hull city centre. The homes location provides service users with easy access to a variety of shops, pubs, public transport etc. The home was rebuilt in 1998 and is a two-storey building with access to the upper floor via a passenger lift. All of the homes bedrooms are single with 42 having en-suite. A number of these single rooms do have a lockable interconnecting door which means couples are able to share a bedroom whilst using the other as a lounge area. The home has an internal style street area, which includes the hairdressers shop, confectionary/coffee shop and memorabilia shop window. The managers office is now located within this area. Central to the home are courtyard areas with patio tables and chairs; all service users are able to access these areas safely. Raleigh Court J54_s869_Raleigh Court_v228762_280705_Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken over 6 hours. The building was looked at and some records were inspected. The majority of the residents and five of the staff group were spoken with. This included the manager. This is the first visit to the home since the last inspection in January. All those minimum standards inspected were met. What the service does well:
The home was found to be clean warm and welcoming. There were no malodours and the staff were working hard to meet the needs of the residents. The residents spoke positively about the home and their lives there commenting on how well the staff care for them. Relatives spoken with during the inspection were positive about the home and commented on the caring nature of the staff. The residents benefit from the homes record keeping as these are very well maintained and detailed instructing the staff in how to best care for them. These records contain a lot of detailed information which is relevant to the physical needs of the residents, likes, dislikes and other preferences are recorded which again help the staff to give a good personal service. The records are compiled with the involvement of the residents and their relatives if this is appropriate; record’s confirmed this, as did residents and relatives. Residents benefit from the staff being well trained and they were more than satisfied with the quality of care provided. Residents’ comments included “the staff are always happy to help you”, “they are all very kind and caring”. The home provide basic induction training which is given to all new staff when they start working. This provides the staff with the skills to care for the residents properly. The home also provides more specialised training in dementia and other areas relating to the needs of elderly people to make sure they can meet the more personal needs of individual residents. Residents live in a safe environment as staff are trained in all aspects of health and safety.
Raleigh Court J54_s869_Raleigh Court_v228762_280705_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. Raleigh Court J54_s869_Raleigh Court_v228762_280705_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 Raleigh Court J54_s869_Raleigh Court_v228762_280705_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 All residents have their needs assessed prior to moving into the home, this ensures their needs can be met. EVIDENCE: Evidence provided indicated that residents are admitted to the home after having undergone an assessment by either the Local Authority or senior staff from the home. The format of the homes needs assessment covers all required areas, copies of completed assessments were available on files, dated and signed. Copies of the Local Authority assessment and care plan are obtained prior to admission for those residents referred through care management. In addition to the pre admission assessment the home undertakes a further assessment once the residenthas arrived. It is on the basis of both these assessments that the residentcare plans are formalised. Raleigh Court J54_s869_Raleigh Court_v228762_280705_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 Residents’ care records ensure personal care and health needs are well met by the staff group. EVIDENCE: Each resident has a plan of care which has been devised from the assessments. The resident or next of kin is involved in the formulation of these and subsequent reviews. Residents had signed their care plans as an indication of their involvement. A from is used which asks the resident where appropriate, or their relative to acknowledge that they are aware and agree with the contents of the care plan. Care plans set out in detail the action to be taken by staff; these are linked to individual risk assessments. Each care plan is reviewed on a daily, weekly and monthly basis. Risk assessments relating to falling, moving and handling are available. Residents health care needs are met and staff ensure they have access to health care services to meet their assessed needs. Equipment is available for the prevention of pressure sores. The home has obtained the Heartbeat award for the provision of healthy meals. The organisation is currently developing a nutritional screening proRaleigh Court J54_s869_Raleigh Court_v228762_280705_Stage 4.doc Version 1.40 Page 10 forma. The Service User guide includes details of all local G.P services. The home makes sure that the residents are seen by any specialist-nursing services; dental, chiropody and ophthalmology. Residents psychological needs are identified through the formal care plan process. Raleigh Court J54_s869_Raleigh Court_v228762_280705_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 The resident are able to have visitors at any reasonable time. Residents are provided with a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. EVIDENCE: Residents are able to receive visitors at all reasonable times. The statement of purpose states that residents are able to choose whom they see and don’t see. No restrictions are placed on visiting and discussion and direct observation confirmed that relatives were made to feel welcome by staff Residents confirmed that their families are offered the opportunity to join in meals and social interactions. The home provides residents with a varied, appealing, wholesome and nutritious diet and as a result has obtained the Heartbeat Award. The quality of the meal was very good and the way in which it had been cooked had taken into account residents’ needs. The staff that are responsible for serving the meals know residents’ likes and dislikes. Residents spoke positively about the quality of the meals. Assistance is offered to residents with individual needs, however, this was not observed during this inspection. Residents are offered a choice at each mealtime; the menu indicates that cooked alternatives are available at both lunchtime and teatime. Tables are set appropriately with
Raleigh Court J54_s869_Raleigh Court_v228762_280705_Stage 4.doc Version 1.40 Page 12 clean tablecloths, serviettes, condiments etc. The Chef is a familiar sight around the dining rooms; residents all spoke affectionately about him and had obviously developed positive relationships. The Chef having cooked the meals visits the dining areas to ensure the presentation is maintained and seek residents’ views about the quality of the meal. Once the evening meal has been served the fridges in the servery areas are filled with sandwiches, cakes etc for supper and through the night. If a resident requests something other than what is in the fridge then staff are able to access the main kitchen. Raleigh Court J54_s869_Raleigh Court_v228762_280705_Stage 4.doc Version 1.40 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 Both relatives and residents knew whom to complain to and had confidence that their complaints would be taken seriously. The residents are protected from abuse. EVIDENCE: A complaints procedure is available which encourages residents and relatives to express their dissatisfaction without fear of repercussion. This procedure includes contact details for the CSCI. Complaints are seen as an opportunity to improve the service as a whole or more specifically for an individual. Residents all said they felt the management style of the home encouraged them to speak out and they were satisfied that they were listened to and issues acted on. Everybody spoken with felt confident that if they had a complaint it would be well received and they would not hesitate to bring such matters to the staff’s attention. In addition to the formal complaints system residents are encouraged to express their grumbles; a record of these is maintained and the manager undertakes a regular audit of these to see if any trends emerge. Raleigh Court J54_s869_Raleigh Court_v228762_280705_Stage 4.doc Version 1.40 Page 14 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) 26 Residents live in a home which is kept clean, hygienic and free from offensive odours. Systems are in place for the control of infection. EVIDENCE: The home was found, on the day of inspection, to be clean, hygienic and free from offensive odours. Systems are in place to control the spread of infections. Laundry facilities are located in an area which ensures that soiled linen is not carried through areas where food is stored, prepared, cooked or eaten and does not intrude on residents. Laundry facilities equipment is industrial and complies with the water supply regulations. Policies and procedures are in place for the control of infection and health and safety. The home has a sluicing facility. Raleigh Court J54_s869_Raleigh Court_v228762_280705_Stage 4.doc Version 1.40 Page 15 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) 29 & 30 The residents are well cared for by a well-trained staff group who have undergone a robust selection and recruitment process. EVIDENCE: The organisation has a detailed recruitment procedure. As part of this inspection random staff files were seen. From these files it was evident that two references were sought. CRB checks are undertaken along with a health assessment. A copy of the General Social Care Code of Conduct is made available to staff. The manager confirmed that all staff are provided with written terms and conditions within 8 weeks of employment and copies of these are retained at headquarters. The organisations policy and procedures regarding the recruitment of volunteers outlines a thorough process, which includes the obtaining of references and a CRB check, however, the home does not currently have any volunteers. Those staff files seen had a photograph attached and the files now include a copy of passport and birth certificate. The company has a detailed induction program which incorporates all mandatory training. From staff files seen it is evident that induction is a formal process which is allocated the appropriate amount of time and attention. The company operates a thorough training program which equips staff for their role and ensures they are able to meet the changing needs of residents. In addition the manager carries out an audit of residents needs compared against the skills of the staff, the purpose of this is to establish if there is any shortfall in training needs. The company training meets the
Raleigh Court J54_s869_Raleigh Court_v228762_280705_Stage 4.doc Version 1.40 Page 16 TOPPS specifications. Staff training is based on individual supervision; this exceeded the three days required per year. Raleigh Court J54_s869_Raleigh Court_v228762_280705_Stage 4.doc Version 1.40 Page 17 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 Residents live in a home which is well managed and has effective administrative procedures to ensure that their health, safety and welfare is protected. EVIDENCE: The home has a detailed Health and Safety policy. Safe working practices are maintained by the provision of training to staff in the form of moving and handling, basic food hygiene, first aid at work, basic first aid, infection control and fire safety. Systems are in place to ensure that all the homes equipment and building maintenance is up to date. Hazard notifications are circulated to the home manager, action taken and then retained for staff to see. Hot water is regulated to control the risks of Legionella along with the risk of scalding. Raleigh Court J54_s869_Raleigh Court_v228762_280705_Stage 4.doc Version 1.40 Page 18 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 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 4
COMPLAINTS AND PROTECTION x x x x x x x 4 STAFFING Standard No Score 27 x 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 4 x x x x x x x x x 3 Raleigh Court J54_s869_Raleigh Court_v228762_280705_Stage 4.doc Version 1.40 Page 19 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 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 Good Practice Recommendations Raleigh Court J54_s869_Raleigh Court_v228762_280705_Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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