Inspection on 26/04/07 for Ravensfield

This inspection was carried out on 26th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Ravensfield 22/03/06

Ravensfield 27/07/05

Ravensfield 14/02/05

Ravensfield 30/06/04

Ravensfield 16/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Ravensfield High Hill Keswick Cumbria CA12 5NX Lead Inspector Diane Jinks Unannounced Inspection 26th April 2007 10:00 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 Ravensfield DS0000035388.V329475.R01.S.doc Version 5.2 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. Ravensfield DS0000035388.V329475.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ravensfield Address High Hill Keswick Cumbria CA12 5NX 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) 017687 72490 01768 80978 www.cumbriacare.org.uk Cumbria Care Mrs Linda May Coles Care Home 30 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (10), Old age, not falling within any other of places category (30) Ravensfield DS0000035388.V329475.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is registered for a maximum of 30 service users to include: up to 30 service users in the category of OP (old age not falling within any other category) up to 10 service users in the category of DE(E) (Dementia over 65 years of age) The staffing levels for the home must meet the Residential Forum Care Staffing Formula for Older Adults. When single rooms of less than 12 sqm usable floor space become available they must not be used to accommodate wheelchair users, and where existing wheelchair users are in bedrooms of less than 12 sqm they must be given the opportunity to move to a larger room when one becomes available. 22nd March 2006 3. 4. Date of last inspection Brief Description of the Service: Ravensfield is operated by Cumbria Care, which is an internal business unit of Cumbria County Council. The home provides accommodation and care for up to 30 older adults, 10 whom may have dementia. The home is situated close to the centre of Keswick and the local services and facilities of the town. The home provides accommodation on two floors, and is divided into two units. The main part of the home is for people who are physically frail, and there is a small unit for people with dementia. There is a passenger lift, hand rails and grab rails to assist people in moving around the home. There are three bathrooms in the home, which are equipped to assist people with a disability. All of the bedrooms are for single occupancy, and three have en-suite toilet facilities. There are pleasant garden areas with seating, and a car park. The weekly fees for this home do not exceed £422.00, although there are extra charges for hairdressing, magazines, chiropodists and other personal items that residents may wish to have. Ravensfield DS0000035388.V329475.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The assessment of this service included an unannounced visit to the home, discussions with the manager and meeting and talking to some of the people who live and work at Ravensfield. Comments about this home and the service it provides were received from people who live at the home, their friends and their relatives. During this visit all the key standards of the National Minimum Standards were assessed. The registered manager had completed a preinspection questionnaire prior to this visit. This assisted in verifying information throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: The home carries out nutritional assessments for people living at Ravensfield. These would benefit from a review to ensure that all aspects that may affect a person’s nutritional intake are clearly recorded. This will help ensure that some significant areas are not overlooked. The home should also consider looking at the daily menus to ensure that all the options and choices are clearly shown. This mainly relates to sandwich fillings and types of soups that will be served. Ravensfield DS0000035388.V329475.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Ravensfield DS0000035388.V329475.R01.S.doc Version 5.2 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 Ravensfield DS0000035388.V329475.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 and 3. Standard 6 does not apply to this home. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People wishing to move into the home have their care needs assessed. This helps to ensure that the home will be suitable and able to meet their needs and expectations EVIDENCE: People participating in this inspection visit indicated that they had received sufficient information about the home. This helped them make a decision about moving into Ravensfield. The manager has recently updated the Service User Guide, which provides information about the type of services that the home can offer. People living at the home have their health and social care needs assessed prior to admission. The assessment records identify where people need assistance and recognises their individual independence. Where residents have complex care needs, assessments are kept under regular review with input from the local social service department where appropriate. Ravensfield DS0000035388.V329475.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at this home have an individual plan of care. This helps to ensure that their health, personal and social care needs are met and reviewed appropriately. EVIDENCE: Samples of care files were looked at during the visit to this home. Some of the people living at the home were spoken to about their views on the services offered by the home. Each person has a detailed plan of their care needs, which is based on their assessment. Care plans are reviewed at least monthly and are agreed with the person concerned or their relative as appropriate. Care plans include some detail of nutritional screening, risk assessment, medication requirements and assistance with moving and handling. The level of risk assessment is dependent upon the individual persons needs, requirements and abilities. These documents are also reviewed at least monthly and provide clear directions and information for staff involved with the care of the resident. The care records show that consideration is given to the person’s individual needs and independence. Ravensfield DS0000035388.V329475.R01.S.doc Version 5.2 Page 10 The nutritional screening process ensures that people living at the home have their weight and nutritional intake monitored. Where concerns are identified, food and fluid intake is monitored. These records would benefit from a review to ensure that they are maintained as up to date as possible and actions, interventions and involvement of others, such as the doctor, district nurse or dietician are clearly documented within the care planning process. Care notes indicate that people living at the home have access to healthcare professionals such as their doctor, community nurses, chiropodists, dentists and opticians. They are also supported to attend hospital and clinic appointments. The home has policies and procedures in relation to the administration of medication. There are designated staff who have the responsibility for administering medication. These staff have undertaken training in order to carry out this task safely. A sample of medication records were looked at during this visit. They were found to be up to date and accurate. Medication is stored securely and in a neatly organised fashion. There are facilities at the home to help ensure that controlled drugs are also stored and recorded safely. There are facilities for medications requiring cold storage. The home has recently changed the pharmacy responsible for dispensing their medication requirements. The manager described the help and support that the home receives from the pharmacy. This helps to make sure that staff are fully aware of the new procedures that have been put in place. Ravensfield DS0000035388.V329475.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living at this home are helped to exercise choice and control over their lives. This means that they are recognised as individuals and treated with respect. EVIDENCE: People living at the home are provided with a large selection of leisure and social activities. A list of events for the coming month is displayed in prominent areas throughout the home. Not all activities meet the expectations of every person living at the home but there is a wide range available and they may choose whether to take part or not. Activities include games, quizzes, and visits to the home by entertainers, music and exercise classes, residents meetings and visits to theatres, restaurants and local places of interest. Activities were described as ‘ good and constructive’. On the day of this visit some people participated in a game of bingo and were very pleased with the prizes they could choose if they won. Several people who live at the home said that ‘there is always something of interest going on here’. There is a garden at the home and people are able to access this in good weather. Some of the people living at the home like gardening and there is some scope for this hobby to be maintained. A new greenhouse was due to be erected after the old one was destroyed by the storms. The home ensures that regular contact with the local community is maintained. Community groups, volunteers and friends frequently hold coffee mornings and other events at the home. Ravensfield DS0000035388.V329475.R01.S.doc Version 5.2 Page 12 Visitors to the home are made welcome. People living at the home may see their visitors in the privacy of their own rooms or in one of the communal areas. One of the people spoken to during this visit said ‘ I am so happy here and my family are happy too. Friends pop in to me and do some shopping for me. I can ring my friends and see visitors when I want. My grandchildren are also able to visit.’ The serving of the lunchtime meal was observed during this visit. The meals were of good portion sizes and people are able to choose their meals. The lunch included fresh vegetables and fruit was available. People living at the home said that the food was very good and that there was always plenty of choice and variety. One person said ‘There are two smashing cooks. Meals are very good and there is always a choice or alternative. Top class’ and another said that ‘the meals are very good. I usually like the food and the kitchen will always listen to alternatives’. Where people need special diets or special adaptations to help them take their meals and drinks, these are provided. People needing assistance with feeding are helped in a sensitive manner and staff sit down with the person on an individual basis. The menus at the home would benefit from a review to ensure that people are fully aware of the choices available. For example where sandwiches, jacket potatoes or omelettes are offered, this should include the type of fillings available. Ravensfield DS0000035388.V329475.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at this home are confident that they can air their views and concerns and they will be listened to and acted upon. EVIDENCE: There is a complaint procedure in place at the home. People living at the home are made aware of the process on admission to the home and these details are also included in the Statement of Purpose and Service User Guide. Residents meetings take place frequently. People living at the home are encouraged to attend the meetings and some of the residents spoken to during this visit indicate that they do attend and find them very useful. People living at the home are aware of whom to speak to if they do have any concerns or complaints. The manager and staff are said to be very approachable and friendly. People spoken to during this visit said that they would have no hesitation in speaking to the manager and are confident that their concerns would be dealt with quickly and efficiently. The home has copies of the local authority guidance and procedures in respect of the mis-treatment of adults. Staff attend training to help them understand their role in recognising and preventing the mis-treatment of adults in their care. The home also has policies and procedures with regard to the use of restraint. Where restraints such as bed rails are in place, this is recorded in a risk assessment. Staff at the home are made aware of the importance of the correct installation and use of this type of equipment. Some specialist training is provided to help staff understand the needs of people who may have illnesses that cause them to demonstrate challenging Ravensfield DS0000035388.V329475.R01.S.doc Version 5.2 Page 14 behaviour at times. This helps to ensure that they are supported in a safe environment. Ravensfield DS0000035388.V329475.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 20 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in this home live in a clean, comfortable and well-maintained environment. EVIDENCE: The location and layout of the home is suitable for its purpose. The location of the home provides the people living there with extensive views of the surrounding mountains and countryside. It is well maintained, furnished and decorated to a high standard. The external grounds are kept tidy, safe and attractive. People living at the home have access to the garden area and some of them are able to participate in gardening. There are a sufficient number of toilets, bathrooms/shower rooms at the home and a new shower has been fitted recently. All areas of the home are equipped to assist people in maintaining their independence and mobility. The bedrooms at the home are small. They are tastefully decorated and people living at the home are able to personalise their rooms with some of their own furniture and possessions. All of the people spoken to during this visit were satisfied with the home and their own accommodation. Ravensfield DS0000035388.V329475.R01.S.doc Version 5.2 Page 16 The laundry at the home is a very compact area but is well organised and very clean and tidy. Cleaning products are stored safely and protective clothing is provided for staff. Special laundry bags are available to help reduce the risk of cross infection. Ravensfield DS0000035388.V329475.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager ensures that people living in this home are safe and supported by experienced and trained staff. EVIDENCE: There is a robust recruitment procedure in place at the home. The recruitment of staff includes obtaining written references from previous employers and carrying out criminal record bureau checks (CRB) and the Protection of Vulnerable Adults list (POVA) checks. This helps to make sure that people living at the home are cared for by suitable staff and protected from harm. The home has regular visits and support from local community organisations and volunteers from the Friends of Ravensfield also visit the home and organise frequent activities. Volunteers must also undergo CRB/POVA checks prior to helping people or working at the home. Again this helps to ensure that people living at the home are protected as far as possible from harm. The majority of staff working at the home have been employed there for many years. This helps to ensure continuity of care for people living at the home. On the day of this visit, there appeared to be sufficient staff on duty to meet the needs of the people living at the home. Comments were received from people living in the home about the staff. They said that they ‘always get very good support. Staff always listen and are usually available when needed.’ ‘Call bells are usually answered promptly.’ ‘Sometimes at night staff seem to be in a hurry’. ‘Staff are sometimes busy with other residents but come as quickly as possible.’ ‘Staff are kind, friendly and helpful.’ These comments indicate that Ravensfield DS0000035388.V329475.R01.S.doc Version 5.2 Page 18 the needs and wishes of people living in the home are generally responded to in a timely fashion. Staff training records show that staff are provided with suitable training to help them understand and meet the needs of people living at Ravensfield. Training includes: Medication, fire procedures, food hygiene awareness, manual handling, mistreatment of adults, induction and foundation training, National Vocational Qualifications in Care (NVQ), dementia awareness and infection control. Supervisors at the home have undertaken special training to help them with the development of care plans for people living at the home. Further training and refresher training is also available and staff are encouraged and supported to take part in this. Ravensfield DS0000035388.V329475.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 36 and 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the people living there. EVIDENCE: The manager at the home is experienced in the needs and care of older adults. She has undertaken training to help keep her knowledge and skills up to date. This helps her to be an effective and efficient manager. There is a quality monitoring system in place at the home and information about this is included in the Service User Guide. Regular resident meetings are held and these help to ensure that people living at the home are able to voice their opinions, which are listened to and acted upon. Where possible, people living at the home manage their own finances. This may sometimes be with the assistance of a friend or family member. There are facilities at the home for safekeeping of personal allowances. This includes the keeping of records and receipts of transactions. Ravensfield DS0000035388.V329475.R01.S.doc Version 5.2 Page 20 Staff at the home are appropriately supervised in their work. The supervisors and manager have undertaken training in ‘People Management’. Detailed records of supervision are kept. The records indicate that staff performance and training needs are discussed and reviewed during supervision meetings. Supervision of staff helps to ensure that staff abide by the policies and procedures of the organisation, which in turn promotes the safety and wellbeing of people living in the home. Samples of the fire records were looked at during this visit. They indicate that staff are provided with training in fire prevention and evacuation procedures and that fire detection systems and equipment are regularly tested and maintained. Records of accidents are kept for staff, people living in the home and visitors to the home where appropriate. Records kept at the home indicate that the health, safety and welfare of people living at the home and staff working in the home are protected. Staff receive relevant training and updates in relation to health and safety subjects. Risk assessments are carried out and reviewed and equipment and systems maintained and serviced regularly. Ravensfield DS0000035388.V329475.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 X X 4 X 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 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 4 3 X 3 Ravensfield DS0000035388.V329475.R01.S.doc Version 5.2 Page 22 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. 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 OP8 Good Practice Recommendations It is recommended that nutritional assessments be reviewed with each person living at the care home. The findings should be recorded and monitored to help ensure that all aspects that may affect a person’s nutritional intake or needs are not overlooked. It is recommended that the weekly menus at the home be reviewed to include detailed information about the choices available at each mealtime. For example the type of fillings for sandwiches, jacket potatoes or omelettes and the type of soup that will be served. Consideration should be given to the views and opinions of people using this service. 2 OP15 Ravensfield DS0000035388.V329475.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Ravensfield DS0000035388.V329475.R01.S.doc Version 5.2 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!