Inspection on 15/01/09 for Ravensmount

This inspection was carried out on 15th January 2009.

CSCI found this care home to be providing an Good service.

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

Ravensmount 11/08/08

Ravensmount 13/08/07

Ravensmount 22/01/07

Ravensmount 06/12/05

Ravensmount 04/07/05

Ravensmount 25/11/04

Ravensmount 13/07/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

CARE HOMES FOR OLDER PEOPLE Ravensmount Alnmouth Road Alnwick Northumberland NE66 2QG Lead Inspector Anne Urwin Brown Key Unannounced Inspection 15th January 2009 09:30 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 Ravensmount DS0000060366.V373640.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. Ravensmount DS0000060366.V373640.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ravensmount Address Alnmouth Road Alnwick Northumberland NE66 2QG 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) 01665 603773 01665 605901 ravensmount@tiscali.co.uk Moorlands Care Homes (N.E.) Limited Laura Jane Appleby Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Ravensmount DS0000060366.V373640.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th August 2008 Brief Description of the Service: Ravensmount is a large detached house that has been extended to provide more spacious accommodation. It is registered to accommodate up to thirty older people. Moorlands Holdings NE Ltd is the service provider. Ravensmount is located on the edge of Alnwick and there is a local bus service to Alnwick town centre from just outside the home. Main line train services run from Alnmouth a few miles away. There are attractive public rooms in the home and all bedrooms have en-suite toilet and washbasin. Accommodation is arranged over three floors and a shaft lift is fitted. Fees range from £419.08 per week. A Statement of Purpose and User guide is available at the home that provides good information about the service. Ravensmount DS0000060366.V373640.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use the service are not put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. How the inspection was carried out Before the visit we looked at: Information we have received since the last visit. How the service dealt with any complaints & concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 6th February, 2009. The visit lasted a total of five hours. During the visit we: Talked with people who use the service, staff, the manager and visitors. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit. We told the manager what we found. Ravensmount DS0000060366.V373640.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? The physical standards have improved since the last visit. There was evidence that there are better arrangements in place for dealing with refurbishment, repairs and upgrading of the building to achieve a more comfortable environment for people living in the home. Most issues related to the premises mentioned in the last report have been addressed. Care plans and risk assessments have been completed for each person living in the home and these provide good information about people’s current needs. Staff training has improved and there are systems in place to ensure that all staff receive mandatory training at appropriate intervals. Induction training has also been provided for all new staff. The arrangements for health and safety practices have been reviewed and appropriate action taken to address shortfalls. Communications systems in the home have improved and there was evidence of good team working at this inspection. A staff supervision programme has been implemented. Ravensmount DS0000060366.V373640.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Ravensmount DS0000060366.V373640.R01.S.doc Version 5.2 Page 8 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 Ravensmount DS0000060366.V373640.R01.S.doc Version 5.2 Page 9 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): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home uses good assessment and admission processes so that people have enough information about the service and are sure that their needs can effectively be met before they decide to live at Ravensmount. EVIDENCE: People have sufficient information about the service provided at Ravensmount before they come to live there. The Statement of Purpose has been reviewed in the past year and the service user guide gives clear information about what it is like to live at Ravensmount. Before each person moves into the home a pre-admission assessment is completed to ensure that staff are able to meet their needs. Information from the assessment and from relatives and/or care management plans is also used Ravensmount DS0000060366.V373640.R01.S.doc Version 5.2 Page 10 to prepare an individual plan outlining each persons care needs. The home understands the importance of having good information about people’s needs before agreeing a placement. Intermediate care is not provided at Ravensmount. Ravensmount DS0000060366.V373640.R01.S.doc Version 5.2 Page 11 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): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Ravensmount have their health and personal needs met in a planned way, and the care is delivered with respect and with regard for their dignity. EVIDENCE: Each person has a personal plan in place that clearly outlines their care needs and how these are met to suit their individual needs. Personal support is responsive to the varied and individual needs and preferences. However there was not always clear information in individual plans about how needs are met by staff, although sometimes information was available in daily notes. Assessment tools are now being well used to identify changes in people’s needs and care plans are updated to reflect changing needs. Other healthcare information is well recorded and evidence was available that good systems are in place to ensure that individual needs are well met. Evidence was available Ravensmount DS0000060366.V373640.R01.S.doc Version 5.2 Page 12 that people’s privacy and dignity is respected and that staff are sensitive to individual needs. There is in place an effective medicines policy that supports good procedures and practice. Staff training has been provided for all staff responsible for administering medicines. Medicines records are well completed and contain required entries. There are checks of medicine practice by the deputy manager. Arrangements for the storage of medicines are satisfactory. Care plans show evidence of people’s wishes, choices and decisions as their health deteriorates. Care staff work consistently with support from the district nurses to support people living in the home who have degenerative conditions and terminal illnesses. There was evidence that appropriate plans are in place for people at this stage of their lives. Ravensmount DS0000060366.V373640.R01.S.doc Version 5.2 Page 13 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): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are encouraged and supported to make choices about their routine and lifestyle. Social, emotional, cultural and recreational needs are met in a way that suits individuals. EVIDENCE: There are good opportunities provided for people to take part in planned activities that meet the social needs of all of the residents. Good information about people’s social care needs is recorded in care plans to show residents preferences about activities and routines are identified. The activity organiser keeps a record of those attending group activities and of any individual work going on. Residents said that they enjoyed the opportunities to join in arranged activities. They said that there were plenty of interesting things to do. The residents said the food was very good. Alternatives were available at each meal time. The menus have been revised since the last inspection and a good variety of food is provided. The cooker has been replaced since the last Ravensmount DS0000060366.V373640.R01.S.doc Version 5.2 Page 14 inspection and a new cooker hood is to be installed shortly. Stocks of food and storage arrangements are satisfactory. All kitchen staff have undertaken appropriate Food Handling training. Drinks are provided regularly through the day and there is a varied selection offered. There was tea, coffee, or cold drinks of either juice or milk. There were biscuits provided. Fruit was also available. The bedrooms are of a very high standard, they are personalised according to the taste of the resident. Residents said they were happy with their rooms and that they had a lot their own personal items around them. Residents have visitors at any time and are able to use their own rooms, or the lounges to see them. One relative said that she is made very welcome when she visits and she said she is very satisfied with the support provided to her mother by the staff. Residents said they were happy with the arrangements for visitors. Ravensmount DS0000060366.V373640.R01.S.doc Version 5.2 Page 15 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): 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 are protected by the good systems in place at Ravensmount for dealing with complaints and safeguarding. EVIDENCE: There is a written complaints procedure that provides clear information about how to make a complaint and the action that is taken to deal with complaints. Good systems are now in place to record complaints, their investigation and outcome. Since the last inspection the manager is using a new format for recording complaints. People living in the home said that they felt able to raise any concerns or complaints with the manager or her staff and that they were satisfied that these would be taken seriously. There are written procedures for dealing with safeguarding matters. No safeguarding referrals have been made since the last inspection. The manager said that staff training is ongoing to ensure that all staff members have a good understanding of safeguarding procedures. Records show that most staff have completed training and further training dates are organised for other staff. Ravensmount DS0000060366.V373640.R01.S.doc Version 5.2 Page 16 There is a policy in place for whistleblowing so that staff can feel confident that if they had any concerns they would be listened to and the information would be treated in confidence. Ravensmount DS0000060366.V373640.R01.S.doc Version 5.2 Page 17 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): 19, 20, 21, 24, 25 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The physical standards in Ravensmount have improved since the last inspection and work has been undertaken to improve the environment for the people living in the home. EVIDENCE: Since the last inspection work has been going on to address issues raised at the last inspections and some works have been completed. At the last inspection a requirement was made that an plan of refurbishment, upgrading and planned safety checks be drawn up identifying priorities and timescales. While no written plan exists, the manager was able to demonstrate that she is working with the owner to address outstanding requirements relating to the premises and showed that this work is ongoing. At this inspection the home was clean and odour free. The sitting room and dining room have new curtains Ravensmount DS0000060366.V373640.R01.S.doc Version 5.2 Page 18 fitted and some chairs have been replace, but others are looking worn and shabby. The lounges and dining room are attractive rooms with good views to the gardens. There is a large conservatory that is used for activities and a small quiet lounge near the front door. Maintenance records are kept to show that issues are reported, and are generally addressed fairly quickly. There is ongoing work to redecorate and refurbish bedrooms as they become vacant. Bathrooms and toilets are tidy and clean. Bedrooms are generally decorated and furnished to an appropriate standard and people have brought in items from their previous homes to personalise their own space. Staff showed that they were aware of good health and safety practice during the inspection. Storage continues to be a problem, however there was evidence that it is now better managed. The laundry was clean, well organised and equipped. The floor is concrete and new flooring has been ordered to ensure that the surface is impermeable. There is sufficient laundry equipment. Infection control procedures are in place and staff training is provided. Ravensmount DS0000060366.V373640.R01.S.doc Version 5.2 Page 19 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): 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. Sufficient appropriately skilled and trained staff are available to meet the needs of the people living in the home. EVIDENCE: Staffing levels have improved since the last inspection and are currently enough to meet the needs, activities and wishes of individuals living in the home. During the visit to the home there were adequate numbers of staff to meet the needs of the residents including carers, domestic and catering staff. People living in the home said that they were happy with the staff and they spoke warmly about the level of support they received. The manager said that existing staff members work additional hours to cover sickness and annual leave. Staff said that they feel well supported by the manager and that there is good communication within the staff team. Good staff recruitment procedures are followed for appointing new staff. Records showed that the manager recognises the importance of effective recruitment in protecting people living in the home. Appropriate checks Ravensmount DS0000060366.V373640.R01.S.doc Version 5.2 Page 20 including reference, Criminal Records Bureau and POVA checks are carried out and records confirmed this. Staff receive appropriate training to equip them to meet the needs of the residents. Training is focused on achieving better outcomes for people living in the home. External providers are used to deliver training for staff. Staff said that they get enough training opportunities and are well supported by the senior staff. Individual training records are in place and are kept up to date. Staff meetings are held regularly and a staff supervision programme is in place. Staff said that they feel well supported by the manager and senior staff. Ravensmount DS0000060366.V373640.R01.S.doc Version 5.2 Page 21 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): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from living in a well managed home and are encouraged to put forward their views. EVIDENCE: The manager was appointed to the post last year and since then has completed the Registered Manager’s award. She previously worked in another home belonging to the same owner. She understands the need to keep up to date with practice and to develop management skills. She is well supported by an experienced senior staff team. Ravensmount DS0000060366.V373640.R01.S.doc Version 5.2 Page 22 The home has a clear statement of purpose that sets out the aims and objectives of the service. There is evidence that the manager and the senior staff team are involved in improving and developing systems that monitor practice and compliance with the plans, policies and procedures of the home. More work is needed in this area to ensure that there is an effective quality assurance system in place. People are encouraged and supported to retain control of their own money. If people are unable to manage their money clear information is kept in their individual records about the reasons for this. All transactions relating to money held are clearly recorded and appropriate procedures for managing residents money are in place so that staff are clear about their responsibilities. Lockable storage is provided in each persons room so that they can keep money or valuables safely. Health and safety policies and risk assessments are in place and staff receive appropriate mandatory training at regular intervals. Regular checks and servicing of fire equipment are carried out and records show staff have received appropriate fire training. Good records are kept of all accidents and there was evidence that these are monitored by senior staff. Ravensmount DS0000060366.V373640.R01.S.doc Version 5.2 Page 23 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 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 2 X X 2 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Ravensmount DS0000060366.V373640.R01.S.doc Version 5.2 Page 24 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 OP19 Regulation 23 Requirement The furnishings in the communal area need to be replaced or repaired as necessary. The door to the kitchen must be made fire proof and then painted. The surrounding wall must be decorated. This will make the home a safer and more pleasant place for people to live. Repairs must be made to the damaged bath, which is leaking. This will give residents more choice and improve the safety of the area. The bedrooms must be redecorated and damaged, or worn, furniture replaced as necessary. This will make the home a safer and more pleasant place for people to live. Timescale for action 01/08/09 2 OP21 23 01/05/09 3. OP24 16 01/08/09 Ravensmount DS0000060366.V373640.R01.S.doc Version 5.2 Page 25 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 OP7 Good Practice Recommendations Care plan documentation needs to be reviewed to ensure that information is not being recorded more than once and to make sure that any actions taken by staff to meet individual care needs are clearly recorded. The arrangements for storage need to be reviewed to ensure that wheelchairs, the hoist, commodes and other equipment are not left in bathrooms and corridors. Arrangements must be put in place to provide professional supervision for the Manager. All staff working in the home need safeguarding training to ensure that people living at Ravensmount are protected. 1. 2. 3. 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