Inspection on 19/01/07 for Ravenstone Nursing and Residential Home

This inspection was carried out on 19th January 2007.

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

Ravenstone Nursing and... 21/08/08

Ravenstone Nursing and... 10/12/07

Ravenstone Nursing and... 25/05/06

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Ravenstone Nursing and Residential Home 7 St Andrews Road Droitwich Worcestershire WR9 8DJ Lead Inspector Lorraine Briggs Unannounced Inspection 19th January 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 Ravenstone Nursing and Residential Home DS0000065965.V326425.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. Ravenstone Nursing and Residential Home DS0000065965.V326425.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ravenstone Nursing and Residential Home Address 7 St Andrews Road Droitwich Worcestershire WR9 8DJ 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) 01905 773265 01905 778890 ravenstone@ashbourne.co.uk Southern Cross Healthcare Ltd Stephen Richard Samuel Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (46), Physical disability over 65 years of age of places (46) Ravenstone Nursing and Residential Home DS0000065965.V326425.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25/05/2006 Brief Description of the Service: Ravenstone Nursing and Residential Home is a 46-bedded care home providing 24-hour nursed care to older people with physiological difficulties. It is situated within central Droitwich, close to local amenities and resources. Accommodation within the home is provided on three floors - the ground floor, the first floor, and a mezzanine level. Access to all areas within the home is provided through the provision of a passenger lift, a platform lift and two staircases. Fees range from £458.00 - £545.00 per week. Ravenstone Nursing and Residential Home DS0000065965.V326425.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was used to make judgements about this service. This includes: information from the provider, staff records kept in the home, medication records, discussion with people who use the service, discussions with the staff team, discussion with the manager, tour of the premises, previous inspection reports, quality assurance process, Fire Authority reports, Environmental Health Office reports, observation of care experienced by people using the service. What the service does well: The home has improved in some areas to the extent that it is now performing well. These include information and assessments, health and personal care, daily life and the environment. Service users spoken with identified the activities and food were much better and had continued to be so. Staff were kind and caring and they felt safe in the home. Ravenstone Nursing and Residential Home DS0000065965.V326425.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Ravenstone Nursing and Residential Home DS0000065965.V326425.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 Ravenstone Nursing and Residential Home DS0000065965.V326425.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): 1, 2 and 3 Quality in this outcome area is good. Prospective residents and their representatives have the information needed to choose a home which will meet their needs. They have their needs assessed and a contract which tells them about the service they will receive This judgement has been made using available evidence including a visit to this service. Ravenstone Nursing and Residential Home DS0000065965.V326425.R01.S.doc Version 5.2 Page 9 EVIDENCE: The admission of new service users takes into account the individual needs, concerns and anxieties of the prospective service user and their families. The manager consults the assessment information to see if the home can meet the prospective service user’ needs before they make the decision to accept the application for admission and offer a placement. The manager has received copies of the summary, and care plans, from those assessments carried out through care management arrangement for most of the service users. Staff training to ensure that they have the necessary skills and ability to care for residents who are admitted is improving. The provider has developed a statement of purpose, which sets out the aims and objectives of the home, and includes a service user guide, which provides information about the service. The guide is made available to service users and their supporters in a standard format within public areas and service users’ bedrooms. Service users are provided with a statement of terms and conditions before admission to the home. It gives information on what service user can expect to receive for the fee they pay and sets out terms and conditions of occupancy. A service user spoken with stated that she was satisfied with the information she and her family had received. She knew how much was to be paid and when it was due. For individuals who are self-funding the service is able to demonstrate how they have undertaken the assessment. They were generally undertaken satisfactorily. Ravenstone Nursing and Residential Home DS0000065965.V326425.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. The health and personal care, which a resident receives, is based on their individual needs. The principles of respect, dignity and privacy are now put into practice. This judgement has been made using available evidence including a visit to this service. Ravenstone Nursing and Residential Home DS0000065965.V326425.R01.S.doc Version 5.2 Page 11 EVIDENCE: The deputy manager has put in a significant amount of work on the care planning system so that it now gives a more informed indication of care provided and progress made by individual service users. Four care plans were examined. The plan includes the information necessary to plan the individual’s care and includes a risk assessment element. There was recorded evidence of updating information and changing actions in the care plans. Service users have access to health care services that meet their assessed needs both within the home and in the local community. Service users have access to dentists, opticians and other community services. The service users’ health is monitored and appropriate action taken. The home seeks professional advice on health care issues, acts upon it and generally is able to provide the aids and equipment recommended. Staff used hoists in as dignified way as possible within public areas. Service users have independence around the home by using motorised wheel chairs. There is written evidence in the care plan of health care treatment and intervention, and a record of general health care information including weight monitoring, and nutritional information. The home has a medication policy which is accessible to staff, medication records are up to date for each service user and medicines received, administered and disposed of are recorded. The manager has been working towards improvement in this area which has been achieved. Staff were seen to be aware of the need to treat residents with respect and to consider dignity when delivering personal care. Service users spoken to stated they were happy with the way that most staff deliver their care and respect their dignity. Ravenstone Nursing and Residential Home DS0000065965.V326425.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. Residents are able to choose their life style, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet with service user’s expectations. Service users receive a healthy, varied diet according to their assessed requirement and choice. This judgement has been made using available evidence including a visit to this service. Ravenstone Nursing and Residential Home DS0000065965.V326425.R01.S.doc Version 5.2 Page 13 EVIDENCE: The home tries to be flexible and now attempts to provide a service which is more individual by using its staff and resources effectively. Service users are consulted on how the home can work to provide them with a flexible lifestyle, and they have been able to make some changes which help to achieve service users’ wishes. A significant example of this is that the manager has introduced regular meetings for service users/families/supporters to provide a forum where they can air their views. Recorded evidence was seen of service user meetings and a menu meeting. Service users are given the opportunity to take part in a variety of activities both within the home and in the community, these are arranged by staff after consulting with service users. Events were clearly displayed around the home. The service attempts to consider the preferences of the majority of its service users but may not always please everyone. The home’s entertainments officer has developed a recording system which demonstrates individual involvement/likes/dislikes/preferences etc. Themed activities are being introduced with associated meals. The home has open visiting arrangements and service users spoken with knew that they can entertain their family and friends in their own room. If they prefer they can use communal areas of the home to talk to visitors. The choice of food in the home has improved and menus seen demonstrate that the dietary needs of residents have been taken into account. The cook has basic food hygiene training, consults with residents and tries to meet the preferences and suggested dishes when preparing the menu. Service users are able to choose to eat in their own room if they wish. Regular drinks and snacks are available. Bowls of fresh fruit were available around the home. Ravenstone Nursing and Residential Home DS0000065965.V326425.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. The service has a complaints procedure which is accessible and now used according to the procedures in the home. Thus, service users are assured that there concerns will be appropriately dealt with. Training is planned so that service users are protected from abuse and have their legal rights protected. This judgement has been made using available evidence including a visit to this service. Ravenstone Nursing and Residential Home DS0000065965.V326425.R01.S.doc Version 5.2 Page 15 EVIDENCE: The service has a complaints procedure that meets the national minimum standards and regulations. The complaints procedure was visible within the home. Complaints received since the last inspection in May 2006 had been dealt with according to the home’s procedure and resolved. The management of this aspect has improved since the last inspection. The manager is clear when incidents need external input and who to refer the incident to. Links with external agencies are satisfactory and include the CSCI, police and adult protection teams. Service users and others associated with the home state that they are satisfied with the service provision, and feel safe and supported. The homes aims and objectives include the rights of service users. Service users are supported to live as independently as possible, exercising their rights to make choices and decisions with assistance when needed. Ravenstone Nursing and Residential Home DS0000065965.V326425.R01.S.doc Version 5.2 Page 16 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 and 26 Quality in this outcome area is good. The physical design and layout of the home has improved to enable service users to live in a safer, better-maintained and comfortable environment, which encourages independence. This judgement has been made using available evidence including a visit to this service. Ravenstone Nursing and Residential Home DS0000065965.V326425.R01.S.doc Version 5.2 Page 17 EVIDENCE: Southern Cross Healthcare has provided resources to significantly upgrade the home. It now has a rolling programme that has improved the decoration, fixtures and fittings. Service users can personalise their rooms as was seen during the tour of the home. Choice of communal areas is good with a choice of dining rooms and lounge areas. There are quiet areas apart from the service user’s bedroom where service users can sit and/or entertain relatives/friends in private. Service users stated they are comfortable, the home is clean, warm, well lit and there is sufficient hot water. The home is clean and tidy, and there have been no outbreaks of infection. Sluicing facilities have improved and now meet the standards. The laundry room is well organised with staff having received COSHH training. Ravenstone Nursing and Residential Home DS0000065965.V326425.R01.S.doc Version 5.2 Page 18 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 adequate. Staff in the home are being trained and are in sufficient numbers to fill the aims of the home and meet the changing needs of residents. This judgement has been made using available evidence including a visit to this service. Ravenstone Nursing and Residential Home DS0000065965.V326425.R01.S.doc Version 5.2 Page 19 EVIDENCE: Service users stated that they are satisfied with that the care they receive and that staff meet their needs. They feel that staff know what they are doing and that the “service” has certainly got better in recent months. Staffing rotas try to take into account the times of high and low activity. Induction programmes are in place and starting to be used with new staff, examples of which were seen. Plans for supervision and appraisals to monitor the performance of staff are now in place. The service is now recognising the importance of training, and is planning to deliver a programme that meets statutory requirements. The manager has identified priorities for training which has previously been lacking. Staff are more clear regarding their role and what is expected of them. The service’s recruitment procedure has improved and now meets the regulations and the national minimum standards. Ravenstone Nursing and Residential Home DS0000065965.V326425.R01.S.doc Version 5.2 Page 20 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 adequate. The management and administration of the home has improved and is based on openness and respect, and effective quality assurance systems have been developed by the provider so that service users can have a voice in the home. This judgement has been made using available evidence including a visit to this service. Ravenstone Nursing and Residential Home DS0000065965.V326425.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager has undergone the registration process with the CSCI. He is aware of and works to the basic processes set out in the National Minimum Standards. The manager has developed a programme to train and develop staff so that they are competent to care for older people. The service is planning to be more user focused, and is working in partnership with family of service users and professionals. The home now has a statement of purpose that sets out the aims and objectives of the service. The manager has developed systems that monitor practice and compliance with the homes plans, policies and procedures. The home has developed an improved approach to manage the health and safety requirements of legislation. The provider is aware of the areas where they need to make improvements and has an action plan for undertaking the work. The addition of dedicated maintenance staff member results in improvements in timely work carried out. A quality survey has been conducted July 2006 and the results collated. It is the stated intention of the management to conduct surveys on a regular basis. Comments received were very positive about the improvement of activities/trips, cleanliness and the quality of food and catering. Records seen showed that accidents and incidents are now recorded and monitored. The registered person is aware of the need to plan the business activity of the home, and manage the finances and resources to deliver the business plan. The service provider takes responsibility for the home’s accounts and business development. Service users have the opportunity to manage their own money if they wish, and facilities are provided to help keep it safe. Where the home manages money on service users’ behalf a system is in place to record transactions and accounts for spending. Checks by the home show that records are up to date. Ravenstone Nursing and Residential Home DS0000065965.V326425.R01.S.doc Version 5.2 Page 22 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 3 3 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 3 X X X X X X 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 Ravenstone Nursing and Residential Home DS0000065965.V326425.R01.S.doc Version 5.2 Page 23 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. 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 Ravenstone Nursing and Residential Home DS0000065965.V326425.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Ravenstone Nursing and Residential Home DS0000065965.V326425.R01.S.doc Version 5.2 Page 25 - 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. 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