Inspection on 06/07/06 for Ravenswood

This inspection was carried out on 6th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Ravenswood 09/03/06

Ravenswood 14/09/05

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 Ravenswood 15 The Avenue Kidsgrove Stoke on Trent Staffordshire ST7 1AT Lead Inspector Peter Dawson Key Unannounced Inspection 6 July 2006 8:30 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 Ravenswood DS0000064271.V303507.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. Ravenswood DS0000064271.V303507.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ravenswood Address 15 The Avenue Kidsgrove Stoke on Trent Staffordshire ST7 1AT 0121 358 2258 F/P 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) Mr Jasbir Singh Johal Mrs Surinder Kaur Johal Rita Lynne Scarlett Care Home 24 Category(ies) of Dementia - over 65 years of age (8), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (2), Old age, not falling within any other category (24) Ravenswood DS0000064271.V303507.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th March 2006 Brief Description of the Service: Ravenswood is a large pleasant, detached property set in secluded gardens of over an acre and very close to Kidsgrove town centre. The property has been extended to provide excellent facilities. Furniture, fittings and equipment are to a high standard and well maintained. The main building accommodates up to 19 people, the annexe in the grounds provides accommodation for up to 5 people on the ground floor. There are 4 shared bedrooms and a total of 5 ensuite bedrooms. The home has registration for up to 8 people with dementia and 2 people with mental health needs. There is presently no registration for people with a physical disability. Ravenswood DS0000064271.V303507.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. At the time of this unannounced inspection there were 24 people in residence. All places were occupied and there was a small waiting list. The inspection was conducted with the Registered Manager and Proprietor. All residents were seen and the majority spoken to. Four members of staff were spoken to. There was an inspection of the physical environment and records relating to the inspection process. Written feedback was received directly by the Commission from 10 Relatives, 9 Residents and 1 GP. A pre-inspection questionnaire was completed by the Manager and returned to the Commission prior to the inspection. Residents spoken to all expressed high levels of satisfaction with the care provided and spoke highly of staff. They spoke in detail about daily life at Ravenswood and said that they made choices about their lives. There were observed very relaxed, positive and affectionate exchanges between residents and staff. Discussions were extensive with residents and none had any complaints or concerns about the care provided, they were all aware of the procedures for making complaints. In written feedback all comments from residents were positive and included: “I like the home very much, my life is improved while I have been living here”. “Very satisfied”. I have no complaints, the staff are very friendly & helpful” “Happy & contented” . “As mum has dementia, taking part in activities is difficult but she is included” . Comments from relatives were similarly complimentary- “Day or night there is always a cup of tea/sandwich (I know as I’ve been there in the early hours following discharge from A & E on occasions) for mum upon her return”. I have only praise for the staff in their continued support/care & understanding towards mum. The weekly charges for care in this home are from £280 - £363. Charges quoted in the pre-inspection questionnaire. What the service does well: Good indications of flexible routines. Chosen lifestyles an integral part of care. Visitors report they can visits at any time. Many regular including daily visitors. Shared care promoted with relatives and residents. There is an excellent example where husband of resident visits daily and assists with personal care. Ravenswood DS0000064271.V303507.R01.S.doc Version 5.2 Page 6 There are 3 couples in the home whose differing needs are met in an individualistic way. A small home with fairly static committed staff group. 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. Ravenswood DS0000064271.V303507.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 Ravenswood DS0000064271.V303507.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1–5 The quality of this outcome is good. This judgement is based upon available evidence including a visit to the service. EVIDENCE: A statement of Purpose/Service Users Guide is available in the home. Copies have been given to all residents and available for prospective residents. Two recently admitted residents were seen and confirmed that appropriate introductions had been made to the home. Their needs had been assessed prior to admission by Care Management personnel and the homes own assessment had been completed. Two admissions had also taken place after new category of resident MD (mental disorder) had been granted. Ravenswood DS0000064271.V303507.R01.S.doc Version 5.2 Page 9 The two people had been appropriately assessed prior to admission and had been integrated well into the home their needs observed to be met very positively. There has been staff training to assist in meeting the needs of these residents. A recommendation of the last report to provide a review of placement after 6 weeks for self-funding residents has been carried out. Often there is no Care Management assessment for these people which disadvantages them. This allows self-funding residents the same standard of service as those funded. Ravenswood DS0000064271.V303507.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 – 11 The quality of this outcome is good. This judgement is based upon available evidence including a visit to the service. EVIDENCE: Care plans were sampled including both permanent and recently admitted residents. The standards were satisfactory. Care plans are based upon assessed need including Care Management (multi-agency) assessments for funded residents and from the homes own assessment for self-funding residents. Care planning information contains a health care record for each resident giving a chronological record of health care interventions. Plans contain adequate information to identify and meet health care needs. Regular health checks are carried out together with medication reviews with visiting GP’s. the home has a good record of early identification of health care needs and the required action to involved health professionals at an early stage. The home deals with 5 separate GP practices and there appear good relationships. Ravenswood DS0000064271.V303507.R01.S.doc Version 5.2 Page 11 This was confirmed in written feedback about the home directly to the Commission from a visiting GP. He felt that the overall care at the home was good and that staff understood and carried out the required actions to sustain good health care. The care plan of a totally dependent resident was reviewed observed and discussed with staff. The plan contained the required information to provide care and the person is visited twice weekly by the District Nursing Service. Staff felt that there had been some weight loss but it was impossible to weigh the person. They were advised to speak to the visiting nurse who had alternative ways of assessing weight loss. A new bed had been purchased and bedguard provided, which was agreed and signed with the relative. A fluid intake chart had been established due to the weight loss. Appropriate pressure relieving equipment was in place and chart recording regular turning. The resident has good appetite and continues to eat at a normal level. The home will ensure this is also recorded. The care given to this resident was to a high standard. A very ill resident had serious chest infection with relatives staying at the home in anticipation but he made a dramatic recovery staff working closely with the GP and nursing service providing recorded fluid inputs and 2 hourly repositioning avoiding pressure area difficulties. The care offered to this resident was also to a very high standard. This was confirmed by the relatives. A resident exhibiting anxiety/agitated behaviour has been referred to the GP and CPN involved. There has been a medication review and staff are closely monitoring the effects. There has been some considerable weight loss with sporadic recording of weight. A requirement is made that all residents must be weighed monthly and weekly where there are concerns about weight loss. A visiting relative of this resident was seen who stated he entirely satisfied with the care his mother received at Ravenswood. He confirmed that family were kept informed of changes in her condition and were involved in all decision making. Care plans were seen to be summarily reviewed on a monthly basis Medication was inspected and found to be accurately recorded and administered. Records reflected this view and indicated a safe system of medication in place. Ravenswood DS0000064271.V303507.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 - 15 The quality of this outcome is good. This judgement is based upon available evidence including a visit to the service. EVIDENCE: There was evidence seen during the inspection of chosen lifestyles and individual preferences being known and applied. Discussions with residents confirmed this. The majority of residents had breakfast on a staggered basis in the dining room, some rose during the morning up to 11.am and others had breakfast served in their bedroom or the lounge area. Cooked breakfasts are available to all. Throughout the morning of this very hot day residents were served drinks continuously sitting in the garden area and under the gazebo. A resident who chose to have his lunch in the gazebo, whilst others were in the dining area, was seen to be served by the proprietor in a setting resembling a country house hotel and similar level of service. Two new residents were seen together and confirmed that they had settled quickly and well into the home. They said that staff were “very kind and helpful”. Their relatives could visit at any time - one said a friend had visited the previous evening at 9pm and spent an hour with her in her bedroom. Ravenswood DS0000064271.V303507.R01.S.doc Version 5.2 Page 13 Two married couples and a couple who have met at Ravenswood use shared accommodation as they wish and their lifestyles are facilitated to allow private time together as they wish. A resident suffering from dementia is visited daily by her husband who spends most of the day with her assisting her with eating etc. He confirms a totally flexible arrangement. He is made welcome has meals there etc. In fact staff expressed concern about his own deteriorating health and clearly have a caring and considerate concern to visitors also. At the time of the last inspection there had been a complaint about food provision. This was addressed at that time very positively and a Proprietor has taken on the duties of cook. The standard, type, quality and serving of food has improved over the past months. The new proprietors purchase quality foods from reputable local companies with no limit upon finance. The result is an improved and higher quality diet then previously provided. The importance of a good and adequate diet for good health and well being is understood and actively promoted by the proprietors who take an active, almost daily role in the home. A recent Bar –B-Q in the large secluded and pleasant grounds provided a meal for 120 residents/visitors/friends, food cooked and prepared to a very high standard with a continental flavour by the proprietors. All staff, their families and friends assisted with the event, in the garden area which caters adequately for that number of people and is an ideal garden-party setting. The event was extremely successful and enjoyed by all. This was confirmed in discussions with residents and from photographs displayed in the home. The garden area is idyllic and used consistently throughout the summer months. There are good seating and eating facilities for residents simply to relax. Residents confirmed that they had been sitting outside during the recent hot spell with staff until 10 pm. The benefits are clear. Ravenswood DS0000064271.V303507.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 – 18 The quality of this outcome is good. This judgement is made using available evidence and a visit to the service. EVIDENCE: There is a complaints procedure in place which complies with Regulation 22. All residents have had a copy of the procedures and copy is posted in the home for visitors. There is a suggestion box in the reception area for other or anonymous complaints or expression of views. The home has not received any complaints since the last inspection. No complaints have been received by the Commission since the last inspection. There is a policy/procedure relating to abuse. All staff are given a copy and sign to confirm that they have read and understood the document. Staff are aware of the broad definitions of abuse. Ravenswood DS0000064271.V303507.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 - 24 The quality of this outcome is good. This judgement is made using available evidence, including a visit to the service. EVIDENCE: The home is in an excellent location and set in extensive, attractive, peaceful secluded grounds yet is only 50 metres from the town centre. The location is suitable for its stated purpose. Residents use the garden area extensively throughout the summer months with a range of suitable seating and eating facilities in sun or shade. There is a good standard physical environment which the present proprietors, who purchased the home in 2005, have improved. Since the last inspection most of the communal areas on the ground floor have been redecorated. Ravenswood DS0000064271.V303507.R01.S.doc Version 5.2 Page 16 Whilst satisfactory before with cream paintwork everywhere, this has been replaced with decoration in varying pastel shades which has enhanced and provided a more domestic type environment. The present proprietors have replaced a large part of the lounge furniture and areas have been recarpeted. Bedrooms are well furnished and decorated with good standard softfurnishings. All have lockable facility and locks to bedroom doors available as required. Some areas which have suffered from cumulative maintenance have been upgraded with new beds and furniture. Following the last inspection the inspector requested a visit from the Fire Officer to review the fire safety aspects in the area adjoining the kitchen area. This has been done and advice and action suggested has been actioned by the home. All bedpan pots/urine bottles have been reviewed following a previous requirement and replaced as required. These items are no longer placed in baths as previously, thereby reducing infection control risks. A major extension to the home is being presently considered by the local council. Depending upon the outcome of that application the proprietors intend to improve the laundry and sluicing facilities available and required. Throughout the home the standards of hygiene and infection control were seen to be high. Thorough cleaning routines are in place. Shared bedrooms have good facilities and all have privacy curtains. Fail safe valves have been fitted to the bathroom areas of the home during the past year and also to some resident areas. A requirement to refix a foodstore on hinges contained in the last report has been actioned. Ravenswood DS0000064271.V303507.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 – 30 The quality of this outcome is adequate. This judgement is made using available evidence, including a visit to the service. EVIDENCE: This is a split-site home. There are 19 people in the main area of the home and 5 in the annexe area which caters mainly for people with dementia. There has to be one person continuously on duty in the annexe throughout the 24 hour period. A total number of 542 care hours per week are provided across the whole site. At the time of this inspection there were 24 people in residents, all beds occupied and a small waiting list has been established. The staffing levels provide the required numbers of staff considering the present dependency levels of residents. Recruitment procedures were checked and a member of staff employed without new CRB (previous one supplied only). It is a requirement of this report that CRB or POVA check must be obtained prior to employment of all new staff. One had brought CRB from previous employment which was not acceptable. Staff training over the past 12 months has included training in: Moving & Handling , Food Hygiene, diabetic care, Skin care, NVQ assessors course, Fire Awareness and COSHH. Ravenswood DS0000064271.V303507.R01.S.doc Version 5.2 Page 18 The home previously had more than 50 of care staff trained to NVQ standards. This has reduced slightly due to member of staff leaving but 4 staff are presently undergoing NVQ training. Supervision is in place for all staff and records were seen. Ravenswood DS0000064271.V303507.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 36, 37, 38 The quality of this outcome is good. This judgement is made using available evidence, including a visit to the service EVIDENCE: The Manager is presently studying as required for the Registered Managers Award. She is due to complete the course by December. The Registered Manager works hands-on on the rota and provides a positive lead in the home. There is an open approach in managing the home which is transparent to staff. The new proprietors have a daily presence in the home and residents have daily access to proprietors, managers and staff. There is a very relaxed atmosphere in the home, visitors having direct access to owners and managers on a daily basis. Residents meetings are held regularly and minutes of meetings kept (not seen on this visit). Ravenswood DS0000064271.V303507.R01.S.doc Version 5.2 Page 20 All have a copy of the complaints procedure and there is a suggestion box in the reception area for comments – anonymous if preferred. Inspection reports are also available in the reception area of the main building and also the annexe. In relation to Health & Safety issues: The Fire Officer has reviewed fire safety in the area of the kitchen since the last inspection. Fire records were not seen on this visit but all necessary tests and checks reported to have been carried out. Moving & Handling training has been provided since the last inspection. There are adequate numbers of staff training in first aid to provide one trained person on each shift. Infection control has been improved with some toileting items discarded. The premises are secure with restrictors on all opening windows. Risk assessments are in place for all resident activity. All required incidents have been reported to the Commission under Regulation 37. Ravenswood DS0000064271.V303507.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 3 3 3 3 3 N/A 3 3 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 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 3 18 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x 3 3 3 Ravenswood DS0000064271.V303507.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. 1 2 3 Standard OP8 OP8 OP29 Regulation 12(1) 12(1) 19(1)(b) Sched 2 Requirement All residents must be weighed monthly and weekly where there are concerns about weight loss. Ensure fluid intake charts record quantity of fluid given and also record food intake. CRB checks must be obtained for all staff prior to employment Timescale for action 07/07/06 07/07/06 07/07/06 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 Ravenswood DS0000064271.V303507.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ravenswood DS0000064271.V303507.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. 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