Inspection on 14/12/06 for Riccall House

This inspection was carried out on 14th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Riccall House 13/03/06

Riccall House 06/12/05

Riccall House 25/01/05

Riccall House 05/08/04

Riccall House 11/03/04

Similar services:

Snydale Care Home

Abbey The

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Riccall House 78 Main Street Riccall York North Yorkshire YO19 6QD Lead Inspector Jo Bell Key Unannounced Inspection 14th December 2006 09:15 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 Riccall House DS0000007669.V324446.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. Riccall House DS0000007669.V324446.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Riccall House Address 78 Main Street Riccall York North Yorkshire YO19 6QD 01757 248586 01757 248123 riccallhouse@aol.com 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) Mrs Gillian Mary Conroy Mr John Anthony Conroy Mrs Diane Moughan Care Home 18 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (18) of places Riccall House DS0000007669.V324446.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service Users to include up to 18 (OP) and up to 18 (DE(E)) up to a maximum of 18 Service Users 1 named service user under the age of 65. This condition will cease when the named service user reaches 65 or leaves the home. 13th March 2006 Date of last inspection Brief Description of the Service: Riccall House is registered to provide personal and social care and accommodation for 18 older people who may have additional dementia care needs relating to their age. The home is located on the main street in the village of Riccall, four miles from the market town of Selby and eight miles from the City of York. The village is on a main bus route to both of these locations. The home consists of a two storey Georgian building with a newer, purpose built ground floor extension. Twelve of the fifteen bedrooms are for single accommodation. None of these have en-suite facilities. One of the three double rooms has an en-suite facility. The home has no passenger lift but has a stair lift. The weekly fees are £395. Riccall House DS0000007669.V324446.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key inspection of the service took place on Thursday 14th December 2006. Prior to the visit a pre-inspection questionnaire was completed. Eight comment cards from relatives, four service user surveys and a GP form were all returned to CSCI. One inspector spent six hours at the home, during this time observations of care practices took place, a range of documentation was examined and discussed and aspects of the environment were inspected. The home provides a good standard of care in a welcoming environment. Staff have the skills and knowledge to care for individuals with both personal and dementia care needs. What the service does well: What has improved since the last inspection? Service users have their care profiles, care plans and risk assessments updated on a monthly basis. The laundry walls have been repaired which ensures they are impermeable and can be easily cleaned. Riccall House DS0000007669.V324446.R01.S.doc Version 5.2 Page 6 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. Riccall House DS0000007669.V324446.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 Riccall House DS0000007669.V324446.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): 3 (Standard 6 is not applicable) Quality in this outcome area is excellent. Service users needs are fully discussed and assessed prior to admission to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users have their needs fully assessed prior to admission. Four relatives were spoken with regarding the assessment process and two service users documentation was examined. It was evident that the home had an excellent system in place to ensure a smooth transition from either home or hospital into Riccall House. The manager assessed individual needs, one or two visits take place where the service user and family discuss all aspects of care, and there is an opportunity to meet the staff. Where individuals are care managed a further assessment is still undertaken to ensure needs can be met. One relative said ‘the home is marvellous’ another said ‘the home cannot do enough for my relative’ this was in relation to admission to the service. Full Riccall House DS0000007669.V324446.R01.S.doc Version 5.2 Page 9 social and personal history is obtained and consideration is given to the best forms of communication with the service users and family should any concerns arise. The manager is very clear regarding the home’s category of registration. Currently the home is registered for up to eighteen service users who are older people with personal care and dementia care needs. Riccall House DS0000007669.V324446.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 & 10 Quality in this outcome area is good. Service users receive a good standard of care where both their health and personal care needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users were observed being treated with respect and dignity throughout the site visit. Staff had a good understanding of meeting individual needs are were competent in caring for people with dementia. Relatives were spoken with, and comment cards completed confirmed that the home provide a good standard of care. One relative said ‘ the care is fantastic’, ‘staff are just wonderful’ . Care plans were checked for two service users. These had detailed information regarding specific needs, risk assessments for nutrition, moving and handling and the use of bed rails were in place. One person who needed a safety belt had her needs thoroughly discussed and documented with both the service user and their relative. This relative was spoken with and was keen to confirm the high standard of care being received and how quality of life had been improved for his relative at Riccall House. Riccall House DS0000007669.V324446.R01.S.doc Version 5.2 Page 11 Staff were observed interacting with service users on a one to one basis and consideration was continually given to maintaining privacy. The home has good links with other healthcare professionals, the district nurse was visiting and documented evidence confirmed they visit regularly when needed. GP comment cards said how ‘excellent’ the care was and positive comments were made from care managers and other relatives. The home have access to chiropody, dentist, continence advisors and community dieticians (via the GP) along with community mental health team if needed. Relatives spoken with confirmed that the home communicate effectively with them regarding any issues or concerns they have. GPs are called appropriately and visits to hospital are made when necessary. The medication system was examined. Service users were observed being given their medication. Currently there is no one in the home who self medicates. A secure system is in place to store controlled drugs and blister pack medication. This is administered correctly and was confirmed when checking two medication charts. A stock balance takes place on a weekly basis and medication is returned and recorded on a systematic basis. Three staff spoken with confirmed they had received distance learning medication training, generally the manager or senior care staff administer the medication. It would be beneficial if a medication audit takes place on a 1-3 monthly basis to identify if any errors have occurred. The system for recording controlled drugs was checked, this was found to be correct, although the pages should be numbered to ensure there is a full audit trail. This was discussed with the manager who was aware of the current guidance. No medication errors have occurred and it is very infrequently that controlled drugs are used. Riccall House DS0000007669.V324446.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 & 15 Quality in this outcome area is good. Service users enjoy a range of activities where the home encourages autonomy and choice. Good home cooked food is offered in a pleasant environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users have the opportunity to participate in a range of activities which are appropriate to the client group. Activities are displayed on a festive board. Visits from carol singers, entertainers, trips to the local pub and in house entertainment is regularly provided. Recently a clothes show took place where the service users bought clothes for Christmas. One volunteer was decorating the lounge and corridor areas with holly and greenery ready for Christmas. Staff are able to offer one to one time with service users which is extremely beneficial, and whilst there is no specific organiser all staff are involved with ensuring service users get enough stimulation. Visitors are warmly welcomed into the home and staff clearly have a good rapport with them. This was observed throughout the day. Links with local churches are forged, and a minister visits the home to offer Communion on a regular basis. Autonomy and choice is encouraged and both relatives and service users discussed individual Riccall House DS0000007669.V324446.R01.S.doc Version 5.2 Page 13 routines for getting up and going to bed, going out and participating in activities. The home provide a good standard of food, this is home-cooked and the chef has many years experience in the catering industry. The food at lunchtime looked appetising with good sized portions, plenty of meat and fresh vegetables are offered with appropriate deserts to follow. There are two dining areas for service users and there is the option to eat in other areas of the home. The dining areas are homely with material napkins, glasses and crockery suitable for this client group. Service users were observed enjoying their lunch and assistance was offered in a dignified manner. The chef is aware of how to fortify food when someone is undernourished. Evidence of weight increase for some service users (where needed) was documented in the care plan. A menu was displayed in the dining room and staff offer a choice of meals to each service user. Staff confirmed they have attended conferences where appropriate food for service users with dementia has been discussed. A hot meal at lunchtime is always provided and at tea time hot and cold dishes and finger food is served. Riccall House DS0000007669.V324446.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 & 18 Quality in this outcome area is good. Both service users and their relatives feel confident in sharing their views and opinions regarding the service. Service users enjoy living at the home and feel safe and well cared for. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users and relatives spoken with all confirmed they were confident in expressing their views if they had any concerns. No negative comments were made regarding the service, and those spoken with said the manager and all staff were approachable and open to any discussions regarding improvements to the service. One complaint has been made since the last inspection which the provider investigated in an appropriate manner. The home have a complaints procedure in place and the manager is keen to foster an open environment where issues can be raised and dealt with effectively. Adult protection was discussed with the manager, staff and provider. Staff had a good understanding of the different types of abuse and how these should be dealt with. When staff undertake NVQ training this area is normally included. The manager was aware of the types of abuse and the immediate action to take to safeguard the individual needs, although a greater awareness of who the Lead Agency is in adult protection and the role of social services, the police, CSCI and the home if an incident occurs is needed. The provider was made aware of the multi-agency document regarding vulnerable adults which was developed by North Yorkshire. Riccall House DS0000007669.V324446.R01.S.doc Version 5.2 Page 15 During the visit staff were observed treating service users appropriately using pleasant language in a dignified manner. Relatives confirmed staff move and handle service users in a gentle manner explaining what is going to happen. Riccall House DS0000007669.V324446.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): 19,22 & 26 Quality in this outcome area is adequate. Service users live in a pleasant environment, though some risks were evident from the laundry area, and with the call bell system. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is very welcoming with areas being well maintained. All areas inspected smelt pleasant with rooms being redecorated on a rolling programme. One relative commented that it would be better if there weren’t so many steps in the home (referring to the steps near the laundry). However, service users observed using them managed them effectively. There are pleasant views from service users rooms and there is access to a garden/patio area. Some service users were observed taking short walks around the grounds, and staff were made aware of their whereabouts through an alarm system. Riccall House DS0000007669.V324446.R01.S.doc Version 5.2 Page 17 Service users rooms examined were clean and tidy, relatives confirmed that clothes are washed and ironed and returned to their wardrobes and drawers, this is the care staffs responsibility. The laundry room had had its walls repaired and painted since the last inspection. There are sufficient washing machines and driers for the number of service users. Staff have attended infection control training and are aware of how to deal with different types of linen. It was evident that access was available to service users and visitors to the laundry, this was discussed at the last inspection. Very hot water, washing powder (on the floor) and access to cleaning fluids was evident. This is putting service users with dementia at risk as they could easily walk into this room as it is located off a main corridor. This was discussed with the manager who was going to action this asap. On one occasion a service user who was spending time in her room did not have access to her call bell, this was discussed with the manager and was going to be rectified. Riccall House DS0000007669.V324446.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 & 30 Quality in this outcome area is good. Service users are cared for by a sufficient number of staff who are recruited effectively and have the skills, knowledge and understanding to meet individual needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users are given a good standard of care. During the visit it was evident that there were enough staff who were appropriately trained to care for individuals with both personal and dementia care needs. During the day and overnight. Staff spoken with said they are offered a range of training relating to care practices. NVQ training is offered which staff confirmed and induction training is equivalent to Skills for Care (formerly TOPSS). It was evident that the home was calm and relaxing. This is partly due to service users behaviour being managed effectively by staff, some one to one sessions were taking place and staff had the opportunity to calmly discuss any issues which were making service users anxious. The manager is supernumerary though time is spent with service users and staff on a daily basis. The recruitment process was discussed with the manager who was aware that two written references, CRB and protection of vulnerable checks are needed prior to commencement of employment. A recruitment policy is available. Staff files were inspected and found to be completed correctly and well maintained. Riccall House DS0000007669.V324446.R01.S.doc Version 5.2 Page 19 Three staff spoken with confirmed checks had been made prior to them starting work and that induction training had taken place. Staff undertake mandatory training during the induction process. Riccall House DS0000007669.V324446.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 & 38 Quality in this outcome area is good. Service users are cared for by an effective manager who readily seeks their views and opinions, finances are well managed and generally health and safety is adhered to. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has undertaken a manager’s award course and is experienced and knowledgeable in caring and managing this client group. All relatives and staff spoken with made positive comments regarding how the home is managed. One GP said ‘an excellent senior staff member’ referring to the manager. Quality assurance in the home was discussed, relatives spoken with said their views are regularly sought both verbally and through surveys Riccall House DS0000007669.V324446.R01.S.doc Version 5.2 Page 21 sent out to them. Information from the relatives comment cards confirmed that communication is good within the home and meetings with service users, relatives and the home take place on a regular basis where views and opinions are obtained. The manager has a quality assurance tool in place which covers a range of areas. Care planning is included though this could be more detailed and it would be useful having a medication audit. The manager discussed sending out a service user survey, again this would be beneficial if in an appropriate format for people with dementia. Service users finances were discussed in the pre-inspection questionnaire and relatives confirmed the process for dealing with money on a daily basis. Some service users have their own money, lockable spaces are provided or the home can keep a small amount of money for items such as extra toiletries, hairdressing, newspapers or private treatments. Health and safety in the home was inspected. The home was generally safe and records pertaining to health and safety were discussed. Information in the pre-inspection questionnaire related to certificates for fire safety, legionella testing, moving and handling equipment and general safety measures was evident. Staff confirmed they receive fire training, moving and handling, infection control, COSHH and first aid. Medication training is offered and staff receive training specific to caring for people with dementia. Training records confirmed this takes place and the home clearly have a commitment to maintaining this. Water temperatures are tested by the manager, currently on a three monthly basis. The frequency needed should be determined by using health and safety guidance (especially when giving a full immersion bath). Random water temperatures were tested and found to be within expected parameters. Emergency lighting was provided and fire alarm testing takes place on a weekly basis, a fire check was being undertaken during the site visit. For those service users who want to have their room doors kept open, door closures are provided. On one occasion a service users room door was propped open with a stool, this was discussed with the manager who stated that a new door closure was waiting to be fitted and this was only a very temporary measure. Riccall House DS0000007669.V324446.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 X x 4 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 2 3 x x 2 x x x 1 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 2 x 3 x x 1 Riccall House DS0000007669.V324446.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES 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 OP22 OP26 OP38 Regulation 16 23 23 Requirement The service user in room 10 must have access to her call bell at all times. Service users must not be able to gain access to the laundry. Service users must not have their doors propped open by unauthorised means (pertaining to room 2) Timescale for action 14/12/06 16/12/06 14/12/06 Riccall House DS0000007669.V324446.R01.S.doc Version 5.2 Page 24 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 OP9 Good Practice Recommendations Controlled drugs should be recorded in a file with numbered pages. A locked container for medication stored in the fridge should be obtained. The manager should familiarise herself with the adult protection referral and investigating procedure. The quality assurance system should include:Residents surveys More detailed care plan auditing Medication audits 2. 3. OP18 OP33 Riccall House DS0000007669.V324446.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Riccall House DS0000007669.V324446.R01.S.doc Version 5.2 Page 26 - 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!