Inspection on 13/07/05 for Richmand House Residential Home Ltd

This inspection was carried out on 13th July 2005.

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

Richmand House Residential Home... 27/09/07

Richmand House Residential Home... 18/12/06

Richmand House Residential Home... 17/10/05

Richmand House Residential Home... 14/02/05

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

CARE HOMES FOR OLDER PEOPLE Richmand House Residential Home 88-90 Melton Road West Bridgeford Nottingham NG2 7NF Lead Inspector Linda Hirst Unannounced 13 July 2005 10:00 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 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. Richmand House Residential Home C53 C03 S61918 Richmand House V238657 130705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Richmand House Residential Home Address 88-90 Melton Road Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0115 9142609 0871 2424469 Richmand House Residential Home Ltd Mrs Susan Melanie Godfrey Care home 14 Category(ies) of OP Old age, x 14 registration, with number of places Richmand House Residential Home C53 C03 S61918 Richmand House V238657 130705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: NONE Date of last inspection 14 February 2005 Brief Description of the Service: Richmand is a care home providing personal care and accommodation for 14 older people. It is owned by Richmand Care Homes Ltd and managed by Susan Godfrey, one of the providers, who also plays a very active part in all aspects of service provision. The home is located in West Bridgford, on one of the main bus routes running through the area. It is approximately half a mile into the centre of West Bridgford, which offers shops, pubs, cafes and other facilities. There are also shops, churches and a post office on the main road, close to the home. It is a semi detached, Victorian house which has been extended and provides 12 single and 1 double bedroom on the ground and first floor. The occupancy increased from 8 to 14 service users in July 2004. All but 2 of the rooms have en-suite facilities. The first floor is accessed by a stair lift. There is a small garden to the rear and off road parking for a small number of cars to the front of the property. Richmand House Residential Home C53 C03 S61918 Richmand House V238657 130705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over half a day with one inspector and the visit was not announced. The main method of inspection used was called ‘case tracking’ which involved selecting three residents and tracking the care they receive. Two of the people selected for “case tracking” have a limited ability to understand and communicate effectively, the third refused to speak to the inspector. Most of the judgements in this report are from observation of staff interactions and reading residents records and documents. The residents themselves were not able to help much in this process. Staff files, complaints, staff training and supervision documents were examined. Two members of staff were spoken with and others were observed in their duties throughout the visit. What the service does well: What has improved since the last inspection? The provider is now doing regular reports on his visits to the home which look at the views of residents, relatives and staff and gives him the chance to check the care provided is of a good quality. All bedrooms now have lockable facilities. No other requirements or recommendations were set after the last visit. Richmand House Residential Home C53 C03 S61918 Richmand House V238657 130705 Stage 4.doc Version 1.40 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. Richmand House Residential Home C53 C03 S61918 Richmand House V238657 130705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Richmand House Residential Home C53 C03 S61918 Richmand House V238657 130705 Stage 4.doc Version 1.40 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 standard(s) 3, 6 The manager makes sure that the staff can meet the needs of potential residents to prevent unnecessary moves taking place. EVIDENCE: The resident who was most recently admitted to the home was “case tracked,” there was evidence of a pre admission assessment and good information had been gathered on her personal history to make sure the staff knew key information about her life and the people who were important to her. There was evidence to indicate that the manager had properly assessed her and made sure the home could meet her needs before admission. Intermediate care is not provided at the home and this standard is not applicable. Richmand House Residential Home C53 C03 S61918 Richmand House V238657 130705 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 10 The care plans and risk assessments are not detailed enough to enable staff to be clear about how to meet the residents’ needs. The residents’ health needs are properly assessed, referrals are made to health professionals and the needs are well provided for. Staff treat residents with patience, dignity and respect. EVIDENCE: The care plans for the residents were examined. There were some good documents within the care plans (particularly the personal histories which give detailed information on residents’ backgrounds.) However the care plans and risk assessments were not sufficiently detailed to properly guide the staff about how to meet the needs of the residents. In one case risk assessments were needed on a resident’s skin care needs and on their ability to eat. There is a sheet in the care plans where residents or relatives can indicate their agreement with the care plans and this provides evidence that they know how staff intend to help them. Richmand House Residential Home C53 C03 S61918 Richmand House V238657 130705 Stage 4.doc Version 1.40 Page 10 It is clear from interviews however that the staff know the residents and their needs well. There is one resident with pressure sores, the District Nurse visits the home daily to provide treatment, and the Tissue Viability Nurse is involved and provides advice, equipment and support. One resident has input from a Clinical Psychologist and another has a community nurse visiting to bring her medication. The records of District Nursing and GP input are well maintained and all of this provides good evidence that residents’ health needs are appropriately met. Throughout the visit, interactions between staff and the residents were observed. The staff respond to residents in a kind, patient and respectful manner even though some behaviour was challenging. One of the residents said that the staff were “nice,” and she likes living at the home. Richmand House Residential Home C53 C03 S61918 Richmand House V238657 130705 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 The residents have access to the local community and are able to receive visitors when they want and in private if they prefer. EVIDENCE: There is a minibus at the home for the residents’ use, and staff said that regular trips out are arranged, these have included trips out to parks, the ballet and staff will walk with residents to the local shops. One of the “case tracked” residents said she goes out regularly to Mass with her family and another resident spends most of her day out of the home visiting family and friends. It is clear that the residents can access the local community as much as their needs and preferences allow. Two residents interviewed said their relatives and friends could visit when they wished, and there are enough communal and private areas for these visits to be in private if the resident wishes. Richmand House Residential Home C53 C03 S61918 Richmand House V238657 130705 Stage 4.doc Version 1.40 Page 12 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 standard(s) 16, 18 The arrangements for complaints are clear and ensure that residents’ concerns are taken seriously and acted upon. The staff are aware of their obligations in respect of abuse and have access to guidance via their own policy and procedure and the Protection of Vulnerable Adults procedure manual. EVIDENCE: There is a complaints procedure in place and this is displayed so that residents and their representatives are clear about the process to follow if they have any concerns. The complaints book was seen, and although two were recorded, these were actually untoward incidents rather than complaints. It is recommended that these be recorded in a separate book to avoid confusion. There have been no complaints received in the past year. Those received previously show evidence of investigation and outcomes and indicate that the manager responds to complaints and takes action as needed. There are copies of the abuse procedure manual at the home which staff can access for guidance in the event of an allegation being made. There have been no allegations of abuse in the past year and none of the staff have been referred to the Protection of Vulnerable Adults First list. The staff interviewed confirmed that they have had in house training on abuse and said they would report any bad practice to the manager without delay. They were aware of their obligations to protect the residents. Richmand House Residential Home C53 C03 S61918 Richmand House V238657 130705 Stage 4.doc Version 1.40 Page 13 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 standard(s) 19, 20, 26 The home is clean, well maintained and offers comfortable accommodation to the residents who live there. EVIDENCE: The home is well maintained, clean and offers comfortable accommodation to the residents. There is an imaginative use of space and several smaller quiet areas have been created to give residents choices about where they sit and with whom. The residents were seen making good use of the garden. Those spoken with said they like the home and feel happy. Richmand House Residential Home C53 C03 S61918 Richmand House V238657 130705 Stage 4.doc Version 1.40 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, 30 The staffing levels meet the needs of the residents living at the home. The staff recruitment procedures are robust and offer protection to vulnerable residents. Staff have access to good levels of training to make sure they are competent to do their job. EVIDENCE: There were three care staff on duty during this visit in addition to the manager and this is above the minimum level of staffing required, although it is appropriate to the needs of the residents. Staff were observed being attentive to residents, offering them regular hot and cold drinks as it was a sunny day and sitting beside those who were unwell encouraging them to take fluids to keep them well. Staff files were inspected and these had all of the information and documentation required to protect the residents. Staff meetings are held regularly and the staff interviewed said they work well together as a team and have good support and training provided. The staff training record indicates that staff have had training on Health and Safety, Basic Food Hygiene, Fire Safety, Medication, Basic First Aid and Communication. Training on Moving and Handling and TOPPS induction training are planned. Richmand House Residential Home C53 C03 S61918 Richmand House V238657 130705 Stage 4.doc Version 1.40 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 36 The home is well run and managed and staff are well supported, supervised and guided. EVIDENCE: Residents have their needs assessed and met and the evidence gathered indicates that the home is well run and managed with the wellbeing of residents at the heart of the operation of the home. Residents said they were happy at the home and the staff commented that the manager/owner is very attached to the residents and open to ideas. Her philosophy is adopted by the staff and this was demonstrated in their interviews. There was evidence of staff supervision on the files and residents confirmed that Sue is available and supportive. Richmand House Residential Home C53 C03 S61918 Richmand House V238657 130705 Stage 4.doc Version 1.40 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 3 x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x x 3 x x Richmand House Residential Home C53 C03 S61918 Richmand House V238657 130705 Stage 4.doc Version 1.40 Page 17 N/A Are there any outstanding requirements from the last inspection? 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 7 16 Good Practice Recommendations Care plans and risk assessments should be more detailed to guide staff Record untoward incidents separately from complaints. Richmand House Residential Home C53 C03 S61918 Richmand House V238657 130705 Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Richmand House Residential Home C53 C03 S61918 Richmand House V238657 130705 Stage 4.doc Version 1.40 Page 19 - 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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