Inspection on 18/12/06 for Richmand House Residential Home Ltd

This inspection was carried out on 18th December 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

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

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

Richmand House Residential Home... 13/07/05

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 Bridgford Nottingham NG2 7NF Lead Inspector Judith Avill Key Unannounced Inspection 18th December 2006 11:30a 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 Richmand House Residential Home DS0000061918.V323499.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. Richmand House Residential Home DS0000061918.V323499.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Richmand House Residential Home Address 88 - 90 Melton Road West Bridgford Nottingham NG2 7NF 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) 0115 9142609 0115 9455861 richmondhouse88-90@tiscali.co.uk Richmand House Residential Home Ltd Mrs Susan Melanie Godfrey, Cedric Anthony Godfrey Mrs Susan Melanie Godfrey Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Richmand House Residential Home DS0000061918.V323499.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No one falling with category OP maybe admitted into Richmand House where there are 13 of category OP already accommodated within this home. 17th October 2005 Date of last inspection Brief Description of the Service: Richmand is a care home providing personal care for up to 13 older people. It is owned by Richmand Care Homes Ltd and managed by one of the providers who 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 from 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 an extended Victorian property and provides 12 single and one double bedroom, with all but two rooms having en suite facilities. The first floor is accessed via a lift. There is a small garden to the rear of the home and car parking for a few cars is available at the front of the home. At the time of inspection fees quoted by the registered manager was £1,482.00 to £2,139.00 per calendar month. Richmand House Residential Home DS0000061918.V323499.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was undertaken using all the information available to the inspector regarding surveys completed by residents and a pre questionnaire completed by the registered provider/manager Susan Godfrey. This visit involved one inspector who was at the home for approximately 5 hours including during lunch. The main method of inspection used was called ‘case tracking’ which involved selecting three residents and tracking the care they receive through checking their records and discussion with them. One of the residents selected was unwell on the day of the inspection but two other residents living at the home were also spoken with. Two members of staff and a visitor were also interviewed. The inspector looked at the records of health and safety checks, medication, residents’ finances, complaints and quality assurance. Lunch was also observed being prepared. Staff were observed undertaking their duties throughout the visit. What the service does well: What has improved since the last inspection? The medication procedure is well documented and medication is secure. The manager reported and records seen evidenced fire risk assessments have been completed. Richmand House Residential Home DS0000061918.V323499.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. Richmand House Residential Home DS0000061918.V323499.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 Richmand House Residential Home DS0000061918.V323499.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&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager undertakes a detailed assessment of prospective residents before providing care to ensure that care needs can be met. EVIDENCE: Four resident’s files seen contained evidence of a pre admission assessment and good information had been gathered on their personal history, preferences and assistance required. Staff spoken with said the manager told them about new residents before their admission. Intermediate care is not provided at the home and this standard is not applicable. Richmand House Residential Home DS0000061918.V323499.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 &10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Due to shortfalls in care planning and risk assessments documentation resident’s needs are at risk of not being met. The homes policies and procedures for the storage administration of medications help to safeguard residents. Residents are treated with respect. EVIDENCE: Residents care plans viewed contain information on individual preferences and choices. One records seen of a resident requiring ‘assistance with dressing’ contained no details of ‘how’ staff need to assist them. The manager reported and staff confirmed that when one resident was not well their body changed in a particular way. No record of observations to be made or action to be taken by staff was evidenced. The care plan for one resident who required two staff to transfer contained no evidence of action to be taken by staff to safely handle them. Richmand House Residential Home DS0000061918.V323499.R01.S.doc Version 5.2 Page 10 Staff spoken with were well aware of the individual care needs of residents and strategies for managing behaviour. Care plans need to be more detailed to ensure any new staff follow good practice. 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. During the visit the inspector observed interactions between staff and the residents. 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. It was observed that medication keys were not stored securely. The manager took immediate action to ensure that medication keys were stored on the person in charge of the shift. Records of medications were checked and were satisfactory on the day of inspection. Richmand House Residential Home DS0000061918.V323499.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 &15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A varied range of appropriate activities is provided for the residents at the home. The routines at the home are flexible and the residents feel they have freedom to decide their own lifestyle. Residents have a varied and nutritious diet that promotes good health. EVIDENCE: Residents said and staff confirmed that they get up when they like, for some this is early, but they said the staff do not wake them, they can have a lie in if they choose. They can go to bed when they choose and one resident said that for her this was usually around 10 p.m. One resident said she “enjoys” her life at the home. There were no relatives visiting the home but residents said their relatives and friends could visit when they wished. They commented that there are enough communal and private areas for these visits to be in private if the resident wishes. Lunch was observed being prepared by care staff on the day of inspection due to the absence of the cook. The food being prepared was fresh and looked appetising. The residents sit in small groups to eat and were relaxed, chatting about the Christmas tree. The residents commented that they get “plenty” to eat and drink and said that the food is varied and well cooked. Richmand House Residential Home DS0000061918.V323499.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 &18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ concerns are taken seriously and acted upon. Residents are safeguarded by the homes adult protection system. EVIDENCE: The record of complaints was inspected. None have been received at the home or via the Commission for Social Care Inspection since the last visit. Complaints and incidents are recorded in separate books. Residents spoken with said they would speak to the manager or staff if they had any concerns and felt safe at the home. There are copies of the abuse procedure manual at the home that 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 register. The staff interviewed confirmed that they were aware of the action to be taken in the event of an allegation 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 DS0000061918.V323499.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 &26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a high standard of furnishings and is very well maintained and offers comfortable accommodation to the residents who live there. The home was clean and tidy throughout. EVIDENCE: The home is well maintained, clean and offers comfortable accommodation to the residents. The standard of furnishings and decorations are to a high standard. There are several smaller quiet areas, which have been created to give residents choices about where they sit and with whom. The residents seen were all sitting in the lounges near the kitchen on the day of inspection. Bedrooms viewed were well maintained and personalised. The garden was well maintained and has a variety of garden furniture. Those residents spoken with said they like the home and feel happy. Richmand House Residential Home DS0000061918.V323499.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The staffing levels meet the needs of the residents living at the home. The lack of getting references as part of the homes recruitment procedures put the residents at risk. Staff have received training to ensure they are competent to do their job. EVIDENCE: On the day of inspection there were two care staff, a housekeeper and the manager on duty. The manager reported she was on night duty that night and had come on duty to prepare the Christmas tree for the residents. The information from the staff rota provided meets the staffing levels for the needs and numbers of residents living at the home. The staff rota indicates letters such as ‘D’ and no key to say what this stands for. This record does not provide enough information on the hours that staff are working in the home. Staff were observed being attentive to residents, offering them drinks and preparing lunch. Attention was given to a resident who was unwell during the inspection. Staff reported that more staff would be available if required to meet the resident’s needs. Residents said staff were kind and caring. The inspector initially checked two staff files and found lack evidence of references for staff working at the home. All staff files were checked during the inspection. Records seen evidenced four staff with no references and three staff with one reference. Six of these have been working at the home for a considerable time however one member of staff who had been employed in Richmand House Residential Home DS0000061918.V323499.R01.S.doc Version 5.2 Page 15 2006 had no references. An immediate requirement was issued for the manager to apply for references. However the home had obtained satisfactory Criminal record Bureau checks for all staff working at the home. Training records seen evidenced and staff spoken with confirmed that all staff attend mandatory training to ensure staff can fulfil the roles and responsibilities of the job. Staff training record and comments indicated that staff had received training which included: Health and Safety, Basic Food Hygiene, Fire Safety, Medication, Basic First Aid, Communication, Moving and Handling and TOPPS induction. Staff confirmed that they are undertaking National Vocational Qualifications (NVQ) and are supported by the manager. During the inspection an assessor for the National Vocational Qualifications (NVQ) visited the home. Richmand House Residential Home DS0000061918.V323499.R01.S.doc Version 5.2 Page 16 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 36 37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run and managed and staff are well supported and supervised. The home has a good system in place to gain the views of people living at the home. Appropriate systems are in place for the safe keeping of resident’s finances. 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 is very supportive and has a great attachment and affection for the residents. Staff spoken with had a warm and caring attitude to all the residents and commented they are happy working at the home. Richmand House Residential Home DS0000061918.V323499.R01.S.doc Version 5.2 Page 17 Residents finances checked were accurate and maintained up to date. Staff files seen contained evidence of supervision and staff and residents confirmed that Sue is available and supportive. The home has satisfactory policies and procedure in place. However it is recommended that the manager review the recruitment procedure to make sure it covers all essential areas especially those relating to temporary staff. Information received prior to the inspection and sampling on the day showed that the health and safety and servicing of equipment records were completed and up to date. Richmand House Residential Home DS0000061918.V323499.R01.S.doc Version 5.2 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 1 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 3 3 2 3 Richmand House Residential Home DS0000061918.V323499.R01.S.doc Version 5.2 Page 19 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 (1) Requirement Timescale for action 26/03/07 2. 3 OP27 OP37 OP29 17 (2) Schedule 6 19 The registered person must ensure that care plans provide comprehensive information for staff to follow. This must include the arrangements for the manual handling of residents The registered person must 26/03/07 ensure the staff rota indicates the hours staff work each shift The registered person must 18/12/06 ensure that all staff employed to work at the home have two satisfactory references before commencing employment Richmand House Residential Home DS0000061918.V323499.R01.S.doc Version 5.2 Page 20 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 OP37 Good Practice Recommendations The manager should review the recruitment procedure to make sure it covers all essential areas especially those relating to temporary staff. Richmand House Residential Home DS0000061918.V323499.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Richmand House Residential Home DS0000061918.V323499.R01.S.doc Version 5.2 Page 22 - 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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