Inspection on 17/05/05 for Richmond

This inspection was carried out on 17th May 2005.

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 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

Richmond 15/07/08

Richmond 14/08/07

Richmond 05/06/06

Richmond 15/11/05

Richmond 11/01/05

Richmond 17/05/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Richmond Collington Lane East Bexhill-on-Sea East Sussex TN39 3RJ Lead Inspector Paul Endersby Unannounced 17 May 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. Richmond H59-H10 S21194 Richmond V225678 170505 Stage 0.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Richmond Address Collington Lane East Bexhill-on-Sea East Sussex TN39 3RJ 01424 217688 01424 210424 None Methodist Homes for the Aged (Organisation) 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) Mrs Debra Macklin Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (OP), 40. of places Richmond H59-H10 S21194 Richmond V225678 170505 Stage 0.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of residents to be accommodated is forty 2. People will be aged sixty five years or over on admission Date of last inspection 11 January 2005 Brief Description of the Service: Richmond is a purpose built home providing personal care and accommodation for forty older people. It is owned and managed by Methodist Homes for the Aged. Single room accommodation is provided throughout. The building has two floors. On the ground floor there are nine rooms and on the first floor there are thirty-one rooms. Meals are served in the dining room or in individual bedrooms if required. There is a programme of regular activities for service users. Richmond H59-H10 S21194 Richmond V225678 170505 Stage 0.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during the morning and early afternoon in May and lasted five hours. The Inspector met with staff and the home’s deputy manager. In depth discussions took place with six residents. The Inspector examined a range of records and other written information including care plans, health and safety information. A tour of the premises was also undertaken. What the service does well: 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Richmond H59-H10 S21194 Richmond V225678 170505 Stage 0.doc Version 1.20 Page 6 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 Richmond H59-H10 S21194 Richmond V225678 170505 Stage 0.doc Version 1.20 Page 7 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) 4 & 5 The pre-admission assessment arrangements, including the facility for preadmission visits and the staff training programme contribute to the homes ability to meet the assessed needs for residents and provide opportunity for residents and their families to assess the quality and suitability of the home. EVIDENCE: Pre admission assessments of prospective residents are undertaken by senior staff of the home. It was clear from inspecting these and other records, from direct observation and from speaking with residents, that the home is largely able to meet the assessed needs of people accommodated. In meeting resident’s needs staff are aided by a wide ranging training programme which includes both core training and topics directly related to residents individual needs. Notwithstanding this the method of informing staff of the needs of new residents is to some extent informal. Prospective residents and their representatives are encouraged to visit the home prior to admission. However in practice not all take up this option. Residents are accommodated on a trial basis before they make a final decision to stay. Richmond H59-H10 S21194 Richmond V225678 170505 Stage 0.doc Version 1.20 Page 8 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 The care planning arrangements are not being used to their full potential for the benefit of residents. The arrangements for monitoring resident’s health care requirements contribute to ensuring that their needs are met. EVIDENCE: Care planning documentation is prepared on all residents which includes assessments, risk assessments and the care plan itself. There is evidence that this documentation is reviewed on a regular basis. However none of the residents seen by the Inspector were aware of the existence of their care plan and none seen by the Inspector were signed. Some care plans are repetitive in their contents and there is some evidence that some links between the assessment and the care plan are not always clear. There is also some evidence that care plans are given only limited use by staff. Residents have full access to community health care services when required. In addition to the General Practitioner service, the home also consults the district nurses as required. Residents also have access to Dentists, Opticians and Chiropodists plus other specialists should the need arise. Most of the residents seen by the Inspector confirmed that their health needs are being met. Within the home, there are policies relating to pressure relief and correct manual handling procedures. Richmond H59-H10 S21194 Richmond V225678 170505 Stage 0.doc Version 1.20 Page 9 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, 14 & 15 Residents expectations and preferences including their ability to make choices are largely met. Links with the community are good and support and enrich residents social opportunities. EVIDENCE: Residents confirmed that as far as possible their expectations and preferences are met. There is a commitment to ensuring that there are a range of activities within and outside of the home that provide residents with meaningful occupation and leisure opportunities. To this end there are two part time activity co-ordinators included in the staff team. The home has a Christian emphasis and there are regular church meetings within the home. Visitors are welcome at any reasonable time and that home is part of the local community. Residents also confirmed that they are able to visit their families or have their families visit them. The forming of friendships within the home is encouraged and respected. There are opportunities for people to attend Day Centres if they wish. It is clear from direct observation and the comments made by residents that the ethos of the home is to maximize resident’s capacity to exercise personal autonomy and choice. To this end all residents felt they were in control of their own lives. All residents seen by the Inspector felt that staff are respectful towards them including both their privacy and dignity. There is a large pleasant dining room at this home where all main meals are served. Residents are encouraged to come to the dining room for meals but should Richmond H59-H10 S21194 Richmond V225678 170505 Stage 0.doc Version 1.20 Page 10 they so require they may have meals in their own private accommodation. Generally residents spoken to were complimentary about the meals. However there were some minor reservations expressed by some residents. Special diets and alternatives to the main menu are available. Richmond H59-H10 S21194 Richmond V225678 170505 Stage 0.doc Version 1.20 Page 11 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) 18 The lack of training for all staff in regard to Adult Abuse and Adult Protection are not completely satisfactory. EVIDENCE: Richmond is part of a large voluntary organization and therefore overseen by a range of external staff. Appropriate policies are in place for the guidance and instruction of staff in regard to Adult Abuse and Adult Protection. However other than training received by staff studying for their NVQ, and reference during staff induction and staff meetings, there is no ongoing training programme for staff. Thus some staff have never received training in Adult Protection and Adult Abuse. This is confirmed by the staff training records where there is little reference to this type of training. Richmond H59-H10 S21194 Richmond V225678 170505 Stage 0.doc Version 1.20 Page 12 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, 21 & 24 The overall standard of the environment within the home is good providing residents with an attractive and homely place to live. EVIDENCE: The home which is purpose built is designed to meet the needs and requirements of older people. It is situated on two floors and includes a shaft lift. The home is situated in its own grounds. The building is light and airy and has a substantial garden. A full time maintenance person is employed and there is a rolling programme of renewal and re-decoration. All residents are accommodated in single rooms with either full en-suite including shower or toilet and wash hand basin. Additionally there are five assisted bathrooms and seven separate toilets. Bedrooms are furnished in such a way as to reflect the lifestyle and interests of individual residents. They are able to furnish their room in its entirety if they so choose. As a result many are personalized with individuals personal items; e.g. photographs, pictures, ornaments and small items of furniture. There have been recent visits by the Fire Brigade and the Environmental Health Department to ensure the relevant standards are adhered to. Richmond H59-H10 S21194 Richmond V225678 170505 Stage 0.doc Version 1.20 Page 13 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, 28 & 30 Care staffing levels are not always sufficient to ensure that residents needs are always appropriately met. EVIDENCE: As at previous inspections staffing levels were the subject of some discussion. Whilst there is a good skill mix of the staff including management, carers, ancillary, the actual number of carers on duty is normally four for forty residents. They are supported by a senior carer who is able to provide some direct care depending on other calls on their time. Some use is made of agency staff to maintain these levels. The administrative maintenance and activities staff are shared with Heatherbank, the adjoining home. There are two waking staff on night duty. Again, as at previous inspections feedback received from some residents indicated that daytime care staffing levels are not considered to be adequate at all times. The ratio of one care to ten residents is lower than would normally be expected in a home of this type. It was confirmed that staffing levels will be included in the forthcoming Quality Audit which will give residents an opportunity to express their views. As already indicated the organization has an obvious commitment to staff training and staff confirmed they are regularly offered opportunities to attend relevant training. In addition eight members of staff, excluding management, have successfully achieved NVQ level 2 or better. Currently a further 13 are in training. A record of all staff training is maintained. The Manager is a Work Base Assessor for NVQ Assessor which supports the progress towards raising the level of staff qualification. All newly employed staff undertake induction and foundation training which meets the current standards. Richmond H59-H10 S21194 Richmond V225678 170505 Stage 0.doc Version 1.20 Page 14 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, 35 & 38 The home is well managed by a suitably qualified and experienced manager. Appropriate arrangements have been made for providing a safe environment for residents. EVIDENCE: The manager was not present during the inspection. However the overall organizational arrangements and the responses from both residents and staff provided evidence that she is competent in running the home. Additionally it was confirmed that the manager is trained and qualified to NVQ level 4 and has undertaken the Registered Managers Award and has successfully completed the City & Guilds Advanced Management for Care course. Most residents manage their own finances or have assistance from family or legal advisers, although when required there is some minor involvement in residents finances by the home’s senior staff. However no one from the home acts as an appointee. Records relating to personal monies are well documented. A sample were inspected and found to be satisfactory. Appropriate arrangements have Richmond H59-H10 S21194 Richmond V225678 170505 Stage 0.doc Version 1.20 Page 15 been made for providing a safe environment for residents. Fire drills are carried out and staff receive regular training. There are fire procedures visible throughout the home and in the service users guide. The home’s accident record book is well maintained. There are regular tests of gas and electrical equipment and systems. Staff training in key areas is provided supported by written policies including first aid, infection control, food hygiene and moving and handling. Richmond H59-H10 S21194 Richmond V225678 170505 Stage 0.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x 3 x x 3 x x STAFFING Standard No Score 27 2 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 3 x x x 3 x x 3 Richmond H59-H10 S21194 Richmond V225678 170505 Stage 0.doc Version 1.20 Page 17 NO 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 7 Regulation 15(1)(2) (a) 13(6) 18(1)(a) Requirement Wherever practicable residents or their representatives should be involved in the preparation and review of their service plans. Training in Adult Protection must be provided for all staff. Staffing levels must be reviewed with a view to providing additional care time. Timescale for action 17.05.2005 2. 3. 18 27 17.05.2005 31.07.2005 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 4 7 Good Practice Recommendations The arrangments for conveying information to staff about new residents should be reviewed. The use of care plans by staff should be reviewed. Richmond H59-H10 S21194 Richmond V225678 170505 Stage 0.doc Version 1.20 Page 18 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Richmond H59-H10 S21194 Richmond V225678 170505 Stage 0.doc Version 1.20 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. 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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