Inspection on 27/05/06 for Richmond Heights Nursing Home

This inspection was carried out on 27th May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Richmond Heights Nursing Home 21/05/07

Richmond Heights Nursing Home 01/11/05

Richmond Heights Nursing Home 19/04/05

Richmond Heights Nursing Home 08/12/04

Richmond Heights Nursing Home 31/07/04

Richmond Heights Nursing Home 09/06/04

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

CARE HOMES FOR OLDER PEOPLE Richmond Heights Nursing Home Woodhouse Road Intake Sheffield South Yorkshire S12 2AZ Lead Inspector Janice Griffin Key Unannounced Inspection 27th May 2006 7:00 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 Richmond Heights Nursing Home DS0000021800.V295606.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. Richmond Heights Nursing Home DS0000021800.V295606.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Richmond Heights Nursing Home Address Woodhouse Road Intake Sheffield South Yorkshire S12 2AZ 0114 253 1992 0114 253 1994 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) Speciality Care (REIT Homes) Limited Mrs Angela Kaye Care Home 55 Category(ies) of Old age, not falling within any other category registration, with number (55) of places Richmond Heights Nursing Home DS0000021800.V295606.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st November 2005 Brief Description of the Service: Richmond Heights is a purpose built, 55 bedded home for older people. There are 53 single en-suite rooms and one double room. It is in a residential area of Sheffield with good access to public services and amenities (e.g. bus services, shops, libraries etc). It is built over two floors all accessed by a lift. The home has a suitable number of lounges and dining rooms. The gardens are landscaped and it has a car park. The previous inspection report was made available to service users and their families, details of this was on the homes notice board. The weekly fees are: £429 to £559. This information was provided on 27th May 2006. The home charges extra for chiropody, toiletries, clothing, telephone, holidays and hairdressing. Richmond Heights Nursing Home DS0000021800.V295606.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place from 7:00 am to 3:50 pm. As part of the inspection process the inspector spoke to eight service users, four relatives and five staff. Most of the service users were seen during the inspection. Some of the service users were unable to contribute to the inspection process so the inspector spent time observing the direct care offered to those service users. Observations confirmed that service users were extremely comfortable and at ease in the company of the staff. The relatives described the service as in the main very good. A number of records were examined which included, the managers preinspection questionnaire, medication records, three service users care plans, three weeks menus and three weeks staff rotas. Records relating to staff recruitment, service users finances, staff training and the homes quality assurance systems were also checked. Several areas of the building were also inspected. One concern has been received at the home since the last inspection the concern was about a medication error. The concern was investigated by the manager and was upheld, which resulted in a member of staff being disciplined. Feedback on the inspection was given to the manager before the inspector left the home. What the service does well: The inspector observed that service users were well dressed in clean clothes and had received a good standard of personal care. Service users had visited the home for trial periods. Service users were encouraged and supported to maintain positive relationships with their families and friends. Staff handovers were taking place on a daily basis these meetings enabled the staff to discuss the current health needs of service users, to ensure that a consistent level of care could be offered. All service users attended a variety of social and leisure activities and these were based very much on the personal preferences of each individual. The home caters well for service users with physical disabilities. A good healthy nutritional diet is provided. Richmond Heights Nursing Home DS0000021800.V295606.R01.S.doc Version 5.2 Page 6 Feedback was being sought on a regular basis from relatives and service users. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Richmond Heights Nursing Home DS0000021800.V295606.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 Richmond Heights Nursing Home DS0000021800.V295606.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Quality in this outcome area is: poor. This judgement has been made using available written evidence, discussion with eight service users, four relatives and a visit to the home. Some service users have moved into the home without having their needs assessed, this does not ensure that their care needs can be met. Service users were able to have informal introductory visits to the home at the time of their admission. The relatives confirmed that this helped the service users to get to know everyone at the home, which made them feel less anxious. This home does not provide intermediate care services. EVIDENCE: Detailed full needs assessments have not been completed by the referring social worker for all service users admitted to the home. The relatives spoken to said at the time of their relatives admission they were able to have an informal introductory visits to the home. Records checked confirmed that service users families had been involved in decisions regarding the arrangements. Richmond Heights Nursing Home DS0000021800.V295606.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10. Quality in this outcome area is: poor. This judgement has been made using available written evidence, discussion with eight service users, and observations made by the inspector at the visit to the home. Discussions with service users, and observations made by the inspector confirmed that the staff promoted the service users privacy and dignity. The information in the care plans was not adequate to ensure that the service users health and social care needs could be met and risk assessments were not being reviewed at regular intervals. This does not protect the well being of service users. There was no evidence to show that service users and their relatives were involved in the care planning and reviewing process. This does not allow the service users and relatives to have a say in how the service users needs are being met. Richmond Heights Nursing Home DS0000021800.V295606.R01.S.doc Version 5.2 Page 10 EVIDENCE: All the service users spoken to said that the staff promoted their privacy and dignity .The inspector observed staff knocking on bedroom doors and waited to be invited in before entering. Service user and relatives meetings had been held on a regular basis. Three service users care plans were checked they were very untidy and information was difficult to retrieve. The care plans did not detail the service users religious and cultural needs and care needs had not been reviewed on a regular basis. Service users and relative were not involved with the production of the care plans or the reviews. Ranges of aids to assist service users with mobility problems were provided; these included lifting hoists and straps, assisted baths, walking frames and wheelchairs. Records were kept of medication received, and disposed of. Medication was securely stored and administered and recorded correctly. A pharmacist had checked the home’s medication systems in February 2006. A copy of the report was not available for inspection. Richmond Heights Nursing Home DS0000021800.V295606.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is: good. This judgement has been made using available written evidence, discussions with eight service users, four relatives, five staff and a visit to the home. Service users had access to a range of leisure activities based on their individual choices and preferences. Service users confirmed that the routines of daily living were flexible and suited their individual preferences. Service users were supported with maintaining and developing contact with their family and friends, and they also said that visitors were always welcome at the home. Which creates a home that people want to visit. A good choice of food was offered at each mealtime. This ensures that the diverse dietary needs of service users are met. EVIDENCE: All the service users spoken to confirmed that staff were extremely supportive and always encouraged them to become integrated into the local community, when they felt able to do this and with the appropriate staff support provided. They also said that the staff supported them with discovering how to enjoy Richmond Heights Nursing Home DS0000021800.V295606.R01.S.doc Version 5.2 Page 12 social situations and activities. And generally this was based on the personal preferences of each individual. A programme of the daily leisure activities was displayed on the notice board. Service users confirmed that they had regular contact with representatives from the local churches and that they were able to visit them at the home if they wished. The inspector observed breakfast and lunch, the meals served looked appetising. The service users and relatives said that the food served at the home was excellent. Ten service users were receiving special diets. Special cutlery and crockery was provided for those service users who had difficulty using knives and forks. Richmond Heights Nursing Home DS0000021800.V295606.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is: good. This judgement has been made after discussion with eight service users, four relatives, five staff members and using available written evidence including a visit to the home. The homes complaints procedure was clear, accessible and contained the necessary information. This is good management practice. Service users were protected from abuse by the awareness of staff through training and the homes procedures. EVIDENCE: The complaints procedure was available for service users, their relatives and staff. The manager confirmed that this would be available in alternative formats and languages should this be requested. All service users, relatives and staff spoken to said that they knew that they could complain if they were not happy about anything and that they felt able to discuss any issues or concerns that they may have with the manager. The complaints record confirmed that no complaints have been made at the home since the last inspection. One concern had been brought to the attention of the Commission For Social Care Inspection. By a visiting social worker. The concern was about a medication error. The concern had been investigated by the homes manager and were upheld which resulted in one staff member being disciplined. The medication system was Richmond Heights Nursing Home DS0000021800.V295606.R01.S.doc Version 5.2 Page 14 check by the inspector at this inspection and no errors were found. Staff had received formal adult protection training this included physical, emotional and sexual abuse. The manager was aware of the Sheffield City Councils adult abuse procedures. No allegations of abuse have been made about this home since the last inspection. Staff had been made aware of the action to take in dealing with third party information. Richmond Heights Nursing Home DS0000021800.V295606.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 and 26. Quality in this outcome area is: adequate. This judgement has been made after discussion with eight service users, four relatives, five staff members and using available written evidence including a visit to the home. The environment within the home was clean providing a comfortable environment for service users. Some decoration was damaged making the home look shabby in parts. The bedroom doors were not fitted with locks. This does not protect the service users privacy. The up stairs corridor door leading to the staircase was not fitted with a lock. This could impose on the service users safety. More attention needs to be paid to the hygiene standards at the home. EVIDENCE: Some parts of the home had been redecorated but some areas still had damaged decoration. The bedroom doors were not fitted with suitable door Richmond Heights Nursing Home DS0000021800.V295606.R01.S.doc Version 5.2 Page 16 locks, a lockable facility was provided in all bedrooms. Service users could smoke in a designated smoking area. Staff expressed concern about service users on the top floor who were wondering around at night, they were concerned that they could fall down the back staircase, as the door leading to the staircase was not fitted with a lock. The teapots used to serve tea from were badly stained and a member of staff was noted to serve tea from a large jug that was also badly stained. Appropriate seating had been provided in the garden for those service users wishing to sit outdoors whenever the weather permitted. Each floor had a number of toilets and bathrooms. Assisted baths and showers were provided for those service users with mobility problems. Toilets were easily accessible as they were close to lounge and dining areas. All the toilets had been adapted for service users with physical disabilities. Staff confirmed that they were provided with protective clothing if they needed it and that all the equipment was in good working order and that it had been serviced as required. Richmond Heights Nursing Home DS0000021800.V295606.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. Quality in this outcome area is: good. This judgement has been made after discussion with eight service users, four relatives, five staff members and using available written evidence including a visit to the home. Care staff had a range of skills and experience, which effectively supported the service users. This will ultimately benefit the health and welfare of the service users. The recruitment information obtained for new staff was not adequate to protect the welfare of service users who live at the home. At least 60 of staff have undertook NVQ training at level 2 or 3, and all staff had completed a range of training relevant to their role. This shows the providers commitment to staff development. EVIDENCE: The staff and service users said that there was enough staff on duty on most shifts but when staff phoned in sick at short notice then they could be difficulties covering their shift. Three staff files were checked; criminal record checks had been done for all three staff. Two references had been obtained; but gaps were noted in two staff’s employment history. Richmond Heights Nursing Home DS0000021800.V295606.R01.S.doc Version 5.2 Page 18 Staff spoken to had an understanding of the home’s fire procedures; they had received training on moving and handling, food safety and infection control. Three staff said that they had not had updated fire safety training for over six months. Staff files checked and discussions with five staff and the manager confirmed that all staff had completed detailed induction training. Staff were observed to be approachable and sensitive to the needs of service users and were able to communicate effectively with each person. Staff had completed training on NVQ in care and this had ensured that more than 60 of the staff team were qualified to level 2/3. Staff were being formally supervised at the frequency specified in the Care Homes Regulations and Standards to fully ensure individual staff development and the monitoring of care practices Richmond Heights Nursing Home DS0000021800.V295606.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. Quality in this outcome area is: adequate. This judgement has been made after discussion with the manager, eight service users, five staff and using available written evidence including a visit to the home. All the service users spoken to and all the staff said the manager was approachable and very professional. This demonstrates a good example to staff. Service users and relatives surveys are completed twice a year. This ensures that the home is run in the best interest of service users. Records were in the main up to date and well ordered to ensure the best interests of service users. The homes policies and procedures met the required standards. Hazardous substances were noted to be insecurely stored. This is dangerous practice. Richmond Heights Nursing Home DS0000021800.V295606.R01.S.doc Version 5.2 Page 20 EVIDENCE: The manager had a job description that clearly defined her roles and responsibilities and staff were aware of her role. There was a quality assurance system, which sought the views of service users and relatives. The responsible individual visits the home on a regular basis a report is written following the visits. No fire exits were blocked but hazardous substances were noted to be insecurely stored. The administrator handles money on behalf of some service users, account sheets were kept, receipts were available for all transactions and all transactions were witnessed by a second individual. Richmond Heights Nursing Home DS0000021800.V295606.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X 2 X 2 STAFFING Standard No Score 27 3 28 4 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Richmond Heights Nursing Home DS0000021800.V295606.R01.S.doc Version 5.2 Page 22 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 Standard OP3 Regulation 14 Requirement Service users must only be admitted to the home on the basis of a full needs assessment, which is completed prior to their admission. The care plans must be tidy so information can easily be retrieved. The service users and their relatives must be involved in the production of the care plans and the reviews. Evidence of their involvement must be in the care plans. Care plans must clearly show that information has been updated. The service users religious, social and cultural needs must be included in their care plans. All risk assessments must be revised to include how risk can be reduced and what action staff will take to reduce the risk. Timescale for action 01/08/06 2. OP7 OP8 15 01/09/06 Richmond Heights Nursing Home DS0000021800.V295606.R01.S.doc Version 5.2 Page 23 3. OP19 23 4. 5. OP19 OP38 OP24 12 16 6. OP26 23 7. 8. 9. OP29 OP30 OP31 18 23 8 10. OP38 12 Areas around the home with stained decoration must be redecorated. This requirement has been outstanding since 2005. A risk assessment must be completed with regard to the safety of the back staircase. All bedroom doors must be fitted with locks suitable for service users capabilities and accessible to staff in emergencies. This requirement has been outstanding since 01/12/05. The stained teapots and jugs must be cleaned or replaced. This requirement has been outstanding since 01/12/05. Gaps in the staff’s employment history must be explored. Staff must have at least two fire drills/practices per year. The manager must have a qualification at NVQ level 4 in management. This requirement has been outstanding since 2005. Hazardous substances must be kept in a secure place at all times. This requirement has been outstanding since 01/12/05. 01/09/06 01/08/06 01/09/06 27/05/06 01/08/06 01/08/06 01/09/06 27/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Richmond Heights Nursing Home DS0000021800.V295606.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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. 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