Inspection on 22/05/07 for Richmond House

This inspection was carried out on 22nd May 2007.

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

Richmond House 21/02/06

Richmond House 13/10/05

Richmond House 08/03/05

Richmond House 03/08/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Richmond House Richmond Road Farsley Leeds LS28 5ST Lead Inspector Ann Stoner Unannounced Inspection 22nd May 2007 10:00 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 House DS0000033217.V335793.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 House DS0000033217.V335793.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Richmond House Address Richmond Road Farsley Leeds LS28 5ST 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) 0113 2555010 0113 2558435 N/A Leeds City Council Department of Social Services Mrs Susan Avery Mimi Anderson Lawrence Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20), Physical disability (1) of places Richmond House DS0000033217.V335793.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The place for physical disability is for the service user named in the NCSC letter dated 8 January 2004 only. 21st February 2006 Date of last inspection Brief Description of the Service: Richmond House is a local authority older person home located in Pudsey, which is approximately 3 miles from the centre of Leeds. The home is close to a good range of local amenities and transport links. There are a total of 20 beds available. Permanent accommodation is provided for one person, the remaining being provided for people receiving a respite or intermediate care service. All of the bedrooms are single rooms with en-suite facilities provided in the intermediate care rooms. There is very good access for people with disabilities into the premises and a shaft lift links the ground and first floor. There is outdoor seating provided and car parking is available. The current fees range from £10. 42 per night to £458. 86 a week. Additional charges are made for hairdressing and private chiropody. This information was supplied to the Commission for Social Care Inspection before the inspection. More up to date information can be obtained from the home. Copies of previous inspection reports are available in the home. Richmond House DS0000033217.V335793.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission for Social Care Inspection (CSCI) inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. All regulated services will have at least one key inspection between 1st April 2006 and 30th June 2007. This is a major evaluation of the quality of a service and any risk it might present. It focuses on the outcomes for people using it. All of the core National Minimum Standards are assessed and this forms the evidence of the outcomes experienced by people using the service. More information about the inspection process can be found on our website www.csci.org.uk The last key inspection was carried out on the 21st February 2006, and a random inspection to look at issues relating to medication was carried out by the CSCI pharmacist on the 5th March 2007. This key inspection visit was unannounced and carried out by one inspector who was at the home from 10.00 until 18.30 on 22nd May 2007. The purpose of the inspection was to make sure the home was operating and being managed for the benefit and well being of the people who use the service and in accordance with requirements. Before the inspection accumulated evidence about the home was reviewed. This included looking at any reported incidents, accidents and complaints. This information was used to plan the inspection visit. During the visit a number of documents were looked and all areas of the home used by the people living there were visited. A good proportion of time was spent talking with the people who were staying at the home, their friends and relatives, community nurses, a visiting doctor as well as the person in charge who was a senior care officer and staff. A pre-inspection questionnaire (PIQ) had been completed before the visit to provide additional information about the home. Feedback at the end of the visit was given to the senior care officer and one of the managers the following day by telephone. I would like to thank everyone who contributed to the inspection process and to the home for the hospitality on the day. Richmond House DS0000033217.V335793.R01.S.doc Version 5.2 Page 6 What the service does well: The home sends out satisfaction questionnaires to people staying at the home and their friends and relatives. Comments on recently returned questionnaires from people living at the home include: • • • • • • • • The meals are good with plenty of choice There is a wide range of different food available The home is lovely and clean, absolutely excellent Staff have been excellent Nothing is too much trouble for staff they are excellent Staff always spend time to listen to people Staff always find time for you Staff are approachable and are ready to listen to you. Comments from friends and relatives of people staying at the home include: • • • • All staff are excellent and we are made welcome at every visit Staff are friendly and very helpful at all times Staff are pleasant and jolly at all times and nothing is too much trouble for them There is always a relaxed and friendly atmosphere. These comments were reinforced during the visit when speaking to people staying at the home, their friends and relatives and visiting healthcare professionals. What has improved since the last inspection? What they could do better: Evidence from previous inspections, the feedback session with the senior care officer and a telephone conversation with one of the managers the day after this inspection all confirmed that the home has a clear commitment to addressing the requirements and recommendations of this inspection. On admission everyone staying at the home should have a contract so that they are aware of the terms and conditions of their stay. People using the respite service should have their needs re-assessed before each stay to make sure that the home can still meet their needs. People’s care needs and the precise action that staff should take to meet these needs must be recorded in the person’s care plan. This will prevent needs Richmond House DS0000033217.V335793.R01.S.doc Version 5.2 Page 7 from being overlooked. Nutritional and falls risk assessments should be carried out for each person to identify those people who may be at risk. The home must introduce a safe system for medication administration without delay to prevent the risk of people receiving the wrong medication. The medicine trolley must be stored securely and handwritten entries on medication records must be signed and checked by a second person to reduce the risk of errors. All staff must receive training on adult abuse to make sure that people staying at the home are safeguarded. Infection control measures must be reviewed to prevent the spread of infection in the home. Recording in staff recruitment files must be improved to meet the requirements of the Care Homes Regulations 2001. The home should consider using valances on divan beds to further enhance bedrooms. The provider should consider increasing the amount of administrative support to the home to allow the management team to concentrate on their management responsibilities. The home should extend the distribution of quality assurance questionnaires and inform people of the outcomes of questionnaires. Some amendments are needed to the way that the home records financial transactions for people staying at the home. This will reduce the risk of errors. All staff should receive fire training twice a year and other training such as moving and handling should take place as required. This will safeguard both staff and people staying at the home. A full list of the requirements and recommendations made at this inspection can be found at the end of this report. 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. Richmond House DS0000033217.V335793.R01.S.doc Version 5.2 Page 8 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 House DS0000033217.V335793.R01.S.doc Version 5.2 Page 9 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): Standards 1, 2, 3, 4, 5 & 6. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. People have enough information to be able to make an informed choice before agreeing to stay at the home, but because a contract is not provided at the point of admission they may not be aware of the terms and conditions of their stay. EVIDENCE: There is a wide range of information available in the front entrance of the home so that people are aware of the service that the home provides. In addition there is a comprehensive file in all of the bedrooms giving people information about the home, most of which is in large print so that is meets the needs of people staying there. The senior care officer said that when a person is referred for their first respite stay they are invited for a day visit to make sure that the person is happy with the home, and that the home can meet their needs. Richmond House DS0000033217.V335793.R01.S.doc Version 5.2 Page 10 Records showed that people with dementia who receive a respite service have their needs re-assessed at each respite stay. Other people have their needs re-assessed every 12 months. It is recommended that all people receiving a respite service have their needs re-assessed before each stay. A discussion took place with the senior care officer on how this could be achieved. Those records sampled showed that people have an assessment completed by a social worker and then the home carries out an assessment to make sure that the placement is suitable. It is recommended that the home’s assessment be extended to include information about people’s cultural, spiritual and religious needs. Care staff were knowledgeable about assessment processes and said that they had sufficient information about people’s needs before the point of admission. They said there is a good communication system in the home and that they have access to all of the assessment information. People receiving an intermediate care service are assessed by the intermediate care team and have a programme of care developed that helps them retain and improve their independence so that they can return home. There was no evidence that people who use the respite or intermediate care service receive a contract and/or terms and conditions of their stay at the point of admission. This means that they may not be aware of the rights and responsibilities of all parties concerned for the duration of their stay. Richmond House DS0000033217.V335793.R01.S.doc Version 5.2 Page 11 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): Standards 7, 8, 9 & 10. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. The home provides a service that meets the needs of the people staying there. Areas of weakness in relation to medication are being addressed by the home and a commitment has been shown to address shortfalls in care records. EVIDENCE: There are care plans in place for everyone using the service. There was some good information in some of the plans such as preferences for a bath or shower, preferred time for bathing and the strengths and abilities of the person, such as ‘can manage to undress and get ready for bed, but does need some help to take his socks off’. Staff said that people receiving an intermediate care service are assessed by the intermediate care team who provide all care for the person during the first 48 hours. They then complete a care plan for the home staff to follow. When staff described the care they gave to one person receiving an intermediate care service it was clear that not all of the care they were giving was detailed Richmond House DS0000033217.V335793.R01.S.doc Version 5.2 Page 12 in the care plan. For example, the precise way that they assisted the person to walk and the way in which they assisted the person to use the toilet. As this information is not recorded there is always the risk that some needs may be overlooked. During a telephone conversation the day after this inspection, one of the managers agreed to discuss this with members of the intermediate care team. There is some form of nutritional assessment incorporated into the home’s moving and handling risk assessment but this does not identify any specific nutritional risks, and there are no risk assessments in place to determine those people who may be at risk of falling. One daily record completed by staff said, ‘A bit abusive to staff member.’ Because there is no description of the actual behaviour the comment is open to interpretation and could be misleading for staff. Because of the service the home provides healthcare professionals visit on a daily basis. A visiting community nurse said, “The home is so nice nobody wants to go home.” She went on to say that there was good communication between the community nursing services and staff at the home and that staff report any issues or concerns immediately and always follow instructions. One GP reviews and assesses the needs of all people receiving an intermediate care service at least once a week. During the inspection he said, “People’s needs are more than met at the home,” and went on to speak about the value of the service that the home provides and the good communication systems in place. A random inspection carried out by a CSCI pharmacist in March 2007 identified several areas of concern relating to the administration, storage and recording of medication at the home. The home is now in discussions with the PCT (Primary Care Trust) pharmacist, the CSCI pharmacist and Boots the Chemist to determine the most appropriate system of administration for the home that is safe and follows guidelines from the Royal Pharmaceutical Society of Great Britain. Until such a system is introduced the home continues to use a system of secondary dispensing in the form of dosette boxes, which means that people staying at the home are at risk of receiving the wrong medication and some medication may not be suitable for removing from the manufacturers’ packaging. The temperature of the fridge, used for storing medication requiring cold storage, is now checked and recorded on a daily basis. The home has introduced a contract for those people staying at the home, who wish to manage their own medication, but this does not show how the person has been assessed as being competent to manage their medication and it does not show the systems that are in place to monitor compliance. Throughout the inspection the medicine trolley was stored in the dining room and was not secured to a wall. This is unsafe. Handwritten entries on Medication Administration Records (MAR) are not checked and countersigned by a second Richmond House DS0000033217.V335793.R01.S.doc Version 5.2 Page 13 person, which increases the risk of errors. During the feedback session with the senior care officer at the end of this inspection and during a telephone conversation with one of the managers the following day it was clear that the home is addressing these issues. Staff described the different ways that they respect and protect people’s privacy and dignity. One person using the service said, “I like it because nobody intrudes and staff always knock on your bedroom door to make sure it is alright to enter.” The home’s quality assurance system includes satisfaction questionnaires for people living at the home. When asked if people’s privacy was respected one person responded by saying, ‘Yes excellent in every way.’ Richmond House DS0000033217.V335793.R01.S.doc Version 5.2 Page 14 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): Standards 12, 13, 14 & 15. People who use the service experience excellent quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. The flexibility of the home provides the opportunity for people to choose how to spend their time during their stay and make choices about daily living activities. EVIDENCE: Throughout the inspection people using the service spoke about having choice and flexibility in the home. One person said, “I have been in worse 5 star hotels than this. The attention you get is fabulous and there is always something to do.” Another person said that she could not fault the home and her visitors described the home as having a ‘lovely atmosphere’. The layout of the home encourages people to sit in small groups where they can sit and chat together and this was certainly evident throughout the inspection. During the inspection staff spent time with people playing cards, dominoes or just sitting and chatting to them. People not wanting to join in were reading Richmond House DS0000033217.V335793.R01.S.doc Version 5.2 Page 15 books and magazines, knitting and keeping themselves occupied with a variety of activities. From discussions with staff it is clear that the home promotes independence whenever possible. Staff said that it was important for people staying at the home to retain and improve their skills in daily living so that they can function at an acceptable level on their return home. This is good practice. Meetings are held for people staying at the home and there was evidence that issues raised by people are addressed. At one meeting people said that they would like an occasional fish and chip supper. During the inspection people staying at the home confirmed that this had taken place the previous week. The cook gave examples of how the menu is changed as a result of feedback from these meetings and through individual discussions with people. There were many visitors in the home throughout the day. All of those spoken to could not praise the home highly enough. Two visitors said they were always made welcome, and others confirmed that they are always offered refreshments. In the information pack in each bedroom visitors are advised that they are more than welcome to stay for a meal. The dining room is bright, spacious and attractive and it is clear that mealtimes are viewed as a social occasion. On each table there is a menu, in large print, that clearly states that if people do not like what is on they menu the home is more than happy to offer an alternative meal such as a jacket potato with assorted fillings, soup, salad or sandwiches. People were seen reading the menu before the meal was served and discussing whether to opt for an alternative. The lunchtime meal was sausage and Yorkshire pudding, potatoes, broccoli, peas and carrots followed by a selection of sweets. Tureens and gravy boats are provided on each table to encourage people to be as independent as possible and to be in control of their portion sizes. This is good practice. Where assistance was needed this was given by staff in a discreet way. The meal was relaxed and people lingered long after finishing their meal to chat with other people sitting at the table. The cook was clearly enthusiastic about her job and had a good understanding of people’s dietary needs. People staying at the home, described the meals as being ‘lovely’ and ‘excellent’. The senior care officer was seen having a telephone conversation with one person who was cancelling her stay due to a hospital admission. This person was upset because her stay coincided with her birthday and she was afraid that she would miss out on the celebrations provided by the home. The manager reassured her that her next stay at the home would include belated birthday celebrations. Richmond House DS0000033217.V335793.R01.S.doc Version 5.2 Page 16 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): Standards 16 & 18. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. People staying at the home and their friends and relatives are assured that any complaint will be dealt with properly. Staff know how to respond to any suspicion or allegation of adult abuse. EVIDENCE: The home has received no complaints during the last twelve months. There is information in large print in all bedrooms informing people on how to make a complaint and both people staying at the home and their friends and relatives said they felt confident that any complaint would be dealt with properly. The senior care officer was aware of what to do if she received an allegation of abuse outside of normal office hours and care staff were aware of the different types of abuse and methods of reporting. Their practice now needs reinforcing by theory. Not all staff have received training on adult protection training. The senior care officer said that this was due to the lack of places on training courses and cancellation of booked training courses. Richmond House DS0000033217.V335793.R01.S.doc Version 5.2 Page 17 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): Standards 19 & 26. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. The home is designed to meet the needs of the people staying at the home, but some infection control practices increases the risk of cross infection. EVIDENCE: The environment is spacious, very well decorated and maintained to a high standard. People staying at the home and their relatives said that the home was better than a 5 star hotel. There are clear directions at the end of every corridor directing people to other parts of the home. This is good practice. Bedrooms are well furnished but the home should consider providing valances on all divan beds. Staff do not routinely wear protective aprons when coming into contact with bodily fluid or clinical waste. They do not double wrap used or soiled continence products. Soiled linen is hand sluiced and water-soluble bags are Richmond House DS0000033217.V335793.R01.S.doc Version 5.2 Page 18 not used for laundering soiled linen. All of this increases the risk of cross infection. The senior care officer said she would discuss these issues with the manager and they would be addressed as a matter of urgency. People using the service and their relatives said that clothing is always laundered to a high standard. Richmond House DS0000033217.V335793.R01.S.doc Version 5.2 Page 19 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): Standards 27, 28, 29 & 30. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. There are sufficient numbers of staff on duty who have the necessary skills to meet the needs of the people staying at the home. EVIDENCE: There were sufficient numbers of staff on duty throughout the day. Staff said that they had enough time to spend with people this was confirmed by the people staying at the home. One care worker started her shift early so that she could spend some time completing course work for a dementia awareness course. She said that there was a strong emphasis on training in the home, and she would get time off in lieu for her early start. This person was also a NVQ (National Vocational Qualification) assessor and said that she had dedicated time for this work so that it did not take her away from her caring duties. This is good practice. The pre-inspection questionnaire states that 65 of staff have completed a NVQ at level 2 or above. New staff complete a thorough induction programme based on the Skills for Care Common Induction Standards, and ongoing training includes dementia Richmond House DS0000033217.V335793.R01.S.doc Version 5.2 Page 20 awareness and healthy eating. The senior care officer was seen giving a new member of staff instruction about fire evacuation procedures. The recruitment records of two members of staff were sampled. In both cases there was no record of the recruitment interview, no evidence of the CRB/POVA (Criminal Record Bureau/Protection of Vulnerable Adults) disclosure checks and no photograph of the person. The senior care officer said that CRB/POVA disclosures are held centrally. Richmond House DS0000033217.V335793.R01.S.doc Version 5.2 Page 21 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): Standards 31, 33, 35, 36 & 38. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. The home is well managed and the interests and health and safety of people staying at the home are promoted and protected. EVIDENCE: Two people job share the manager’s role, and two people job share a senior care officer’s role. Staff said that this did not cause any problems, as there was an established communication system in the home. They also said that they felt supported and valued by all members of the management team. Staff meetings are held regularly and staff said that they are free to speak their mind and voice opinions. Richmond House DS0000033217.V335793.R01.S.doc Version 5.2 Page 22 Throughout the inspection the senior care officer was extremely busy and at times unable to do very much because of constant interruptions due to the office resembling a reception area. The home has administrative support for one day a week, but due to the constant flow of visitors and health care professionals mainly because of the service provided, some consideration should be given to increasing the amount of administration support to the management team, particularly during weekday office hours. Staff said that they receive supervision but records showed that this does not always happen as often as it should. The senior care officer said that this was a result of pressures on management time. The home distributes quality assurance questionnaires to people staying at the home and their friends and relatives. Responses from recently returned questionnaires were very positive. The home should extend the distribution of these questionnaires to include health care professionals. It is also recommended that the home analyse the results of the questionnaires and make these available to all interested parties, so that people are aware of how the home intends to address any issues raised. The majority of people staying at the home look after their own money and lockable facilities are provided in all rooms. Some people hand in money to the home for safekeeping. Records are kept of all transactions but signatures are not always recorded when money is returned to people or when money is handed over on behalf of a person staying at the home. The manager and the senior staff team carry out regular checks of the money and the system is also subject to regular external audit. During the inspection a member of staff reported a health & safety issue to the senior care officer, who in turn dealt with the issue promptly. The preinspection questionnaire shows that servicing and maintenance takes place as required. All accidents in the home are analysed on a monthly basis to identify any patterns or trends. All accidents are recorded, but where an accident involving a person staying at the home is not witnessed by staff, there is no record kept of when the person was last seen and by whom. Fire bells are tested weekly at a different actuation point each time. Not all staff receive fire training at intervals of no more than 6 months and training records show that mandatory training such as moving and handling is not updated as required. Richmond House DS0000033217.V335793.R01.S.doc Version 5.2 Page 23 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 3 2 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 2 Richmond House DS0000033217.V335793.R01.S.doc Version 5.2 Page 24 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 Requirement Everyone using the service must have a detailed care plan that gives staff clear instructions on how to deliver care in all aspects of their life. Timescale for action 31/07/07 2 OP26 13 (3) This will make sure that needs are not overlooked. Infection control measures to 15/07/07 prevent the spread of infection in the home must be implemented. This will make sure that the risk of cross infection is reduced. 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 OP2 Good Practice Recommendations A contract of residency should be available to people at the point of admission. This will make sure that people have accurate and up to date information about the conditions of their stay at the point of admission. DS0000033217.V335793.R01.S.doc Version 5.2 Page 25 Richmond House 2 OP3 People receiving a respite service should have their needs assessed before each stay. This will make sure that there have been no changes to the person’s needs and that the home is still in a position to meet these needs. The home’s assessment should be extended to include information about people’s cultural, spiritual and religious needs. Staff should complete nutritional and falls risk assessments when a person is admitted and this should be repeated and updated as necessary. This will make sure that those people at risk are identified and appropriate preventative action can be taken. Staff should describe actual behaviour rather than using terms such as ‘abusive’. This will make sure staff have accurate information and prevent different interpretations of written information. Medication should only be administered from the containers supplied by the pharmacy. This will reduce the risk of people receiving the wrong medication. The medication trolley should be stored securely. This will prevent unauthorised access to medication. All handwritten MAR entries must be checked and countersigned by a second person. This will reduce the risk of errors. All staff should receive training on adult abuse and adult protection. This will make sure that people staying at the home are safeguarded. The home should consider provided valances on all divan beds, unless there is a clear reason for not doing so. This will further enhance bedrooms. A record of the recruitment interview should be held on staff files. This will provide evidence that good equal opportunities practices are followed. Staff files should include a recent photograph of the person. Evidence of CRB/POVA disclosures should be available in the home for inspection. 3 OP7 4 OP7 5 OP9 6 OP18 7 OP19 8 OP29 Richmond House DS0000033217.V335793.R01.S.doc Version 5.2 Page 26 This is needed to meet the Care Homes Regulations 2001. 9 OP31 The provider should consider increasing the amount of administration support to the home. This will release senior staff from carrying out reception duties and allow them to concentrate on their management responsibilities. The distribution of the home’s quality survey questionnaires should be extended to include health care professionals and other interested parties. The information from the surveys should be collated and made available to all interested parties together with any action plan developed to address any shortfalls. Where money is handed over on behalf of a person staying at the home a signature should be obtained from the person handing over the money and the person receiving the money. Where money is returned to a person staying at the home, a signature should be obtained from that person and also from the person returning the money. This will reduce the risk of errors, misunderstandings and financial abuse. Where an accident involving a person staying at the home is not witnessed by staff a record should be kept of when the person was last seen and by whom. All staff should receive fire training at intervals of no longer than 6 months. Mandatory training such as moving and handling should be updated as required. 10 OP33 11 OP35 12 13 OP38 OP38 Richmond House DS0000033217.V335793.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Richmond House DS0000033217.V335793.R01.S.doc Version 5.2 Page 28 - 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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