This inspection was carried out on 2nd March 2006.
CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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.
CARE HOMES FOR OLDER PEOPLE
Richmond House - North Yorkshire County Council Richmond House Reeth Road Richmond North Yorkshire DL10 4EF Lead Inspector
Kate Shackleton Unannounced Inspection 2nd March 2006 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 - North Yorkshire County Council DS0000034414.V277565.R01.S.doc Version 5.1 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 - North Yorkshire County Council DS0000034414.V277565.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Richmond House - North Yorkshire County Council Richmond House Reeth Road Richmond North Yorkshire DL10 4EF 01748 823135 01748 821465 richmond.house-nyccsstinternet.com Address 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) North Yorkshire County Council Mrs Judith Ann Benson Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Richmond House - North Yorkshire County Council DS0000034414.V277565.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 28th June 2005 Brief Description of the Service: Richmond House is a care home owned and operated by North Yorkshire County Council and registered to provide a service for 31 older people of either gender aged over 65 years who do not have any specialist requirements. The home was purpose built approximately 45 years ago. Service users’ bedrooms are on the ground and first floors. All bedrooms are intended for single occupancy. There is direct access from the home to extensive grounds and gardens to the rear of the home. A day centre providing up to 20 places per week day is situated in a separate area of the ground floor. The home is located within a short walk of Richmond town centre. Richmond House - North Yorkshire County Council DS0000034414.V277565.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on the 2nd March 2006 and took 5 hours including preparation time. The majority of time was spent talking with the service users in small groups and privately in their bedrooms and with the staff on duty. Lunch was taken with service users. There were opportunities to observe staff providing the care service. A sample of service user files was examined and a check was made as to whether the home had complied with requirements from the last inspection. There was a relaxed but busy atmosphere in the home and service users were observed socialising with their peers and staff. What the service does well: What has improved since the last inspection?
There has been significant redecoration and refurbishment to the communal areas and some bedrooms providing a pleasant and clean environment for service users. Dangerous substances are now properly labelled and stored safely so that accidents to service users are less likely to happen. Staff have received training in the safe administration of medications this will minimise the risk of errors ensuring the safety of service users. Richmond House - North Yorkshire County Council DS0000034414.V277565.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Richmond House - North Yorkshire County Council DS0000034414.V277565.R01.S.doc Version 5.1 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 House - North Yorkshire County Council DS0000034414.V277565.R01.S.doc Version 5.1 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): These standards were not fully assessed at this visit. EVIDENCE: Richmond House - North Yorkshire County Council DS0000034414.V277565.R01.S.doc Version 5.1 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 and 10 Service users personal and social care needs are met. EVIDENCE: A recommendation was made at the last inspection that care plans should be reviewed and revised to ensure that they address all care needs and that staff should receive training in medication issues. Management confirmed that all plans have been reviewed and three plans examined set out clearly the needs of service users and the level of assistance that staff needed to provide without reducing independence. Discussions with service users showed that staff provided them with the support they needed. Medication training has been provided for the designated staff that administer medicines. Service users spoken with discussed the staff’s approach to care. They said that staff was kind, polite and very helpful. They were addressed by their preferred name and staff always knocked on doors before entering. Service users are provided with bedroom door keys. Positive relationships were observed between staff and service users with good-humoured banter being exchanged.
Richmond House - North Yorkshire County Council DS0000034414.V277565.R01.S.doc Version 5.1 Page 10 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 Service users believe the home fulfils their expectations and they have choice and control about how they live their lives. EVIDENCE: Feedback received from service users say that they are very satisfied with the service they receive. There is a range of activities available and they can attend the day centre, which operates within the home if they want to. A religious service is periodically arranged in the home and arrangements are made for people who want to attend church. Family and friends are made welcome and are offered the opportunity to stay for a meal. A number of visitors were seen in the home. Staff was heard offering people choices and service users were able to cite many examples about how they exercise choice and control in their lives. Lunch was taken with service users. There is a choice of meal and it was nicely presented. Service users can choose to eat in their own rooms or in the dining room. The atmosphere in the dining room was relaxed and service users were given as long as they needed to complete their meal. Appropriate support was offered to people who required help. Richmond House - North Yorkshire County Council DS0000034414.V277565.R01.S.doc Version 5.1 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 the following standard(s): 18 To ensure the protection of the service users, staff need to be trained about what they should do if allegations of abuse are made or abuse is suspected. EVIDENCE: A requirement was made at the last inspection that staff receive training in adult abuse issues. To date, only nine staff have completed the training. Feedback from team managers suggested that the training given didn’t provide staff with the information they needed about how to respond following an abuse allegation. Managers spoken to were hesitant about what they should do in such circumstances and would report it to their line manager for guidance. The home has a Protection of Vulnerable Adults policy and procedure. Richmond House - North Yorkshire County Council DS0000034414.V277565.R01.S.doc Version 5.1 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 the following standard(s): 24 and 26 The home is clean and well maintained offering service users a pleasant environment in which to live. EVIDENCE: A requirement was made at the last inspection that some areas in the house needed redecoration and replacement/cleaning of specific carpets. This has been done. The only carpet seen that either needs replacing or cleaning is in the sun lounge. The carpet is quite badly stained. Whilst visiting people in their own bedrooms, the rooms were seen to be warm and comfortable with lots of the service users own possessions displayed. Richmond House - North Yorkshire County Council DS0000034414.V277565.R01.S.doc Version 5.1 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 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): These standards were not fully assessed at this visit. EVIDENCE: A recommendation was made at the last visit that the cook should receive training about nutrition for older people. Since that time, a new cook has recently been recruited and a request has been made to the training department to source this training. Richmond House - North Yorkshire County Council DS0000034414.V277565.R01.S.doc Version 5.1 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 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): These standards were not fully assessed at this visit EVIDENCE: A recommendation was made at the last inspection to store securely any dangerous substances and to stop wedging fire doors open. The substances are now properly labelled and stored correctly and a self-closing device has been fitted to the office door. Richmond House - North Yorkshire County Council DS0000034414.V277565.R01.S.doc Version 5.1 Page 15 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 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 X 17 X 18 1 X X X X X 3 X 2 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X Richmond House - North Yorkshire County Council DS0000034414.V277565.R01.S.doc Version 5.1 Page 16 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 OP18 Regulation 13(6) Requirement Staff must receive training in the protection of vulnerable adults (Timescale of 31st December 2005 not met) The carpet in the sun lounge must be properly cleaned to remove the stains or replaced. Timescale for action 30/06/06 2 OP26 23(2) 31/03/06 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 House - North Yorkshire County Council DS0000034414.V277565.R01.S.doc Version 5.1 Page 17 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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