CARE HOME ADULTS 18-65
Richmond Lodge 11-15 Richmond Avenue South Benfleet Essex SS7 5HE Lead Inspector
Nicola Dowling Unannounced Inspection 13th February 2006 10:00 Richmond Lodge DS0000015558.V282742.R01.S.doc Version 5.1 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 Lodge DS0000015558.V282742.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 Adults 18-65. 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 Lodge DS0000015558.V282742.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Richmond Lodge Address 11-15 Richmond Avenue South Benfleet Essex SS7 5HE 01268 566178 01268 566178 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) Estuary Housing Association Limited Mr Robert George Hine Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (12) of places Richmond Lodge DS0000015558.V282742.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Excluding any person who is liable to be detained under the provision of the Mental Health Act 1983. 3rd October 2005 Date of last inspection Brief Description of the Service: Richmond Lodge is a care home providing nursing care for 12 residents with mental health needs. It is situated in South Benfleet and is very close to local shops, amenities and transport. The premises consist of 12 single bedrooms and one has ensuite facilities. There is a large bright lounge with a variety of comfortable chairs and sofas and a smaller seating area. There is a kitchen and dining room. The conservatory is used as the smoking room. The premises are surrounded by a large well-kept garden that is secure. There is parking to the front of the premises. Richmond Lodge DS0000015558.V282742.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection took place on one day and consisted of, a brief tour of the home observing the interaction between staff and residents and reading of documents. The manager and a qualified member of staff were on duty along with three support workers. The residents that were at home were seen and most spoken to. Some residents were out at work during the inspection. There were no visitors to the home that could give their views of the service. However residents commented that they were happy living at the home and “life was ok” there. The Commission for Social Care Inspection did not receive an action plan following the last inspection that detailed how the home intended to manage the requirements set. At this inspection the previous requirements were checked and had been addressed. However it is disappointing that the home did not respond with an action plan. A thank you is extended to the staff and service users who took part in the inspection and for their help and hospitality. What the service does well: What has improved since the last inspection?
There was evidence that the maintenance issues highlighted at the last inspection had been investigated. However as yet the residents have not benefited from any work carried out regarding the ventilation in the bathroom. A contract has been put in place for the safe disposal of medicines and recruitment records all now contain staff identification. A cleaner has been employed and staff have been booked on to a food hygiene course to update their knowledge. Richmond Lodge DS0000015558.V282742.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 Lodge DS0000015558.V282742.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Richmond Lodge DS0000015558.V282742.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Standards 2, 3, 4, and 5 were met at the last inspection and not inspected at this inspection. Richmond Lodge DS0000015558.V282742.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6&7 Residents are enabled to make their own decisions within the home. There are good highlighted risk assessments however these are not all supported by a care plan. EVIDENCE: Two care files were checked for risk assessments and care plans. Both were generally good however one was found to have a risk assessment without a care plan to support it. All other risk assessments and care plans were matched together. Residents are encouraged to be as independent as possible and this includes making their own decisions. Residents confirmed that they spent their own money on items that they wanted and that staff are helpful to them. Richmond Lodge DS0000015558.V282742.R01.S.doc Version 5.1 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Standards 12, 13, 14, 15, 16 and 17 were met at the last inspection and not inspected at this inspection. Richmond Lodge DS0000015558.V282742.R01.S.doc Version 5.1 Page 11 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 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 Staff ensure that personal support is carried out in private and as the resident wishes. EVIDENCE: Residents confirmed that any nursing care was undertaken in private. For example depot injections are given in the residents own room. Residents choose their preferred method of personal care and staff are familiar with the residents preferred habits. The residents’ appearance reflected their own personal dress sense. The residents’ confirmed that they could choose their rising and bedtimes. The manager confirmed and provided documentary evidence that the home has a waste disposal contract for the safe disposal of medicines. Richmond Lodge DS0000015558.V282742.R01.S.doc Version 5.1 Page 12 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Standards 22 and 23 were met at the last inspection and not inspected at this inspection. Richmond Lodge DS0000015558.V282742.R01.S.doc Version 5.1 Page 13 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 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 The residents live in a homely environment however some maintenance issues have not been fully resolved. EVIDENCE: Residents and staff manage some cleaning however a cleaner has been employed for regular cleaning duties. Maintenance such as refreshing paintwork and replacing stained carpets are organised on a rotational basis by Estuary Housing Association’s maintenance department. The poor ventilation in the upstairs bathroom has been investigated, however at the time of inspection this matter was still waiting to be attended to, leaving this area hot and damp for the residents. The home does offer a warm and comfortable environment for the residents to live in and the residents commented that they were happy with their environment. Richmond Lodge DS0000015558.V282742.R01.S.doc Version 5.1 Page 14 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 34 and 35 The residents are looked after by trained staff however some of the staff at the home do not hold a recognised qualification in care. Recruitment documentation is satisfactory. EVIDENCE: A qualified nurse is on duty at every shift. The support workers receive training from EHA in subjects relevant to the care needs of the residents. Also the staff are all updating their food hygiene training as identified at the last inspection. However none of the support workers hold an NVQ certificate. The staff group are aware of the residents needs and bring their life skills to the work place. There are no staff under the age of 18 working in the home. A sample of recruitment documents were checked and this documentation was satisfactory. Richmond Lodge DS0000015558.V282742.R01.S.doc Version 5.1 Page 15 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 The manager has the appropriate qualifications and experience and runs the home in the best interests of the residents. EVIDENCE: The manager is a trained nurse and also holds a NVQ in management. Systems are in place to obtain the residents views of the service and for the residents to contribute to the day-to-day running of the home. Safety certificates were displayed and all were current. Residents that were asked were happy with the way the home is run. Richmond Lodge DS0000015558.V282742.R01.S.doc Version 5.1 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 x 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 x ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 x STAFFING Standard No Score 31 x 32 2 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x x x 3 x x x x x x Richmond Lodge DS0000015558.V282742.R01.S.doc Version 5.1 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 2 Standard YA6 YA24 Regulation 15(2)(b) 23(2)(p) Requirement The Registered Person must ensure that the risk assessments are supported by a care plan The Registered Person must ensure that the EHA maintenance team work towards the planned date for work on the bathroom ventilation Timescale for action 30/05/06 30/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA32 Good Practice Recommendations 50 of care staff should hold or work towards the NVQ in care. Richmond Lodge DS0000015558.V282742.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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