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Inspection on 03/10/05 for Richmond Lodge

Also see our care home review for Richmond Lodge for more information

This inspection was carried out on 3rd October 2005.

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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The staff at the home provide good supervision of care for the residents personal and health care needs. All the residents are mobile and have access to all areas of the home. There are also some bedrooms on the ground floor for those whose mobility is slow. Residents are encouraged to maintain their independence by doing things for themselves. This ranges from going out to work or to caring for their own belongings. All the residents contribute to the household chores and the staff will help or prompt residents with their activities of daily living activities. For example help with laundry or cleaning. The staff are approachable and there is enough staff on duty to care for the residents. The day shifts consist of one qualified nurse and two support workers. The staff on duty are familiar with the residents and the residents knew who their key-worker was. The residents have the freedom to come and go from the home as they please. Some residents have the opportunity to stay over with their relatives and the home welcome contact with family and friends. Generally the residents spoken with said that they were happy with the home and had day trips and holidays to look forward to.

What has improved since the last inspection?

A new fence has been erected around the perimeter of the garden. This makes the garden private and secure. The residents have had their rooms redecorated with new flooring; also there is a bigger office space. To maintain the cleanliness of the home a cleaner is going to be employed. This is because the residents are becoming older and less able to help with some of these tasks. Therefore the employment of a cleaner means that staff can continue to spend time with the residents to help motivate them rather than on cleaning jobs.

What the care home could do better:

Staff recruitment records are much improved however there are still some documents that are missing. The Estuary Housing Association personnel department have the task of completing this area of practice to make sure that staff employed are safe to work with this group of people. There are some areas of the home that need maintenance, for example a damp patch on the stairs and better ventilation in the bathroom. Some areas of staff training also need updating. Food hygiene was one area and is important as staff prepare food for the residents.

CARE HOME ADULTS 18-65 Richmond Lodge 11-15 Richmond Avenue South Benfleet Essex SS7 5HE Lead Inspector Nicola Dowling Unannounced Inspection 3rd October 2005 10:00 Richmond Lodge DS0000015558.V257508.R01.S.doc Version 5.0 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.V257508.R01.S.doc Version 5.0 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.V257508.R01.S.doc Version 5.0 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.V257508.R01.S.doc Version 5.0 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. 21/02/05 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, dining room and conservatory that are used as the smoking room. The premises are surrounded by a large well-kept garden which is secure. There is parking to the front of the premises. Richmond Lodge DS0000015558.V257508.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on one day and consisted of, a tour of the home, talking with staff and residents, observing the care given and reading of documents. The manager was not on duty during the unannounced inspection therefore the staff nurse on duty and the deputy manager assisted with the inspection. Not all the residents were seen as they were out of the home. Of the residents in the home most were seen and spoken to as well as most of the staff on duty. There were no visitors to the home that could give their views of the service. 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? A new fence has been erected around the perimeter of the garden. This makes the garden private and secure. The residents have had their rooms redecorated with new flooring; also there is a bigger office space. To maintain the cleanliness of the home a cleaner is going to be employed. This is because the residents are becoming older and less able to help with some of these tasks. Therefore the employment of a cleaner means that staff Richmond Lodge DS0000015558.V257508.R01.S.doc Version 5.0 Page 6 can continue to spend time with the residents to help motivate them rather than on cleaning jobs. 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.V257508.R01.S.doc Version 5.0 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.V257508.R01.S.doc Version 5.0 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): 2, 3, 4 and 5 The home manages the admission process well. EVIDENCE: There have not been any new admissions since the last inspection. The service user guide explains the admission procedure and details how introductory visits occur. Before admission a qualified member of the staff team undertakes an assessment of the prospective resident to ensure that the home can cope with the residents needs. Nurses trained in mental health staff the home along with experienced support workers. The residents’ have a contract, which they sign. Richmond Lodge DS0000015558.V257508.R01.S.doc Version 5.0 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 and 9 Care plans were good and up to date and detailed highlighted risks. EVIDENCE: One resident spoken with was aware of their care plan and had input into them. The care plans that were seen were clear and contained appropriate risk assessments. For example one resident self medicates and a risk assessment had been carried out on the resident’s ability to do this activity. Also risk assessments were in place for fire and smoking. The daily care notes were generally good and descriptive of the resident’s day however some entries were brief. There was evidence that care plans were reviewed and residents confirmed this. Richmond Lodge DS0000015558.V257508.R01.S.doc Version 5.0 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): 12, 13, 14, 15, 16 and 17 Residents have a relaxed lifestyle with a variety of activities and a choice of food. Staff observe residents wishes and support residents’ to maintain family contact. EVIDENCE: Residents that are able, go out to work or to day care centres. Residents manage their transport for these activities themselves. The home offer days out, one of which was a day trip to France that residents’ said they enjoyed. A holiday is also being arranged. Activities in the home are devised on an individual basis and are based on the residents’ abilities. For example one resident spends time doing very detailed drawings. The residents’ art-work is also on display in the home. The staff observe residents rights and residents confirmed this. For example the residents’ receive and open their own post, staff knock on residents bedroom doors before entering, and they were aware of when some residents wanted to be left alone. Richmond Lodge DS0000015558.V257508.R01.S.doc Version 5.0 Page 11 The home offers a choice of food. There is a daily menu and if residents want something different from this they write their preferred option down. All the residents were aware of how to use this system. Richmond Lodge DS0000015558.V257508.R01.S.doc Version 5.0 Page 12 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): 19 and 20 The home provides good physical and psychological care to the residents. The new law that sets out the procedure for the disposal of medicines from the home has not been implemented yet. EVIDENCE: There was evidence in the care files that residents go to out-patients to see a psychiatrist. Residents’ go to a local GP surgery for their physical health needs. Female residents have various health screening appointments. Diabetic conditions are monitored well and findings recorded. There has been a recent change in the law about how medicines from a nursing home are disposed of. The home is currently looking into this change. However the home continue to manage the residents’ medication in a safe way. Richmond Lodge DS0000015558.V257508.R01.S.doc Version 5.0 Page 13 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): 22 and 23 There is a satisfactory complaints procedure and there are policies and procedures for the protection of vulnerable adults. EVIDENCE: The home has successfully dealt with one complaint about the home. The complaints procedure is displayed and residents spoken with knew who to talk to if they had any concerns. Staff are aware of the policy for the Protection of Vulnerable Adults and confirmed that they had received training in this topic. No adult protection incidents have been recorded at this home. Richmond Lodge DS0000015558.V257508.R01.S.doc Version 5.0 Page 14 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 and 30 The residents live in a homely environment, however there are some maintenance issues. EVIDENCE: The premises are safe, bright and cheerful, airy, and free from offensive odours. The home offers a warm environment for the residents’ and there is sufficient heating and lighting. The bathrooms upstairs have no ventilation making them hot and damp. There was a large damp patch on the carpet on the stairs. Staff were unclear what the source of this damp patch was. Some parts of the home could be better cleaned. The home have already taken steps to rectify the cleaning issues by employing a cleaner who is due to start soon. Richmond Lodge DS0000015558.V257508.R01.S.doc Version 5.0 Page 15 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): 34 and 35 Recruitment documentation has improved however some training courses have slipped. EVIDENCE: Most recruitment documents were in place with only the person’s proof of identification missing. Estuary Housing Association personnel team are in the process of collating the missing information. Training records were inspected and staff are up to date with some courses. However as a general theme food hygiene courses for staff had not been recently undertaken. Richmond Lodge DS0000015558.V257508.R01.S.doc Version 5.0 Page 16 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): 39 and 42 The home is managed and run in the best interests of residents’. Health and safety issues in the home are identified and appropriate measures are put in place. EVIDENCE: Residents have taken part in Estuary Housing Association quality network review project, this aims to find out what the residents view of the home that they live in is. Residents at the home also have opportunities to feedback their views via meetings and discussions. A random sample of records was inspected and these evidenced that safety checks had been carried out on appliances. A record of fire drills, checks and procedures was available including, a fire plan and risk assessments for smoking. Richmond Lodge DS0000015558.V257508.R01.S.doc Version 5.0 Page 17 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 2 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x x x 2 2 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Richmond Lodge Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x DS0000015558.V257508.R01.S.doc Version 5.0 Page 18 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA20 Regulation 13(2) Requirement The Registered Person must make arrangements for the safe disposal of medicines from the home The Registered Person must provide ventilation in the upstairs bathroom The Registered Person must ensure that recruitment files have proof of identification in them. Timescale for action 30/11/05 2 3 YA24 YA34 23(2)(p) Schedule 2 30/11/05 30/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA24 YA30 YA35 Good Practice Recommendations The Registered Person should investigate the source of the damp patch on the stairs. Ensure that a cleaner is employed, allowing care staff to spend time with the residents Staff should have regular food hygiene up-date courses, as they are responsible for preparing and serving food. Richmond Lodge DS0000015558.V257508.R01.S.doc Version 5.0 Page 19 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 © 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 Lodge DS0000015558.V257508.R01.S.doc Version 5.0 Page 20 - 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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