Inspection on 02/02/07 for Richmond Park

This inspection was carried out on 2nd February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 Park 22/01/06

Richmond Park 19/05/05

Richmond Park 22/11/04

Richmond Park 29/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Richmond Park High Street Workington Cumbria CA14 4ES Lead Inspector Diane Jinks Unannounced Inspection 10:00 2 February 2007 nd 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 Park DS0000035365.V323445.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 Park DS0000035365.V323445.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Richmond Park Address High Street Workington Cumbria CA14 4ES 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) 01900 325030 www.cumbriacare.org.uk Cumbria Care Mrs Janice Sarah Sibbald Care Home 29 Category(ies) of Dementia - over 65 years of age (17), Old age, registration, with number not falling within any other category (29) of places Richmond Park DS0000035365.V323445.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection.. The home is registered for a maximum of 29 service users to include: up to 29 service users in the category of OP (older people not falling within any other category) up to 17 service users in the category of DE(E) (Dementia over 65 years of age) When single rooms of less than 12 sqm usable floor space become available they must not be used to accommodate wheelchair users, and where existing wheelchair users are in bedrooms of less than 12 sqm they must be given the opportunity to move to a larger room when one becomes available. 22nd January 2006 3. Date of last inspection Brief Description of the Service: Richmond Park is operated by Cumbria Care, an internal business unit of Cumbria County Council. It is managed on a day-to-day basis by Mrs Janice Sibbald. The home is situated close to the centre of Workington and all of its facilities and services. The home provides accommodation and care for up to 29 older people, 17 of who may have dementia. The accommodation is provided on two floors and the home is divided into three living units. The units consist of lounge and dining room areas, each with small kitchen. Resident’s rooms, toilets and a bathrooms are nearby. On the ground floor there is a large lounge that is used to provide daycare for people from the local community Monday - Friday. This room can be used residents during the evening and weekends for special events and social occasions. The Home is equipped to assist people with a physical disability and has a passenger lift, handrails and grab rails as well as equipment in bathrooms and toilets. There are well-maintained gardens with seating and a small car park. The weekly fees range from £363.00 to £422.00 depending on the assessed care needs of service users. Additional charges are payable for such things as newspapers, magazines, hairdressing and personal items. Richmond Park DS0000035365.V323445.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The assessment of this service included an unannounced visit to the home, discussions with the manager and staff at the home as well as meeting and talking to some of the people living there. During this visit all the key standards of the National Minimum Standards were assessed. Questionnaires were sent out to people living at the home, their relatives and representatives. These helped to obtain personal views of the services provided by the home from people with varied backgrounds and experiences. The registered manager had completed a pre-inspection questionnaire prior to this visit. This assisted in verifying information throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Richmond Park DS0000035365.V323445.R01.S.doc Version 5.2 Page 6 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 Park DS0000035365.V323445.R01.S.doc Version 5.2 Page 7 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): 1 and 3. Standard 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users receive a full and comprehensive needs assessment prior to their admission to the home. EVIDENCE: The samples of service user files looked at during the inspection indicate that service users and prospective service users receive a full and comprehensive needs assessment prior to their admission to the home. This helps to ensure that the home will be suitable and will be able to meet their requirements appropriately. Service users and their relatives indicate that they are provided with sufficient information about the home prior to moving in. The home has a Statement of Purpose which is available to service users and prospective service users. This document provides information about the services that are available at the home. The Statement of Purpose has just been updated. A copy is kept in the reception area of the home with a copy of the home’s last inspection report. Richmond Park DS0000035365.V323445.R01.S.doc Version 5.2 Page 8 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): 7, 8, 9 and 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service user’s health, personal and social care needs are clearly set out in individual care plans, which are kept under regular review. EVIDENCE: The care plans looked at during the visit contain very detailed information regarding the care needs of service users. The plans identify clearly the assistance that each service user requires, whilst encouraging and promoting their independence. This helps to ensure that people using this service are treated with respect and dignity. The plans include detailed nutritional assessments, which the manager has recently started to undertake for each resident. The manager plans to carry out this type of assessment for all residents on their admission to the home. Care plans also contain details of risk assessments and functional assessments. Where risks have been identified, clear strategies are documented for staff to follow, including the use of any specialist equipment if necessary. This information helps to ensure that service users are supported in their daily life in a safe and appropriate way. These records are reviewed at least monthly or more frequently if resident’s care needs change. Richmond Park DS0000035365.V323445.R01.S.doc Version 5.2 Page 9 Records viewed during this visit indicate that people living at the home have access to health care professionals such as doctors, community nurses, podiatrists and are assisted to attend hospital appointments where necessary. There is a medication policy and procedure in place at the home. Staff have received some training to help ensure that medication is administered safely. Medication records are kept. Samples of these records were looked at during the visit and were found to be kept accurately. Medication is recorded coming into the home and details of medication returned to the pharmacy are also recorded. There are arrangements in place for safe storage and recording of the administration of controlled drugs. A specially designated fridge is available for medication requiring cold storage. Where service users may be receiving oxygen therapy, their rooms are clearly identified on a floor plan of the home as a safety measure. As an extra safety precaution, the manager was advised to place signs on the doors of rooms where oxygen may be in use. Richmond Park DS0000035365.V323445.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are given opportunities to participate in leisure and recreational activities if they wish. EVIDENCE: People taking part in the inspection via interview or questionnaires indicate that there are activities available at the home. They are able to participate in them if they wish. Relatives and friends are made welcome in the home and are able to visit freely. Activities available include trips to places of interest, shows and meals out. Activities in the home include baking, carpet bowls, bingo and other entertainment. Church services are also held in the home and service users may choose whether to attend or not. On the day of the inspection there was a very competitive game of ‘darts’ taking place. Both staff and residents were taking part in this game, whilst others were enjoying watching the entertainment. Some service users had chosen not to join in with this activity and were sitting watching a film on the television, sitting in quieter areas of the home or in their own rooms. Service users indicated that they were happy at the home and the care staff were said to be very kind and helpful. They added that they are able to make Richmond Park DS0000035365.V323445.R01.S.doc Version 5.2 Page 11 other choices about their daily lives for example when they wish to get up or go to bed, bathe and their meals. Weekly menus are placed throughout the home and service users are aware of them. The lunchtime meal was served during the inspection. There was a choice available and the meal looked nutritious and appealing. A good portion size was served. Residents said that the meals are very good with plenty of choice and variety. Where residents require assistance from staff, this is carried out with care and sensitivity. Residents said that the staff treat them well and are very caring. Work is currently underway to ensure that the nutritional needs of service users are met appropriately. Nutritional assessments have been carried out. Where issues are identified, advice is sought to ensure that service users receive a balanced and nutritious diet, with supplements if necessary. The cook is very aware of all likes/dislikes, allergies or any special dietary requirements of service users and ensures that appropriate diets are provided. ‘Taster’ days have also been organised so that residents can try out any proposed changes to the menu. The cook attends resident’s meetings and listens to feedback, comments and suggestions about changes or additions to the menus. As part of this work, the menus at the home would benefit from a review to ensure that sufficient detail of information is included, especially at teatime, such as type of sandwich fillings and soup. Richmond Park DS0000035365.V323445.R01.S.doc Version 5.2 Page 12 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): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are confident that any issues or complaints that they may have will be listened too, taken seriously and acted upon. EVIDENCE: The home has not received any formal complaints. Comments have been received from relatives of some service users via a recent satisfaction survey carried out by the home. Similar comments were received by CSCI in questionnaires that were sent to the same people. The manager is in the process of addressing these matters to try to put them right. There is a robust and comprehensive complaint process at the home and this is accessible to service users, their relatives and visitors to the home. People living at the home indicate that they would speak to the manager or one of the supervisors if they had any problems. They felt that they would be taken seriously and their problems would be resolved properly. There are also procedures in place to help prevent the mistreatment of adults. These include the local multi-agency policies and procedures. Staff are provided with training to help raise their awareness of adult abuse and adult protection. The home does not have a policy regarding situations where restraint may be required. There are some residents who have bed rails fitted to help prevent them from falling out of bed. There are records and risk assessments in place for these pieces of equipment. However, bed rails could be seen as a ‘restraint’. This was discussed with the manager and she was advised to review this to ensure that a procedure was in place. Richmond Park DS0000035365.V323445.R01.S.doc Version 5.2 Page 13 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): 19, 21, 22 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean, warm and well maintained. This helps to ensure that people live in a safe environment. EVIDENCE: The home is tastefully decorated and well maintained throughout. The home consists of three ‘units’ although residents are free to move around all areas of the home. Each unit has lounge areas, dining areas and a small kitchen. Some bedrooms have en-suite toilet facilities and there are extra toilets and bathrooms for communal use, throughout the home. The kitchen areas on the units are well stocked to ensure that residents are able to access hot and cold drinks and snacks at any time. The communal bathrooms are equipped with aids and adaptations to help service users maintain their independence and personal hygiene. Two of the baths have been replaced in the last twelve months. However, some of the enamel is damaged and has started to corrode one of the baths in particular. This was drawn to the attention of the manager to ensure that they are Richmond Park DS0000035365.V323445.R01.S.doc Version 5.2 Page 14 repaired as soon as possible to help prevent the possibility of any cross infection. Emergency call bells were tied up in one bathroom. This was also drawn to the attention of the manager, should a service user fall on the floor, it would be difficult for them to raise the alert. Service user’s rooms have been personalised to their own tastes and are homely and comfortable. Residents are able to bring items of their own furniture and personal possessions such as pictures and ornaments, into the home with them. The residents spoken to on the day of this visit were very satisfied with their rooms. One resident was waiting to move into a larger room in order to accommodate their specialised equipment more suitably. There is a small laundry at the home. This is kept clean, tidy and well organised. Protective clothing is available for use by staff, which helps to prevent the risks of cross infection. Outside the home there is a small parking area and a lovely, private garden and patio area, which the residents make use of in the summer. Richmond Park DS0000035365.V323445.R01.S.doc Version 5.2 Page 15 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): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by trained and competent staff, which helps to ensure that their needs are met appropriately. EVIDENCE: People participating in the inspection process generally indicate that sufficient staff are on duty in order to meet the needs of people living at this home. On the day of the visit there were sufficient staff on duty to ensure that service users were supported appropriately and that leisure activities took place too. Approximately half the staff employed at the home have gained a National Vocational Qualification (NVQ) in care. Additional training courses have been undertaken, for example manual handling, first aid, fire safety, food hygiene, health and safety and emergency action. Some specialist training has been undertaken by some staff including care planning, dementia awareness, medication and managing challenging behaviour. Where staff have received training in previous employment, documented evidence is obtained to verify this. This helps to ensure that service users are supported by competent and well-trained staff. There is a robust staff recruitment procedure in place, based on equal opportunities. Written references are obtained and criminal record bureau checks (CRB) and protection of vulnerable adults (POVA) checks are obtained prior to the employment of staff. The home has a low turnover of staff and a large proportion of the workers have been employed at the home for many Richmond Park DS0000035365.V323445.R01.S.doc Version 5.2 Page 16 years. This helps to ensure that people living at the home have consistency and continuity in the care and support that they receive. Training and refresher training is provided to staff to help ensure that they are competent and kept up to date with current legislation and good practice guidance. Regular supervision is also carried out to help ensure that staff work in accordance with the aims, objectives, policies and procedures of the home. Richmond Park DS0000035365.V323445.R01.S.doc Version 5.2 Page 17 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): 31, 32, 33 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run by a competent and experienced manager. The home has an open, positive and inclusive atmosphere and is run in the best interests of service users. EVIDENCE: Service users said that they were able to discuss things with the manager if they wished. Staff indicated that there was a ‘good team’ at the home and that they feel well supported in their work. Residents are encouraged to participate in the running of the home and residents meetings are held at regular intervals. Any concerns can be addressed at this meeting. Records kept at the home were accurate, up to date and stored in an organised and satisfactory manner. Where accidents and incidents had occurred the manager had ensured that records and notifications had been made as required. Richmond Park DS0000035365.V323445.R01.S.doc Version 5.2 Page 18 The manager has recently undertaken a satisfaction survey of the service and was in the process of evaluating the information. Some issues had been highlighted and the manager has started to address them. Information from the questionnaires, together with other service monitoring information such as staffing levels, staff training and staff sickness, is used to inform the business development plan for the service. The registered manager ensures that safe working practices are in place at the home. There is a fire risk assessment that has been reviewed regularly and kept up to date. A tour of the kitchen was undertaken as part of this visit to the home. The cook and the manager ensure that all aspects of food hygiene are maintained. Protective clothing is worn by everyone working or having need to enter the kitchen area. Food is stored appropriately, covered, labelled and dated. Richmond Park DS0000035365.V323445.R01.S.doc Version 5.2 Page 19 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X 2 3 X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 X X X X 3 Richmond Park DS0000035365.V323445.R01.S.doc Version 5.2 Page 20 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 OP21 Regulation 13(3) 23(2)(c) Requirement The registered person must ensure that the communal baths are maintained in good repair to prevent the risk of cross infections. Timescale for action 31/03/07 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 Refer to Standard OP9 OP15 Good Practice Recommendations It is recommended that safety notices are posted in all areas of the home where oxygen cylinders are in use or stored. It is recommended that the menus at the home are reviewed to ensure that sufficient detail of information is included, especially at teatime, such as the type of sandwich fillings and soup. It is recommended that a policy and procedure with regard to ‘restraint’ is developed and implemented. Consideration should be given to equipment, aids and adaptations, which could be viewed as ‘restraints’. 3 OP18 Richmond Park DS0000035365.V323445.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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. 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