Inspection on 02/09/08 for Richmond Residential Care Home

This inspection was carried out on 2nd September 2008.

CSCI found this care home to be providing an Adequate service.

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 Residential Care Home 12/09/06

Richmond Residential Care Home 27/01/06

Richmond Residential Care Home 11/10/05

Richmond Residential Care Home 01/02/05

Richmond Residential Care Home 17/08/04

Richmond Residential Care Home 24/02/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 13/11/2008.

CARE HOMES FOR OLDER PEOPLE Richmond Residential Care Home Recreation Road Shirebrook Mansfield Nottinghamshire NG20 8QE Lead Inspector Rose Moffatt Unannounced Inspection 2nd September 2008 09:30 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 Residential Care Home DS0000020082.V371225.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 Residential Care Home DS0000020082.V371225.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Richmond Residential Care Home Address Recreation Road Shirebrook Mansfield Nottinghamshire NG20 8QE 01623 748474 F/P 01623 748474 richmond.house2@tesco.net 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) Richmond Residential Care Limited Vacancy Care Home 25 Category(ies) of Dementia (25), Old age, not falling within any registration, with number other category (25) of places Richmond Residential Care Home DS0000020082.V371225.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old Age, not falling within any other category - Code OP Dementia - Code DE The maximum number of service users who may be accommodated is 25 12th September 2006 2. Date of last inspection Brief Description of the Service: Richmond Care Home is in the village of Shirebrook, near to local shops, facilities and public transport. The home is in an older building that has a long history of care provision. There is an ongoing building programme to improve and extend the facilities at the home. Part of the extensive grounds has been made accessible to residents. The home provides personal care for up to 25 older people, including people who need care because of dementia. Car parking space is provided. The fees at the home range from £345.52 to £380.00 per week. The fees do not include hairdressing, chiropody and personal toiletries. This information was provided by the acting manager at the inspection visit on 02/09/08. Information about the home, including CSCI inspection reports is available in the main entrance area of the home, or from the acting manager. Richmond Residential Care Home DS0000020082.V371225.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The focus of our inspections is on outcomes for people who live in the home and their views on the service provided. The inspection process looks at the provider’s ability to meet regulatory requirements and national minimum standards. Our inspections also focus on aspects of the service that need further development. We looked at all the information that we have received, or asked for, since the last key inspection or annual service review. This included: • The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. • Surveys returned to us by people using the service and from other people with an interest in the service. • Information we have about how the service has managed any complaints. • What the service has told us about things that have happened in the service, these are called ‘notifications’ and are a legal requirement. • The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. • Relevant information from other organisations. • What other people have told us about the service. We carried out an Annual Service Review (ASR) of the home in December 2007. The ASR looked at all the above information. The ASR showed us that the home continued to provide good outcomes for people living there. We sent out 10 surveys to people living in the home and 7 of these were completed and returned to us before the inspection visit. All 7 had been completed by relatives of the people in the home. We sent out 10 surveys to staff working in the home and 4 of these were completed and returned to us. We carried out an unannounced inspection visit that took place over 5½ hours on one day. The inspection visit focused on assessing compliance to requirements made at the previous inspection and on assessing all the key standards. Richmond Residential Care Home DS0000020082.V371225.R01.S.doc Version 5.2 Page 6 There were 25 people accommodated in the home on the day of the inspection visit. People who live in the home, visitors and staff were spoken with during the visit. The acting manager was available and helpful throughout the inspection visit. Some people were unable to contribute directly to the inspection process because of communication difficulties, but they were observed during the visit to see how well their needs were met by staff. ‘Case tracking’ was used during the inspection visit to look at the quality of care received by people living in the home. Three people were selected and the quality of the care they received was assessed by speaking to them and /or their relatives, observation, reading their records, and talking to staff. The registered manager for the home, Mrs Stella State, left in July 2008. The acting manager, Mrs Tracey Taylor, was appointed in August 2008. What the service does well: What has improved since the last inspection? What they could do better: Care plans should be in place for each person living in the home and should cover all of the person’s needs. The care plans should be reviewed monthly to ensure people’s needs are being fully met. Richmond Residential Care Home DS0000020082.V371225.R01.S.doc Version 5.2 Page 7 There could be better records of complaints that include the action taken and the outcome of the complaint. This will ensure that people’s concerns are taken seriously and appropriate action taken. Staff should all have training about safeguarding vulnerable adults and about safe manual handling. This will help to protect people and ensure any risks are minimised. 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 Residential Care Home DS0000020082.V371225.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 Residential Care Home DS0000020082.V371225.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): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was a satisfactory assessment process so that people were confident their needs could be met in the home. EVIDENCE: Seven people returned surveys to us before the inspection visit and six of them said they had received enough information about the home. People spoken with during the inspection visit told us they had not seen the Service User Guide for the home. The acting manager said the Service User Guide and Statement of Purpose were being updated to take account of recent changes in management and registration. Richmond Residential Care Home DS0000020082.V371225.R01.S.doc Version 5.2 Page 10 We looked at the records of three people living in the home. All had been assessed by social services and / or hospital staff prior to admission to determine their needs. All had a pre-admission assessment by the home, though only one of these was fully completed. Two people had details of their personal preferences regarding daily routines, food and drink, leisure interests, and so on. The other person’s records did not include these details. One person had a ‘life story’ completed, the other two did not have this. Six of the people who returned surveys said they always had the care and support they needed, one said they usually did. Most of the people we spoke to told us their needs were met. One person told us the care was “first class”. A relative said they were pleased a person who had recently come to live in the home had “settled in so well”. Most of the staff told us that they had training to help them understand and meet the needs of people in the home. The AQAA said that there is a trial period of three months for people coming to live in the home and that people always stay beyond the trial period. The home offers respite care and this is used regularly by several people. People who have respite care nearly always move into the home on a permanent basis when this becomes necessary. Standard 6 did not apply as there were no people receiving intermediate care in the home. Richmond Residential Care Home DS0000020082.V371225.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): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There were inconsistencies and gaps in care plans and reviews so it was not clear that people received care to meet their individual needs and preferences. EVIDENCE: We looked at the care records for three people in the home. One person did not have a care plan. The acting manager said this was because the person had recently come into the home, approximately three weeks before the inspection visit. The care plan was started on the day of the inspection visit. Two people had care plans that included most of their assessed needs. The care plans included sufficient detail of the action needed by staff to meet their needs, and included reference to how their privacy and dignity should be maintained. Neither of these people had a care plan about their spiritual needs, or about their social / leisure needs. One did not have care plans about communication or about mouth care. Richmond Residential Care Home DS0000020082.V371225.R01.S.doc Version 5.2 Page 12 One of the care plans had been reviewed and noted that the person and their relatives were happy with the care. One care plan had not been reviewed even though the person had been in the home for three months and had complex health and personal care needs. There were records of the visits of the doctor, district nurse, and chiropodist. The daily records were generally informative. One person was noted to have a sore area and was to be seen by the district nurse. However, there was no further mention of this in the daily records or in the records of visits made by the district nurse. The acting manager was able to give a verbal update. There was evidence that people’s health was monitored and appropriate referrals made to the doctor and district nurse. For example, one person was seen by the doctor for a review of their medication when possible unwanted effects were noted. Six of the seven people who returned our surveys said they always received the care and support they needed, and one said they usually did. Five people said they always received the medical support they needed and two said they usually did. Most people we spoke with said their needs, or the needs of their relative, were met at the home. One person told us about some issues that were making them unhappy. When we brought this to the acting manager’s attention, appropriate action was taken to start addressing the issues. The AQAA said “care plans are up to date at all times”. The AQAA said the home planned to improve by computerising care plans to allow easier recall and tracking of changes, and also to hold monthly care review meetings for staff to discuss any issues about the care of people in the home. Medication was stored securely. The room used to store medication felt very warm on the day of the inspection visit. Medication was administered by senior care assistants who had all received appropriate training. There were records of the receipt and disposal of medication. The medication administration records for some people had handwritten instructions, rather than the pre-printed instructions from the pharmacist, as the people were newly admitted to the home. The handwritten instructions were signed by the member of staff who had written them, but not counter-signed by another member of staff who had checked the instructions were correct. All seven people who returned our surveys said staff always listened to them and acted on what they said. People told us staff were “friendly”, “kind”, “they Richmond Residential Care Home DS0000020082.V371225.R01.S.doc Version 5.2 Page 13 are good listeners”, and “they can’t do enough for me or the wife”. A relative said the staff had become “an extended family” to them. We observed that staff spoke to people in a respectful and appropriate way. Staff we spoke with were able to give examples of how they ensure people’s dignity and privacy were maintained. The care plans seen referred to how privacy and dignity should be promoted. Richmond Residential Care Home DS0000020082.V371225.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): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was a range of activities, flexibility in routines, and a satisfactory choice of meals so that the lifestyle in the home generally met people’s needs, preferences and expectations. EVIDENCE: The care records included details of people’s life history, preferences, likes and dislikes, though these details had not been completed for two of the care records seen. There were mixed responses about the provision of activities at the home. Two people who returned our surveys said there were always activities they could take part in, three said there usually were, and one said there sometimes were. One person said there were never activities to take part in, but said this was because the person was too ill to be able to take part. Richmond Residential Care Home DS0000020082.V371225.R01.S.doc Version 5.2 Page 15 People we spoke with during the inspection visit told us they were pleased that the new acting manager had started to organise more activities. One person had particularly enjoyed a recent baking session. There were regular activities, such as trips out, visiting entertainers, and a weekly religious service. Seasonal events were celebrated, such as bonfire night, and the home held a summer fair. On the day of the inspection visit people were watching television, reading newspapers, and some of the ladies were having their nails manicured. People we spoke with said they could get up and go to bed when they wanted to. Staff we spoke with were clear that people’s individual preferences should be respected in daily routines. Four of the people who responded to our surveys said there always enough staff available when needed, three said there usually were. Staff we spoke with and those who responded to our surveys said there were usually enough staff to meet people’s needs. There were several visitors in the home on the day of the inspection visit, including a minister from a local church. Visitors said they were always made welcome. One visitor was pleased with the improvements to the garden and said they had enjoyed sitting outside with their relative. Three people who responded to our surveys said they always liked the meals at the home, four people said they usually did. Most people spoken with said they enjoyed the meals and said they could have a choice. We observed that people were regularly offered hot and cold drinks during the day. The lunchtime meal served during the inspection visit appeared appetising and people said they had enjoyed it. Since the last inspection, the dining room had been redecorated. A new dining room was being built and the acting manager said this was hoped to be in use by the end of September 2008. The new dining room was larger than the existing one and had large windows looking out onto the garden courtyard. The AQAA said the home was continually striving to improve the daily life and social activities for people living there. They planned to do this by training staff, introducing more activities – such as making cards, and having more themed days throughout the year – and also by employing an activities coordinator when the number of people living in the home increased. Richmond Residential Care Home DS0000020082.V371225.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): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The complaints system was not sufficiently robust to ensure that all complaints were fully investigated. There were satisfactory policies and in place and sufficient staff knowledge and awareness to ensure people were protected. EVIDENCE: The complaints procedure was displayed in the main entrance area. The procedure needed updating with the correct contact details for CSCI. The procedure displayed was not the same as the one in the home’s procedures manual. A complaints book was kept in the main hallway and also complaints forms for people to use if they wished. There were two complaints referred to by the ex-manager in the complaints book, but no other record could be found by the new acting manager of the action taken and the outcome of these complaints. Six people who returned our surveys said they knew how to make a complaint and one person said they did not know. All seven people said they knew who to speak to if they were not happy with anything. People spoken with said they had not been given a copy of the complaints procedure, but would be Richmond Residential Care Home DS0000020082.V371225.R01.S.doc Version 5.2 Page 17 happy to take any concerns to the manager or the owners. All of the staff spoken with and those who responded to our surveys said they knew what to do if anyone wanted to raise concerns about the home. No complaints about the home had been made directly to CSCI. We had received information with some concerns about the home and this was taken into account during the inspection visit. There were suitable policies and procedures in place for safeguarding vulnerable adults. We found that some staff had not received specific training about safeguarding vulnerable adults issues and procedures. The acting manager said this training was booked for October 2008 for all staff. Staff we spoke with were clear about the issues involved and about reporting any suspicions or disclosures of abuse. Although we had received notifications as required about deaths at the home, we had not received any notifications of other events as specified in the regulations. The information in the AQAA indicated that there were possibly two events that should have been notified to us. We also received information during the inspection visit about another event that should have been notified to us. (See Management and Administration section of this report). Richmond Residential Care Home DS0000020082.V371225.R01.S.doc Version 5.2 Page 18 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 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 was clean, well maintained and suitably equipped so that people lived in a safe, pleasant environment that met their needs. EVIDENCE: Many changes and improvements had been made to the home since the previous inspection visit in September 2006. The programme of building work had continued. The home had recently changed the registration to accommodate up to 25 people, (previously 19), and planned for this to increase again in 2009 when further building work was completed. The driveway to the main entrance had been block-paved and a fence erected to screen the overgrown and unused areas of the land surrounding the home. Richmond Residential Care Home DS0000020082.V371225.R01.S.doc Version 5.2 Page 19 A courtyard garden area had been created with access by French doors from a new small lounge. The courtyard garden area was level, easily accessible and safe as it was completely enclosed. Garden furniture was provided. People in the home and their visitors told us they enjoyed sitting out in this area in good weather. The lounge space had been increased by the addition of a small lounge off the main lounge. The new dining room was due to be completed by the end of September 2008 and included French doors opening into the garden courtyard. The main lounge had a large, wall mounted, screen for television and films on DVD. There was a separate smaller lounge with a television and another lounge as a designated smoking room. The lounges were suitably furnished. Improvements had been made to existing bedrooms so that all except two had en-suite facilities. The bedrooms seen were suitably furnished and were personalised with people’s own belongings. All the bedrooms had lockable storage for people to use if they wished, and had locks to the doors. The acting manager said no-one currently in the home had chosen to have a key for their bedroom door. The bathrooms were bright and pleasant with a choice of baths and showers to meet different needs. There was a ‘wet room’ shower that people could use whilst seated in a special shower chair. There was no assisted bath available, but the acting manager said this was being considered by the providers as part of the ongoing improvements to the home. The laundry was small, though suitably equipped with commercial type washer and dryer. The home was clean and free from offensive odours on the day of the inspection visit. All the people who responded to our surveys and all those we spoke with said the home was always fresh and clean. One person was pleased that bed linen was changed at least once a week and that their bedroom was always kept clean. Most staff with were infection. and using had received training about the control of infection. Staff spoken aware of the procedures to follow to reduce the risk of spreading We observed staff using disposable gloves and aprons appropriately, anti-bacterial hand gel. Richmond Residential Care Home DS0000020082.V371225.R01.S.doc Version 5.2 Page 20 The AQAA gave details of all the improvements made and of the plans for the next 12 months. The AQAA said “Funds for any repairs and refurbishment are available with no limitations placed on this area”. Richmond Residential Care Home DS0000020082.V371225.R01.S.doc Version 5.2 Page 21 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. There were satisfactory recruitment practices and staff training, along with appropriate staffing levels so that people were protected and well supported. EVIDENCE: The staff rotas showed that there were usually three care assistants on duty from 7am to 3pm, including one senior care assistant. There were usually three care assistants between 3pm and 6.30pm, then two care assistants until 9.30pm. There were two care assistants working the night shift. The acting manager’s hours were not included on the rotas. Care staff were supported by a cook and domestic staff. Four people who returned our surveys said there were always staff available when needed, three said there usually were. Two staff who returned our surveys said there always enough staff to meet people’s needs and two said there usually were. People spoken with said there usually were enough staff available. A visitor said there were always staff around in the lounges when Richmond Residential Care Home DS0000020082.V371225.R01.S.doc Version 5.2 Page 22 they visited the home. A relative was pleased the person was “never left on her own for long”. The AQAA said that 93 of care staff had achieved National Vocational Qualification (NVQ) at level 2 or above. The training records seen and staff we spoke with confirmed this. The AQAA said there was a low turnover of staff at the home. There was no-one currently going through the induction programme as no new care staff had recently been employed at the home. The home had information about the Skills For Care induction training programme, but there was no evidence that this had been put into practice. Staff training was mostly up to date, including training about the care of people with dementia. Some staff had not received training about manual handling since March 2007. As noted previously, some staff had not received training about safeguarding vulnerable adults and this was planned for October 2008. We looked at the records of four members of staff. All included the required documents and information, such as a Criminal Records Bureau (CRB) disclosure, proof of identification and a photograph. Two records had some gaps in the employment history. Most staff said that communication between staff, including the manager, was always good. They said, “The communication is excellent”, and, “we all work well together as a team”. Richmond Residential Care Home DS0000020082.V371225.R01.S.doc Version 5.2 Page 23 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, 33, 35 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 was effectively managed so that people received a consistent and well organised service that was run with their best interests in mind. EVIDENCE: The registered manager for the home, Mrs Stella State, had left in July 2008. One of the providers, Mrs Elaine Styles-Hudson, had acted as manager for a short time before an acting manager was appointed in August 2008. The new acting manager, Mrs Tracey Taylor, had experience in care and management and had already achieved NVQ Level 4 in care and the Registered Manager’s Richmond Residential Care Home DS0000020082.V371225.R01.S.doc Version 5.2 Page 24 Award. The providers were actively involved in the running of the home, (though were away on holiday on the day of the inspection visit). People told us the acting manager was “always helpful”, “approachable”, and “well organised”. People said they would be able to go to the acting manager or the providers with any concerns and were confident that appropriate action would be taken. The AQAA was completed by the providers and was returned by the agreed date. The AQAA contained clear, relevant information that was supported by a wide range of evidence. The AQAA let us know about changes made and where improvements were still needed. The data section was fully completed. Although we had received notifications as required about deaths at the home, we had not received any notifications of other events as specified in the regulations. The information in the AQAA indicated that there were possibly two events that should have been notified to us. We also received information during the inspection visit about another event that should have been notified to us. Copies of notifications sent were not available for inspection at the home due to the change in management – as the acting manager had only been post for three weeks, she was still finding her way around the information systems in the home. The home’s quality assurance system included a suggestion box for people living in the home or their relatives, a complaints book left in the main hallway, surveys sent out to people living in the home, relatives and professionals involved in their care. There were regular staff meetings. The acting manager said a monthly ‘surgery’ was planned where the acting manager would be available for people or their relatives to bring any concerns or ideas for improving the home. The AQAA gave examples of where changes had been made as a result of listening to people’s views about the home. These included providing more activities and incorporating people’s wishes and ideas into the ongoing building work. We looked at the records of people’s personal money kept at the home. The money was stored securely with access limited to the acting manager and the providers. The records included receipts kept and two signatures for each transaction. The balances were checked regularly by the acting manager and assistant manager. Richmond Residential Care Home DS0000020082.V371225.R01.S.doc Version 5.2 Page 25 The AQAA showed that the maintenance of systems and equipment was up to date. We looked at accident records and fire safety records. The records seen were satisfactory and up to date. There were two maintenance men employed at the home so that any repairs needed were promptly dealt with. Richmond Residential Care Home DS0000020082.V371225.R01.S.doc Version 5.2 Page 26 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Richmond Residential Care Home DS0000020082.V371225.R01.S.doc Version 5.2 Page 27 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. ` Standard OP1 Regulation 5(1)(2) Requirement There must be a Service User’s Guide available to each person living in the home so that people have access to information about the home. Each person living in the home must have a care plan that specifies how their needs in respect of health and welfare are to be met. The care plan must be produced in consultation with the person and/or their representative. This will ensure that people have the care they need in the way they expect and prefer. There must be records of all complaints made about the home, including the action taken and the outcome. This will ensure that people are confident their concerns will be taken seriously and appropriate action taken. All staff working in the home must have training about safeguarding vulnerable adults so that people are fully protected. DS0000020082.V371225.R01.S.doc Timescale for action 14/10/08 2 OP7 15 30/09/08 3 OP16 17(2) 30/09/08 4 OP18 13(6) 30/11/08 Richmond Residential Care Home Version 5.2 Page 28 5 OP18 37 6 OP30 13(4)(b) (c) Notifications of all events as specified in the regulations must be made to CSCI. This will ensure that people are protected. All staff working in the home must have appropriate training to ensure the safe manual handling of people living in the home. 30/09/08 31/10/08 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 OP7 OP9 OP9 Good Practice Recommendations Care plans should be reviewed every month to ensure that people’s changing needs are recognised and appropriately supported. The temperature of the room used for medication storage should be monitored to ensure that medication is stored at the correct temperatures. Where there are handwritten instructions on medication administration records, there should be two signatures of staff who have checked the entry is correct. This will protect people and ensure medication is given as prescribed. An explanation should be given for any gaps in the employment history of applicants for jobs at the home. This will ensure a more robust recruitment procedure and help to protect people. The acting manager should apply for registration with CSCI to ensure that she is a fit person to run the home. 4 OP29 5 OP31 Richmond Residential Care Home DS0000020082.V371225.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Residential Care Home DS0000020082.V371225.R01.S.doc Version 5.2 Page 30 - 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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