Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 27/01/06 for Richmond Residential Care Home

Also see our care home review for Richmond Residential Care Home for more information

This inspection was carried out on 27th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

Residents and visitors spoken with were pleased with standards of care at the home, commenting that "you couldn`t find a better place", and that the staff were "very good" and "kind". There was a relaxed atmosphere and a good rapport between residents and staff. Residents meetings were held weekly to keep residents informed about activities and events in the home and the continuing building work, and to give residents the opportunity to comment on life in the home. Staff training was a high priority at the home with most of the care assistants having achieved NVQs in care. The records seen were well kept and up to date.

What has improved since the last inspection?

Two new lounges had been completed as part of the improvement programme, providing more communal space for residents.

What the care home could do better:

The complaints procedure and quality assurance system both needed further development to ensure the home was run in the best interests of the residents. A risk assessment was needed of the potential hazards to residents, visitors and staff regarding the continuing building work to ensure their safety.

CARE HOMES FOR OLDER PEOPLE Richmond Recreation Road Shirebrook Mansfield Nottinghamshire NG20 8QE Lead Inspector Rose Veale Unannounced Inspection 10:45 27 January 2006 th 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 DS0000020082.V281210.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Richmond DS0000020082.V281210.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Richmond Address Recreation Road Shirebrook Mansfield Nottinghamshire NG20 8QE (01623) 748474 (01623) 744228 stella.state@richmondcarehome.co.uk 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) Maximise Holdings Limited Stella State Care Home 19 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (19) of places Richmond DS0000020082.V281210.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Plus Three (3) Day Care Places The home must only accommodate a maximum of 16 residents (OP), including a maximum of 7 (DE), until the planned 4 bedroom extension has been completed. This is to be achieved by the conversion of 3 single rooms on the first floor to become 2 single rooms with en-suite facilities, and the development of 4 new single bedrooms with en-suite facilities in the extension at the side of the home. A newly built garden room and smoking room will be erected adjacent to the south side of the home to resolve the under-provision of communal space at the home. The improvement of bathroom facilities will be resolved by the removal of the upstairs shower room, the creation of a new bathroom in the upstairs of the new build and the creation of a new bathroom in place of the downstairs toilets, (adjacent to the kitchen corridor). The existing access to the laundry, (through the small front lounge), will be closed off and new access created through the new build area. 11th October 2005 Date of last inspection Brief Description of the Service: Richmond Care Home is situated in the village of Shirebrook, near to local shops and facilities and public transport. The home is in an older building which has a long history of care provision. A programme of building work has been undertaken and redevelopment is underway for a newly built extension. Part of the extensive grounds has been made accessible to residents. The home provides personal care for up to 19 older people, including up to 7 people who need care because of dementia. Car parking space is provided. Richmond DS0000020082.V281210.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced. There were 12 residents accommodated in the home on the day of the inspection, including 7 residents assessed as requiring specialist dementia care. Residents, visitors and staff were spoken with during the inspection. Records were examined, including care, medication, staff, and health and safety records. The manager was available and very helpful throughout the inspection. The home was undergoing extensive building work to provide new bedrooms and bathrooms and to improve existing bedrooms. An anonymous complaint about the home had been received by CSCI and was investigated as part of the inspection. No evidence was found to substantiate the complaint and it was not upheld. What the service does well: What has improved since the last inspection? What they could do better: The complaints procedure and quality assurance system both needed further development to ensure the home was run in the best interests of the residents. A risk assessment was needed of the potential hazards to residents, visitors and staff regarding the continuing building work to ensure their safety. Richmond DS0000020082.V281210.R01.S.doc Version 5.1 Page 6 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 DS0000020082.V281210.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Richmond DS0000020082.V281210.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not assessed at this inspection. A requirement was made at the last inspection that confirmation must be made in writing to prospective residents that the home is able to meet their needs. The manager said that this would be put into practice when a new admission was being considered. There had been no new admissions since the last inspection. Richmond DS0000020082.V281210.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 Residents were protected by the robust systems in place for the safe handling of medication. EVIDENCE: The medication policy for the home was seen and included all the required information. Medication was securely stored. Medication administration records, (MARs), were correctly completed. An area of good practice was the use of the ‘carer notes’ section of the MARs for staff to note any changes to the usual medication, for example, medication given as required for pain relief, or medication refused and the reason why. Staff administering medication had received appropriate training. The manager was advised to provide a list of the usual signatures and initials of staff administering medication. A requirement made at the previous two inspections that a medication fridge must be provided had not been met. Medication requiring refrigeration was stored securely in a locked cash box in the kitchen fridge. Richmond DS0000020082.V281210.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not assessed at this inspection. All these standards were assessed and met at the previous inspection. Richmond DS0000020082.V281210.R01.S.doc Version 5.1 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Residents and their representatives were confident that complaints would be properly dealt with. However, further development of the complaints procedure was needed to include records kept of all complaints. EVIDENCE: The home’s complaints policy was displayed in the main entrance area and included all the required information. The manager said that the home did not keep records of complaints as no formal complaints had been received. It was discussed with the manager that the home should keep a record of even seemingly minor complaints. A record should be kept of the action taken and the outcome of the complaint. Residents, visitors and staff spoken with were happy to take any concerns or complaints to the manager and felt confident that prompt action would be taken. An anonymous complaint about the home was received by telephone on 25/01/06 and was investigated as part of this inspection. The complaint was that since the cook had recently left the home, the care staff doing the cooking were not competent and did not want to do it. Also, that the stocks of food at the home were low. During the inspection, the manager and staff were interviewed, the staff rotas were seen, staff training records were seen, and the stocks of food were checked. The staff rotas seen and discussion with staff showed that the home’s part-time cook and a care assistant, who had previously worked as the cook at the home and who regularly provided cover for the cooks, were doing the cooking. Both members of staff had up to date food hygiene training. The Richmond DS0000020082.V281210.R01.S.doc Version 5.1 Page 12 stock of food in the fridges, freezers and store cupboards was satisfactory. Residents spoken with were pleased with the meals provided. There was no evidence found to substantiate the complaint and the complaint was therefore not upheld. Richmond DS0000020082.V281210.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 26 The home was clean and pleasant and residents were protected by the systems in place for the control of infection. EVIDENCE: There was continuing building work at the home to provide new bedrooms and bathrooms and to improve existing bedrooms. Residents and visitors spoken with said the building work had not caused any major problems. Since the last inspection, two new lounges had been completed, improving the environment and facilities for residents. One resident and a visitor commented that one of the new lounges felt ‘too big’ and consideration should be given to rearranging furniture to make the room more homely. No risk assessment had been carried out regarding the ongoing building work and the potential hazards for residents, visitors and staff. The home appeared clean and was free from offensive odours on the day of the inspection. The laundry equipment was satisfactory. Staff spoken with had received training in infection control measures and were well aware of Richmond DS0000020082.V281210.R01.S.doc Version 5.1 Page 14 actions to take to ensure proper hygiene. For example, using disposable aprons and gloves when assisting residents with personal care. Richmond DS0000020082.V281210.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 and 30 Residents’ needs were well met by a trained and competent staff team. EVIDENCE: The staff training records were seen. Most of the care assistants had achieved NVQs in care. All the staff had received training such as fire safety, manual handling, adult protection, food hygiene, and health and safety. Some staff had received training in dementia awareness. Staff spoken with confirmed the training they had received and said that training was a high priority at the home. Richmond DS0000020082.V281210.R01.S.doc Version 5.1 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 and 38 The quality assurance system needed further development to ensure the home was run in the best interests of residents. The health and safety of residents and staff were generally well promoted and protected by the systems in place in the home. EVIDENCE: Quality assurance in the home was carried out informally through residents meetings, care reviews, and discussions with residents and their representatives. There was no formal system of an annual quality audit with a report produced for residents and their representatives. Residents meetings were held every week and notes were kept. Health and safety records were seen, including the fire log book, accident reports, maintenance and servicing records. All the records seen were well kept and up to date, except the gas safety certificate which had recently Richmond DS0000020082.V281210.R01.S.doc Version 5.1 Page 17 expired. Staff had received training in fire safety, first aid, health and safety, and manual handling. Staff spoken with were clear on health and safety procedures, such as correct storage of cleaning products, safe manual handling, and infection control. Fresh potatoes and vegetables were stored in a preparation room off the kitchen. This storage should be reviewed as the room was quite warm on the day of the inspection and the potatoes were stored in bags directly on the floor. Some leftover food stored in the fridges had not been labelled with the content and date. Richmond DS0000020082.V281210.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X X X 3 Richmond DS0000020082.V281210.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13(2) Timescale for action Medication requiring refrigeration 30/06/06 must be stored securely in a suitable refrigerator. Original timescale 01/05/05 A record must be kept of all 30/04/06 complaints made with the action taken and the outcome. A risk assessment must be made 28/02/06 regarding the potential hazards to residents, visitors and staff during the building work. A formal quality assurance 30/04/06 system must be developed. The Landlord’s Gas Safety 28/02/06 Certificate must be renewed and a copy supplied to CSCI. Requirement 2. 3. OP16 OP19 22(3) 13(4) 4. 5. OP33 OP38 24 23(2)(c) Richmond DS0000020082.V281210.R01.S.doc Version 5.1 Page 20 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 OP9 OP38 OP38 Good Practice Recommendations There should be a list of the usual signatures and initials of all staff that administer medication in the home. Any leftover food stored in the fridges should be clearly labelled with the content and date. The storage arrangements for fresh vegetables should be reviewed to ensure storage at a suitable temperature. Richmond DS0000020082.V281210.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 DS0000020082.V281210.R01.S.doc Version 5.1 Page 22 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!