Inspection on 31/08/05 for Richmond Residential Care Home

This inspection was carried out on 31st August 2005.

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

The inspector 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 02/11/06

Richmond Residential Care Home 01/12/05

Richmond Residential Care Home 24/08/04

Richmond Residential Care Home 13/05/04

Richmond Residential Care Home 01/03/04

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

CARE HOMES FOR OLDER PEOPLE Richmond Residential Care Home 80 Penkett Road Wallasey Wirral CH45 7QW Lead Inspector John McCabe Unannounced 31 August 2005 9:30 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 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 Version 1.30 F52_F02_s18931_Richmond_v230526_310805_Stage_4.doc Page 3 SERVICE INFORMATION Name of service Richmond Residential Care Home Address 80 Penkett Road Wallasey Wirral CH45 7QW 0151 639 3050 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Milecertain Limited David Wakefield CRH PC 20 Category(ies) of MD(E) registration, with number 20 of places Richmond Residential Care Home Version 1.30 F52_F02_s18931_Richmond_v230526_310805_Stage_4.doc Page 4 SERVICE INFORMATION Conditions of registration: 1) Adults (aged 30-64 years) with a mental disorder (excl learning disability) may be accommodated. 2) Elderley persons (aged 65-75 years) with a mental disorder (excl learning disability) may be accommodated. Date of last inspection 24 August 2004 Brief Description of the Service: The home is a large detached house, which offers personal care to 20 service users with mental health problems. The home is decorated to a high standard, and has well cared for gardens. Both the interior and exterior of the house are well maintained. Service users lead an open flexible lifestyle within the home; some of the service users attend college and local community centres on a daily basis. The home is close to the local amenities, pubs cafes shops and bus station. The home has a strict policy on unprescribed drugs and alcohol; both are not allowed to be brought into the home.. Richmond Residential Care Home Version 1.30 F52_F02_s18931_Richmond_v230526_310805_Stage_4.doc Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took four hours; the home’s administrator and a senior carer were present throughout the inspection. Both resident and staff files were reviewed; a tour of the building and gardens took place. Residents’ care staff and domestics were spoken with during the inspection. The home was clean and tidy, with adequate staffing levels to care for the residents. Residents said the home was like a hotel; they enjoyed the choice of foods and activities that were undertaken in the home. 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. Richmond Residential Care Home Version 1.30 F52_F02_s18931_Richmond_v230526_310805_Stage_4.doc 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 Standards Statutory Requirements Identified During the Inspection Richmond Residential Care Home F52_F02_s18931_Richmond_v230526_310805_Stage_4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5. The Homes Statements Purpose is up to date and ensures that the home stays within the category of resident agreed with the commission, and prospective residents have some knowledge of the home before they decide to move in on a permanent basis. The residents’ pre-admission assessment documentation is robust and comprehensive; this ensures that the skill mix of the workforce in the home can meet the residents’ identified care needs. EVIDENCE: All residents in the home are provided with a statement of terms and conditions, plus a contact when they move in to the home on a permanent basis. Residents are able to visit the home or have an overnight stay before they move in on a permanent basis. Admissions to the home are infrequent, as most of the residents are on long stay. The home’s senior carers, and manager undertake a pre-admission assessment on residents before they are admitted to the home, to ensure care needs are identified and can be met. Other health care professionals GP, Social Worker and Community Psychiatric Nurses (CPN) known to the resident are also involved in the assessment. Richmond Residential Care Home F52_F02_s18931_Richmond_v230526_310805_Stage_4.doc Version 1.30 Page 8 Care staff in the home undertakes special care training, which is ongoing, to ensure that the assessed and changing care needs of the residents are met. Richmond Residential Care Home F52_F02_s18931_Richmond_v230526_310805_Stage_4.doc Version 1.30 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 standard(s) 7,8,9.10,11. Residents’ individual health, personal and psycho/social care needs are clearly recorded, and provide care staff the information they need to meet the residents’ care needs. EVIDENCE: All residents in the home have an individual care plan, which is formulated on admission to the home, reviewed by the senior carers on a regular basis. Daily health records are documented daily for each resident, this includes any critical incidences plus any visits from GPs, CPN or social workers etc. No resident in the home self medicates, all medications for residents are administered by the carers in the home. The protocols for the receipt, storage, disposal, and documentation of medications in the home are in accordance with the National Minimum Standards (NMS). The homes “communication book” was reviewed; this evidenced a great deal of information about, staff, domestic issues but also relevant clinical and care incidences of the service users. It is recommended that any clinical information, incidences, must be recorded in the residents daily health record Richmond Residential Care Home F52_F02_s18931_Richmond_v230526_310805_Stage_4.doc Version 1.30 Page 10 so as health information, so as to ensure that is comprehensive information about the resident which is recorded daily. Richmond Residential Care Home F52_F02_s18931_Richmond_v230526_310805_Stage_4.doc Version 1.30 Page 11 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 standard(s) 12,13,14,15 Residents have choice and flexibility how they spend their day in the home, and pursue leisure and educational activities according to their choice and preferences. This allows independence and individuality for each resident. EVIDENCE: Richmond Residential Care Home F52_F02_s18931_Richmond_v230526_310805_Stage_4.doc Version 1.30 Page 12 Residents in the home are encouraged to participate in education and training outside the home, residents attend the local college and day centres for various educational and leisure pursuits. Residents in the home are currently enrolled on an art, cookery course at the local social centre. Care staff in the home help service users with benefits/finance problems or refer residents to appropriate agencies. The majority of residents in the home manage their own weekly personal allowances. All transactions have signatures and receipts. Care staff in the home encourages service users to maintain links with their family and friends. If visitors are restricted to the home, it is with the consent and agreement of the individual service user. Residents can entertain their visitors in the communal lounge or in the privacy of their own room. All residents have a lockable bedroom; in cases of emergency care staff can over ride the lock. The routine of the home is flexible as regards mealtimes and bedtimes. Residents have access to all parts of the home and gardens. Residents said they “enjoyed living here”, “it’s better than a hotel”, and “I like all the food.” Rules on smoking, alcohol and non - prescribed drugs are clearly stated in the contract of the service users within the home. Menu planning is a joint decision between carers and residents. Richmond Residential Care Home F52_F02_s18931_Richmond_v230526_310805_Stage_4.doc Version 1.30 Page 13 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 standard(s) 16,17,18. The home has a satisfactory complaints system with evidence that residents feel their views are being listened to and acted upon. The homes policy and training programmes for POVA, and Whistle blowing, ensure that the homes residents are protected from any abuse. EVIDENCE: There have been no internal complaints, and no complaints to the CSCI. The home has robust complaints procedure, which is documented in the residents guide and the staff handbook. Many of the residents use their vote in local elections; care staff assists residents when ever necessary. The care home has up to date information on the Protection of Vulnerable adults, this information is communicated to new employees on their induction course. There was evidence that many of the staffs in the home had undertaken training on POVA protocols, and the Whistle Blowing Policy. All residents can access their NHS entitlements, which include dentists, opticians, chiropodist etc. Richmond Residential Care Home F52_F02_s18931_Richmond_v230526_310805_Stage_4.doc Version 1.30 Page 14 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 standard(s) 19,20,21,22,23,24,25,26 The standard of decor within this home is good, with evidence of continuing improvements, through maintenance and planning. The home does present as a homely, safe and comfortable environment for the residents. EVIDENCE: Through maintenance and planning, the home presents as a homely, safe and comfortable environment for the residents. Richmond Residential Care Home F52_F02_s18931_Richmond_v230526_310805_Stage_4.doc Version 1.30 Page 15 The home is well maintained and decorated, suitable for its stated purpose. The premises are safe, comfortable, and free from smells, there are grab rails throughout the house, and ramps for wheelchair access. The communal lounge, dining room is furnished in a homely way,( there is a separate lounge for smokers), with domestic lighting, television, and a hot drinks facility for the service users. The front and rear gardens are well cared for and tended, and offer seating for the service users. The paved patio area of the garden has been relayed, so as to make the area safe for both service users and staff. Most of the residents have personalised their own bedrooms with photographs and memorabilia. On the day of the inspection, there was discarded trunk freezer and sofa being stored in the rear garden. These are potentially hazardous to residents, or children from the local community and must be removed from the home. The home offers access to local amenities, local transport, and relevant support services to suit the personal and lifestyle needs of the service users. Richmond Residential Care Home F52_F02_s18931_Richmond_v230526_310805_Stage_4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 The standard of vetting and recruitment practices is not safe and does not ensure appropriate checks being carried out on all new staff. This means that the residents are put at risk. EVIDENCE: On the day of the inspection, staff person files were being reviewed it was noticed that member of care staff who had been employed on 10/7/05, her CRB was dated 17/11/03. From the 26th July 2004, no person can be employed in a care home without an up to date CRB/POVA check. Also CSCI do not recognise portable CRBs from previous employees. The home’s administrator took immediate action so as not compromise the regulations. All staff has signed their induction document to confirm they have all been instructed on Adult Protection protocols. Staff training is ongoing as evidenced from the personal files of the staff. Richmond Residential Care Home F52_F02_s18931_Richmond_v230526_310805_Stage_4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,,36,37,38. Staff morale is high in the care home, resulting in an enthusiastic workforce that works positively with residents to improve their whole quality of life, plus the turnover of care staff is low. EVIDENCE: The registered manager has over 18 years experience in social care, for the past six years has managed the home in a competent and professional manner. The registered manager successfully completed an NVQ level 4 management studies in June of 2004. Staff and residents informed the inspector that, the home was run in an open, positive transparent way, both staff and residents have regular meetings with the manager; the meetings are minuted and actioned upon. Richmond Residential Care Home F52_F02_s18931_Richmond_v230526_310805_Stage_4.doc Version 1.30 Page 18 All staff in the home has documented supervision six times per year, this ensures that all staff have the opportunity to discuss with the manager, and other senior nurses, any issues that can effect or improve the care for the residents. Documented supervision of all staff gives the staff and managers opportunities to discuss their own or identified training needs. The home’s certificates of insurance and worthiness for machines, gas, electricity, fire equipments, lift, hoists were in date and valid. The Employer’s Liability Insurance, which is displayed in the main hall of the home, the certificate is valid and in date. Richmond Residential Care Home F52_F02_s18931_Richmond_v230526_310805_Stage_4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 3 3 3 Richmond Residential Care Home F52_F02_s18931_Richmond_v230526_310805_Stage_4.doc Version 1.30 Page 20 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 19 Regulation 13 Timescale for action The registered person must 30th ensure that the discarded freezer September and sofa in the rear garden of 2005. the home are removed. The registered person must 30th ensure that, before care staff are September employed in the home they must 2005. have an enhanced CRB/POVA certificate. Requirement 2. 29 18 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Richmond Residential Care Home F52_F02_s18931_Richmond_v230526_310805_Stage_4.doc Version 1.30 Page 21 Commission for Social Care Inspection Liverpool Area Office 3rd Floor 10 Duke Street Liverpool, L1 5AS 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 Residential Care Home F52_F02_s18931_Richmond_v230526_310805_Stage_4.doc Version 1.30 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. 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