Inspection on 23/01/06 for Ridge House

This inspection was carried out on 23rd 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 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

Ridge House 06/01/08

Ridge House 08/11/06

Ridge House 25/07/05

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Ridge House Ridge House Church Street Morchard Bishop Crediton Devon EX17 6PJ Lead Inspector Ms Rachel Fleet Unannounced Inspection 23rd January 2006 10.40 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 Ridge House DS0000064221.V271084.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. Ridge House DS0000064221.V271084.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ridge House Address Ridge House Church Street Morchard Bishop Crediton Devon EX17 6PJ 01363 877301 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) Ridge House Residential Home Limited Mrs Deborah Jane Bradford Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Ridge House DS0000064221.V271084.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th July 2005 Brief Description of the Service: Ridge House is registered to provide personal care, but not nursing care, for up to 15 residents over retirement age. The home is in the village of Morchard Bishop, next door to the parish church and opposite the village school. It is an older, large detached house, with a more recent extension. All bedrooms are for single occupancy, and seven have en-suite facilities. There is a lounge, a conservatory lounge area off the dining room, and a sitting area in the entrance hallway – which also has a staircase and stair lift to the first floor. The home has accessible, mature grounds, with a long patio overlooking the rear gardens and countryside beyond. There is parking space at the front of the home. Ridge House DS0000064221.V271084.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector, Rachel Fleet, was at the home for four hours. She met with nine of the 15 residents, six of whom gave their views in more depth. She also looked at various records, including care notes for three residents, and spoke with three of the staff. Mrs Bradford was also available throughout the inspection. Standards that were met at the last inspection were not re-inspected on this visit. The report from that inspection, carried out on 25 July 2005, should therefore be read along with this report, for fuller information. What the service does well: What has improved since the last inspection? The staff training programme includes topics related to current residents needs. Receipts are obtained for each expenditure from residents personal monies where it is held on their behalf by the Home. The health and safety of residents and staff are better protected by revised practices for dealing with soiled laundry, revision of the fire policy after consultation with the local fire authority, and further development of the risk management plan for Legionella. There has been investment in new equipment and in refurbishment – a hoist, armchairs, upgrading of the kitchen, specialist bedroom furniture, and non-slip flooring in high-risk areas. Ridge House DS0000064221.V271084.R01.S.doc Version 5.1 Page 6 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. Ridge House DS0000064221.V271084.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 Ridge House DS0000064221.V271084.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): 3 There are good systems for ensuring prospective residents’ needs are identified. The home does not offer intermediate care. EVIDENCE: Mrs Bradford carries out pre-admission needs assessments of prospective residents living locally. In one case, she had sent the assessment template to the carer of one prospective resident who lived away, for completion. A needs assessment was seen from a previous care setting for another resident. The assessments were generally very comprehensive and individualised, but spiritual needs were not as well considered as other possible needs. This was discussed with Mrs Bradford, since it has relevance for promotion of diversity. Ridge House DS0000064221.V271084.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 Some omissions in medication practices may lead to unsafe administration of medication. EVIDENCE: Residents were satisfied with how their medication needs were met by staff. Residents’ medication is obtained weekly from the local surgery, the contents checked on receipt, and a list of contents kept with the cassette. Facilities for items needing cold storage have been improved since the last inspection. But minimum/maximum daily temperature readings are not recorded, as would be good practice whilst insulin is being stored. Some omissions in medication practices may lead to unsafe administration of medication. Some entries on handwritten medication administration sheets did not include all necessary details – the dose to be given, for example (the entry showing only numbers of tablets to be given). Where variable doses of medication are prescribed, the dose or number of tablets given was not always recorded. Ridge House DS0000064221.V271084.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): These core standards were met at the last inspection. EVIDENCE: Ridge House DS0000064221.V271084.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): These core standards were met at the last inspection. EVIDENCE: Ridge House DS0000064221.V271084.R01.S.doc Version 5.1 Page 12 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): These core standards were met at the last inspection. EVIDENCE: Ridge House DS0000064221.V271084.R01.S.doc Version 5.1 Page 13 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 & 30 Staff have an appropriate level of training to meet residents’ needs safely. EVIDENCE: Residents were complimentary about the staff – their personal qualities, skills and competency as carers. Staff spoken with had a Care NVQ2 or 3; seven of the 14 care staff have a Care NVQ2 or 3 (or equivalent qualification). During the inspection, staff were observed to be unhurried, polite and friendly when attending to residents, assisting them appropriately. There is a good written induction programme for new staff, linked to nationally recognised standards and with supporting information (Maslow’s hierarchy of needs, for example). Staff said new staff were always accompanied by a more experienced member of the team. Nearly all staff are undertaking an infection control course, with a training session taking place during the inspection. Training related to the needs of residents (Parkinsonism and strokes, for example) was on the training programme seen for 2006. Ridge House DS0000064221.V271084.R01.S.doc Version 5.1 Page 14 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): 31, 33, 35 & 38 The home is well managed, resulting in practices that promote and safeguard the health, safety and welfare of the residents (including their financial interests). Residents are involved in developing how the home is run, but quality assurance systems are not formally established. EVIDENCE: Mrs Bradford has gained the Registered Managers Award. She and her husband have run the home for several years. Mrs Bradford is currently undertaking an infection control course along with her staff. Residents and staff felt the home was well managed, with both groups saying the owners were very helpful. CSCI has not received any complaints about the home. Residents felt the home was run for their benefit, with enough flexibility of the routines, etc. to meet individuals’ wishes. Mr & Mrs Bradford see each resident daily, with the opportunity to check if people are satisfied with the service they receive, or if they have any concerns. This has not been formalised, however, to provide a report on quality of care provided by the service. Ridge House DS0000064221.V271084.R01.S.doc Version 5.1 Page 15 Records for personal monies held by the Home for two residents were well kept, with receipts obtained for each expenditure. Residents felt the home would look after their monies appropriately. Residents and staff did not have concerns about safety matters at the home. Staff described appropriate handling of soiled laundry to reduce cross-infection risks. Mrs Bradford had amended the fire policy, after seeking advice from the fire authority about whether staff should investigate the cause of fire alarms sounding before ringing the fire service. Fire safety checks were recorded at recommended intervals. Staff confirmed fire drills were carried out; these were not recorded, but Mrs Bradford said she would do so in future. Accident forms were appropriately detailed. Falls without resultant injury were recorded in care records, rather than on accident forms. Mrs Bradford felt able to audit such occurrences because she is present at the home so regularly. There are good, updated risk assessments for each resident regarding falls. The risk assessment plan for Legionella has been improved since the last inspection. Ridge House DS0000064221.V271084.R01.S.doc Version 5.1 Page 16 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 Ridge House DS0000064221.V271084.R01.S.doc Version 5.1 Page 17 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 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 X 17 X 18 X X X X X X X X X 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 3 X 2 X 3 X X 3 Ridge House DS0000064221.V271084.R01.S.doc Version 5.1 Page 18 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 OP33 Regulation 24(2) Requirement You must, regarding reviews carried out at appropriate intervals - in relation to assessing & improving the quality of care provided, supply a report on these to the Commission and make a copy available to residents. Timescale for action 31/05/06 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 OP9 Good Practice Recommendations You should ensure residents are protected by the home’s procedures for dealing with medicines, by: a) Recording minimum/maximum daily fridge temperature readings when insulin is being stored; b) Ensuring all entries on medication administration sheets have sufficient detail, including the dose to be given, & the dose or number of tablets given where variable doses of medication are prescribed. Ridge House DS0000064221.V271084.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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. 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