Inspection on 08/11/06 for Ridge House

This inspection was carried out on 8th November 2006.

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

Ridge House 06/01/08

Ridge House 23/01/06

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 Key Unannounced Inspection 8 November 2006 10.30 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 Ridge House DS0000064221.V309898.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. Ridge House DS0000064221.V309898.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ridge House Address Ridge House Church Street Morchard Bishop Crediton Devon EX17 6PJ 01363 877335 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.V309898.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd January 2006 Brief Description of the Service: Ridge House is registered to provide personal care, but not 24-hour nursing care, for up to 15 residents over retirement age. It is run by Mr & Mrs Bradford, who work at the home in various roles (including care-giving) on an almost daily basis. Mrs Bradford is registered with the Commission for Social Care Inspection (CSCI) as manager. 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. Two are accessed by a small flight of steps, and careful assessment of mobility is made with prospective residents before any are given these bedrooms. 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. Weekly fees at the time of the inspection were £306 - £460. These did not include the costs of chiropody (£10), hairdressing, toiletries, newspapers or magazines, some transport costs, private phone lines, and continence aids other than any provided through local health services - which are at cost price. Inspection reports produced by the Commission for Social Care Inspection (CSCI) about the home are available on request from the owners, or the person otherwise in charge at the time. Ridge House DS0000064221.V309898.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector, Rachel Fleet, was at the home for just over seven hours for this unannounced inspection. Mrs Bradford had completed a pre-inspection questionnaire from the Commission, and made herself available throughout the inspection. Of ten sent out, five completed CSCI surveys or comment cards were returned by residents – four anonymously, with one being only partly completed - or their representative in the fifth case. Of eight surveys sent out, responses were received from five care staff, and from both community-based health or social care professionals who were sent one. The inspector met with eight of the 15 residents (seven of whom could give their views in some depth), three visitors to other residents, and two staff. She also looked at care-related records, including more in-depth inspection of care notes for three residents who included newer residents, someone with communication difficulties and someone receiving care from district nurses. ‘Quality of care’ surveys, accident forms, kitchen records, personal monies records (kept by the home) and medication-related records were also seen. Information gained from all these sources and from communication with the service since the last inspection is included in this report. The Commission has not received any concerns or complaints about the home since the last inspection. What the service does well: Residents’ comments during the inspection included, “They’re very cheerful, and have a little talk when they have time” (-about the staff); “If you ask for help, they give it to you”; and, “I get everything I want, and nothing I don’t want.” One survey respondent wrote, “It is a wonderful caring place. I love it. I am very happy here.” A visitor similarly said, “They have a very good reputation in the village…they’re very caring here.” Another said the home had been recommended to them by a GP, and felt the home gave ‘excellent care’. Prospective residents’ needs are fully identified, helping ensure the home is able to care for them if they choose to live there. This, with good care planning, provides staff with necessary information about residents, so they know how to meet their needs and preferences. Co-working with a variety of community-based professionals ensures residents’ health care needs are met well. Residents also benefit from the catering arrangements, which take into account their preferences as well as their health and social needs. They enjoy a Ridge House DS0000064221.V309898.R01.S.doc Version 5.2 Page 6 good, homely, well-maintained environment that promotes their comfort, independence and health. Choice and thus control are promoted - with respect for residents’ rights and dignity. Residents’ lives are being enriched by a developing variety of opportunities for fulfilment. These include supportive and interesting contact with residents’ families, friends and the local area, so residents benefit from being part of a community. Mrs Bradford has the knowledge, skills and experience to ensure the home is run well, in the best interests of the residents. This includes good attention to suggestions, concerns or complaints, so they are used to improve the service provided. The safety and welfare of everyone at the home are promoted by policies and practices that reduce risks to their wellbeing, including safeguarding residents from abuse (financial, etc.). A number of staff are employed in different roles, ensuring a sufficient range of knowledge and skills to meet residents’ various needs. The care staff team have a good level of basic knowledge and skills to ensure residents are in safe hands. What has improved since the last inspection? What they could do better: When asked if there was anything the home could do better, one resident said, “No – they’d have to go a long way to find anything.” A staff suggestion was for more one-to-one time with residents. Residents’ medications are generally handled well, but improvements to some aspects of practice would make systems safer. Recruitment is undertaken carefully by the home, but getting all required information about prospective staff before employing them would help ensure as much as possible that new staff are suitable to care for residents. Staff are well supported and the team are trained to a safe level, but residents would benefit if all staff had regular updating on conditions associated with ageing, to ensure that they will recognise and meet residents’ changing needs. Ridge House DS0000064221.V309898.R01.S.doc Version 5.2 Page 7 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. Ridge House DS0000064221.V309898.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 Ridge House DS0000064221.V309898.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. The home does not offer intermediate care (St. 6). Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A good variety of systems are in place to ensure prospective residents’ needs are fully identified, promoting success of any subsequent admission to the home. EVIDENCE: A template used by the home for pre-admission assessment of needs includes all the areas in the relevant National Minimum Standard for care homes. A completed one seen had good detail about the individual’s preferences, care needs, social history, etc. Information had also been obtained from previous carers, in some cases, or Social Services care managers. A new resident confirmed Mrs Bradford had visited her to discuss her needs, before the resident looked around the home; she found the information she was given before moving in was accurate. Another resident similarly said they discussed and agreed their care before their admission. A relative of a third resident Ridge House DS0000064221.V309898.R01.S.doc Version 5.2 Page 10 confirmed they had received full information (including a sample contract, liabilities, and the service provided) when making enquiries about the home, which was also reflected by the surveys. Ridge House DS0000064221.V309898.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 – 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is good information about residents’ general care needs, informing staff how to meet their needs and preferences. Multidisciplinary working ensures residents receive good health care. There is adequate management of residents’ medication, although attention to some aspects of practice would promote safer systems. There is good respect for residents’ privacy, with promotion of their dignity and rights. EVIDENCE: There was comprehensive information about residents’ various needs based on information gained before and added to since their admission, including social histories as well as health problems and personal care needs. CommunityRidge House DS0000064221.V309898.R01.S.doc Version 5.2 Page 12 based professionals’ surveys said staff showed a clear understanding of residents’ needs and added their advice to residents’ care plans. All but one care plan seen had been reviewed recently; Mrs Bradford said she would carry out the overdue review promptly. Residents confirmed their care was discussed with them, although this was not always evident from records kept. Residents felt staff attended to their health needs and medication well, one being particularly grateful that the home had helped them through some very poor health. Community-based professionals said the home worked in partnership with them. Records showed staff had contacted the district nurse when they noted a change in a resident’s condition, and the nurse was now attending regularly. Other residents’ records included regular communication with GPs about various health problems noted by staff, and visits by a dentist and an optician. Handling plans were seen, ensuring safety for both residents and staff when residents were being assisted to move. A resident with diabetes had an annual review with community-based health services to monitor their condition in the long-term. Staff attended to a frail resident regularly during the inspection, and although the resident had limited communication, staff clearly knew how to interact with them. Pressure-relieving mattresses and cushions were seen, used to prevent frailer residents getting sore when sitting or lying. Most medications were dispensed weekly from the local surgery, with tablets sent in individual compliance aids for each resident; these were stored securely. A resident spoken with was aware of recent changes to their medication, seen recorded in care notes. Staff signed administration charts to indicate what medication the resident had taken. However, no record was seen of why medication had not been taken on occasion, or of what was then returned in the aids to the surgery at the end of the week. Although weekly information sent with medication was kept, evidence was needed to show stated items had been received, since the aids were not sealed units. Mrs Bradford addressed this immediately, by signing to confirm receipt of new stocks, and said she will keep a record of medicines returned to the surgery in the aids. When a controlled drug is prescribed, it stored in the same way as other medication, rather than with additional measures taken to ensure safer storage, which would be good practice. A previous recommendation relating to insulin storage and recording of medication doses appeared to have been addressed. Two visitors said that although the people they visited had some challenging traits, staff always responded well to them. Residents felt their privacy was respected, during personal care, or when visitors came, for example. And community-based professionals confirmed they could see residents in private. Bathrooms and toilets have privacy locks, and some residents have been given locks on their bedroom doors as requested. Ridge House DS0000064221.V309898.R01.S.doc Version 5.2 Page 13 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 – 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are a good variety of opportunities for fulfilment, to enrich residents’ lives, although planned developments will improve these. Good links are maintained with residents’ families, friends and the community around the home, helping to ensure residents benefit from supportive and interesting relationships. There is good promotion of residents’ right to choice, supporting residents’ control of their lives. There are good catering arrangements that meet residents’ preferences, as well as their social and health needs. EVIDENCE: Residents said they went to in-house activities such as quizzes and skittles. A Communion service took place during the inspection – a regular event at the home. Staff reported organising ‘Scrabble’ games for a new resident who Ridge House DS0000064221.V309898.R01.S.doc Version 5.2 Page 14 enjoyed this game, and giving hand massages to a mentally frail resident, as well as trying to provide individuals with opportunities to take up or continue previous interests (painting, gardening and trips to garden centres, buying CDs for a lady who enjoyed singing to music). One staff member was due to take a course on exercise and promoting mobility, which they hoped to use to run exercise sessions for residents. Outings and activities are paid for by the home, including aromatherapy, lunches at the local pub and trips out for afternoon tea. When asked if there was enough for them to do with their time, one resident said, “There are so many of us who can’t join in a lot of things because we can’t hear or see.” Three others and a visitor reflected this, although all were very satisfied with the home. Mrs Bradford said the home has story audiotapes, for any resident to use, and has arranged for monthly sessions to be provided by a local organisation which should be suitable for people with impaired sight or hearing. These are to start in the new year. When asked if visitors were made to feel welcome, one resident said, “There’s always a cup of tea for them.” Visitors said they could call at any time. A relative said former local neighbours came to visit residents once they moved in. The home was described as being ‘very social’ and having a community feel, rather than that of a care business. Mrs Bradford was described as ‘outstanding’ regarding the level of contact she maintained with relatives who lived away, keeping them well informed. Residents felt they were given sufficient choice in the day-to-day life of the home. Bedrooms had been personalised with residents’ own possessions. A visitor said their friend didn’t like lots of foods and was always offered alternatives. Staff do not act as appointee for any residents, leaving residents free to choose who assist them with their financial affairs. The great majority of comments about the food were very positive and included, “Very good”, “Wonderful”, “Always a very good and varied choice”, and “Mum loves the food”; one resident felt it was ‘dull’ and the one thing they were not keen on (- being very positive about the home otherwise). A visitor said a bowl of fruit was provided to residents if they wanted it; Mrs Bradford this was also offered daily at meals. A list of residents’ stated ‘dislikes’ is kept in the kitchen, updated if it is noted that a resident has not enjoyed something; although specific choices are not offered at main meals, residents and visitors confirmed they are provided with a preferred alternative if the planned menu is something an individual does not like. During the inspection, the lunchtime was unhurried, and the cook was heard checking with residents if the meal had been satisfactory. A response in one survey completed anonymously was that the resident liked the meals ‘sometimes’ and would like to see menus in advance; menus are displayed in the dining room, but it was not known whether the respondent ate there or ate in their own room. Ridge House DS0000064221.V309898.R01.S.doc Version 5.2 Page 15 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 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Positive relationships within the home help ensure that residents and other stakeholders fully feel any concerns are responded to appropriately. There are good safeguarding policies and practices in use, to try to protect residents from abuse. EVIDENCE: Residents said they felt able to complain or raise concerns, especially since they saw Mr & Mrs Bradford regularly. One added, “If you want anything, you go and ask.” A survey response, to a question asking if they knew who to talk to if they weren’t happy, said the Bradfords were very helpful. A visitor said Mrs Bradford always listened to their views, reflected by others who said the Bradfords were always available to discuss any matters – concerns, suggestions, etc. The Commission and community-based professionals who returned surveys had not received any complaints about the home. And Mrs Bradford confirmed there had been no complaints made to the home, as indicated in the pre-inspection questionnaire. Residents asked felt safe at the home, one including, “I’m not wanting for anything” – feeling they were well looked after. Four completed surveys confirmed the respondent had received a contract from the home, protecting Ridge House DS0000064221.V309898.R01.S.doc Version 5.2 Page 16 their rights. A risk assessment was seen where one resident had rails fitted to their bed, to ensure these were being used appropriately (being a potential form of restraint). Staff said they had had relevant training, including discussing restraint as part of a care qualification they had undertaken; one spoken with knew where to get contact information for reporting any abuse of residents if it occurred, which Mrs Bradford has made easily accessible – displaying them clearly on noticeboards. Ridge House DS0000064221.V309898.R01.S.doc Version 5.2 Page 17 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 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy a good, homely, well-maintained environment that promotes the quality of their daily lives, including their independence and health. EVIDENCE: Residents spoken with were satisfied with their accommodation, including heating and lighting; care notes showed one had been provided with a brighter lightbulb in their bedroom, on requesting one. Raised toilet seats and wash stools, a bath with a hoist and a shower facility, appropriate door holders, and ramp access to the patio/garden were seen - all promoting ease of access and residents’ independence in mobility. Mrs Bradford said she had visited a prospective resident in their previous care setting when physiotherapists were present, and then an assessment had been carried out at the home, to ensure they could access certain rooms at the home before they were admitted. A vacated room seen had been completely refurbished, which Mr Bradford said Ridge House DS0000064221.V309898.R01.S.doc Version 5.2 Page 18 was done routinely. Good standards of décor noted throughout the home, and large areas had recently been re-carpeted. New furniture had been purchased recently. A visitor said they had not noted any hazards or problems with the environment on their visits; a resident said repairs like fitting a new light bulb were done immediately. The pre-inspection questionnaire indicated gas and fire safety systems were overdue for a service, but Mr Bradley confirmed part of this had since been carried out, in October 2006, and was to be completed later in November 2006. The home was very clean when the inspector arrived, and without any malodours. Residents confirmed this was the usual standard, one saying, “Everything is kept in apple-pie order,” and another saying, “It’s kept beautifully – nothing is ever dirty.” One survey included that the respondent would like the toilets cleaned more regularly; no cleanliness problems were found during the inspection, however. The laundry was orderly, with written guidance displayed on appropriate wash programmes for proper cleaning of laundry. Staff described appropriate handling of soiled items, and disposable gloves and aprons were available around the home, to reduce risks of crossinfection. Ridge House DS0000064221.V309898.R01.S.doc Version 5.2 Page 19 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 – 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff numbers and the skill mix are good, helping to ensure residents’ various needs can be met. Recruitment practices are adequate, although obtaining all required information before employing staff in the home would help ensure residents are protected from unsuitable staff. The staff team has a good level of basic knowledge and skills to guide practice and ensure residents’ safety. Training and support for staff is adequate, although residents would benefit if all staff had updating on caring for people with conditions associated with ageing, to ensure that they meet changing needs. EVIDENCE: A resident said, “There are plenty of staff – they’re very kind and thoughtful. I’ve no complaints about them at all.” Four completed residents’ surveys said staff were usually or always available when they needed them – one adding “24 hours”. The surveys also said that they usually or always got the care and support they needed. During the inspection, residents were attended to in a Ridge House DS0000064221.V309898.R01.S.doc Version 5.2 Page 20 timely and unhurried way, with staff continually occupied but not appearing rushed. One staff said they had enough time to give care indicated in care plans but would like more one-to-one time with residents. Residents and visitors said staff answered call bells were quickly and knew what help they needed – with mobility, for example. People said staff turnover seemed low, in that they saw the same staff rather than lots of new faces. Care staff are supported by a cook and cleaning staff for part of the day, minimising time spent on non-care duties. The cook is now being employed for extra hours to ensure new food regulations are addressed. Rotas showed – and staff confirmed - there are usually three carers on duty in the morning, two later in the day, and overnight one staff member is on duty with the Bradfords being on call. The Bradfords said they themselves also work shifts if any vacancies or staff shortages arise, until other staff are found. Employment information was looked at for the two staff employed since the last inspection. They had been interviewed, and two good references obtained for each. However, police checks had not been completed until after they started working at the home. Mrs Bradford had discussed gaps in employment history where relevant, although had not recorded the conversation. It was very positive to see from the pre-inspection questionnaire that at least half of the care staff have a recognised care qualification. Both staff spoken with had a National Vocational Qualification in Care, at Level 3. The home’s written induction programme for new staff meets nationally recognised standards. It was noted from staff and the pre-inspection questionnaire that whilst mandatory training was given regularly, there was less training or updating on conditions of old age, which would ensure staff can recognise and meet changing needs of residents. For example, a significant minority of residents said they had sight problems; this topic was not on recent or planned training programmes, although Mrs Bradford said the visiting optician had explained individual residents’ conditions to staff present at their last visit. Ridge House DS0000064221.V309898.R01.S.doc Version 5.2 Page 21 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 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has excellent levels of skills and experience, which ensures the home is run well. There are good strategies in place to help ensure the home is adequately run in the best interests of the residents. Good practices used by the home protect residents’ financial affairs. The safety and welfare of everyone at the home are promoted by good policies and practices that reduce risks to their health. Ridge House DS0000064221.V309898.R01.S.doc Version 5.2 Page 22 EVIDENCE: Mrs Bradford has gained the Registered Managers Award. She has run the home for several years, undertaking recent updating on first aid and new legislation regarding fire safety and food safety. There was evidence of resident-focused development and improvement of the service, in a broad variety of ways. And prompt attention to any areas for improvement identified by the inspection process. Residents’ and visitors’ positive feelings are reflected throughout this report. Community-based professionals were satisfied with the overall care provided, one saying, “Very satisfied.” Staff surveys also indicated satisfaction with the running of the home and the support they received, no issues being raised about various aspects of management included in questions. Residents said the Bradfords regularly checked how they were, one adding they were always open to suggestions. Surveys on different aspects of homelife are carried out at least yearly, with views of visitors such as relatives and community-based professionals also sought, to assess and improve the quality of care provided; the most recent findings had been shared with residents and the Commission. Several very positive letters from relatives, sent in with surveys, were seen during the inspection; community-based professionals had also been included in surveys. The Bradfords had begun to address any suggestions. Surveys were seen that will be used soon, to get residents’ views on menus and then on the staff. Staff said there were minuted staff meetings, but they also saw the Bradfords regularly so could discuss any matters on other occasions. Residents and visitors were satisfied with how the home handled personal money kept by them on residents’ behalf. A relative said the resident they visited always looked presentable, the home ensuring they saw the hairdresser regularly, etc. Records checked for two residents were well kept, with receipts available and two signatures obtained to verify transactions recorded; cash held by the home matched the recorded balance. Records showed the newest staff member had had aspects of health and safety training (safe handling, first aid, food hygiene). The kitchen was clean and orderly; food in fridges was covered and dated as necessary, with recorded storage temperatures showing fridges and freezers were kept at recommended temperatures – all helping ensure food provided was fit to eat. Where window restrictors were found to be absent from two upper windows, Mrs Bradford confirmed these had been fitted within 24 hours. Annual testing of electrical appliances was taking place. Beds have been replaced by ones suitable for access with a hoist, promoting safe handling if mobility needs change. Accident forms are completed if a resident sustains an injury as a result; records of falls without injury were seen in care notes. The fire logbook showed safety checks Ridge House DS0000064221.V309898.R01.S.doc Version 5.2 Page 23 were carried out at recommended intervals; staff said a fire drill had occurred the week before, when fire bells sounded due to a ‘false alarm’. Ridge House DS0000064221.V309898.R01.S.doc Version 5.2 Page 24 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 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 Ridge House DS0000064221.V309898.R01.S.doc Version 5.2 Page 25 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 OP29 Regulation 19 Requirement (1) The registered person shall not employ a person to work at the care home unless (a) the person is fit to work at the care home; (b) subject to paragraphs (6), (8) and (9), he/she has obtained in respect of that person the information and documents specified in paragraphs 1 to 9 of Schedule 2. This is especially regarding timely police checks, such as the ‘POVAfirst’ check, & evidencing that gaps in employment history have been explored. Timescale for action 31/12/06 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 It is recommended you ensure residents are protected by the home’s procedures for dealing with medicines, DS0000064221.V309898.R01.S.doc Version 5.2 Page 26 Ridge House including that a clear audit trail of each resident’s medication is kept (as detailed in ‘The Administration and Control of Medicines in Care Homes and Children’s Services’, The Royal Pharmaceutical Society of Great Britain, 2003), with attention to: a) Recording why prescribed medication has not been taken; b) Confirming what medication is received into the home and disposed of, including if returned to the pharmacy in compliance aids. 2. OP9 It is recommended that controlled drugs are stored as indicated in ‘The Administration and Control of Medicines in Care Homes and Children’s Services’, The Royal Pharmaceutical Society of Great Britain, 2003, and the ‘Misuse of Drugs (Safe Custody) Regulations 1973’, to ensure better storage practices. It is recommended you ensure that there is a staff training and development programme that ensures staff fulfill the aims of the home and meet the changing needs of service users, especially with regard to training or updating on conditions associated with old age. 3. OP30 Ridge House DS0000064221.V309898.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ashburton Unit D1, Linhay Business Park Ashburton Devon TQ13 7UP 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 Ridge House DS0000064221.V309898.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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