Inspection on 18/10/07 for Ridgemount

This inspection was carried out on 18th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Ridgemount 13/02/07

Ridgemount 07/11/05

Ridgemount 31/05/05

Ridgemount 02/09/04

Ridgemount 05/04/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Wingham Court

Old Hastings House

Anchorstone Services Limited

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

CARE HOMES FOR OLDER PEOPLE Ridgemount Ridgemount The Horseshoe Banstead Surrey SM7 2BQ Lead Inspector Lesley Garrett Unannounced Inspection 18th October 2007 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 Ridgemount DS0000040824.V346553.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. Ridgemount DS0000040824.V346553.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ridgemount Address Ridgemount The Horseshoe Banstead Surrey SM7 2BQ 01737 858950 01737 851056 jan.norman@anchor.org.uk keri.sherwood@anchor.org.uk Anchor Trust 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) Mrs Jeanette Anne Norman Care Home 64 Category(ies) of Dementia - over 65 years of age (28), Learning registration, with number disability over 65 years of age (2), Mental of places Disorder, excluding learning disability or dementia - over 65 years of age (20), Old age, not falling within any other category (60), Physical disability over 65 years of age (8), Sensory Impairment over 65 years of age (2) Ridgemount DS0000040824.V346553.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th February 2007 Brief Description of the Service: Ridgemount is a Care Home, situated in Banstead, offering care and accommodation for sixty- four service users. The registered provider is Anchor Trust. The home is set over three floors and comprises of five wings, with twelve bedrooms in each, plus a small unit with four bedrooms. Each of the five wings has its own kitchen, dining room and lounge. The bedrooms all have ensuite toilet and wash hand basin facilities and each wing has a bathroom, shower room and extra toilet. The home is set in its own grounds and all areas are accessible to the service users. The fees charged range from £458.00 to £710.00 per week based on individual needs. Ridgemount DS0000040824.V346553.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the care home was an unannounced ‘Key Inspection’. The inspector arrived at the service at 10.30 and were in the home for six hours. It was a thorough look at how well the home is doing. It took into account detailed information provided by the home and any information that CSCI has received about the service since the last inspection. The inspector spent time talking with people living at the home in order to seek their views about the home and the care they receive. Responses to questionnaires that the Commission had sent out had been received prior to the inspection and this information also assisted with the inspection. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. Documents sampled during and the inspection included care plans, daily records and risk assessments, medication procedures, staff files, a variety of training records, and the home’s safeguarding and complaints policies and procedures. The home had submitted the Annual Quality Assurance Assessment (AQAA) prior to the inspection, some details of which have been added to the report. From the evidence seen by the inspector and comments received, the inspector considers that the home would be able to provide a service to meet the needs of individuals who have diverse religious, racial or cultural needs. The inspector would like to thank the staff and people who use the service for their hospitality. What the service does well: Pre-admission assessments are through and involve a visit to see the resident either at home or in hospital but also visits to the home are encouraged prior to admission. Care plans are detailed and the inspector sampled the current folders and the planned new folders that the staff are busy preparing. Ridgemount DS0000040824.V346553.R01.S.doc Version 5.2 Page 6 Food supplied by the home is of a good standard and residents were complimentary about this and the chefs are well trained. The home deals with any complaints promptly and staff had a good knowledge of the safeguarding adults procedures. The home has an ongoing refurbishment programme, which keeps the home in a good state of repair and decoration. 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. The summary of this inspection report can be made available in other formats on request. Ridgemount DS0000040824.V346553.R01.S.doc Version 5.2 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 Ridgemount DS0000040824.V346553.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1&6 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. All people who use the service have a pre-admission assessment and are confident that their needs will be met. The home does not provide intermediate care beds. EVIDENCE: All prospective people who wish to use the service have a pre-admission assessment. The manager stated, and the AQAA confirmed that, the home prefers all individuals to visit the home for a number of hours so that they can meet staff, other people in the service and visit the bedroom that is to be theirs. The inspector spoke with one individual who said ‘I came for a days assessment and didn’t want to go back home’. Five care plans were sampled and this confirmed that the assessments took lace and care plans were then generated from this assessment. Ridgemount DS0000040824.V346553.R01.S.doc Version 5.2 Page 9 Ridgemount DS0000040824.V346553.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service have individual plans, which reflect the care and support they require and their health care needs are fully met. The medication policies and procedures that are in place and implemented by staff protect service users. The privacy and dignity of the individuals are respected. EVIDENCE: Individual care plans were in place and the inspector sampled five. These had been well written by the staff containing detailed information about the people who use the service. The manager said that the home is in the middle of changing their individual care plans and showed examples of the new system. The folders contained information about how personal care will be delivered, evidence of gender preference for delivering this care and risk assessments. There was evidence that the people who use the service had been consulted about their care plans and the staff had reviewed the paperwork every month. Comments received by CSCI said ‘I like to do as much for myself as possible Ridgemount DS0000040824.V346553.R01.S.doc Version 5.2 Page 11 but the staff are always ready to give me a hand’, a relative told the inspector ‘the staff are very caring here and always available to help the residents when asked. The manager said that the home benefits from four general practices that cover the home. All of the people at the home are registered with one of the surgeries and the GP will visit whenever the home calls them. The manager also stated that any resident could visit the GP at the surgery supported by a member of staff. The home is also supported by distract nurses who visit at least twice a week and the local ambulance station is opposite the home and arrive very quickly in an emergency and the manager said they are very good support to the home. One survey form returned from a GP practice said ‘the care home has an appropriate relationship with the surgery seeking advice appropriately’ and another GP stated ‘well managed with good caring staff. Good environment for clients’. One survey form returned said ‘the resident’s health and well being is monitored and relatives are kept informed of any changes’. Opticians visit the home and but also the residents can visit their own opticians and one resident told the inspector that he often walks into the village if he needs an appointment. The physiotherapist also visits to do fall risk assessments to enable the residents to stay as mobile as possible. Other regular visitors to the home are the chiropodist, continence advisor and the dietician when requested. The medication policy and procedure were sampled and the medication trolley was stored securely. The home has a monitored dosage system (MDS), which is supplied by the local Pharmacist. Five medication administration charts were sampled and no gaps were seen and clear instructions for staff were available for the administration. The chemist provides training for staff and all staff that handles medication had training and the records were sampled. One survey form completed said ‘the staff give me the medication I need and check that I have taken the things I can self-administer’. During the inspection staff were observed to be knocking on bedroom doors and bathrooms prior to entering respecting the privacy and dignity of the people using the service. All bedroom doors had locks for those individuals who wished to use them. All bathrooms had privacy curtains as well as doors to ensure extra privacy should someone enter. Ridgemount DS0000040824.V346553.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use the service are supported to exercise choice and control in all that they do and the food is of a good quality. EVIDENCE: The inspector spoke to a variety of residents and staff during the day all of which spoke highly of the activities and the general running of the home. It was noted that people were moving freely around the home and several people were observed reading the daily papers and chatting with other people in the home including staff. The home benefits from two activity organisers and on the day of inspection one organiser was returning from the shops with a resident. The manager stated that the resident’s enjoyed outside activities, which included walks into the village and visits to pubs and restaurants. The activity programme was prominently displayed and one comment received said ‘there is a stimulating programme of activities’. The inspector was also told ‘I enjoy the bingo here every Sunday and I go to the social night every Saturday there is always Ridgemount DS0000040824.V346553.R01.S.doc Version 5.2 Page 13 something to do’. Another resident said ‘I usually go out for Christmas but I am thinking I might stay here this year’. The manager said that the Women’s Institute have visited the home and had knitted some of the blankets. Schools visit especially at Christmas to sing carols but will also visit with their teacher and talk to the resident’s. Local to the home is a day centre and the people who use that service made and supplied all the hanging baskets for the home this year. The home also supports residents in their spiritual and religious beliefs and a service is held once every week with residents given the choice if they wish to attend. One resident attends a local church every Sunday. The care plans that were observed demonstrated that the people who use the service are asked about their likes and dislikes including food preferences. One resident told the inspector ‘the staff are always giving us choices about the activities we want to attend when to get up and go to bed and choice about food’. On the day of inspection the chef, assistant chef and kitchen assistant were all on duty. All food is put into heated trolleys and then taken to the dining rooms for staff to dish up the food. The chef told the inspector that all staff has been trained how to serve the food but the chefs visit every dining room to ensure this is being carried out. All catering staff either has or are currently studying for a Cater Craft qualification, which is an Anchor homes BTEC qualification. The inspector received only compliments about the food served at the home one resident said ‘I have only had one meal that I didn’t like since I’ve been here’ another said ‘the food is well presented and I enjoy it I don’t like spicy food but there is always a choice’. The inspector observed that the tables in the dining room were laid up with tablecloths and napkins one resident said ‘I help everyday to lay the tables ready for lunch and supper’. Adapted cutlery and equipment was available if required and the chef said that special diets are catered for including a pureed and diabetic diets. Ridgemount DS0000040824.V346553.R01.S.doc Version 5.2 Page 14 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 excellent. This judgement has been made using available evidence including a visit to this service. The people who use the service are protected by the homes complaints policies and safeguarding procedures. EVIDENCE: The AQAA details that complaints and feedback is actively welcomed to improve the service provision. The manager said that a complaints log is kept and the home has received two complaints since the last inspection and both have now been resolved. No complainant has contacted the commission with information concerning a complaint made to the service since the last inspection. The inspector spoke with many residents during this inspection and all were very clear on how they would make a complaint. The complaints policy was displayed on the wall and is available to all residents and their relatives or representatives. The inspector sampled that the home has the local authorities multi agency procedures for safeguarding adults and the manager advised that the home follows these procedures. The home also has a local safeguarding policy, which was in line with the local authorities. The manager stated that the home has had one referral under these procedures since the last inspection and that has been resolved. Staff spoken to on the day of inspection demonstrated a good knowledge of the Ridgemount DS0000040824.V346553.R01.S.doc Version 5.2 Page 15 safeguarding procedures and said that they receive regular training. The training records for the home confirmed that training had taken place for staff. Ridgemount DS0000040824.V346553.R01.S.doc Version 5.2 Page 16 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 excellent. This judgement has been made using available evidence including a visit to this service. People who use the service live in a well-maintained environment, which was clean and hygienic. EVIDENCE: During a tour of the building the inspector observed that the home was well maintained and decorated. The inspector observed the refurbishment programme up to 2015. The manager said toast this year seven bedrooms have already been decorated and carpets replaced. The AQAA details that all communal areas on the ground floor has had new carpets and lounge furniture. A large conservatory is planned for this year on the downstairs dining room, which will give the home a large entertaining space. In order to ensure the safety and protection of residents it was noted that each exit of the home contained keypads. The garden was safe and accessible and Ridgemount DS0000040824.V346553.R01.S.doc Version 5.2 Page 17 suitable for wheelchair users. The manager said that the raised garden beds were good for the less mobile resident, as they were still able to join in the gardening club. People spoken with told the inspector that they liked their bedrooms, which were comfortable. It was noted that people’s bedrooms were individualised and some contained their own items of furniture, personal possessions, leisure items including televisions, radios and books. All rooms were clean and free from malodour. The AQAA stated that the home has an infection control policy and arrangements were in place for the collection of clinical waste. It was observed that there were sufficient hand washing facilities and the home is considering supplying alcohol gel hand rub for staff and visitors to help with prevention of infection over the winter months. The laundry area was a good size and a new laundress is about to start work the beginning of November. The inspector spoke with members of the housekeeping team and found them to be knowledgeable about infection control procedures and they had received training. Ridgemount DS0000040824.V346553.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fill the aims of the home and meet the changing needs of people who use the service. EVIDENCE: The staffing numbers on the day of the inspection were observed to meet the current needs of the people living in the home. The deputy manager compiles the staff rotas and said that they are worked out using a good skill mix and numbers can be increased if the dependency levels of the residents increase. The home does not use agency staff, which benefits the people who use the service, as they know all staff members. The AQAA states that the home has a comprehensive National Vocational Qualification (NVQ) training programme and 69 of the care staff has this qualification. All team leaders either have or are studying for the NVQ at level 3. Senior staff had management training and the deputy manager has also completed his NVQ at level 4. Three recruitment folders were sampled and these contained all the required employment documentation. The AQAA states that the home has robust recruitment procedures in place and a company recruitment team supports them. Ridgemount DS0000040824.V346553.R01.S.doc Version 5.2 Page 19 The staff mandatory and induction training records were sampled and evidenced that the home is committed to the ongoing training and development of staff in order to ensure that the home’s staff are suitably trained and competent in their duties. The records indicated that all staff had undertaken the necessary mandatory training. Ridgemount DS0000040824.V346553.R01.S.doc Version 5.2 Page 20 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 excellent. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness, has effective quality assurance systems developed by a qualified competent manager. EVIDENCE: It was evident through observation and talking with residents and staff that the manager had good knowledge about managing the care home and had the skills and experience to ensure the safety and well being of all persons in the home. The manager stated that she has been in post slice June 2005 and that she has made good progress with her Registered Managers Award. Ridgemount DS0000040824.V346553.R01.S.doc Version 5.2 Page 21 People’s views about the service were actively sought and quality assurance procedures were in place to seek the views of people who use the service and any visitors to the home. Resident meetings are held every three months and minutes are kept so that any issues can be acted upon. The homes bursar explained that the home is not involved in keeping residents money. The inspector sampled a variety of health and safety records and the AQAA assisted with this. On the day of inspection the fire alarms and emergency lighting was being tested. The home’s policies and procedures promote the health, safety and welfare of people in the home. Ridgemount DS0000040824.V346553.R01.S.doc Version 5.2 Page 22 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 4 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 4 X X X X X X 4 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 4 X X 4 Ridgemount DS0000040824.V346553.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ridgemount DS0000040824.V346553.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Oxford Office 4630 Kingsgate Oxford Business Park South Cowley Oxford OX4 2SU 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 Ridgemount DS0000040824.V346553.R01.S.doc Version 5.2 Page 25 - 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!